March 29, 2023 - PBS NewsHour full episode

AMNA NAWAZ: Good evening, and welcome.

I'm Amna Nawaz.

GEOFF BENNETT: And I'm Geoff Bennett.

On the "NewsHour" tonight: The former CEO of Starbucks faces congressional scrutiny over allegations of anti-union practices.

AMNA NAWAZ: In the wake of the school shooting in Nashville, parents once again grapple with how to speak with their children about gun violence.

GEOFF BENNETT: And 20 years on, we examine the long-lasting impact of the U.S. invasion of Iraq and the ongoing debate about whether the war was justified.

VALI NASR, School of Advanced International Studies, Johns Hopkins University: It's difficult to see that the United States and the Middle East are better off.

Firstly, we removed a brutal, dangerous dictator, but we replaced him with chaos.

(BREAK) GEOFF BENNETT: Good evening, and welcome to the "NewsHour."

The former head of Starbucks, Howard Schultz, went head to head with Democrats on Capitol Hill today in a tense hearing over efforts to unionize at the company he founded.

AMNA NAWAZ: Schultz's opposition to unions has long been public.

But some lawmakers and labor leaders allege that Schultz has made union-busting moves that are illegal.

Schultz denied it forcefully.

As congressional correspondent Lisa Desjardins reports, the hearing was a key moment in the battle over recent efforts to unionize.

LISA DESJARDINS: In one of the Senate's largest committee rooms, packed with intensity... HOWARD SCHULTZ, Former CEO, Starbucks: Starbucks Coffee Company did not break the law.

LISA DESJARDINS: ... a confrontation over business, workers and American values, as former Starbucks CEO Howard Schultz faced a top critic, Vermont Senator Bernie Sanders.

SEN. BERNIE SANDERS (I-VT): Over the past 18 months, Starbucks has waged the most aggressive and illegal union-busting campaign in the modern history of our country.

That union-busting campaign has been led by Howard Schultz.

LISA DESJARDINS: The former CEO fought back, insisting his company is the worker-empowering place it claims to be, touting Starbucks' average wage per hour.

HOWARD SCHULTZ: Today, baristas in our stores, earned on average $17.50, with benefits and other income included, such as 100 percent paid college tuition, the first of its kind in American business.

LISA DESJARDINS: But thousands of workers are demanding more.

Nearly 300 locations have voted to unionize since 2021.

That is about 3 percent of the chain's U.S. stores.

But, so far, they are yet to sign a single contract.

SEN. EDWARD MARKEY (D-MA): You are out of touch.

Union-busting is disgusting.

LISA DESJARDINS: The National Labor Relations Board has accused the company of hundreds of labor law violations, denying raises and other benefits from pro-union workers.

In a Buffalo, New York, case earlier this month, an administrative judge found Starbucks had used -- quote -- "egregious and widespread misconduct" in an effort involving 20 stores.

But Schultz insisted the company has never broken the law.

HOWARD SCHULTZ: We're innocent because we have done everything that we possibly can to respect the right under the law of our partners' ability to join a union.

LISA DESJARDINS: At least one other former employee testified otherwise.

JAYSIN SAXTON, Fired Starbucks Worker: In July, I led a two-day unfair labor practice strike and delivered our demands.

A month later, I was fired for supposedly being disruptive.

I did not receive any writeup or discipline, and there was no investigation.

LISA DESJARDINS: The hearing was, in part, rapid-fire grilling, led by Sanders.

SEN. BERNIE SANDERS: Were you ever informed of or involved in a decision to discipline a worker in any way who was part of a union-organizing drive?

HOWARD SCHULTZ: I was not.

SEN. BERNIE SANDERS: Have you ever threatened, coerced, or intimidated a worker for supporting a union?

HOWARD SCHULTZ: I have had conversations that could have been interpreted in a different way than I intended.

LISA DESJARDINS: But it was also a higher debate over who decides what is best for companies and workers.

HOWARD SCHULTZ: Our preference is to maintain the direct relationship we have had with our employees that we call partners.

SEN. TAMMY BALDWIN (D-WI): You employ over 235,000 people in -- over 3,000 in my state of Wisconsin, alone.

You can't possibly have a direct relationship with all of them.

LISA DESJARDINS: It is a high-stakes and closely watched clash, as efforts to unionize have taken shape at other companies, including Apple and Amazon.

Some Republicans challenged unions in general, including former businessmen and Utah Senator Mitt Romney.

SEN. MITT ROMNEY (R-UT): Profit incentive and greed has been there from the beginning of humankind but, there's also a union greed.

LISA DESJARDINS: Others tried to turn the table on committee Chair Sanders.

SEN. MARKWAYNE MULLIN (R-OK): You have been in office for 28 years, and you and your wife has immersed (sic) a wealth of over $8 million.

SEN. BERNIE SANDERS: If I am worth $8 million, that is good news to me.

(LAUGHTER) SEN. BERNIE SANDERS: I'm not aware of it.

That is a lie.

LISA DESJARDINS: Schultz, whose net worth is estimated at over $3 billion by Forbes, responded to criticism of being out of touch.

HOWARD SCHULTZ: This moniker of billionaire, let's get at that, OK.

I grew up in federally subsidized housing.

Let me finish.

I grew up in federally subsidized housing.

My parents never owned a home.

I came from nothing.

LISA DESJARDINS: But the question is where Schultz and Starbucks go now, as unions and some in Congress keep up a loud push.

For the "PBS NewsHour," I'm Lisa Desjardins.

GEOFF BENNETT: In the day's other headlines: The U.S. Senate moved to reclaim war-making powers for Congress.

The vote was 66-30, repealing approvals for the first Gulf War in 1991 and the invasion of Iraq in 2002.

The bipartisan support overcame opposition by some Republicans for rescinding the authorizations for use of military force, or AUMFs.

