Surveillance and Spying On American People

The Pronk Pops Show 869, April 7, 2017, Story 1: Trump Imperial Presidency of The American Empire –Trump Just Another Progressive Global Interventionist Not An American First Nationalist –Another Undeclared War — 59 Tomhawk Cruise Missiles Attack al Shayrat Airbase Destroying 6 Aircraft and One Runway — Videos — Story 2: What is Next? United States Led Coalition of Egypt, Jordan, Kurds, Saudi Arabia, and Turkey to Destroy Islamic State, Jabhat Al Nustra Front ( al-Qaeda’s Syrian affiliate), Radical Islamic Terrorist Jihadists in Syria, Hezbollah, and Bashar al-Assad Syrian Regime –Videos — Story 3: Supreme Court Justice Neil Gorsuch Confirmed 54 Yes — 45 No — Videos

Posted on April 7, 2017. Filed under: American History, Blogroll, Breaking News, Chemical Explosion, Congress, Countries, Donald J. Trump, Donald Trump, Egypt, European History, European Union, Foreign Policy, France, Government, Government Dependency, Government Spending, Great Britain, History, House of Representatives, Illegal Immigration, Immigration, Independence, Iraq, Islamic Republic of Iran, Islamic State, Israel, Israel, Italy, Jordan, Language, Libya, Lying, Middle East, Natural Gas, News, Oil, Philosophy, Photos, President Barack Obama, President Trump, Qatar, Radio, Rand Paul, Raymond Thomas Pronk, Resources, Rule of Law, Russia, Senate, Spying, Surveillance and Spying On American People, Syria, Technology, Terror, Terrorism, Turkey, United Kingdom, United States of America, Videos, Violence, War, Wealth, Weapons, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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Pronk Pops Show 869: April 7, 2017

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Pronk Pops Show 821: January 20, 2017

Pronk Pops Show 820: January 19, 2017

Pronk Pops Show 819: January 18, 2017

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Pronk Pops Show 817: January 13, 2017

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Pronk Pops Show 813: January 9, 2017

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SYRIA FALSE FLAG LEADS TO WAR – Ron Paul

The world reacts to the strikes against Syria

Gen. Jack Keane reacts to US airstrikes in Syria

Mark Steyn: Trump hit a reset button for the world

President Trump’s Syria policy raises concerns

Sen. Paul: We didn’t have the debate, we simply went to war

A look at the intel that led to US strike on Syrian airbase

US Strikes Syria: Chemical attack not the first in Syrian civil war

Marco Rubio: President had legal, moral authority to attack

Israeli PM Netanyahu ‘fully supports’ US strike on Syria

President Trump Orders U.S. Airstrike on Syria

Trump turns on Assad: How will US strikes impact war in Syria? (part 1)

BREAKING! WE’RE AT WAR! TRUMP JUST LAUNCHED A MASSIVE STRIKE AGAINST SYRIA WW3 HAS BEGUN!!!

Issue Analysis: Trump, Assad, Syria, China, North Korea, UN Resolutions, Russia and What’s Next?

President Donald Trump Bombs Syria

Syria Chemical Attack: Push For Ousting Bashar al-Assad

Seymour Hersh: Obama “Cherry-Picked” Intelligence on Syrian Chemical Attack to Justify U.S. Strike

Global Empire – The World According to Seymour Hersh [Part Two]

Global Empire – The World According to Seymour Hersh [Part One]

Turkey’s interests in the Syrian civil war

Saudi Arabia’s role in the Syrian civil war

Why Do Saudi Arabia And Iran Hate Each Other?

TURKEY vs SYRIA Military Power Comparison | Turkish Army VS Syrian Arab Army | 2016

Image result for phosgene posters

Toxicity of Phosgene with Audio

FSA use poison gas on SAA and Syrian people supplied by Turkey

Phosgene Exposure

Gas warfare in the First World War

What is Sarin Gas?

Published on Sep 7, 2013

Hank discusses the chemistry of sarin, the nerve agent that killed more than 1400 people in a chemical weapons attack in Syria.

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AMERICA’S TOP GENERAL JUST GAVE TRUMP SOMETHING THAT WILL SCARE NORTH KOREA TO DEATH!

Published on Apr 7, 2017

Sub for more: http://nnn.is/the_new_media | Danny Gold for Liberty Writers reports, Anyone who has been watching the news recently is sure to have heard all about North Korea and their nukes. They also know President Donald Trump is NOT happy about it and he and Mattis are ready to STRIKE BACK!

 

Why did Donald Trump strike al-Shayrat air base?

An aerial view of the al-Shayrat Airfield near Homs, Syria, 07 October 2016
An aerial view of the al-Shayrat Airfield near Homs, Syria, 07 October 2016 CREDIT: US DEPARTMENT OF DEFENCE HANDUT

The strike on al-Shayrat air base near the western Syrian city of Homs was both a symbolic and a tactical one.

The airfield is not just a valuable military target, it is also the one from which the Syrian government launched its chemical attack on Tuesday.

Donald Trump had intended the raid as a direct retaliation. 

Shayrat is one of the largest and most active Syrian Air Force bases, which has served as the nerve centre of its missions against rebels in Homs, as well as Palmyra, where government forces have been battling Islamic State of Iraq and the Levant (Isil).

Watch | Donald Trump: Syria strike in ‘vital’ US interest

However, it is believed that the US gave advance warning of the missile strike to Russia, which gave the Syrian military some time to move most of its assets to another base.

The Russians, who intervened militarily on behalf of the Bashar al-Assad regime in October 2015, have aircraft stationed at bases across Syria and the US could not risk accidentally hitting one.

Russia reportedly reinforced the base and built additional runways before beefing up its operations there.

Maj Gen. Igor Konashenkov, Russian defense ministry spokesman, reported on Friday that only 23 of the 59 Tomahawk cruise missiles reached the air base.

The raid damaged one of its two runways, according to pictures shared on social media which also showed severe fire damage to other parts of the base.

Rami Adbulrahman, director of UK-based Syrian Observatory for Human Rights monitor said he was told 90 per cent of the base was destroyed and senior airforce commander, Brigadier Khalil Issa Ibrahim, was among the seven reported killed.

Before 2013 the base was used to store chemical weapons but nothing was targeted that could have contained them now.

It was believed there may have been sarin gas stored in one warehouse but that was avoided.

Maj Konashenkov said they destroyed six MiG-23 fighter jets of the Syrian air force which were under repairs, but did not damage other warplanes.

A former pilot who was stationed at Shayrat before he defected said Shayrat could hold up to 45 aircraft and that had they all been hit it would have had a major impact on the Syrian military’s strike capacity.

The mayor of Homs criticised the strikes, saying they only aided terrorists as the base was the main operations centre for carrying out strikes against Isil.

Fares Shehabi, an MP for Aleppo, posted on Twitter: “Trump attacked an airport solely dedicated to fighting ISIS in central Syria and providing aid to besieged civilians in Deir Ezzor.”

http://www.telegraph.co.uk/news/2017/04/07/did-donald-trump-strike-al-shayrat-air-base/

Jumping to conclusions; something is not adding up in Idlib chemical weapons attack

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BEIRUT, LEBANON (4:47 P.M.) – At least 58 people were killed in a horrific gas attack in the Idlib Governorate this morning. However, even before investigations could be conducted and for evidence to emerge, Federica Mogherini, the Italian politician High Representative of the European Union (EU) for Foreign Affairs and Security Policy, condemned the Syrian government stating that the “Assad regime bears responsibility for ‘awful’ Syria ‘chemical’ attack.”

The immediate accusation from a high ranking EU official serves a dangerous precedent where public outcry can be made even before the truth surrounding the tragedy can emerge

Israeli President, Benjamin Netanyahu, joined in on the condemnation, as did Amnesty International.

Merely hours after the alleged chemical weapons attack in Khan Sheikhun, supposedly by the Syrian government, holes are beginning to emerge from opposition sources, discrediting the Al-Qaeda affiliated White Helmets claims.

For one, seen in the above picture, the White Helmets are handling the corpses of people without sufficient safety gear, most particularly with the masks mostly used , as well as no gloves. Although this may seem insignificant, understanding the nature of sarin gas that the opposition claim was used, only opens questions.

Within seconds of exposure to sarin, the affects of the gas begins to target the muscle and nervous system. There is an almost immediate release of the bowels and the bladder, and vomiting is induced. When sarin is used in a concentrated area, it has the likelihood of killing thousands of people. Yet, such a dangerous gas, and the White Helmets are treating bodies with little concern to their exposed skin. This has to raise questions.

It also raises the question why a “doctor” in a hospital full of victims of sarin gas has the time to tweet and make video calls. This will probably be dismissed and forgotten however.

Terrorist Mohammed Alloush is not a gas expert, he is just one of the participants in the crime https://twitter.com/maytham956/status/849235559117619201 

@maytham956 Hmm…’Patients are flooding in’ YET this ‘doctor’ (seems the main source of ‘gas attack’) has time to film, tweet and videocalls… pic.twitter.com/SfLOfjE2pG

View image on Twitter

It is known that about 250 people from Majdal and Khattab were kidnapped by Al-Qaeda terrorists last week. Local sources have claimed that many of those dead from the chemical weapons were those from Majdal and Khattab.

ALSO READ  In Video | ISIS Hunters secure gas fields in east Palmyra

This would suggest that on the eve of upcoming peace negotiations, terrorist forces have once again created a false flag scenario. This bares resemblance to the Ghouta chemical weapons attack in 2013 where the Syrian Army was accused of using the weapons of mass destruction on the day that United Nations Weapon’s Inspectors arrived in Damascus.

Later, in a separate chemical weapon usage allegation, Carla del Ponte, a UN weapons inspector said that there was no evidence that the government had committed the atrocity. This had however not stopped the calls for intervention against the Syrian government, a hope that the militant forces wished to eventuate from their use of chemical weapons against civilians in Khan-al-Assal.

Therefore, it is completely unsurprising that Orient TV has already prepared a “media campaign” to cover the Russian and Syrian airstrikes in Hama countryside against terrorist forces, with the allegations that the airforces have been using chemical weapons. And most telling, there announcement of covering the use of chemical weapons by the Syrian government, hours before this allegation even emerged…….. Seems like someone forgot to tell him that it would not occur for a few more hours before his tweet.

