By GEOFF MULVIHILL, Associated Press

Republican Texas Gov. Greg Abbott has signed a first-of-its-kind law that lets anyone sue prescribers and others responsible for getting abortion pills into the state.

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Supporters are heralding the law, which Abbott signed Wednesday, as a way to enforce an existing ban. Abortion-rights advocates are bashing the law, saying it has the potential to turn abortion opponents, aggrieved former lovers and others into bounty hunters.

But it doesn’t mean that organizations will stop sending pills into Texas.

Angel Foster, who runs Massachusetts-based The MAP, which prescribes the regimen of pills to women in every state, said her organization will keep sending pills to women in Texas, as it has about 10,000 times in the past two years.

“We really don’t change things unless we’re legally required to,” she said.

Rebecca Nall, the founder of I Need an A, which runs a website with abortion access information, suggested other providers also won’t change.

“We’re confident people in Texas (and every state) will still be able to get abortion pills by mail,” she said in an email.

Pills are at the heart of a new generation of abortion lawsuits

The majority of abortions in the U.S. employ pills, usually a combination of the drugs misoprostol and mifepristone.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022 and allowed states to enforce abortion bans, the method has moved to the center of the latest legal and political battles.

At least eight Democratic-controlled states have adopted shield laws that seek to protect medical professionals in their borders who prescribe the pills via telehealth and send them to patients in states where abortion or telehealth pill prescriptions are banned.

Those prescriptions are a key reason that the number of abortions has not fallen despite 12 states enforcing bans on abortion at all stages of pregnancy, with limited exceptions, and four more barring it after about six weeks of gestation.

The Texas law allows $100,000 claims against prescribers and others

The Texas law, which is to take effect in three months, builds on an approach the state used when it implemented an earlier abortion ban: leaving enforcement to private people filing lawsuits rather than the government.

Under this measure, anyone could file a claim for $100,000 against people who cause the pills to be sent to Texas.

If a pregnant woman, the man who impregnated her or other close relatives sue successfully, they could be entitled to collect the entire $100,000. Others who sue would be in line for $10,000 — with the other $90,000 going to charity.

The law also answers a provision of shield laws that allows protected prescribers to sue those who sue them. The Texas law says that would not apply for the civil suits that originate there.

One provider says her group won’t be deterred

The Abortion Coalition for Telemedicine, which provides legal and other support for abortion pill prescribers, is telling members that the shield laws should protect them from civil suits from Texas, said McKensey Smith, the group’s deputy director.

Texas, the nation’s second most populous state, accounts for about one-third of the pills The MAP prescribes.

Foster said that she expects other prescribers to keep sending the pills to Texas, too.

She still anticipates the law will have an impact: Women seeking abortion in Texas could stop telling others that they are planning to seek pills from out-of-state providers lest those confidants use the information to launch lawsuits.

“One of the effects will be to isolate abortion patients in Texas,” Foster said.

Pill access is facing other court challenges

Mary Ziegler, a law professor at the University of California, Davis, said she expects that people sued under the Texas law will make their own court claims, arguing that it is not enforceable.

“The drug manufacturers and the providers are all willing to take the risk that the shield laws will protect them,” she said.

She said the result could be individual court decisions on whether the Texas law applies in certain circumstances rather than one sweeping ruling.

Those suits won’t be the first legal test around abortion pills, though.

Last month, Texas and Florida asked a court if they could join a lawsuit filed by the attorneys general of Idaho, Kansas and Missouri that seeks to have some federal approvals for mifepristone rolled back — and possibly blocking telehealth prescriptions for it.

And a New York doctor accused of shipping pills out of state faces two legal actions: criminal charges in Louisiana and a civil judgment in Texas. New York officials are refusing to extradite her or to enforce the judgment.

By THALIA BEATY

NEW YORK (AP) — Open Society Foundations, the family philanthropy of hedge fund billionaire George Soros, has consistently been one of the largest funders of human rights organizations around the world. But what that means has changed in recent years, with a new focus on addressing inequality.

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“It’s about paying attention to how inequality is a deep, deep corrosive instrument to democracy,” Leonard Benardo, senior vice president at OSF, told The Associated Press at the foundations’ offices in New York.