SEN. CHUCK SCHUMER (D-NY): The entire world has changed dramatically since 2002, and it's time the laws the books catch up with those changes.

These AUMFs have outlived their use.

These repeals will not harm our service members abroad, nor will it hinder our ability to keep Americans safe.

SEN. JAMES RISCH (R-ID): I don't support the repeal of the 2002 AUMF at this time.

This needs to be repealed, there's no question about it.

It should be replaced by something.

And that is one of the real problems here, because the debate to do that has been ongoing for as long as I have been here.

GEOFF BENNETT: It is unclear whether the Republican-controlled House will support the repeal.

In Ukraine, explosions knocked, out power today in Russian-occupied Melitopol, a major logistical hub in the south.

Ukraine's military did not directly claim responsibility.

Meantime, the head of the U.N. nuclear agency, Rafael Grossi, visited the nearby Zaporizhzhia power plant for a safety assessment.

He said the situation has worsened since he visited last September.

Pope Francis has been hospitalized in Rome for a respiratory infection.

The Vatican says he does not have COVID, but is having trouble breathing and needs several days of treatment.

Francis had greeted crowds at his weekly audience in St. Peter's Square before heading to the hospital.

He is 86 years old.

The U.S. and Israel faced a rare public flare-up today over a court overhaul plan.

President Biden had urged Prime Minister Benjamin Netanyahu to drop the plan that's provoked crippling strikes and protests.

Netanyahu tweeted back that: "Israel makes its decisions by the will of its people and not based on pressures from abroad."

This afternoon, White House national security spokesman John Kirby played down the dispute, but urged compromise in Israel.

JOHN KIRBY, NSC Coordinator For Strategic Communications: One of the great things that we share, our two countries share, are some basic, fundamental democratic institutions and principles, and one of them is,again, the broadest possible base of public support for major changes like this, changes which affect the system of checks and balances.

GEOFF BENNETT: For now, Netanyahu has frozen the plan and started negotiations with his political opponents.

The U.N. General Assembly is asking the world's top court to spell out what nations must do to fight climate change.

An opinion from the International Court of Justice would not be binding, but supporters say it would encourage greater action.

Today's vote came on a resolution pushed by the Pacific island nation of Vanuatu.

Mexico's president vowed today to punish anyone responsible for the deaths of 38 migrants in a fire.

It happened late Monday in Ciudad Juarez across the border from El Paso, Texas when fire broke out at a detention center.

Surveillance camera video showed migrants burning their mattresses to protest being deported, but guards walked away without unlocking the cells as the fire spread.

RANIEL MURILLO, Venezuela Migrant (through translator): To all of those people who died, the guards could've opened the gates to let the migrants out.

They didn't open the gate, leaving them locked in.

The guards didn't help the migrants because they didn't feel like it.

The guards treat you badly.

GEOFF BENNETT: Most of the victims were from Central American countries.

Back in this country, Republican lawmakers in Kentucky enacted limits for transgender minors over the Democratic governor's veto.

The measure bans gender-affirming care for those under 18 and restricts which bathrooms they can use.

Opponents have threatened court action against the law.

The FDA has approved the first over-the-counter sales of an opioid treatment drug.

Narcan nasal spray is a version of the lifesaving drug naloxone that can reverse overdoses.

Today's FDA action means Narcan will be available without a prescription by late summer.

And, on Wall Street, stocks rallied, as fears of bank troubles receded.

The Dow Jones industrial average gained 323 points, or 1 percent, to close at 32717.

The Nasdaq rose 1.8 percent.

The S&P 500 was up 1.4 percent.

And still to come on the "NewsHour": the health risks for pregnant women of color in rural parts of the U.S.; North Carolina becomes the latest state to expand Medicaid; and several states consider bills that would limit which bathrooms trans people can use.

AMNA NAWAZ: First lady Dr. Jill Biden is attending a vigil in Nashville tonight to honor and remember the six people killed in a mass shooting at the Covenant School earlier this week.

It's part of a citywide candlelight vigil.

Singers Sheryl Crow, Margo Price, and Ketch Secor are performing as part of the event.

Once again, parents and caregivers around the country are considering how they want to talk to children about this attack and gun violence.

Some important perspective on all of that now from Dr. Tori Cordiano.

She's a clinical psychologist specializing in children and adolescents who practices in Ohio.

Dr. Cordiano, welcome and thanks for joining us.

As you know, after each one of these shootings, especially in schools, especially when children are killed, the question comes up, how should parents and caregivers talk to kids, if they should talk to kids about it?

What would you say to that?

And how is the conversation different depending on how old the children are?

DR. TORI CORDIANO, Laurel School's Center for Research on Girls: So, this is largely driven by a child's age and their developmental level.

I think, with younger children, you can really consider how much access they will have to this news.

And they may not actually be aware of it.

So you may not need to have this conversation with them.

With older elementary school children, if you feel that they are likely to hear about it from friends or from teachers, you will want to bring the conversation up.

And I always like the idea of starting with, what have you heard about what happened in Nashville?

And if they haven't heard anything, or if you have a sense that they haven't heard anything, you can start with, I want to tell you about something that happened in Nashville.

With older children, you can expect that if they haven't already heard about it, they will hear about it in school.

And so you will want to have that conversation with them at the outset, so that they can process it with you and they're not blindsided by it.

It's also really helpful to start with what they have heard and then ask about what questions they have.

The goal is to give them manageable, clear information, but to not inundate them with the details that can be overwhelming or scary.

You want to, as parents and caregivers, have a space where you can process this, where you can think about it, talk about it with other people, have your own place to process your feelings about it.

Of course, you may get emotional about it when you're talking with your children, and that is OK.

It is emotional.

It's sad, it's scary, it's angering.

But you want to also have your own space separate from them where you can really process your own feelings about it, so that your conversation with them can focus on caring for them in that moment.