Orient TV reporter :
“tomorrow we are launching a media campaign to cover the airstrikes on Hama country side including the usage of CW”

Meanwhile, pick up  trucks have been photographed around bodies of those killed. Again, it must be questioned why there are people around sarin gas without any protective gear, and not affected at all when it can begin attacking the body within seconds? Also, the pick up trucks remain consistent to what local sources have said that many of those dead were kidnapped by Al-Qaeda terrorists from pro-government towns in rural Hama.

ALSO READ  Update from Syrian airbase targeted by US missiles

Also, what is brought into question is where the location of the hose is coming from in the below picture, a dugout carved into the rock. This also suggests that the location is at a White Helmets base where there are dug out hiding spots carved into the mountainside and where they have easy access to equipment, as highlighted by Twitter user Ian Grant.

In response to the allegations, the Syrian Arab Army soldiers in northern Hama denied the use of chemicals weapons today. This is consistent with the Russian Ministry of Defense who denied any involvement in the attack.

The army “has not and does not use them, not in the past and not in the future, because it does not have them in the first place,” a military source said.

And this of course begs the question. With the Syrian Army and its allies in a comfortable position in Syria, making advances across the country, and recovering lost points in rural Hama, why would they now resort to using chemical weapons? It is a very simple question with no clear answer. It defies any logic that on the eve of a Syria conference in Brussels and a week before peace negotiations are to resume, that the Syrian government would blatantly use chemical weapons. All evidence suggests this is another false chemical attack allegation made against the government as seen in the Khan-al-Assal 2013 attack where the terrorist groups hoped that former President Obama’s “red-line” would be crossed leading to US-intervention in Syria against the government.

Most telling however, is that most recent report shows that the government does not deny striking Khan Sheikhun. Al-Masdar’s Yusha Yuseef was informed by the Syrian Army that the air force targeted a missile factory in Khan Sheikoun, using Russian-manufactured Su-22 fighter jet to carry out the attack. Most importantly, the Su-22’s bombs are unique and cannot be filled with any chemical substances, which is different than bombs dropped from attack helicopters. Yuseef was then told that the Syrian Air Force did not know there were any chemical substances inside the missile factory in Khan Sheikhoun. It remains to be known whether there actually were chemicals in the missile factory targeted by the airstrikes, or whether the terrorist forces used gas on the kidnapped civilians from the pro-government towns and brought them in the lorry trucks to the site of the airstrikes. Whether they were gassed by the militant forces, or the airstrikes caused a chemical weapon factory to explode, the gruesome deaths of children, seen foaming in the mouth because of the gas, lays in the hands of the terrorists.

ALSO READ  Autopsies confirm Assad behind chemical attack in southern Idlib: Turkish state media

Therefore, it becomes evident that the area targeted was definitely a terrorist location, where it is known that the White Helmets share operation rooms with terrorist forces like Al-Qaeda as seen after the liberation of eastern Aleppo. Civilians and fighting forces, including Kurdish militias, have all claimed that militant groups that operate in Idlib, Hama and Aleppo countrysides, have used chemical weapons in the past. Therefore, before the war cries begin and the denouncement of the government from high officials in power positions begin, time must be given so that all evidence can emerge. However, this is an important factor that has never existed in the Syrian War, and the terrorist forces continue to hope that Western-intervention against the government will occur, at the cost of the lives of innocent civilians.

https://www.almasdarnews.com/article/jumping-conclusions-something-not-adding-idlib-chemical-weapons-attack/

The Western media refutes their  own lies.

Not only do they confirm that the Pentagon has been training the terrorists in the use of chemical weapons, they also acknowledge the existence of a not so secret “US-backed plan to launch a chemical weapon attack on Syria and blame it on Assad’s regime” 

London’s Daily Mail in a 2013 article confirmed the existence of an Anglo-American project endorsed by the White House (with the assistance of Qatar) to wage a chemical weapons attack on Syria and place the blame of Bashar Al Assad.

The following Mail Online article was published and subsequently removed. Note the contradictory discourse: “Obama issued warning to Syrian president Bashar al Assad”, “White House gave green light to chemical weapons attack”.

This Mail Online report published in January 2013 was subsequently removed from Mail Online. For further details click here

The Pentagon’s Training of  “Rebels” (aka Al Qaeda Terrorists) in the Use of Chemical Weapons

CNN accuses Bashar Al Assad of killing his own people while also acknowledging that the “rebels” are not only in possession of chemical weapons, but that these “moderate terrorists” affiliated with Al Nusra are trained in the use of chemical weapons by specialists on contract to the Pentagon.

In a twisted logic, the Pentagon’s mandate was to ensure that the rebels aligned with Al Qaeda would not acquire or use WMD, by actually training them in the use of chemical weapons (sounds contradictory):

“The training [in chemical weapons], which is taking place in Jordan and Turkey, involves how to monitor and secure stockpiles and handle weapons sites and materials, according to the sources. Some of the contractors are on the ground in Syria working with the rebels to monitor some of the sites, according to one of the officials.

The nationality of the trainers was not disclosed, though the officials cautioned against assuming all are American. (CNN, December 09, 2012, emphasis added)

screenshot of the CNN article, the original link has been redirected to CNN blogs,

The above report by CNN’s award winning journalist Elise Labott (relegated to the status a CNN blog), refutes CNN’s numerous accusations directed against Bashar Al Assad.

Who is doing the training of terrorists in the use of chemical weapons?  From the horse’s mouth: CNN

Sources: U.S. helping underwrite Syrian rebel training on securing chemical weapons

And these are the same terrorists (trained by the Pentagon) who are the alleged target of  Washington’s counterterrorism bombing campaign initiated by Obama in August 2014:

“The Pentagon scheme established in 2012 consisted in equipping and training Al Qaeda rebels in the use of chemical weapons, with the support of military contractors hired by the Pentagon, and then holding the Syrian government responsible  for using the WMD against the Syrian people.

What is unfolding is a diabolical scenario –which is an integral part of military planning– namely a situation where opposition terrorists advised by Western defense contractors are actually in possession of chemical weapons.

This is not a rebel training exercise in non-proliferation. While president Obama states that “you will be held accountable” if “you” (meaning the Syrian government) use chemical weapons, what is contemplated as part of this covert operation is the possession of chemical weapons by the US-NATO sponsored terrorists, namely “by our” Al Qaeda affiliated operatives, including the Al Nusra Front which constitutes the most effective Western financed and trained fighting group, largely integrated by foreign mercenaries. In a bitter twist, Jabhat al-Nusra, a US sponsored “intelligence asset”, was recently put on the State Department’s list of terrorist organizations.

The West claims that it is coming to the rescue of the Syrian people, whose lives are allegedly threatened by Bashar Al Assad. The truth of the matter is that the Western military alliance is not only supporting the terrorists, including the Al Nusra Front, it is also making chemical weapons available to its proxy “opposition” rebel forces.

The next phase of this diabolical scenario is that the chemical weapons in the hands of Al Qaeda operatives will be used against civilians, which could potentially lead an entire nation into a humanitarian disaster.

The broader issue is: who is a threat to the Syrian people? The Syrian government of Bashar al Assad or the US-NATO-Israel military alliance which is recruiting “opposition” terrorist forces, which are now being trained in the use of chemical weapons.” (Michel Chossudovsky, May 8, 2013, minor edit)

http://www.blacklistednews.com/Pentagon_Trained_Syria%E2%80%99s_Al_Qaeda_%E2%80%9CRebels%E2%80%9D_in_the_Use_of_Chemical_Weapons/57792/0/38/38/Y/M.html

4 DEADLIEST CHEMICAL WEAPONS

During the World War I, a new, deadly type of weapon was used for the first time; toxic gas. Considered uncivilised prior to the war, the development and military usage of poisonous gas grenades was soon called for by the demands of both sides to find a new way to overcome the stalemate of unforeseen trench warfare.

First used at the Second Battle of Ypres on 22 April 1915, cylinders filled with toxic gas soon became one of the most devastating and effective weapons used in the entire Great War, killing more than 90,000 soldiers and injuring about 1.25 million. In this article, we are going to explore the 4 of most deadly chemical weapons ever conceived, their history, usage, and effects on the human beings.

4.Mustard Gas(Yperite)

While Germans were releasing the mustard gas in year 1917 near the Belgian city of Ypres for the first time, chemist Frederic Guthrie was most likely turning in his grave. In year 1860, this British professor discovered the mustard gas, and also experienced its toxic effects first-hand for the first time. 57 years later, after its first military usage at Ypres, it got its infamous nickname, Yperite.

In the beginning, Germans planned to use the mustard gas only as a paralyzing agent. However, they soon found out, that when in sufficient concentrations, this gas could be easily lethal to the majority of the enemy soldiers.

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/d/dc/British_55th_Division_gas_casualties_10_April_1918.jpg

Soldiers after the mustard gas attack

Due to its dangerous properties, mustard gas soon became a popular chemical weapon, used in WWII, during the North Yemen Civil War, and even by Saddam Husein in year 1988. Even 150 years after its discovery, antidote is still to be discovered.

Pure mustard gas is colourless, oily liquid at room temperature. When used in its impure form, as warfare agent, it is usually green-brown in color and has an specific odor resembling mustard or garlic, hence the name. Yperite fumes are more than 6 times heavier than air, staying near the ground for several hours, effectively filling and contaminating enemy’s trenches, and killing everyone without proper protection.

https://i1.wp.com/upload.wikimedia.org/wikipedia/commons/f/fd/155mmMustardGasShells.jpg

Mustard gas shells

Lethal dose for an adult man weighing 160 lbs is approximately 7,5 g of liquid mustard gas, when in contact with his skin for several minutes. However, when used in its gaseous form, lethality greatly depends on its concentration and on the length of exposure. Gas mask is usually not enough to be protected from this gas; it can easily penetrate the skin and kill the victim from inside. It easily passes through most of the clothes, shoes or other materials. For instance, standard rubber gloves could protect the skin for only about ten minutes.