The transformation follows four years of internal upheaval, more than a year of new program selection and a generational leadership change. In some ways, the new emphasis reflects the foundations’ commitment to rethinking and reimagining its work, based on Soros’ own view that in open societies, no person or institution has a monopoly on the truth.

Leaders at the foundations said they remain committed to supporting key parts of the human rights ecosystem. They now provide long term, unrestricted funding to human rights organizations as part of what they call “network grants.” One new program focuses on protecting human rights defenders, especially those that advocate against environmental destruction.

Another constant, Benardo said, is the foundations’ commitment to acting as a “political philanthropy.”

“George Soros and Alex Soros see this place as a political philanthropy and that means a more active participation in questions over power,” said Benardo. Alex Soros, one of George’s sons, took over leading OSF in late 2022.

The foundations, along with its founder, have long drawn the ire of powerful leaders and right-wing movements and recently have been targeted again by President Donald Trump and his administration.

FILE – Alex Soros, left, on behalf of his father George Soros, in the East Room of the White House, Saturday, Jan. 4, 2025, in Washington. (AP Photo/Manuel Balce Ceneta, File)

For decades, it seemed that OSF’s movement for more open societies was proceeding well, Benardo said, as newly independent former Soviet states turned toward some form of democracy. Now, that tide has reversed course, with the rise of authoritarianism.

“It’s forced us to grapple with the limits of what we can achieve and the ways in which we go about it,” Benardo said.

OSF also says it’s increased its support to African countries and the Global South in general, but did not provide specific figures. In 2023, the most recent year funding data appears on its website, OSF said it granted out $125.5 million through its Africa programs.

The foundations have not determined what programming will continue in Europe, but insist that they have not abandoned the continent. Emily Tamkin, author of the book “The Influence of Soros,” said this wouldn’t be the first time OSF has moved away from Europe, if that is what they are doing. After a large group of Central European countries joined the European Union in 2004, the foundations also signaled that they would turn their focus elsewhere.

“It would be new in that they’re pulling away from Europe at a time when the values that they have sought to promote in Europe are on pretty clearly shaky ground,” Tamkin said.

Conspiracies about Soros overshadow the foundations’ actual impact

George Soros has long had a reputation for influencing events around the world, through his financial investments, his political donations and his philanthropy. But right-wing leaders have also found it very convenient to blame Soros for things he didn’t do, Tamkin said.

In August, Trump accused the Soroses of funding violent protest in the U.S. and said they should face racketeering charges.

“We’re not going to allow these lunatics to rip apart America any more,” Trump wrote on TruthSocial. He renewed that call after the assassination of Charlie Kirk last week.

OSF said the accusations were “outrageous and false,” and that its mission “is to advance human rights, justice, and democratic principles at home and around the world.”

Author and publisher Anna Porter, who interviewed Soros for her book, “Buying a Better World: George Soros and Billionaire Philanthropy,” said it’s useful for people in power to have a boogeyman to blame. But it’s not actually true that the Soros is secretly fomenting social chaos.

“There’s no nefarious hidden agenda because Soros has always been very open about putting his money where his ideas are (that) he’s openly supporting,” Porter said.

Many recipients of OSF’s funding highly valued the support, which was often more flexible than grants from other funders. The foundations staff, which has shrunk to 500 from a high of 1,700 before 2021, provided expertise, connections and coaching for recipients.

Altogether, the foundations’ internal reorganization meant the human rights field was already on unstable footing when the second Trump administration slashed foreign aid funding this year. The U.S. had long been among the largest funders of human rights.

Brian Kagoro, the managing director for the Open Society Foundations, said the foundations do not plan to try to fill the gap. Instead, the foundations are trying to orient their programs to “ensure that we start actually building out alternatives that are more rooted in the local as well as regional economies, especially for Africa,” Kagoro said.

New ideas and a focus on their own learning

In this transition, OSF has spent significant time developing new programs and since November, they have published a new digital magazine, The Ideas Letter. Led by Benardo, it commissions essays mostly on topics of political economy. Benardo said fostering critique and unorthodox ideas is one of the foundations’ response to polarization.

“If all you’re focusing on is a one ideological band or a way of reasoning or approach to the world, I think that you’re contributing to a society that has been riven by polarization,” Benardo said.