AMNA NAWAZ: Dr. Cordiano, as you know, mass shootings are now commonplace in America.

According to the Gun Violence Archive, there have been 130 so far this year alone.

And they don't even comprise the majority of gun violence in America, which we know disproportionately impacts children of color.

Is there a cumulative toll with that kind of exposure to violence that you worry about in children?

DR. TORI CORDIANO: Absolutely.

There's a cumulative tool that comes out in the form of trauma.

And some of this, we may not be seeing right away.

We may be seeing the generational effects of this.

We may be seeing this over the long term.

But, certainly, when children are exposed to violence, when it is happening around them, when it is part of their daily experience, when they have survived these attacks, or even if they are -- just this is part of their reality, that they are hearing about these and worrying about these, that can certainly take a toll and for some children can lead to trauma and more mental health issues down the line.

AMNA NAWAZ: We know this generation of children are regularly put through lockdown drills, right, phrased differently depending on their age in school.

But every generation, you hear this, has some version of a drill, or they had nuclear attack drills for some generations, depending on where you live.

There are tornado drills.

There's fire drills.

Are these different in some way?

DR. TORI CORDIANO: They are.

And it really depends on the nature of the drill and how much they simulate an actual attack, an active shooter attack.

There is good research being done on this, which is really important, because we want to know, from large samples of children, what this experience is like for them.

We want to balance the best ways to keep them safe with not putting them in traumatic experiences.

So there is research being done on how best to conduct these drills if they are going to happen, so that they don't create more trauma for children and more difficult experiences.

AMNA NAWAZ: During those conversations with children, they are likely to ask, could it ever happen in my school or my church or my neighborhood or to me?

And I will tell you, the impulse among parents is to lie and say, it will never happen to you.

How do you suggest parents handle that?

DR. TORI CORDIANO: Yes, this is, again, where it's very important for parents to be able to have their own place to process feelings about this, because, of course, parents' instinct is to keep their kids safe and want them to feel safe.

And our job as parents is to be the steady, study presents.

So, depending on the nature of the children's questions, depending on their age, their developmental level, you can remind them of the things that keep them safe in their school and the adults that keep them safe, and remind them that they can always talk with you and other trusted adults in their lives about questions that they have or scary feelings that they have in the wake of these events.

AMNA NAWAZ: Dr. Tori Cordiano, clinical psychologist specializing in children and adolescents, thank you for joining us.

DR. TORI CORDIANO: Thank you.

GEOFF BENNETT: A newly released CDC report shows maternal deaths nearly doubled over three years, with over 1,200 deaths in 2021.

And, in rural communities, maternal mortality is almost double urban rates, a stark reminder of the struggle to access maternal health care across much of the country.

With support from the Pulitzer Center and in collaboration with the Global Health Reporting Center, Stephanie Sy reports from Pickens County, Alabama, for our series Rural Rx.

STEPHANIE SY: Shaky cinder block steps lead to the doorknob-less entrance of Peatrice Ball's trailer in a rural area of Pickens County, Alabama.

Inside, a mermaid-and-unicorn-themed room with a bed full of balloons is close enough to a little girl's dream.

PEATRICE BALL, Alabama Resident: Everyone knows unicorns perfect.

STEPHANIE SY: The single mom of two is making the best of things.

Her 3-month-old baby still seems as sleepy as a newborn.

After all, Ariana (ph) was delivered prematurely at 34 weeks by emergency C-section.

PEATRICE BALL: I have really been depressed and I had her, with not having no transportation, and she was in the NICU for 27 days.

So it's kind of horrible.

STEPHANIE SY: So you did have this car working for a while?

PEATRICE BALL: Yes.

STEPHANIE SY: No transportation because the car in front of her trailer has been broken since she was about four months' pregnant, and she can't afford to fix it.

Public transportation is scarce in these parts.

They discharged you in four days.

And so what did that mean?

I mean, how often were you able to see Ariana?

PEATRICE BALL: Well, any time that I could get a ride.

It was probably like once a week or every two weeks.

So it's hard.

I used to cry every day when she was in the NICU.

STEPHANIE SY: The heartache of being separated from her newborn contributed to her postpartum depression.

Still without a car, she totes her two girls with her on a rural bus service to her follow-up doctor appointments.

Even with those hardships, Ball told us she feels lucky.

In an area deserted by basic services, including maternal health care, Ball has Dr. Cathy Lavender.

DR. CATHY LAVENDER, Family Medicine Obstetrician: How are you today?

PEATRICE BALL: Good.

DR. CATHY LAVENDER: Good.

STEPHANIE SY: What is it like for women accessing maternity health care in rural communities like this?

DR. CATHY LAVENDER: There's only one provider in this county that provides prenatal care.

STEPHANIE SY: And that's you.

DR. CATHY LAVENDER: And that is me.

So there's a lot of pressure.

(LAUGHTER) STEPHANIE SY: In 1980, more than 80 percent of Alabama's rural counties had a hospital providing obstetrical service.

After four decades of closings and consolidation, it's down to 30 percent.

The only hospital in Pickens County is one of the many that shut down.

DR. CATHY LAVENDER: All right, let me just listen.

STEPHANIE SY: But Lavender still makes the 45-minute trip out here from Tuscaloosa every Wednesday to see patients like Peatrice Ball.

Access to care is one of the underlying factors behind Alabama's high maternal mortality rate, 36 deaths per 100,000 live births, the third highest rate in the nation in 2020.

DR. CATHY LAVENDER: I think it's multifactorial.

I do think that economics plays a large role.

The fact that a lot of our state is rural and not centered in large cities certainly makes a difference in maternal mortality.

We also know that Black women have a higher mortality rate than other ethnic groups.

STEPHANIE MITCHELL, Birth Sanctuary: This is it.