4 or 6 hours after exposure, burning sensation appears in the affected areas, followed by reddening of the skin. After next 16 hours, large blisters appear on the affected skin, subsequently causing severe scarring and sometimes even necrosis. If the eyes were affected, temporary or permanent blindness typically occurs after few days.

https://i1.wp.com/upload.wikimedia.org/wikipedia/commons/6/68/Mustard_gas_burns.jpg

Soldier with mustard gas burns

When inhaled, first symptoms start to manifest themselves after several hours, starting with chest pain, bloody coughing and vomiting, followed by muscle spasms. Death usually occurs within 3 days, caused either by lung edema or heart failure.

3.Phosgene

In year 1812, 22-year old British amateur chemist John Davy syntetized the phosgene gas for the first time. However, it didn’t contain any phosphorus, its name was derived from greek words phos(light) and gennesis(birth). John Davy probably assumed that his invention would be used in a more sensible way, however, on 9.th of December, 88 tons of phosgene were released during the trench warfare in France, killing 69 men and seriously injuring more then 1,200.

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/9/9d/Phosgene_poster_ww2.jpg

U.S. Army phosgene identification poster(WWII)

Germans were satisfied by the results, so they soon started using grenades filled by phosgene in combat. It accounts for more than 60% of all deaths caused by the chemical warfare during the First World War, more than chlorine and mustard gas combined.

During the Second World War, most soldiers were well-prepared for the possible use of this deadly gas, so the casualties were nowhere that high. However, phosgene-filled grenades used during the 1942 Battle of Kerch by Nazi Germany allegedly injured at least 10,000 Soviet soldiers.

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/b/ba/Nach_Gasangriff_1917.jpg

British casualties after German phosgene attack

Which deadly properties does this gas possess? At low temperatures, it is a colourless liquid. However, when heated to more than 8 degrees celsius, it evaporates quickly. Its odor has been often described by the survivors as pleasant, similar to newly mown hay or wet grass. After release, it contaminates the area for about 10 minutes, double the time in the winter. When compared to chlorine, phosgene has a major advantage; first symptoms start to manifest themselves after much longer time period, usually after more than five minutes, allowing more phosgene to be inhaled.

After one inhales high concentrations of this lethal gas, his chances of survival are very mild. After few minutes, he is likely to die of suffocation, because phosgene aggresively disrupts the blood-air barrier in the lungs.

https://i1.wp.com/upload.wikimedia.org/wikipedia/commons/3/34/Australian_infantry_small_box_respirators_Ypres_1917.jpg

Australian soldiers wearing gas masks(WWI)

After inhaling less concentrated phosgene, you might be little bit better off. One hour after exposure, first symptoms include strong burning sensation in pharynx and trachea, severe headache and vomiting, followed by pulmonary edema(swelling and fluid buildup), which often leads to suffocation.

To this day, phosgene remains one of the most dangerous chemical weapons in the world. Although not as deadly as sarin or nerve gas, it is very easy to manufacture; no wonder it’s often used during terrorist attacks. Homemade phosgene grenade can be easily created by exposing a bottle of chloroform to UV-light source for a few days.

2.Sarin

If previous two chemicals weren’t dangerous enough, here comes the sarin, often known as the most powerful of all nerve agents.

Sarin was developed back in 1938 by a group of 4 German scientists, Scharder, Ambros, Rudiger and van der Linde, during their research of pesticides. During the WWII, this deadly gas was first used by the Nazi Germany in June 1942. At the end of the war, Germany allegedly possessed more than 10 tons of sarin.

https://i1.wp.com/blogs.reuters.com/great-debate/files/2013/04/japan-sarin1.jpg

Japanese firemen decontaminating the Tokyo subway after sarin attack

However, it is most famous for being used during the 1995 terrorist attack on the Tokio subway by a Japanese cult Aum Shinrikyo, killing 13 people and allegedly injuring more than 5,000. It was also used back in August 2013 by al-Assad’s forces in Ghouta, Syria, killing more than 1,700 people.

Sarin belongs to the group of nerve gasses, the deadliest of all toxic gasses used in chemical warfare. It is highly toxic; a single drop of sarin the size of the head of a pin is enough to kill an adult human. In addition, most of the victims usually die few minutes after contamination.

It usually enters the organism via respiration, but it can also penetrate the skin or be ingested. In home temperature, sarin is a colourless liquid without significant odor, similar to water. However, when exposed to higher temperatures, it starts to evaporate, being still odorless. After release, it often remains deadly for more than 24 hours.

https://i2.wp.com/asset0.cbsistatic.com/cnwk.1d/i/tim2/2013/08/30/762px-Demonstration_cluster_bomb_620x488.jpg

Missile filled with sarin containers

Immediately after exposure, first symptoms include strong headaches, increased salivation and lacrimation(secretion of tears), followed by gradual paralysis of the muscles. Death is caused by asphyxiation or heart failure.

According to some sources, Sarin is 500 times more deadly than kyanide, with its lethal dose being only about 800 micrograms. Only 5 tons of sarin, obiviously properly dosed, would be enough to wipe out entire humanity.

1.Agent Orange

This mixture of two herbicides, most famous for its usage in Vietnam War, is not a chemical weapon in the true sense of the word. It was discovered in year 1943 by American botanic Arthur Galston. In year 1951, further research started by the scientific team in the military base of Detrick, Maryland.

https://i0.wp.com/24.media.tumblr.com/270a4453b15492b15b6551f10388fef4/tumblr_mt92auzYjZ1s88ji3o1_1280.jpg

Barrel of ”Agent Orange”

During the War of Vietnam, it was widely used for deforestation of the large areas covered by thick jungle, to enable easier and more effective bombing of enemy bases and supply routes. Although designed as herbicide, the Agent Orange also contained large amounts of dioxin, a highly toxic compound, making it one of the most deadly chemical weapons ever deployed.

In years 1962-1971, military operation with codenames ”Ranch Hand” or ”Trail Dust” took place in Southern Vietnam. During this operation, jungles in the region were heavily showered by this herbicide, primarily in the areas of Mekong delta. Mixture was storaged in orange barrels, hence the name ”Agent Orange”. During the operation, more than 20 million gallons of this dangerous chemical were used, destroying large areas of jungle, contaminating air, water and food sources.

https://i2.wp.com/digitaljournalist.org/issue0401/images/griffiths/09.jpg

Vietnamese babies born with severe birth defects

In high concentrations, dioxin causes severe inflammation of skin, lungs and mucous tissues, sometimes resulting in chronic obstructive pulmonary disease, pulmonary edema, or even death, however, it also affects eyes, liver and kidneys. It is also highly effective carcinogen, known for causing laryngeal and lung cancer.

It is estimated, that the usage of Agent Orange during the Vietnam War led to more than 400,000 people being killed or maimed, and 500,000 children born with mild to severe birth defects as a result of contamination. Agent Orange alone killed 10 times more people than all other chemical weapons combined.

Tomahawk (missile)

From Wikipedia, the free encyclopedia
For the sounding rocket, see TE-416 Tomahawk.
Tomahawk
Tomahawk Block IV cruise missile -crop.jpg

A BGM-109 Tomahawk flying in November 2002
Type Long-range, all-weather, subsonic cruise missile
Place of origin United States
Service history
In service 1983–present
Used by United States Navy
Royal Navy
Production history
Manufacturer General Dynamics (initially)
Raytheon/McDonnell Douglas
Unit cost $250,000(FY2014)[1] (Block IV)
Specifications
Weight 2,900 lb (1,300 kg), 3,500 lb (1,600 kg) with booster
Length Without booster: 18 ft 3 in (5.56 m)

With booster: 20 ft 6 in (6.25 m)

Diameter 20.4 in (0.52 m)
Warhead Nuclear: W80 warhead (retired)[2]
Conventional: 1,000 pounds (450 kg) High explosive or Submunitions dispenser with BLU-97/B Combined Effects Bomb or PBXN
Detonation
mechanism
FMU-148 since TLAM Block III, others for special applications

Engine Williams International F107-WR-402turbofan
using TH-dimer fuel
and a solid-fuel rocket booster
Wingspan 8 ft 9 in (2.67 m)
Operational
range
Block II TLAM-A – 1,350 nmi (1,550 mi; 2,500 km) Block III TLAM-C, Block IV TLAM-E – 900 nmi (1,000 mi; 1,700 km)

Block III TLAM-D – 700 nmi (810 mi; 1,300 km)[3]

Speed Subsonic; about 550 mph (890 km/h)
Guidance
system
GPS, INS, TERCOM, DSMAC, active radar homing (RGM/UGM-109B)
Launch
platform
Vertical Launch System (VLS) and horizontal submarine torpedo tubes (known as TTL (torpedo tube launch))

The Tomahawk (US /ˈtɑːməhɔːk/ or UK /ˈtɒməhɔːk/) is a long-range, all-weather, subsonic cruise missile. Introduced by General Dynamics (now Boeing Defense, Space & Security)[4][5] in the 1970s, it was initially designed as a medium to long-range, low-altitude missile that could be launched from a surface platform. It has been improved several times, and after corporate divestitures and acquisitions, is now made by Raytheon. Some Tomahawks were also manufactured by McDonnell Douglas.

Description

The Tomahawk missile family consists of a number of subsonic, jet engine-powered missiles designed to attack a variety of surface targets. Although a number of launch platforms have been deployed or envisaged, only sea (both surface ship and submarine) launched variants are currently in service. Tomahawk has a modular design, allowing a wide variety of warhead, guidance, and range capabilities. The Tomahawk project was originally awarded to Applied Physics Laboratory in Laurel, Maryland by the US Navy. James H. Walker led a team of scientists to design and build this new long range missile. The original design, updated with advanced technology, is still used today.

The missile is named after the Tomahawk, a one-handed axe used as a tool and a weapon by pre-contact Native Americans in the United States.

Variants

There have been several variants of the BGM-109 Tomahawk employing various types of warheads.