This search for new ideas continued through the redefinition of their programs, which OSF now calls “opportunities.” For over a year, Kagoro, who is based in Johannesburg, said his team commissioned research, convened experts and consulted polls to determine how they should redesign their work.

The foundations’ staff developed pitches for different opportunities, which were ultimately approved or rejected by the board. Three were approved for Africa, including a five-year program focused on critical minerals and a peace-building program. The foundations also said it will work on democratic futures for eight years in Kenya, Nigeria and Senegal.

Kagoro said they’ve shifted their focus away from electoral cycles in recognition of the potential of recent large movements led by young people, who are not participating in political parties in large numbers.

“It was clear to us that the classical idea of democracy is not what people were fighting for, but they still believed in societies that were more open, inclusive, participatory, in states that were more accountable,” Kagoro said.

They have already launched calls for proposals for the three new African program areas, Kagoro said, and more than half the applications have come from organizations that would be new to OSF.

Associated Press coverage of philanthropy and nonprofits receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP’s philanthropy coverage, visit https://apnews.com/hub/philanthropy.

By JESSICA SACHS and ANN MARIE VANDERVEEN/News21

ALLENTOWN, PA. (AP) — Junior Clase’s cluttered kitchen table paints a picture of his life in the United States. Scattered across it are bottles of deodorant and conditioner that he sends back to the Dominican Republic, a Spanish-language Bible and a plastic medical brace for his wife, Solibel Olaverria.

Olaverria began having intense headaches and vomiting five months after she joined her husband in the U.S. In the emergency room, she was diagnosed with a brain aneurysm; during surgery to stop it from rupturing, she suffered a stroke and was induced into a coma.

She left the couple’s Allentown row house in December 2022 and has yet to return. Clase worries she never will.

In February 2023, Clase said, hospital administrators suggested transporting his still-comatose wife to a facility back in the Dominican Republic — an option he refused.

“They told me that they could send her back to my country,” he said – even without his consent. “At that moment, she was missing a piece of her skull. … If they put her in an airplane or a helicopter, it was possible that she would die.”

Though the federal government is the only entity with the jurisdiction to remove people from the U.S., hospitals across the nation sometimes return uninsured noncitizen patients in need of long-term care to their countries of origin.

Advocates call this “medical deportation.” Hospitals and medical transport companies refer to it as “medical repatriation.” By either name, the practice exists in ethical and legal gray areas – without specific federal regulations, widespread public knowledge or a national tracking system.

Facing limited options for care, some immigrant patients and family members may voluntarily decide to continue treatment outside of the U.S. Other times, experts say, the process occurs without full consent.

Lori Nessel, a professor at Seton Hall University who supervised a 2012 report about medical repatriation, said the practice amounts to “private deportation.”

“They were essentially being deported,” she said, “but outside of the legal process for deportation, because there was no immigration court involved.”

While some foreign governments track these repatriations, data is inconsistent and doesn’t reflect whether patients wanted to return, felt they had no other option or were forced to leave.

Over the past two decades, academics, advocates and reporters have struggled to put a number on the phenomenon, which involves a tangled network of hospitals, air transport companies and consulates that work in different states and countries.

Since 2020, the Philadelphia-based Free Migration Project has tracked 19 cases of patients facing medical deportation, through referrals and a telephone hotline it runs. Six of those came in the first six months of 2025, from cities in Pennsylvania but also Florida, New Jersey and New York, according to Adrianna Torres-García, deputy director of the organization.

“We’ve had a higher volume of cases in the same span of time than any other given year,” Torres-García said. “It’s also more complex cases.”

Experts believe medical deportation happens more than tracking efforts account for, and some worry cases could now increase, given that the practice sits at the intersection of health care and immigration – two systems undergoing drastic change in the second Trump administration.

Early on, Olaverria was able to get treatment under a federal law that requires Medicare-participating hospitals to provide stabilizing care to anyone with an emergency condition, regardless of insurance, ability to pay or immigration status. Hospitals can then file for reimbursement through Emergency Medicaid.

But the tax and spending cut bill President Donald Trump signed in July significantly reduces how much the government will pay into Emergency Medicaid. The law also makes some immigrants, including refugees and asylees, ineligible for traditional Medicaid and Medicare.

Immigrants without legal status have long been ineligible for these programs, and even green card holders have to wait five years before they are eligible for Medicaid.