STEPHANIE SY: The state's racial disparity and maternal mortality is one of the reasons that drove Stephanie Mitchell to start Birth Sanctuary, a birthing center under construction in Gainesville, Alabama.

STEPHANIE MITCHELL: This is the output of what you get, an area that's never bothered to, like, change in thinking about how softly, how unconscious bias right, or not so softly, blatant anti-Black racism affect patient outcomes.

And so right here is one of our two labor and birth suites.

STEPHANIE SY: A certified midwife, Mitchell is building what will be the first freestanding birth center owned and operated by midwives in the state.

Research shows that midwifery care, particularly in birth centers, can improve pregnancy outcomes, from fewer preterm births to a lower risk of surgical intervention during delivery.

STEPHANIE MITCHELL: OK, how's it going?

Thank you so much for your patience.

JAZMIN BLAKE, Nurse: Everybody's been doing good.

STEPHANIE SY: Jazmin and Hakeem (ph) Blake are clients of Mitchell's.

Their prenatal visit started like a family pageant.

JAZMIN BLAKE: Are you training your little sister to be a good big sister?

BOY: I'm trying to.

JAZMIN BLAKE: You're trying to.

(LAUGHTER) STEPHANIE SY: Jazmin, a nurse herself, is preparing for her second home birth.

When she had her two boys, midwife-attended home births were still illegal in Alabama.

They had to drive nearly 35 miles to a hospital in Tuscaloosa.

JAZMIN BLAKE: So, when I went and got into labor, I mean, we are flying up the interstate with our flashers on to get up there to make sure we get there in time.

Especially in rural areas in the African American community, a lot of times, moms don't get the care that they need.

And they really need to be advocated for if they have a hospital birth.

But if you're having the baby at home, you can -- you have that support.

STEPHANIE SY: Tell me what the home birth was like of your daughter.

JAZMIN BLAKE: Oh, it was amazing.

It was beautiful.

I was able to be in my environment.

I had my husband there.

He actually caught our daughter.

So, he was in the birthing tub with us.

STEPHANIE SY: It came down to trust for the Blakes, who said, even if they have to pay out of pocket for Stephanie Mitchell's midwifery services, it's worth it.

Distrust of the medical establishment may also be an obstacle for the increasing number of pregnant women who use illicit drugs, especially in states like Alabama, where substance use during pregnancy may constitute a felony.

BRANDI THACKER, Expectant Mother: I was scared to tell the OB doctor, so I was trying to get help elsewhere.

I actually missed my first two appointments to begin with.

It was within a week.

I didn't show up because I was scared.

STEPHANIE SY: Living in rural Walker county, Brandi Thacker is eight months' pregnant.

Before she could get into treatment, Thacker says she was arrested for possession and threatened with a chemical endangerment charge.

Alabama is one of only three states to criminalize and incarcerate women for substance use during pregnancy.

BRANDI THACKER: I mean, even me knowing that this baby is a miracle and me wanting it more than anything in this world, the drugs is - - it's hard to come off of without help sometimes.

STEPHANIE SY: Drug abuse is one of the top three causes of maternal death in Alabama.

And, according to Dr. Cathy Lavender, the state's laws don't help.

DR. CATHY LAVENDER: It is a barrier in treatment for a lot of our patients.

They won't come to their appointments because they're afraid that they might fail the drug test.

STEPHANIE SY: What's really needed, she says, is more drug treatment services in rural areas and new ways of thinking about access to prenatal care in general.

DR. CATHY LAVENDER: The ways that we're giving care is not solving our maternal mortality crisis.

So we must start thinking outside the box.

We must start thinking of ways to reach women and to address their needs.

DR. CATHY LAVENDER: Hey, Erica, how you feeling?

ERICA LATHAM, Expectant Mother: I'm OK. STEPHANIE SY: Lavender is piloting a telehealth model that loans medical equipment to low-risk pregnant women in isolated rural areas.

DR. CATHY LAVENDER: Let me know when you get a reading.

ERICA LATHAM: One (INAUDIBLE) over 81.

DR. CATHY LAVENDER: OK, great.

STEPHANIE SY: She walks a patient through an exam, with the mother herself taking her and her baby's vitals.

DR. CATHY LAVENDER: I hear it.

I hear it for a few seconds.

STEPHANIE SY: Erica, do you think you have a future as a doctor?

(LAUGHTER) STEPHANIE SY: The telehealth visit allows mom Erica Latham (ph) to get her basic prenatal checkups done, and access to her own monitoring tools gives her peace of mind.

DR. CATHY LAVENDER: Swallow again.

STEPHANIE SY: Combating maternal mortality also means continued access to care in the year after a woman gives birth, say experts.

In the U.S., 52 percent of maternal deaths occur after delivery.

Now taking medication for postpartum depression, Peatrice Ball knows all too well that the health struggles can linger.

What do you wish was provided to pregnant single mothers like yourself?

PEATRICE BALL: I just feel like we need more people that care about us.

STEPHANIE SY: As complex as the problem of maternal mortality is, sometimes, the solution starts with something pretty simple.

For the "PBS NewsHour," I'm Stephanie Sy in Pickens County, Alabama.

GEOFF BENNETT: Staying on the topic of health care access, this week, North Carolina became the latest in a growing number of states to expand Medicaid under the Affordable Care Act.

Governor Roy Cooper signed the bill into law Monday, marking a major victory for Democrats in their efforts to expand federally assisted health care coverage to low-income Americans.

GOV.

ROY COOPER (D-NC): The strength of our communities depends on the health of our people.

And today is a historic step toward a healthier North Carolina.

When this law takes effect, it'll make health care accessible for more than 600,000 North Carolinians.

GEOFF BENNETT: Expanding health care access has gained support among voters.

The latest "PBS NewsHour"/NPR/Marist poll shows 63 percent of Americans believe it's the government's responsibility to ensure health care coverage to Americans.