  • BGM-109A Tomahawk Land Attack Nuclear (TLAM-N) – Not deployed.[6]
  • BGM-109A Tomahawk Land Attack Missile – Nuclear (TLAM-A) with a W80 thermonuclear weapon. Retired from service sometime between 2010 and 2013.[2]
  • RGM/UGM-109B Tomahawk Anti Ship Missile (TAS-M) – active radar homing anti-ship missile variant; withdrawn from service in the 1990s.
  • BGM-109C Tomahawk Land Attack Missile – Conventional (TLAM-C) with a unitary warhead. This was initially a modified Bullpup warhead.
  • BGM-109D Tomahawk Land Attack Missile – Dispenser (TLAM-D) with cluster munitions.
  • RGM/UGM-109E Tomahawk Land Attack Missile (TLAM Block IV) – improved version of the TLAM-C.
  • BGM-109G Ground Launched Cruise Missile (GLCM) – with a W84 nuclear warhead; withdrawn from service in 1991.
  • AGM-109H/L Medium Range Air to Surface Missile (MRASM) – a shorter range, turbojet powered ASM with cluster munitions ; never entered service, cost US$569,000 (1999).[7]

Ground-launched cruise missiles (GLCM) and their truck-like launch vehicles were employed at bases in Europe; they were withdrawn from service to comply with the 1987 Intermediate-Range Nuclear Forces Treaty. Many of the anti-ship versions were converted into TLAMs at the end of the Cold War. The Block III TLAMs that entered service in 1993 can fly farther and use Global Positioning System (GPS) receivers to strike more precisely. Block III TLAM-Cs retain the DSMAC II navigation system, allowing GPS only missions, which allow for rapid mission planning, with some reduced accuracy, DSMAC only missions, which take longer to plan but terminal accuracy is somewhat better, and GPS aided missions which combine both DSMAC II and GPS navigation which provides the greatest accuracy. Block IV TLAMs are completely redesigned with an improved turbofan engine. The F107-402 engine provided the new BLK III with a throttle control, allowing in-flight speed changes. This engine also provided better fuel economy. The Block IV TLAMs have enhanced deep-strike capabilities and are equipped with a real-time targeting system for striking fleeing targets. Additionally, the BLOCK IV missiles have the capabilities to be re-targeted inflight, and the ability to transmit, via satcom, an image immediately prior to impact to assist in determining if the missile was attacking the target and the likely damage from the attack.

Upgrades

UGM-109 Tomahawk missile detonates above a test target, 1986

A major improvement to the Tomahawk is network-centric warfare-capabilities, using data from multiple sensors (aircraft, UAVs, satellites, foot soldiers, tanks, ships) to find its target. It will also be able to send data from its sensors to these platforms. It will be a part of the networked force being implemented by the Pentagon.

Tomahawk Block III[7][6] introduced in 1993 added time-of-arrival control and navigation through Digital Scene Matching Area Correlator (DSMAC) and jam-resistant GPS, smaller, lighter WDU-36 warhead, engine improvements and extended missile’s range.

Tactical Tomahawk Weapons Control System (TTWCS)[8] takes advantage of a loitering feature in the missile’s flight path and allows commanders to redirect the missile to an alternative target, if required. It can be reprogrammed in-flight to attack predesignated targets with GPS coordinates stored in its memory or to any other GPS coordinates. Also, the missile can send data about its status back to the commander. It entered service with the US Navy in late 2004. The Tactical Tomahawk Weapons Control System (TTWCS) added the capability for limited mission planning on board the firing unit (FRU).

Tomahawk Block IV[9][10][11] introduced in 2006 adds the strike controller which can change the missile in flight to one of 15 preprogrammed alternate targets or redirect it to a new target. This targeting flexibility includes the capability to loiter over the battlefield awaiting a more critical target. The missile can also transmit battle damage indication imagery and missile health and status messages via the two-way satellite data link. Firing platforms now have the capability to plan and execute GPS-only missions. Block IV also has an improved anti-jam GPS receiver for enhanced mission performance. Block IV includes Tomahawk Weapons Control System (TTWCS), and Tomahawk Command and Control System (TC2S).

On 16 August 2010, the Navy completed the first live test of the Joint Multi-Effects Warhead System (JMEWS), a new warhead designed to give the Tomahawk the same blast-fragmentation capabilities while introducing enhanced penetration capabilities in a single warhead. In the static test, the warhead detonated and created a hole large enough for the follow-through element to completely penetrate the concrete target.[12] In February 2014, U.S. Central Command sponsored development and testing of the JMEWS, analyzing the ability of the programmable warhead to integrate onto the Block IV Tomahawk, giving the missile bunker buster effects to better penetrate hardened structures.[13]

In 2012, the USN studied applying Advanced Anti-Radiation Guided Missile (AARGM) technology into the Tactical Tomahawk.[14]

In 2014, Raytheon began testing Block IV improvements to attack sea and moving land targets.[15] The new passive radar seeker will pick up the electromagnetic radar signature of a target and follow it, and actively send out a signal to bounce off potential targets before impact to discriminate its legitimacy before impact.[13] Mounting the multi-mode sensor on the missile’s nose would remove fuel space, but company officials believe the Navy would be willing to give up space for the sensor’s new technologies.[16] The previous Tomahawk Anti-Ship Missile, retired over a decade earlier, was equipped with inertial guidance and the seeker of the Harpoon missile and there was concern with its ability to clearly discriminate between targets from a long distance, since at the time Navy sensors did not have as much range as the missile itself, which would be more reliable with the new seeker’s passive detection and active millimeter-wave radar.[17][18] Raytheon estimates adding the new seeker would cost $250,000 per missile.[19] Other upgrades include sea-skim mode[20] – low-altitude flight over water at high subsonic speeds. The first Block IV TLAMs modified with a maritime attack capability will enter service in 2018-2019.[21]

A supersonic version of the Tomahawk is under consideration for development with a ramjet to increase its speed to Mach 3. A limiting factor to this is the dimensions of shipboard launch tubes. Instead of modifying every ship able to carry cruise missiles, the ramjet-powered Tomahawk would still have to fit within a 21-inch diameter and 20-foot long tube.[16]

In October 2015, Raytheon announced the Tomahawk had demonstrated new capabilities in a test launch, using its onboard camera to take a reconnaissance photo and transmit it to fleet headquarters. It then entered a loitering pattern until given new targeting coordinates to strike.[22]

By January 2016, Los Alamos National Laboratory was working on a project to turn unburned fuel left over when a Tomahawk reaches its target into an additional explosive force. To do this, the missile’s JP-10 fuel is turned into a fuel air explosive to combine with oxygen in the air and burn rapidly. The thermobaric explosion of the burning fuel acts, in effect, as an additional warhead and can even be more powerful than the main warhead itself when there is sufficient fuel left in the case of a short range target.[11][23]

TACTOM(Tactical Tomahawk) is Tomahawk’s modernization program that will incorporate an all-weather-seeker[24] that will complement Tomahawk’s Synthetic Guidance Mode; which uses a high-throughput radio signal to update the missile in flight, giving it new target information as a maritime or land target moves.

Launch systems

Each missile is stored and launched from a pressurized canister[25] that protects it during transportation and storage, and also serves as a launch tube. These canisters were racked in armored box launchers (ABL), which were installed on the re-activated Iowa-class battleships USS Iowa, USS New Jersey, USS Missouri, and USS Wisconsin. The ABLs were also installed on eight Spruance-class destroyers, the four Virginia-class cruisers, and the USS Long Beach. These canisters are also in vertical launching systems (VLS) in other surface ships, capsule launch systems (CLS) in the later Los Angeles-class submarines, and in submarines’ torpedo tubes. All ABL equipped ships have been decommissioned.

For submarine-launched missiles (called UGM-109s), after being ejected by gas pressure (vertically via the VLS) or by water impulse (horizontally via the torpedo tube), the missile exits the water and a solid-fuel booster is ignited for the first few seconds of airborne flight until transition to cruise.

After achieving flight, the missile’s wings are unfolded for lift, the airscoop is exposed and the turbofan engine is employed for cruise flight. Over water, the Tomahawk uses inertial guidance or GPS to follow a preset course; once over land, the missile’s guidance system is aided by terrain contour matching (TERCOM). Terminal guidance is provided by the Digital Scene Matching Area Correlation (DSMAC) system or GPS, producing a claimed circular error probable of about 10 meters.

The Tomahawk Weapon System consists of the missile, Theater Mission Planning Center (TMPC)/Afloat Planning System, and either the Tomahawk Weapon Control System (on surface ships) or Combat Control System (for submarines).

Several versions of control systems have been used, including:

  • v2 TWCS – Tomahawk Weapon Control System (1983), also known as “green screens,” was based on an old tank computing system.
  • v3 ATWCS – Advanced Tomahawk Weapon Control System (1994), first Commercial Off the Shelf, uses HP-UX.
  • v4 TTWCS – Tactical Tomahawk Weapon Control System, (2003).
  • v5 TTWCS – Next Generation Tactical Tomahawk Weapon Control System. (2006)

Navigation and other details

The TLAM-D contains 166 sub-munitions in 24 canisters: 22 canisters of seven each, and two canisters of six each to conform to the dimensions of the airframe. The sub-munitions are the same type of Combined Effects Munition bomblet used in large quantities by the U.S. Air Force with the CBU-87 Combined Effects Munition. The sub-munitions canisters are dispensed two at a time, one per side. The missile can perform up to five separate target segments which enables it to attack multiple targets. However, in order to achieve a sufficient density of coverage typically all 24 canisters are dispensed sequentially from back to front.

TERCOM – Terrain Contour Matching. A digital representation of an area of terrain is mapped based on digital terrain elevation data or stereo imagery. This map is then inserted into a TLAM mission which is then loaded onto the missile. When the missile is in flight it compares the stored map data with radar altimeter data collected as the missile overflies the map. Based on comparison results the missile’s inertial navigation system is updated and the missile corrects its course. TERCOM was based on, and was a significant improvement on, “Fingerprint,” a technology developed in 1964 for the SLAM.[26]

On July 26, 2014 it was announced that 196 additional Block IV missiles had been purchased.[27]

DSMAC – Digital Scene Matching Area Correlation. A digitized image of an area is mapped and then inserted into a TLAM mission. During the flight the missile will verify that the images that it has stored correlates with the image it sees below itself. Based on comparison results the missile’s inertial navigation system is updated and the missile corrects its course.