In effect, experts said, the changes will leave even more immigrants uninsured and provide less funding for emergency care if they need it.

“If immigrants are unable to get as much coverage, then they’re not going to be able to get as much care,” said Andrew Cohen, an attorney with Health Law Advocates, a public interest law firm in Boston. “That’s where medical deportations could really grow.”

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The legal requirement to treat anyone with an emergency condition won’t go away, said Benjamin Sommers, a health policy researcher at Harvard University. But with the federal government paying less toward Emergency Medicaid, states could also decide to reduce how much funding goes to emergency care, shifting the burden to hospitals – or individuals.

Patients “get sent bills that they often can’t pay, that often are going to go to collections,” Sommers said, adding that some may even go bankrupt. “Sometimes we see hospitals diverting patients. … I think there’ll be more of that.”

Raymond Lahoud, a Pennsylvania lawyer who represents hospitals and health networks in cases related to immigration, said hospitals fulfill their obligations to treat all patients but often need to consider further options once those patients are stabilized.

“There comes a point where the hospital has done everything it medically could do, and now that person has to move on to their next step in rehabilitation or certain kinds of end-of-life care,” he said.

U.S. citizens might be discharged to other hospitals, long-term care facilities or their families. Noncitizens, with limited access to health insurance, might instead get sent to a facility in their country of origin.

Hospitals sometimes pay private medical transport companies to conduct repatriations and provide in-air care. These services routinely cost tens of thousands of dollars but may still be cheaper than long-term or indefinite care; in the U.S., inpatient hospital care cost an average of $3,132 per day in 2023, according to health policy research firm KFF.

“Unfortunately, it becomes a financial burden to the hospital,” said Craig Poliner, president of MedEscort, an Allentown-based medical air transport company that works with hospitals to facilitate medical repatriations.

Poliner insisted that MedEscort would never repatriate a patient without consent and said company officials work with hospitals to follow the American Medical Association’s discharge guidelines.

“The patients really do better in their own countries, in their own culture,” he said. “We’re not forcing anybody back. We convince them why we think it’s better. If we have the right approach, it usually resolves itself.”

However, advocates noted that immigration status, a lack of insurance, the injury or illness itself, unfamiliarity with the health care system and language barriers can hinder someone’s ability to give informed consent.

In 2013, John Sullivan, a social worker based in Tempe, Arizona, traveled to Mexico to study medical repatriation as part of a Fulbright scholarship. He interviewed patients who had been sent back, along with family members, health workers and Mexican officials.

Sullivan said the circumstances surrounding consent in some of those cases were “unclear.” “It was almost like migrants would describe feeling like they had no other choice,” he said.

Olaverria entered the U.S. on a temporary tourist visa, and when she sought treatment, she was uninsured. In the first days of March 2023, Clase said, hospital administrators gave him an ultimatum: Find care for his wife elsewhere, or they would follow through with her transfer to the Dominican Republic.

Clase said the only option he felt he had was to keep his wife where she was. He didn’t believe she would survive the flight to the Dominican Republic, and if she did, he didn’t trust that she’d receive the care she needed there. He couldn’t properly care for her at home, and she didn’t have insurance to cover the cost of another facility in the U.S.

Local advocates connected Clase with the Free Migration Project, which organized protests against Olaverria’s transfer. Outside the hospital, protesters carried homemade signs on neon-colored posters calling for an end to medical deportation.

After local media coverage, Clase said, hospital administrators agreed to hold off on the transfer if they could work together to find another long-term care option. The hospital did not respond to requests for comment.

Media coverage of Olaverria’s case helped bolster interest in a bill before the Philadelphia City Council to stop nonconsensual medical repatriations, and in December 2023, it became the nation’s first and only law banning the practice, according to experts.

The policy requires hospitals in the city to obtain patients’ written consent and provide information about their rights and options for care before transferring them out of the U.S. It also requires hospitals to determine whether patients are eligible for programs that could pay for their care – and, if so, help them enroll.

Philadelphia hospitals also must now report medical repatriations to the city’s Department of Public Health. Agency spokesman James Garrow said hospitals submitted five repatriation reports in 2024, the first full calendar year for which data was collected.