For more on this latest investment in Medicaid access, we're joined by North Carolina Secretary of Health and Human Services Kody Kinsley.

Secretary Kinsley, welcome to the "NewsHour."

KODY KINSLEY, North Carolina Secretary of Health and Human Services: Great to be here.

Thank you.

GEOFF BENNETT: North Carolina is expanding Medicaid to adults who make up to 138 percent of the federal poverty level.

So that would be about $41,000 for a family of four.

You have been traveling the state talking to people who would benefit from this expanded access.

What are you hearing and what are you seeing?

KODY KINSLEY: People are really excited.

First, I want to just thank the governor for building such a broad coalition of people that have worked so hard over the last decade to get us to where we are today.

But, in the last few years, some things have changed.

First and foremost, the additional payments from the Biden administration to really incentivize states to join Medicaid changed the conversation.

And then also seeing people experience the mental health crisis that were in this country today has made people realize that we have got to have every tool at our disposal, and there's no tool that would change the game for mental health in North Carolina more than Medicaid expansion.

GEOFF BENNETT: To your point about that, across the country, mental health care centers, across North Carolina, many of them have closed, and it's jails that ended up becoming mental health care facilities.

Tell me more about your plan to invest in health care.

KODY KINSLEY: Well, we want to invest using those signing bonus dollars for Medicaid expansion, a billion dollars to try to rebuild capacity in a mental health system that we know has languished for far too long.

And we have got to take the resources to where the people need it; 60 percent of people in incarcerated settings have a substance use disorder, many of whom have a co-occurring mental health illness.

If people had those sorts of rates of diabetes or any other disease, we would know that there's a problem with that system.

So we want to invest in pre-arrest diversion, jail-based treatment programs, reentry programs that break this costly cycle that we know our local communities bear the brunt of.

We need health care, and not handcuffs.

And that's something that we have heard firsthand from sheriffs all across North Carolina, as we have been battling the opioid epidemic.

We're not going to arrest ourselves out of these issues.

If we give people health care, divert them to treatment, give them a path to recovery, we not only heal themselves.

We get to support them in healing their families and their communities.

This is the right path forward.

And targeting our work in the justice system is a smart investment.

GEOFF BENNETT: You know, when you say that the conversation around expanding Medicaid has changed, I spoke with Phil Berger, the North Carolina Republican Senate leader, on this program some weeks ago.

He initially objected to Medicaid expansion in North Carolina, had a change of heart.

He now says it makes perfect sense.

There are still some folks who have some questions about the cost, to include Donald Bryson.

He runs the North Carolina-based John Locke Foundation, and he had some issues with the overall price tag.

DONALD BRYSON, John Locke Foundation: The problem is, how much is this going to cost us in the long term?

What's the woodworking effect of Medicaid expansion in North Carolina?

How much is this additional hospital bed assessment going to cost taxpayers in North Carolina?

These are all questions that are unanswered, but it seems like we're betting everything on one-time $1.8 billion funding.

GEOFF BENNETT: So what about that?

What about the cost?

And what's the plan to prevent cost overruns?

KODY KINSLEY: You know, I would have loved for us to expand Medicaid a long time ago.

But the advantage of going this far down the path is, we have got a lot of other proof from other states.

We see that Medicaid expansion helps control costs for health care and helps save rural hospitals.

And we know that the federal government is committed to maintaining the 90/10 match.

The plan that we have worked out to have our hospitals pay for that 10 percent match, this is cost-contained.

This is a smart investment.

And people -- right now, we pay for this care for people, no matter what, when they end up in the emergency department with a stroke or a major cardiovascular event.

Reaching them at a point of prevention and getting them on preventative care is a lot cheaper.

This is not only a smart investment for resources.

It's going to make a large difference over time.

GEOFF BENNETT: It's been more than a decade since the Supreme Court ruled that states did not have to accept Medicaid expansion under the Affordable Care Act.

Nearly half of the states opted out; 40 states now have it.

But what has that meant for working-class North Carolinians, for seniors, for folks who live in rural areas to have not had expanded access to health care for more than a decade?

KODY KINSLEY: I grew up in North Carolina, and I grew up without health insurance.

I know firsthand what it's like to have family members try to decide whether they're going to buy food or they're going to see the doctor, parents praying that their arm is just hurt or sprained, not broken.

These are -- my story, like these other 600,000 stories in North Carolina that will benefit from expansion, have been heartbreaking day by day.

This last decade of waiting has meant that some of the people who started on this journey with us are no longer here because they have lost their lives.

I mean, this is the right thing to do.

And I'm glad that we are doing it now.

And I hope that we can continue to invest in people, because they are our greatest strength in North Carolina.

GEOFF BENNETT: Kody Kinsley is the secretary of health and human services for the state of North Carolina.

Thanks for being with us.

KODY KINSLEY: Thank you.

AMNA NAWAZ: In 2016, North Carolina was in the spotlight when it became the first state to pass a bill barring transgender people from using bathrooms consistent with their gender identity.

The law sparked national outrage and was repealed a year later.

But, just in the last week or so, Idaho, Iowa and Arkansas have passed their own versions of bathroom bills.

And Arkansas is on the verge of passing an even more restrictive bill.

Laura Barron-Lopez has the latest.

LAURA BARRON-LOPEZ: Last week, Arkansas bans students from kindergarten through high school from using public school bathrooms that match their gender identity.

Another bill in the state would allow someone to be charged with a misdemeanor if they enter a public changing room of the opposite sex with so-called sexual intent and a minor is present.

So far, six states have passed bathroom bills of their own.

And, just this year, more than two dozen bathroom bills have been filed by Republicans in at least 15 states, more than any other year.

For more on these bills and their impact, I'm joined by Jo Yurcaba.

They cover LGBTQ issues for NBC Out of NBC News.

Jo, thanks for joining.