  • Total program cost: $US 11,210,000,000[28]

Operational history

Remnants of a shot down Tomahawk from Operation Allied Force, showing the turbofan engine at the Museum of Aviation in Belgrade, Serbia

United States Navy

In the 1991 Gulf War, 288 Tomahawks were launched, 12 from submarines and 276 from surface ships.[29] The first salvo was fired by the Destroyer USS Paul F. Foster[30] on January 17, 1991. The attack submarines USS Pittsburgh and USS Louisville followed.

On 17 January 1993, 46 Tomahawks were fired at the Zafraniyah Nuclear Fabrication Facility outside Baghdad, in response to Iraq’s refusal to cooperate with UN disarmament inspectors. One missile crashed into the side of the Al Rasheed Hotel, killing two civilians.[31]

On 26 June 1993, 23 Tomahawks were fired at the Iraqi Intelligence Service’s command and control center.[32]

On 10 September 1995, the USS Normandy launched 13 Tomahawk missiles from the central Adriatic Sea against a key air defense radio relay tower in Bosnian Serb territory during Operation Deliberate Force.[33]

On 3 September 1996, 44 cruise missiles between UGM-109 and B-52 launched AGM-86s, were fired at air defence targets in Southern Iraq.[34][35]

On 20 August 1998, 79 Tomahawk missiles were fired simultaneously at two separate targets in Afghanistan and Sudan in retaliation for the bombings of American embassies by Al-Qaeda.[2]

On 16 December 1998, 415 Tomahawk missiles were fired at key Iraqi targets during Operation Desert Fox.[36]

In early 1999, 218 Tomahawk missiles were fired by US ships and a British submarine during Operation Allied Force against key targets in Serbia and Montenegro.[3]

In October 2001, approximately 50 Tomahawk missiles struck targets in Afghanistan in the opening hours of Operation Enduring Freedom.[4][37]

During the 2003 invasion of Iraq, more than 802 Tomahawk missiles were fired at key Iraqi targets.[38]

On 3 March 2008, two Tomahawk missiles were fired at a target in Somalia by a US vessel during the Dobley airstrike, reportedly in an attempt to kill Saleh Ali Saleh Nabhan, an al Qaeda militant.[39][40]

On 17 December 2009, two Tomahawk missiles were fired at targets in Yemen.[41] One of the targets was hit by a TLAM-D missile. The target was described as an ‘alleged Al-Qaeda training camp’ in al-Ma’jalah in al-Mahfad a region of the Abyan governorate of Yemen. Amnesty International reported that 55 people were killed in the attack, including 41 civilians (21 children, 14 women, and six men). The US and Yemen governments refused to confirm or deny involvement, but diplomatic cables released as part of United States diplomatic cables leak later confirmed the missile was fired by a US Navy ship.[42]

On 19 March 2011, 124 Tomahawk missiles[43] were fired by U.S. and British forces (112 US, 12 British)[44] against at least 20 Libyan targets around Tripoli and Misrata.[45] As of 22 March 2011, 159 UGM-109 were fired by US and UK ships against Libyan targets.[46]

On 23 September 2014, 47 Tomahawk missiles were fired by the United States from the USS Arleigh Burke and USS Philippine Sea, which were operating from international waters in the Red Sea and Persian Gulf, against ISIL targets in Syria in the vicinity of Raqqa, Deir ez-Zor, Al-Hasakah and Abu Kamal,[47] and against Khorasan group targets in Syria west of Aleppo.[48]

On 13 October 2016 five Tomahawk cruise missiles were launched by USS Nitze at three radar sites in Yemen held by Houthi rebels in response to anti-ship missiles fired at US Navy ships the day before.[49]

On 6 April 2017, 59 Tomahawk missiles were launched from the USS Ross (DDG-71) and USS Porter (DDG-78), targeting Shayrat, a military airfield near Homs, in Syria. The strike was in retaliation for the alleged use of chemical weapons by Syrian President Bashir Al-Assad. Initial reports indicate that the Syrian airbase was ‘almost completely destroyed’ after the US strike.[50]

As of 2015, the United States Navy has a stockpile of around 3,500 Tomahawk cruise missiles of all variants, with a combined worth of approximately US $2.6 billion.[51]

Royal Navy

In 1995 the US agreed to sell 65 Tomahawks to the UK for torpedo-launch from her nuclear attack submarines. The first missiles were acquired and test-fired in November 1998; all Royal Navy fleet submarines are now Tomahawk capable, including the new Astute-class.[52][53][54][55] The Kosovo War in 1999 saw the Swiftsure-class HMS Splendid become the first British submarine to fire the Tomahawk in combat. It has been reported that seventeen of the twenty Tomahawks fired by the British during that conflict hit their targets accurately;[citation needed] the UK subsequently bought 20 more Block III to replenish stocks.[56] The Royal Navy has since fired Tomahawks during the 2000s Afghanistan War, in Operation Telic as the British contribution to the 2003 Iraq War, and during Operation Ellamy in Libya in 2011.

In April 2004, the UK and US governments reached an agreement for the British to buy 64 of the new generation of Tomahawk missile—the Block IV or TacTom missile.[57] It entered service with the Royal Navy on 27 March 2008, three months ahead of schedule.[58] In July 2014 the US approved the sale to the UK of a further 65 submarine-launched Block IV’s at a cost of US$140m including spares and support;[59] as of 2011 the Block III missiles were on Britain’s books at £1.1m and the Block IV at £0.87m including VAT.[60]

The Sylver Vertical Launching System on the new Type 45 destroyer is claimed by its manufacturers to have the capability to fire the Tomahawk, although the A50 launcher carried by the Type 45 is too short for the weapon (the longer A70 silo would be required). Nevertheless, the Type 45 has been designed with weight and space margin for a strike-length Mk41 or Sylver A70 silo to be retrofitted, allowing Type 45 to use the TLAM Block IV if required. The new Type 26 frigates will have strike-length VLS tubes. SYLVER user France is developing MdCN, a version of the Storm Shadow/Scalp cruise missile that has a shorter range but a higher speed than Tomahawk and can be launched from the SYLVER system.

United States Air Force

The Air Force is a former operator of the nuclear-armed version of the Tomahawk, the BGM-109G Gryphon.

Other users

The Netherlands (2005) and Spain (2002 and 2005) were interested in acquiring the Tomahawk system, but the orders were later cancelled in 2007 and 2009 respectively.[61][62]

In 2009 the Congressional Commission on the Strategic Posture of the United States stated that Japan would be concerned if the TLAM-N were retired, but the government of Japan has denied that it had expressed any such view.[63]

It is believed that the SLCM version of the Popeye was developed by Israel after the US Clinton administration refused an Israeli request in 2000 to purchase Tomahawk SLCM’s because of international Missile Technology Control Regime proliferation rules.[64]

As of March 12, 2015 Poland has expressed interest in purchasing long-range Tomahawk missiles for its future submarines.[65]

Operators

Map with Tomahawk operators in blue

Current operators

See also

https://en.wikipedia.org/wiki/Tomahawk_(missile)

Story 2: What is Next?  United States Led Coalition of Egypt, Jordan, Kurds, Saudi Arabia, and Turkey to Destroy Islamic State, Jabhat Al Nustra Front ( al-Qaeda’s Syrian affiliate), Radical Islamic Terrorist Jihadists in Syria, Hezbollah, and Bashar al-Assad Syrian Regime –Videos — Military strike comes after Trump previously railed against Syria intervention

What comes next after Syria missile attack

Story 3: Supreme Court Justice Neil Gorsuch Confirmed 54 Yes — 45 Nos

Senate confirms Neil Gorsuch for Supreme Court (C-SPAN)

The Senate Goes “Nuclear”

Mike Pence Reads Final Vote Confirming Neil Gorsuch To Supreme Court | NBC News

Senate Democrats trigger “nuclear option” to curb filibusters

Harry Reid goes Nuclear Pushes Major Senate Filibuster Rules Change

 

Reid, Democrats trigger ‘nuclear’ option; eliminate most filibusters on nominees

The Senate goes nuclear

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It’s more than just a rule change: The so-called “nuclear option” will fundamentally alter the way the Senate operates – for good.(Casey Capachi/(In Play))
November 21, 2013

Senate Democrats took the dramatic step Thursday of eliminating filibusters for most nominations by presidents, a power play they said was necessary to fix a broken system but one that Republicans said will only rupture it further.

Democrats used a rare parliamentary move to change the rules so that federal judicial nominees and executive-office appointments can advance to confirmation votes by a simple majority of senators, rather than the 60-vote supermajority that has been the standard for nearly four decades.

The immediate rationale for the move was to allow the confirmation of three picks by President Obama to the U.S. Court of Appeals for the District of Columbia Circuit — the most recent examples of what Democrats have long considered unreasonably partisan obstruction by Republicans.

In the long term, the rule change represents a substantial power shift in a chamber that for more than two centuries has prided itself on affording more rights to the minority party than any other legislative body in the world. Now, a president whose party holds the majority in the Senate is virtually assured of having his nominees approved, with far less opportunity for political obstruction.

The main combatants Thursday were the chamber’s two chiefs, Majority Leader Harry M. Reid (D-Nev.) and Minority Leader Mitch McConnell (R-Ky.), who have clashed for several years over Republican filibusters of Obama’s agenda and nominees.

Reid said the chamber “must evolve” beyond parliamentary roadblocks. “The American people believe the Senate is broken, and I believe the American people are right,” he said, adding: “It’s time to get the Senate working again.”

McConnell linked the rule change to the methods used to approve Obama’s health-care law solely with Democratic votes. The normally reserved GOP leader paced at his desk during his speech, often turning his back to Democrats to address only his fellow Republicans.

“It’s a sad day in the history of the Senate,” McConnell told reporters, calling the move a Democratic “power grab.”

The clash ended with a vote nearly as partisan as the times — 52 to 48, with all but three Democrats backing the move and every Republican opposing it.

The vote was the culmination of more than 25 years of feuding over nominations, beginning with President Ronald Reagan’s choices for the Supreme Court and including Obama’s picks for obscure federal regulatory agencies. Each side in Thursday’s debate cited its own statistics to state its case.