Claudia Martínez participated in the campaign to pass the law after her uncle faced medical repatriation. The personal photos, wedding memorabilia and Bible quotes that decorate her living room walls hang alongside a “Community Power Award” from the Pennsylvania Immigration Coalition.

“I don’t want anyone to go through what I went through,” Martínez said.

In May 2020, a motorcycle struck Martínez’s uncle, an immigrant from Guatemala. When Martínez arrived at the hospital, she found him comatose and intubated, with injuries that rendered him almost unrecognizable.

Weeks later, Martínez said, a hospital social worker asked for her uncle’s immigration status. She later learned the hospital and MedEscort planned to transfer him to a facility in Guatemala.

“I was in shock,” Martínez said. “He was intubated. … He was not in a condition to travel.”

She said she rejected the transfer in conversations with hospital officials and MedEscort, but Poliner said MedEscort got authorization for the repatriation from family members in Guatemala. Martínez disputes that.

Eventually, Martínez connected with the Free Migration Project, which organized a protest outside the hospital on the day of her uncle’s scheduled transfer.

In the end, the medical deportation was scrapped. Ultimately, with the help of community advocates, Martinez’s uncle was able to access a form of state-sponsored insurance. He moved into a rehabilitation center and stayed for three years, until his insurance ran out.

In May 2024, his family decided it would be best for him to return to Guatemala to be at home with his wife. He can walk again but has significant memory impairments.

“He is someone who loves to joke,” Martínez said. “This, I think he didn’t lose.”

Consulates are often involved in the medical transport of their citizens, helping to secure travel documents and occasionally paying for airfare on less expensive commercial flights.

Between 2014 and 2024, the Mexican General Directorate of Consular Protection and Strategic Planning reported 8,227 medical repatriations; 328 of those took place in 2024. The data does not distinguish between patients who wanted to return and those who felt pressured or coerced.

“Sometimes the level of care that they are going to receive in their hometowns … is not going to compare to the one they receive here, and they know that – so it’s very rare that a patient says, ‘I want to leave,’” said one Mexican consular official, who did not want to be named to avoid repercussions in their ongoing work with hospitals.

If patients want to stay in the U.S., they may not know what options are available to them. Hospitals, too, may be unaware of alternatives, said Cohen, who runs a program that helps eligible immigrant patients access insurance.

In some states, immigrants who don’t qualify for federal insurance programs may be able to access certain state-funded programs instead.

“(Hospitals are) preemptively doing something that they wouldn’t even need to do if they knew about these pathways into better coverage,” Cohen said.

In May 2023, Olaverria was transferred into a long-term care facility in Allentown. Two months later, she woke up from the coma. She still cannot walk or use the bathroom on her own, and she can speak only a few words.

Later that year, Clase and his wife obtained medical deferred action, which allowed them to temporarily remain in the country. It also allowed Clase to get a work permit and Olaverria to access emergency medical assistance from the state.

Between working two jobs and attending church services three times a week, Clase keeps his ritual of visiting his wife every day. Flower bouquets rest on the bookshelf in her room.

He wipes her mouth, adjusts her neck and massages her curled-in hands. And he still tells her stories that can make her laugh.

For him, life outside this routine is virtually nonexistent. When he gets home each night, he sleeps and occasionally cries.

“This country consumes you,” he said.

Clase and Olaverria are working to apply for a visa that would allow them to stay longer. But her ability to continue in long-term care is uncertain.

Despite this, Clase carries forward, focused on the familiar paths of his daily routine, all of which lead to Olaverria.

“The majority of my time,” he said, “I dedicate it to my wife.”

This report is part of “Upheaval Across America,” an examination of immigration enforcement under the second Trump administration produced by Carnegie-Knight News21. For more stories, visit https://upheaval.news21.com/

By MARK THIESSEN

ANCHORAGE, Alaska (AP) — The brawny bruins on the Alaska Peninsula are ready to brawl it out to see which will win this year’s fattest bear title in the wildly popular annual online voting contest known as Fat Bear Week.

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The main event featuring adult bears starts next week, but first up Thursday is what the National Park Service calls a “chubby cubby appetizer.” Fat Bear Jr. voters can cast ballots through Friday for their favorite adolescent ursine, with the winner advancing to the big show.