The latest Arkansas bill originally criminalized transgender people's access to bathrooms based on a minor being in that bathroom.

Now the amended version applies only where there is sexual intent, according to the bill, when a minor is present.

Republican state Senator John Payton, the lead sponsor of the bill, said he didn't intend for it to target transgender people.

STATE SEN. JOHN PAYTON (R-AR): Now, I have also had e-mails that say that trans people are not a threat to minors, like middle-aged white, straight, Baptist men are, which I'm one of.

And I have got good news.

This bill applies to me.

It applies to all of you if you choose to enter the bathroom the opposite of your sex.

LAURA BARRON-LOPEZ: How could this bill be interpreted or enforced?

JO YURCABA, NBC Out: That's one of the big questions with these bathroom bills and was a question back when North Carolina's H.B.2 was proposed in 2016.

And trans people are just wondering, what would that look like when they go into the bathroom?

Is someone going to just be able to challenge who they are at any time or ask for their I.D.?

Within schools, there would be a clear policy from the school district, but there's a similar lack of clarity.

Would teachers be policing students' bathroom use?

And even with this amendment to the bill regarding sexual intent, advocates still fear that someone, a trans person, could be challenged in a restroom, even though the bill now is not intended to target transgender people.

LAURA BARRON-LOPEZ: And a parent, Aaron Jennen, a lifelong Arkansas resident, father of a transgender daughter, testified before Arkansas state lawmakers yesterday, and he said that he would never force his daughter to go into a men's restroom.

AARON JENNEN, Father of a Transgender Daughter: Before she came out as trans and before she was diagnosed with gender dysphoria, I witnessed the stress and anxiety she had around to using the public changing rooms and bathrooms.

We would be out in public.

She would need to use the bathroom.

And she would beg us to the point of tears to take her home.

LAURA BARRON-LOPEZ: As you talk to people like this father across the country, what are you hearing is the impact of these bills on transgender kids and adults?

JO YURCABA: So, trans youth and their families have told me that these bills really put a target on their backs at school, because, for example, the bills have a provision usually that says that young people can use a single-occupancy bathroom, such as a teachers bathroom, if they don't want to use the bathroom of their assigned sex at birth.

And trans young people have told me that often those bathrooms are far away from their classes.

It means they have to walk along way.

They can't go to the bathroom with their friends.

And that draws unwanted attention.

And these are students who already face more bullying.

And so what it does is, it really makes it feel like it's dangerous for them to just use the bathroom at school.

So I have had youth telling me that they will avoid using the bathroom altogether.

LAURA BARRON-LOPEZ: And what about for transgender adults?

Because this bill, specifically the one that just was amended, would apply to them.

JO YURCABA: Yes.

Yes, for trans adults, it's similar.

They feel that these kinds of bathrooms will make them a target -- or these kinds of laws will make them a target in bathrooms.

They're worried that, as people testified at yesterday's hearing, they already face violence in bathrooms.

So they're afraid that these laws will make them even more of a target when they go into a bathroom.

LAURA BARRON-LOPEZ: And when North Carolina passed its bathroom bill in 2016, there was a massive backlash.

Why is there a resurgence of these bills in Republican-led states?

JO YURCABA: I think there's been a resurgence of these bills, in part because legislation targeting LGBTQ people has just been growing exponentially over the last three years.

So you have more than 400 bills targeting LGBTQ people that have been filed so far this year in state legislatures.

And as those have been filed, they have been growing increasingly more extreme.

And the best example we have of that is gender-affirming care bans.

So, when those were first filed a few years ago, they targeted minors, which advocates said was still already very extreme.

More recently, this year, we saw the first ever bill that would have banned gender-affirming care for people up to 26 years old.

So, as they're growing more extreme, conservatives are also feeling like they can add on these bills that would have previously sparked more backlash, like bathroom bills.

LAURA BARRON-LOPEZ: And, as you just noted, bathroom bills are not happening in a vacuum.

There was a new "PBS NewsHour"/NPR/Marist poll that found 43 percent of Americans now support laws criminalizing gender-affirming care for minors; 54 percent oppose such laws.

That's a 15 percentage point increase since April of 2021.

So, when you look at all of these anti-LGBTQ bills that have been proposed, the gender-affirming care bans, bans on education about gender identity, do you see a difference in the outreach to these bills?

JO YURCABA: Yes, absolutely.

We have seen a huge difference in outreach, for example, to what advocates have dubbed Florida's don't say gay and trans bill, which targets education there, and between outrage directed at these gender-affirming care bans.

And I think that's for a few reasons.

First is just because most people know lesbian, gay, bisexual people, but they're much less likely to know trans people, and they're even less likely to know trans youth.

So they don't know what their lives look like.

They don't know what their health care looks like.

And, as a result, they're more susceptible to misinformation about it.

A lot of these bills describe health care for trans youth as mutilation.

They say it permanently sterilizes them, that trans children are receiving surgeries, when that isn't the case.

So, what's happening is, you're seeing a lot less backlash because people just don't understand what care looks like for these young people.

LAURA BARRON-LOPEZ: Jo Yurcaba of NBC Out, thank you so much.

JO YURCABA: Thank you.

AMNA NAWAZ: At this moment 20 years ago, thousands of American troops were racing across the deserts of Southern Iraq toward Baghdad to depose Saddam Hussein and dismantle his alleged weapons of mass destruction programs.

The quick victory over Saddam led to a near decade of civil war and occupation, no discovery of WMD, and the deaths of more than 4,400 American troops, and, by some estimates, 300,000 Iraqis.

Now we look back at the decision to invade the bloody American occupation and where Iraq stands today with Paul Wolfowitz.

He was deputy secretary of defense during the George W. Bush administration.

During the 1980s and '90s, he held a number of senior jobs at the Defense and State Department.

Vali Nasr was an adviser at the State Department during the Obama administration.