Democrats said the attempted filibusters of Chuck Hagel during his confirmation hearing to become defense secretary, a first for any nominee to lead the Pentagon — as well as a blockade of picks to head the National Labor Relations Board and the Consumer Financial Protection Bureau — exceeded anything Democrats did when they were in the minority. In addition, Democrats charged that Republicans didn’t even have substantive objections to the D.C. Circuit nominees they filibustered.

After the vote, Obama told reporters at the White House that Republicans had turned nomination fights into a “reckless and relentless tool” to grind the gears of government to a halt and noted that “neither party has been blameless for these tactics.” However, he said, “today’s pattern of obstruction . . . just isn’t normal; it’s not what our founders envisioned.”

Republicans countered that they had confirmed 99 percent of Obama’s judicial selections. McConnell accused Democrats of eyeing the D.C. Circuit in an effort to stack the court, which reviews many cases related to federal laws and regulations, to tilt its balance in a liberal direction.

What made the day so historic for senators, former senators and the small collection of parliamentary experts in Washington was the simple majority vote used to execute the changes — a tactic so extreme it is known as the “nuclear option.”

Previous majorities had threatened to upend filibuster rules in this manner, but relying on a simple majority vote had been used only for relatively minor procedural changes to how amendments were handled, never to eliminate the super­majority requirement altogether. Before Thursday, the standard precedent was that major rule changes needed a two-thirds majority. The change was so significant that Reid and his leadership team held a victory party with liberal activists afterward in a room just off the Senate floor.

Republicans said the way Democrats upended the rules will result in fallout for years. “It’s another raw exercise of political power to permit the majority to do anything it wants whenever it wants to do it,” Sen. Lamar Alexander (Tenn.), the GOP’s parliamentary expert, told reporters.

Republicans vowed to reciprocate if they reclaim the majority.

“Democrats won’t be in power in perpetuity,” said Sen. Richard C. Shelby (Ala.), a 27-year member. “This is a mistake — a big one for the long run. Maybe not for the short run. Short-term gains, but I think it changes the Senate tremendously in a bad way.”

After the vote, Reid told reporters that his views on the issue had evolved — from eight years ago, when Republicans held the majority and he led the fight to protect the filibuster. He acknowledged that he wouldn’t mind seeing the supermajority requirement abolished for everything but that there were not enough votes in his caucus to support such a move.

Reid first faced pressure on this issue from junior Democrats four years ago, particularly Sen. Jeff Merkley, a former speaker of the Oregon state House, who became the point person for growing the anti-filibuster movement. But Reid repeatedly rejected their effort as too radical.

Even if Republicans want to do away with the filibuster someday, Reid said, Thursday’s move was worth it because the current climate had become too hostile to get anything significant done. Reid said he faced a choice: “Continue like we are or have democracy?”

The rule change does not apply to Supreme Court nominations or to legislation.

Individual senators will still be able to seize the floor for marathon speeches opposing nominees, as Sen. Rand Paul (R-Ky.) did in a nearly 13-hour session in March against the nomination of John Brennan as CIA director. But once such speeches end, the majority will be able to confirm nominees without needing bipartisan support.

With the Senate majority very much up for grabs in midterm elections next year, Democrats placed a big bet on maintaining control of the chamber. GOP leaders have suggested that, if given the Senate majority back, they might further strip filibuster rules so they could dismantle Obama’s landmark domestic achievement, the Affordable Care Act, on a simple majority vote.

In his remarks, McConnell finally turned to Democrats and said that a majority of them had never served in the minority and then lectured the longtime members who knew what it was like to be on the other side.

“The solution to this problem is at the ballot box,” he said. “We look forward to having a great election in 2014.”

https://www.washingtonpost.com/politics/senate-poised-to-limit-filibusters-in-party-line-vote-that-would-alter-centuries-of-precedent/2013/11/21/d065cfe8-52b6-11e3-9fe0-fd2ca728e67c_story.html?utm_term=.5bf7f548abcf

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The Pronk Pops Show 868, April 6, 2017, Story 1: Neoconservatives and Progressive Global Interventionists Elite Banging The War Drums For American Empire Warfare and Welfare State vs. We The People America First Non-interventionists For American Republic Peace and Prosperity Economy — American People Not Readily Accepting Big Lie Media Propaganda on Syria Chemical Gas Air Attack — Another False Flag — Sunni and Shia Have Being Killing Each Other For Hundreds of Years — Stop Being Imperial Umpire For A Religious Sectarian Civil War and Proxy War — National Interest — Oil and Gas — Videos

Posted on April 6, 2017. Filed under: American History, Benghazi, Bernie Sanders, Blogroll, Bombs, Breaking News, Business, College, Communications, Computers, Congress, Corruption, Countries, Cruise Missiles, Defense Spending, Donald J. Trump, Donald J. Trump, Donald Trump, Donald Trump, Egypt, Elections, Empires, European History, European Union, Federal Government, Foreign Policy, Fourth Amendment, Free Trade, Freedom of Speech, Genocide, Government, Government Dependency, Government Spending, Great Britain, Hate Speech, History, House of Representatives, Human, Human Behavior, Iran Nuclear Weapons Deal, Iraq, Islam, Islamic Republic of Iran, Islamic State, Israel, Jordan, Law, Libya, Life, Lying, Marco Rubio, Media, Medicare, Middle East, MIssiles, National Security Agency, Nerve Gas, News, Nuclear Weapons, Obama, Philosophy, Photos, Pistols, Politics, Polls, President Barack Obama, President Trump, Progressives, Qatar, Radio, Rand Paul, Rand Paul, Raymond Thomas Pronk, Regulation, Religion, Rifles, Rule of Law, Russia, Scandals, Second Amendment, Security, Senate, Social Security, Spying, Surveillance and Spying On American People, Surveillance/Spying, Syria, Taxation, Taxes, Technology, Terror, Terrorism, U.S. Negotiations with Islamic Republic of Iran, United Kingdom, United States Constitution, United States of America, Videos, Violence, War, Wealth, Weapons, Weather, Welfare Spending, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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Pronk Pops Show 868: April 6, 2017

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Updated

Breaking News

Undeclared War!

President Trump Launches 59 Cruise Missile Attack From Two U.S. Destroyers Against Syrian Air Base 

President Trump Neoconned!

Trump Orders ATTACK on Syria – April 6, 2017 – FULL Press Conference

RAW USA launches cruise missile strike on Syria Regime Breaking News April 6 2017 

RAW USA launches cruise missiles strike on Syria RUSSIA IRAN backed ASSAD Regime after chemical Warfare weapons attack Breaking News April 6 2017

Neo-CONNED speech by Ron Paul

U.S. Launches Missiles at Syrian Base After Chemical Weapons Attack

The United States launched dozens of cruise missiles Thursday night at a Syrian airfield in response to what it believes was Syria’s use of banned chemical weapons that killed at least 100 people, U.S. military officials told NBC News.

Two U.S. warships in the Mediterranean Sea fired 59 Tomahawk missiles intended for a single target — Ash Sha’irat in Homs province in western Syria, the officials said. That’s the airfield from which the United States believes the government of Syrian President Bashar al-Assad fired the banned weapons.

There was no immediate word on casualties. U.S. officials told NBC News that people were not targeted and that aircraft and infrastructure at the site were hit, including the runway and gas fuel pumps.y

Trump Speaks on Missile Strike in Syria 2:48

“Assad choked out the lives of helpless men, women and children,” President Donald Trump said in remarks from Mar-a-Lago, his family compound in Palm Beach, Florida.

“It is in this vital national security interest of the United States to prevent and deter the spread and use of deadly chemical weapons,” said Trump, who called on other countries to end the bloodshed in Syria.

Related: Trump: Why I Launched a Missile Attack on Syria

Trump is in Florida for a meeting with Chinese President Xi Jinpeng. Defense Secretary James Mattis, Secretary of State Rex Tillerson and national security adviser H.R. McMaster traveled to Florida with him.

Defense Secretary James Mattis, Secretary of State Rex Tillerson and national security adviser H.R. McMaster traveled to Florida with Trump. In Washington, Vice President Mike Pence returned to the White House after having gone home for dinner Thursday evening.

Syrian television characterized the missile strike “as American aggression” Friday morning. But Ahrar Al Sham, the largest Syrian armed rebel group, told NBC News it “welcomes any U.S. intervention through surgical strikes that would deter the Assad regime capabilities to kill civilians and shorten the suffering of our people.”

Syria Crisis: Trump Given Military Options After Chemical Attack 2:25

Tillerson and Nikki Haley, the U.S. ambassador to the United Nations, have bluntly blamed Syria for the chemical weapons attack, whose victims included at least 25 children.

Tillerson told reporters on Thursday that “there is no doubt in our minds” that the Syrian regime was responsible for the attack. And in a combative speech at the U.N. Security Council on Wednesday, Haley warned: “When the United Nations consistently fails in its duty to act collectively, there are times in the life of states that we are compelled to take our own action.”y

Tillerson on Assad Regime: He Has ‘No Role’ to Govern Syria0:58

NBC News reported Thursday that Defense Secretary James Mattis briefed President Donald Trump on U.S. military options, which included carrying out targeted strikes against those responsible for Tuesday’s attack.

There was no immediate reaction from Russia, which Tillerson and Haley have accused of turning a blind eye to Syria’s transgressions.

“Russia cannot escape responsibility for this,” Haley said at the United Nations. “They chose to close their eyes to the barbarity. They defied the conscience of the world.”

Thursday, Tillerson urged Russia to “consider carefully their continued support of the Assad regime.”

Story 1: Progressive Global Interventionists Elite Banging The War Drums For American Empire Warfare and Welfare State vs. We The People America First Non-interventionists For American Republic Peace and Prosperity Economy — American People Not Readily Accepting Big Lie Media Propaganda on Syria Chemical Gas Air Attack — Another False Flag — Sunni and Shia Have Being Killing Each Other For Hundreds of Years — Stop Being Imperial Umpire For A Religious Sectarian Civil War — National Interest — Oil and Gas — Videos

Image result for false flagImage result for false flagImage result for false flagImage result for map syria united states attack on syria air base april 2017Image result for map syria united states attack on syria air base april 2017Image result for cartoons syria sarin false flagImage result for cartoons syria sarin false flagImage result for cartoons syria sarin false flagImage result for number killed in syrian civil war through 2016Image result for syrian gas attack april 5, 2017 map idlib syriaImage result for syrian gas attack april 2017  Image result for syrian gas attack april 2017Image result for syrian gas attack april 5, 2017 map

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President Trump may be considering military action in Syria

Gen. Keane on the possibility of US military action in Syria

Trump Orders Attack On Syria! Will Russia Respond? Is Trump Wrong?