The contest, which began in 2014, is meant to showcase the resiliency of the brown bears, which pack on the pounds each fall to survive the harsh winter by gorging on salmon at Brooks River in remote Katmai National Park and Preserve. People can watch the bears on livestream cameras.

“It really is an opportunity for people to think about how bears survive, what they need to do to survive, what the ecosystem provides them and look at their individual success stories, as well,” said explore.org naturalist Mike Fitz, who started the contest when he was a ranger at Katmai.

This year’s sockeye run has been abundant, so voters can expect some especially corpulent contestants.

Here’s a closer look at the popular online event:

How to vote in Fat Bear Week

The 12 bears — which will be announced Monday — will be featured in the single-elimination, bracket-style tournament. All voting is done online at www.fatbearweek.org, with the winner declared Sept. 30.

The first round features eight bears squaring off in four separate contests to advance to the second round. Four bears receive first-round byes.

This image provided by the National Park Service shows 26 male cub at the Katmai National Park and Preserve in Alaska on Sept. 13, 2025. (C. Loberg/National Park Service via AP)

There are about 2,200 brown bears within Katmai, a 6,562-square-mile park on the Alaska Peninsula, which extends from the state’s southwest corner toward the Aleutian Islands. To be featured in the contest, the bears must frequent the area of the main Brooks Camp.

Getting a bear on a scale is impossible

Actually weighing the bears would be a dangerous and monumental task, so it’s up to voters to judge size by looks alone. Male brown bears at Katmai weigh about 700 to 900 pounds mid-summer and can bloat to over a 1,000 pounds by September or October, thanks to successful foraging.

A 1,200-pound male bear isn’t unusual at Katmai. Others have been estimated to be about 1,400 pounds. Females are about half to two-thirds the size of adult males.

Not all about the fatness

There are factors other than girth to consider, Fitz said.

Voters could consider the challenges some contestants have had to overcome, such as the multitasking females who protect their young and produce milk for the cubs while also fattening up for winter themselves.

This image provided by the National Park Service shows the cubs 803s at the Katmai National Park and Preserve in Alaska on July 19, 2025. (C. Loberg/National Park Service via AP)

There’s precedent for a mama bear to take the prize. Grazer, the two-time defending Fat Bear Week champion, beat one of the biggest bears in the Brooks River, Chunk, in last year’s final.

Even though the contest is virtual, the two bears did actually fight it out in the park months earlier. Chunk attacked one of Grazer’s cubs after it fell over a waterfall, an attack that was broadcast live. Grazer fought off Chunk, but the cub later died.

Chunk adapts to a newly broken jaw

Chunk is back at the park this year but returned to Brooks River in June with a broken jaw, Fitz said. The right side of his jaw is hanging loose and will never heal properly.

It probably happened in a fight with another bear. When they attack each other, they target the head and neck, and sometimes they lock jaws. The torque can snap a brown bear’s mandible.

The good news for Chunk is that he’s already adapted to his new disability and it doesn’t seem to have affected his appetite. He remains one of the largest bears on the river.

Exceptional salmon run equals fat bears

Brooks Falls is famous for brown bears snagging salmon out of the air as the fish try to jump upstream to get to their spawning ground.

This image provided by the National Park Service shows cub 128 at the Katmai National Park and Preserve in Alaska on June 26, 2025. (C. Loberg/National Park Service via AP)

That didn’t happen much this year, as an exceptional salmon run reduced the need for bears to compete for fishing spots at the falls.

“We are kind of expecting really to have some of the fattest bears we’ve ever seen in the event,” Fitz said.

Fat Bear Jr.

Fat Bear Jr. is going to have a familial feel to it this year.

In one semifinal Thursday, cub 128 Junior will face off against a pair of cubs competing together.

This image provided by the National Park Service shows bear 26 male cub at the Katmai National Park and Preserve in Alaska on July 23, 2025. (C. Loberg/National Park Service via AP)

Cub 128 Junior is the offspring of two-time champ Grazer and sibling of the bear killed by Chunk last year.

She will face the 803s, cubs from bear 803. They are known for being mischievous, trying to get into vehicles and boats, and playing with one of the livestream cameras.

The other semifinal pits siblings from the same spring litter of bear 26. 26 Female is smaller and lighter in color than her brother, 26 Male, and a little more subdued. The male is bolder than his sister, which might give him an edge if food is limited.