He's now a professor of international relations at Johns Hopkins School of Advanced International Studies.

And Charles Duelfer, who helped run U.N. weapons inspections during the '90s in Iraq.

After the U.S. 2003 invasion of Iraq, he led the CIA's Iraq Survey Group, which also looked for Iraq's weapons of mass destruction.

Welcome to all three of you, gentlemen, and thank you for joining us today.

Ambassador Wolfowitz, I'd like to begin with you, because you were an advocate for the invasion and for toppling Saddam Hussein.

Knowing what we know today, what we have known and watched and learned over these last 20 years, is the U.S. better off today as a result of that war?

Are Iraqis better off?

PAUL WOLFOWITZ, Former U.S. Deputy Defense Secretary: I think the right question to ask is, are we better off today than if Saddam Hussein or his sons were still in power in Iraq?

And, for me, the answer to that is definitely yes.

I believe it was the right thing to do.

And I think we're much better off as Americans today because Saddam Hussein is not running the second most important country in the Persian Gulf.

AMNA NAWAZ: Tell us why you think that is.

What do you think the threat would be today?

PAUL WOLFOWITZ: Look, I -- let's start with a fact which is indisputable.

There has not been a repetition of the 9/11 attacks or anything like it in the 20 years since.

That was President Bush's main concern, as it had to be, I believe.

President Clinton had been warning about the danger of Saddam Hussein's weapons of mass destruction back in the '90s.

And his secretary of defense actually went on television with a small bag of sugar saying, if this were anthrax, it could be spread out in the air and thousands of Americans would die.

He was right about that.

And I honestly believe that there's been a misunderstanding, partly caused by our inadequate intelligence, the belief that there was stockpiles of various things in Iraq.

The important question -- and I believe Charles Duelfer's Iraq Survey Group established the fact that Saddam was ready to restart all three of his programs.

The one that I always considered most dangerous was not the nuclear one, which was -- would be much harder to conceal and much further down the road and much harder to hand over to any terrorist group.

It was, frankly, the biological weapons program, which Charles can contradict me if I'm wrong, but I believe the ISG said that this would - - could be reconstituted in a matter of weeks or a few months.

And it's worth bearing in mind that, when we finally found his -- not we -- when UNSCOM finally found his program in Iraq, it was five years after they'd started inspections.

And they only found it then because Saddam Hussein's son-in-law defected and told us about it.

In other words, the time between the development of a biological threat and its actual discovery is going to be much too long.

And we have seen, in this pandemic, what a biological threat can do to the whole world and to the United States.

So, having that in the hands of one of history's worst megalomaniac dictators would not be a good thing for America.

AMNA NAWAZ: Vali Nasr, what do you make of this idea that Saddam could have reconstituted those weapons, could have posed a greater threat?

Do you believe the U.S. and Iraqis, the world is better off without him in power today?

VALI NASR, School of Advanced International Studies, Johns Hopkins University: Counterfactual history is difficult to conduct here.

Things might have been very different.

Saddam might have died a year later, maybe not, and maybe he would have been a greater danger.

But it's difficult to see that the United States and the Middle East are better off.

Firstly, we removed a brutal, dangerous dictator, but we replaced him with chaos.

And Iraqis went through hell and back in the aftermath of what transpired.

And I don't believe that they feel that they're better off.

I was recently in Iraq.

And most of the young people, even the Shia young people, have a nostalgia for the Saddam era.

Secondly, by dismantling the Iraqi military, shattering the Iraqi state, we opened the Arab world for a level of Iranian infiltration into the Arab world that was not possible before the removal of Saddam from power.

It has been at a scale that we cannot reverse it.

We have been for 20 years trying to put the Iranian genie back in the box, and we can't.

The now-much-feared and ballyhooed Quds Force of the Revolutionary Guard was a small unit of the Guard before Iraq happened.

It was in Iraq, that it became the empire that it is.

And, finally, I would say that, regardless of what we argue about the sagacity of going into Iraq, at some point, the war lost the American public, the cost of it, the outcome of it.

It created a sense of aversion to war on both sides of the aisle, Republicans and Democrats.

At the base of these parties, there is an aversion to war.

In the region, but I'm sure farther away, in China, in Russia, the conclusion is that the United States will no longer go to war that easily.

We rely on sanctions.

But, essentially, we are far less capable of getting our way on the world stage, because many friends or foes don't see credibility in our use of threat -- threat of force.

And I think we -- American geostrategy, American world standing, particularly in the Middle East, has not recovered from the outcome of the Iraq War.

AMNA NAWAZ: I'd like to get more into the impact in just a moment.

But, Charles Duelfer, I will turn to you here about those weapons of mass destruction, because they were the primary justification to launch the invasion.

And you led the Iraq Study Group to find those weapons of mass destruction in 2005.

Your final report said that the hunt for those weapons had -- quote -- "gone as far as feasible," and all the headlines ran, no weapons of mass destruction in Iraq.

But I'd like to get your reaction to what Mr. Wolfowitz raised about the possibility of Saddam Hussein reconstituting those weapons.

Did you find that to be true?

CHARLES DUELFER, Former Chief U.S.

Weapons Inspector: In a word, yes.

And, bear in mind, the intelligence assessments about Saddam's WMD were wrong, but they were wrong with -- for several reasons.

For one reason, there was an attitude basically that Saddam would be crazy not to have WMD.

Remember, in the 1980s, he was at war with Iran.

Iran was using something called human wave attacks.

Saddam made and used 101,000 chemical munitions.

Arguably, that saved him in that war.

Secondly, in the 1991 war, when Iraq went into Kuwait, the United States expelled him from Kuwait, but did not go to Baghdad.

Saddam had in his mind that one of the reasons contributing to the failure or the decision not to go to Baghdad in 1991 was his possession of WMD at that time.