Syria Gas Attack: Assad’s Doing…Or False Flag?

Streamed live on Apr 5, 2017

Just days after the US Administration changed course on Syrian President Assad, saying he could stay, an alleged chemical weapon attack that killed dozens of civilians has been blamed on the Syrian government. Did Assad sign his own death warrant with such an attack…or does some other entity benefit?

[youytube=https://www.youtube.com/watch?v=LULzvg1gA5U]

Ron Paul: The Word That Best Defines Libertarianism Is Non-Intervention

Sen. John Barrasso Speaking on Trump Considering Military Action in Syria & North Korea

Cotton: President Trump struck the ‘right tone’ on Syria

Corker Comments on Suspected Chemical Weapons Attack in Syria

Rubio, Cardin call for Assad, Putin to be held accountable for Syria chemical weapons attack

Will the U.S. take military action in Syria?

Do powerful people in Washington want to know the truth?

Syrian Chemical False Flag Exposed

Laura Ingraham Show PODCAST April 6, 2017 – Bob Costa: ‘Trump Has Always Used His Family In Business

Unconfirmed Syria Chemical Weapons Attack is Iraq Weapons of Mass Destruction REDUX

What we know about the chemical attack in Syria

Syria Gas Attack: Assad’s Doing…Or False Flag?

Syria’s war: Who is fighting and why?

Was Syrian Chemical Attack A False Flag?

Understanding the Refugee Crisis in Europe, Syria, and around the World

Aftermath of Syrian chemical attack sparks outrage

World leaders condemn the Syrian chemical attack

Syria nerve gas attack: Chemical weapons expert debunks Assad’s defense

War in Syria: Russia and West clash over Idlib gas attack (part 1)

Published on Apr 5, 2017

Subscribe to France 24 now:
http://f24.my/youtubeEN

FRANCE 24 live news stream: all the latest news 24/7
http://f24.my/YTliveEN

On Tuesday in Idlib, a province in the Northwest of Syria, at least seventy people were killed, 20 of them children, in what appears to have been a chemical weapon attack in the rebel-held town of Khan Sheikhoun. Initial reports point to the nerve agent Sarin gas. Our panel of experts asks who was behind this attack. What explanations are being given, and do they stack up?
Click here for PART TWO.

Another suspected chemical weapons attack is latest chapter in brutal Syrian conflict

‘Assad Has Unleashed Horror in Syria’: World Reacts to Alleged Chemical Attack

Syria Gas Attack: Russia says chemical depot held by rebels bombed

Turkish President Erdogan calls chemical attack in Syria “inhuman and unacceptable”

“The Desperate BBC Propaganda Machine Blames Assad For Chemical Attack Before Any Investigation.”

Russia denies involvement in reported Syrian chemical attack

Children caught in Syria ‘chemical attack’- BBC News

Published on Apr 5, 2017

The UN Security Council has held an emergency session to discuss the suspected gas attack on a rebel-held town in Syria. The attack is believed to have killed more than 70 people, including children. The Syrian government has denied responsibility, while its ally Russia says the gas came from rebel weapons on the ground. But those claims have been widely rejected by western governments, as our Chief International Correspondent Lyse Doucet reports.

Syria conflict: ‘Chemical attack’ in Idlib kills 58 – BBC News

Published on Apr 4, 2017

At least 58 people have been killed and dozens wounded in a suspected chemical attack on a rebel-held town in north-western Syria, a monitoring group says. The Syrian Observatory for Human Rights reported that strikes on Khan Sheikhoun by Syrian government or Russian jets had caused many people to choke. Later, aircraft fired rockets at local clinics treating some of the survivors, medics and opposition activists said. The Syrian government has repeatedly denied using chemical weapons.

UN Ambassador Nikki Haley Condemns Russia, Iran After Chemical Attack In Syria | NBC News

UK: Chemical Attack Bears All Hallmarks of Assad

UNSC holds emergency meeting on Syria chemical attack

WATCH LIVE: U.N. Security Council Holds Emergency Meeting On Syria Chemical Attack | TIME

The TRUTH About the Syria Gas Attack

Hillary in Rat Line for Syria False Flag Sarin Gas Attack says Pulitzer Prize Winning Journalist

Sy Hersh Reveals Potential Turkish Role in Syria Chemical Strike That Almost Sparked U.S. Bombing

Global Empire – The World According to Seymour Hersh [Part Two]

Published on Aug 10, 2016

Tariq Ali talks to investigative journalist, Seymour Hersh, about his revelations concerning the chemical attack at Ghouta, Syria in August 2013.

Seymour Hersh Exposes Erdogan’s Chemical Adventure in Syria

Published on Apr 8, 2014

The US author reveals secret US reports warning that Al-Nusrah terrorist group affiliated with Qatar and Turkey, posses a chemical weapons cell. Worst threat since 9/11.

Global Empire – The World According to Seymour Hersh [Part One]

Published on Aug 10, 2016

Tariq Ali talks to investigative journalist, Seymour Hersh, about the assassination of Osama bin Laden in Pakistan in 2011 and describes what the Americans and Pakistanis knew about his whereabouts.

Global Empire – Syria After Trump

Seymour Hersh: Obama “Cherry-Picked” Intelligence on Syrian Chemical Attack to Justify U.S. Strike

Published on Dec 9, 2013

Writing in the London Review of Books, Hersh argues that the Obama administration “cherry-picked intelligence to justify a strike against Assad.” The administration failed to disclose it knew Syrian rebels in the al-Nusra Front had the ability to produce chemical weapons. Evidence obtained in the days after the attack was also allegedly distorted to make it appear it was gathered in real time.

Whose sarin? Seymour M. Hersh
Barack Obama did not tell the whole story this autumn when he tried to make the case that Bashar al-Assad was responsible for the chemical weapons attack near Damascus on 21 August. In some instances, he omitted important intelligence, and in others he presented assumptions as facts. Most significant, he failed to acknowledge something known to the US intelligence community: that the Syrian army is not the only party in the country’s civil war with access to sarin, the nerve agent that a UN study concluded — without assessing responsibility — had been used in the rocket attack. In the months before the attack, the American intelligence agencies produced a series of highly classified reports, culminating in a formal Operations Order — a planning document that precedes a ground invasion — citing evidence that the al-Nusra Front, a jihadi group affiliated with al-Qaida, had mastered the mechanics of creating sarin and was capable of manufacturing it in quantity. When the attack occurred al-Nusra should have been a suspect, but the administration cherry-picked intelligence to justify a strike against Assad.

In his nationally televised speech about Syria on 10 September, Obama laid the blame for the nerve gas attack on the rebel-held suburb of Eastern Ghouta firmly on Assad’s government, and made it clear he was prepared to back up his earlier public warnings that any use of chemical weapons would cross a ‘red line’: ‘Assad’s government gassed to death over a thousand people,’ he said. ‘We know the Assad regime was responsible … And that is why, after careful deliberation, I determined that it is in the national security interests of the United States to respond to the Assad regime’s use of chemical weapons through a targeted military strike.’ Obama was going to war to back up a public threat, but he was doing so without knowing for sure who did what in the early morning of 21 August.

He cited a list of what appeared to be hard-won evidence of Assad’s culpability: ‘In the days leading up to August 21st, we know that Assad’s chemical weapons personnel prepared for an attack near an area where they mix sarin gas. They distributed gas masks to their troops. Then they fired rockets from a regime-controlled area into 11 neighbourhoods that the regime has been trying to wipe clear of opposition forces.’ Obama’s certainty was echoed at the time by Denis McDonough, his chief of staff, who told the New York Times: ‘No one with whom I’ve spoken doubts the intelligence’ directly linking Assad and his regime to the sarin attacks.

But in recent interviews with intelligence and military officers and consultants past and present, I found intense concern, and on occasion anger, over what was repeatedly seen as the deliberate manipulation of intelligence. One high-level intelligence officer, in an email to a colleague, called the administration’s assurances of Assad’s responsibility a ‘ruse’. The attack ‘was not the result of the current regime’, he wrote. A former senior intelligence official told me that the Obama administration had altered the available information — in terms of its timing and sequence — to enable the president and his advisers to make intelligence retrieved days after the attack look as if it had been picked up and analyzed in real time, as the attack was happening. The distortion, he said, reminded him of the 1964 Gulf of Tonkin incident, when the Johnson administration reversed the sequence of National Security Agency intercepts to justify one of the early bombings of North Vietnam. The same official said there was immense frustration inside the military and intelligence bureaucracy: ‘The guys are throwing their hands in the air and saying, “How can we help this guy” — Obama — “when he and his cronies in the White House make up the intelligence as they go along?”‘…()

Obama Was Lying!

President Obama’s Syria Address [FULL SPEECH]

Seymour Hersh’s Latest Bombshell: U.S. Military Undermined Obama on Syria with Tacit Help to Assad

Published on Dec 22, 2015

A new report by the Pulitzer-winning veteran journalist Seymour Hersh says the Joints Chiefs of Staff has indirectly supported Bashar al-Assad in an effort to help him defeat jihadist groups. Hersh reports the Joint Chiefs sent intelligence via Russia, Germany and Israel on the understanding it would be transmitted to help Assad push back Jabhat al-Nusra and the Islamic State. Hersh also claims the military even undermined a U.S. effort to arm Syrian rebels in a bid to prove it was serious about helping Assad fight their common enemies. Hersh says the Joints Chiefs’ maneuvering was rooted in several concerns, including the U.S. arming of unvetted Syrian rebels with jihadist ties, a belief the administration was overly focused on confronting Assad’s ally in Moscow, and anger the White House was unwilling to challenge Turkey and Saudi Arabia over their support of extremist groups in Syria. Hersh joins us to detail his claims and respond to his critics.