Add to that the experience, as Paul mentioned, of the weapons inspectors, where we were in Iraq, on the ground, trying to account and put in place a monitoring system for what he had acknowledged, but he started off with a big lie.

He only acknowledged at first the obvious things, ballistic missiles and chemical munitions.

There was a pattern of great, gradual revelations, which, ironically, the closer he came to telling the truth, the less we really believed him, because the pattern of lies was longer and more established.

When the weapons inspectors left, the United States intelligence community and intelligence communities around the planet were left largely blind.

From 1998, when the weapons inspectors left, up until the beginning of the war, there was very little data to make assessments on.

And so the assessments tended to be negative, particularly after 9/11, when the risk of being wrong, the tolerance for risk was very low.

So I think it's important to understand the background when the decision was made to go into the war in 2003.

The decision, I think, and the implementation of it, you can make very strong criticisms of, as Vali has done.

But the point in time when that decision was made, it's hard to imagine a different decision, in fact, being taken.

AMNA NAWAZ: Ambassador Wolfowitz, you have said that there were mistakes made after the invasion, and that helped to contribute to the destruction we have seen and the devastation for Iraqis in the years since.

What were those mistakes, in your mind?

PAUL WOLFOWITZ: I wouldn't put it was a mistake to disband the Iraqi army.

It was an instrument of tyranny and it wasn't very popular.

And most of the Shia draftees in that army just went home after at the end of the war.

The mistake was trying to replace it with a small mechanized force that was not supposed to do internal security.

This is in the middle of when the only real threat in Iraq at that point was an internal one.

And we formed, I think it was a small -- three very small divisions that were only supposed to guard the borders.

That wasn't the problem.

And there were many, many Iraqis who were lining up to reenlist in the army.

We could have created a different one.

And that's what we in the Pentagon and most of the interagency thought we were going to do before we went in.

We went to Iraq saying we would liberate Iraq.

And, instead, we impose an occupation.

And some of the leading religious authorities in that country said, what are you doing here?

You said, you would liberate us, and now we have an occupation.

That sounds just like what the Israelis are doing on the West Bank and Gaza.

It was a terrible mistake.

And I think we paid a large price for that at the beginning.

But on the other point of... AMNA NAWAZ: Ambassador Wolfowitz, I... PAUL WOLFOWITZ: Can just say very quickly?

AMNA NAWAZ: Yes, please.

PAUL WOLFOWITZ: I really disagree strongly with the idea that we needed a brutal Saddam regime in order to provide stability in that region.

It didn't stop the Iranians and Hezbollah from killing, I don't know the number of American Marines in Beirut in 1983, when Saddam was securely in power, and, unfortunately, when we were supporting him in his war against Iran.

The consequence of that brutal Saddam was a eight-year war against Iran, in which I think 300,000 Iraqis and 600,000 Iranians died, followed on by this occupation of Kuwait in which we had to mount one of the largest military forces in modern history to evict him from that small country.

We didn't -- Iraq was not a force for stability under Saddam at all.

Quite the contrary.

AMNA NAWAZ: Vali Nasr, would you like to respond to that?

VALI NASR: Well, I would put the issues that Ambassador Wolfowitz raised a little differently.

The issue is not that we needed Saddam for stability in the Middle East or we needed a brutal Iraqi army.

The issue is that we didn't replace these with elements of order, something that either within Iraq or within the region would serve our broader goals.

The issue is not protecting Saddam or the - - or the military.

The issue is that we never had an adequate plan of, what do we replace them with, I think is a larger legacy for the United States now, because we're still dealing with the consequences of this part of it, Iranian power in the Arab world, and still a weak Iraq that can be home to ISIS, can potentially be a source of danger again.

AMNA NAWAZ: Ambassador Wolfowitz, in terms of where we are today, where this war resides in American history, Americans recognize one of the primary justifications to even launch that war was weapons of mass destruction that were never found.

And it's been well-reported since he passed that Colin Powell said the act he most regretted was the 2003 U.N. Security Council presentation where he laid out evidence, U.S. evidence, for those Iraqi weapons of mass destruction, which turned out not to exist.

What is your response to that?

PAUL WOLFOWITZ: I think it was a mistake to talk about stockpiles.

And I attribute that to the way the intelligence was coming through.

Everyone believed that intelligence, not only our people.

The French and German intelligence were pretty much saying the same thing.

We should have been more careful.

And I think the conclusion that Charles Duelfer arrived at, which is that there was a capability to regenerate programs would have been a much better place to stand on.

And history would also be very different if we had adopted a different military strategy from the beginning.

It took us, I think the correct number of years is from 2003 to 2006 or '7 to institute the counterinsurgency strategy that General Petraeus applied successfully.

If we had started that earlier, I believe history would look very different now.

AMNA NAWAZ: Vali Nasr, I will give you the last word here.

What would you say?

VALI NASR: It's important to think about the fact that, had this war as Ambassador Wolfowitz suggested, been conducted differently after we entered into Iraq, had we left a different legacy there, the question of the reasons we went in would not loom as large as they do right now.

When we continuously debate reasons why we went in and question the motivations of going in, it's almost we are admitting to the fact that it's better we wouldn't have gone to war, because, if we went to war, we're going to make a mess of it.

And I don't think that's a good legacy for the United States.

I think how we conducted the war after we arrived is as important as the reasons why we went in.

AMNA NAWAZ: It's striking that, 20 years later, we are still debating and still discussing the impact of that war.

Vali Nasr, Charles Duelfer, and Paul Wolfowitz, thank you very much for joining us.

GEOFF BENNETT: Remember, there's a lot more online at PBS.org/NewsHour, including a look into how the newly legal marijuana market in some states is competing against the entrenched illegal market.

AMNA NAWAZ: And that is the "NewsHour" for tonight.

I'm Amna Nawaz.

GEOFF BENNETT: And I'm Geoff Bennett.

Have a great evening.