US, Russia Announce Syria Chemical Weapons Deal

U.S. Ship Begins Neutralizing Syrian Chemical Weapons

MV Cape Ray Storage Area Tour

MV Cape Ray Disposal Practice

MV Cape Ray FDHS

Published on Jul 2, 2014

As part of the U.N. Organization for the Prohibition of Chemical Weapons (OPCW) Joint Mission to eliminate chemical materials from the Syrian Arab Republic, the U.S. will destroy approximately 700 metric tons of chemicals aboard the MV Cape Ray. Danish and Norwegian vessels will transport the chemicals to a yet-unnamed Italian port for transfer to the MV Cape Ray. The MV Cape Ray, part of the U.S. Maritime Administration’s Ready Reserve Fleet, has been retrofitted with two field-deployable hydrolysis systems designed to neutralize the dangerous chemicals before disposal at a commercial facility.

MV Cape Ray’s Bridge

MV Cape Ray Command Post Tour

MV Cape Ray Laboratory Tour

False flag

From Wikipedia, the free encyclopedia
“False colors” redirects here. For the imaging technique, see False-color.

This US Douglas A-26 C Invader was painted in fake Cuban Air Force colors for the military invasion of Cuba undertaken by the CIA-sponsored paramilitary group Brigade 2506 in April 1961.

The contemporary term false flag describes covert operations that are designed to deceive in such a way that activities appear as though they are being carried out by entities, groups, or nations other than those who actually planned and executed them.[1]

Historically, the term “false flag” has its origins in naval warfare where the use of a flag other than the belligerent’s true battle flag before (but not while) engaging the enemy has long been accepted as a permissible ruse de guerre; by contrast, flying a false flag while engaging the enemy constitutes perfidy.[1]

Operations carried out during peace-time by civilian organizations, as well as covert government agencies, can (by extension) also be called false flag operations if they seek to hide the real organization behind an operation.[citation needed]

Use in warfare

In land warfare such operations are generally deemed acceptable in certain circumstances, such as to deceive enemies providing that the deception is not perfidious and all such deceptions are discarded before opening fire upon the enemy. Similarly in naval warfare such a deception is considered permissible provided the false flag is lowered and the true flag raised before engaging in battle:[2]auxiliary cruisers operated in such a fashion in both World Wars, as did Q-ships, while merchant vessels were encouraged to use false flags for protection.

Such masquerades promoted confusion not just of the enemy but of historical accounts: in 1914 the Battle of Trindade was fought between the British auxiliary cruiser RMS Carmania and the German auxiliary cruiser SMS Cap Trafalgar which had been altered to look like Carmania. (Contrary to some possibly mendacious accounts, the RMS Carmania had not been altered to resemble the Cap Trafalgar.)

Another notable example was the World War II German commerce raider Kormoran which surprised and sank the Australian light cruiser HMAS Sydney in 1941 while disguised as a Dutch merchant ship, causing the greatest recorded loss of life on an Australian warship. While Kormoran was fatally damaged in the engagement and its crew captured the outcome represented a considerable psychological victory for the Germans.[3]

Other examples from WWII included a Kriegsmarineensign in the St Nazaire Raid and captured a German code book: the old destroyer Campbeltown, which the British planned to sacrifice in the operation, was provided with cosmetic modifications that involved cutting the ship’s funnels and chamfering the edges to resemble a German Type 23torpedo boat.

By this ruse the British were able to get within two miles (3 km) of the harbour before the defences responded, where the explosive-rigged Campbeltown and commandos successfully disabled or destroyed the key dock structures of the port.[4][5]

Air warfare

In December 1922–February 1923, Rules concerning the Control of Wireless Telegraphy in Time of War and Air Warfare, drafted by a commission of jurists at the Hague regulates:[6]

Art. 3. A military aircraft must carry an exterior mark indicating its nationality and its military character.
Art. 19. The use of false exterior marks is forbidden.

This draft was never adopted as a legally binding treaty, but the ICRC states in its introduction on the draft that ‘To a great extent, [the draft rules] correspond to the customary rules and general principles underlying treaties on the law of war on land and at sea’,[7] and as such these two non–controversial articles were already part of customary law.[8]

Land warfare

In land warfare, the use of a false flag is similar to that of naval warfare: the trial of Otto Skorzeny, who planned and commanded Operation Greif, by a U.S. military tribunal at the Dachau Trials included a finding that Skorzeny was not guilty of a crime by ordering his men into action in American uniforms. He had relayed to his men the warning of German legal experts: that if they fought in American uniforms, they would be breaking the laws of war; however, they probably were not doing so simply by wearing the American uniforms. During the trial, a number of arguments were advanced to substantiate this position and the German and U.S. military seem to have been in agreement.

In the transcript of the trial,[9] it is mentioned that Paragraph 43 of the Field Manual published by the War Department, United States Army, on 1 October 1940, under the entry Rules of Land Warfare states “National flags, insignias and uniforms as a ruse – in practice it has been authorized to make use of these as a ruse. The foregoing rule (Article 23 of the Annex of the IVth Hague Convention), does not prohibit such use, but does prohibit their improper use. It is certainly forbidden to make use of them during a combat. Before opening fire upon the enemy, they must be discarded’.”

The American Soldiers’ Handbook was also quoted by Defense Counsel: “The use of the enemy flag, insignia, and uniform is permitted under some circumstances. They are not to be used during actual fighting, and if used in order to approach the enemy without drawing fire, should be thrown away or removed as soon as fighting begins.” Subsequently, the outcome of the trial has been codified in the 1977 Protocol Additional to the Geneva Conventions of 12 August 1949 (Protocol I):

Article 37. – Prohibition of perfidy

1. It is prohibited to kill, injure, or capture an adversary by resort to perfidy. Acts inviting the confidence of an adversary to lead him to believe that he is entitled to, or is obliged to accord, protection under the rules of international law applicable in armed conflict, with intent to betray that confidence, shall constitute perfidy. The following acts are examples of perfidy:
(a) The feigning of an intent to negotiate under a flag of truce or of a surrender;
(b) The feigning of an incapacitation by wounds or sickness;
(c) The feigning of civilian, non-combatant status; and
(d) The feigning of protected status by the use of signs, emblems or uniforms of the United Nations or of neutral or other States not Parties to the conflict.
2. Ruses of war are not prohibited. Such ruses are acts which are intended to mislead an adversary or to induce him to act recklessly but which infringe no rule of international law applicable in armed conflict and which are not perfidious because they do not invite the confidence of an adversary with respect to protection under that law. The following are examples of such ruses: the use of camouflage, decoys, mock operations and disinformation.

Article 38. – Recognized emblems

1. It is prohibited to make improper use of the distinctive emblem of the Red Cross, Red Crescent or Red Lion and Sun or of other emblems, signs or signals provided for by the Conventions or by this Protocol. It is also prohibited to misuse deliberately in an armed conflict other internationally recognized protective emblems, signs or signals, including the flag of truce, and the protective emblem of cultural property.
2. It is prohibited to make use of the distinctive emblem of the United Nations, except as authorized by that Organization.

Article 39. – Emblems of nationality

1. It is prohibited to make use in an armed conflict of the flags or military emblems, insignia or uniforms of neutral or other States not Parties to the conflict.
2. It is prohibited to make use of the flags or military emblems, insignia or uniforms of adverse Parties while engaging in attacks or in order to shield, favour, protect or impede military operations.
3. Nothing in this Article or in Article 37, paragraph 1 ( d ), shall affect the existing generally recognized rules of international law applicable to espionage or to the use of flags in the conduct of armed conflict at sea.

Cyber warfare

A false flag in the cyber domain is slightly different and easier to perpetrate than in other physical theaters of war. Cyber false flags refer to tactics used in covert cyber attacks by a perpetrator to deceive or misguide attribution attempts including the attacker’s origin, identity, movement, and/or code/exploitation. This misdirection tactic can cause misattribution (permitting response and/or counterattack as a condiciosine qua non under international law) or misperception which can lead to retaliation against the wrong adversary.

Cyber false flags can exist in the cyber domain when:

  1. Weaponized cyber exploits use recycled code/variants from previous attacks;
  2. Exploits are developed to mimic the scope and complexity of other malware;
  3. Exploits are procured rather than developed;
  4. Exploits are executed from new/unknown operator command servers;
  5. Malware calls out to or connects to known operator command servers;
  6. The action or attack is outsourced;
  7. The compromise is socially engineered to misguide investigations towards other operators;
  8. The audit trail or lack thereof conceals actual intent or actions with other exploits designed to mislead investigators.

As pretexts for war

Russo-Swedish War

In 1788, the head tailor at the Royal Swedish Opera received an order to sew a number of Russian military uniforms. These were then used by the Swedes to stage an attack on Puumala, a Swedish outpost on the Russo-Swedish border, on 27 June 1788. This caused an outrage in Stockholm and impressed the Riksdag of the Estates, the Swedish national assembly, who until then had refused to agree to an offensive war against Russia. The Puumala incident allowed King Gustav III of Sweden, who lacked the constitutional authority to initiate unprovoked hostilities without the Estates’ consent, to launch the Russo-Swedish War (1788–1790).[10]

Second Sino-Japanese War

Japanese experts inspect the scene of the ‘railway sabotage’ on South Manchurian Railway

In September 1931, Japanese officers fabricated a pretext for invading Manchuria by blowing up a section of railway. Though the explosion was too weak to disrupt operations on the rail line, the Japanese nevertheless used this Mukden incident to seize Manchuria and create a puppet government for what they termed the “independent” state of Manchukuo.[11]

World War II

Gleiwitz incident

Alfred Naujocks

The Gleiwitz incident in 1939 involved Reinhard Heydrich fabricating evidence of a Polish attack against Germany to mobilize German public opinion for war and to justify the war with Poland. Alfred Naujocks was a key organiser of the operation under orders from Heydrich. It led to the deaths of Nazi concentration camp victims who were dressed as German soldiers and then shot by the Gestapo to make it seem that they had been shot by Polish soldiers. This, along with other false flag operations in Operation Himmler, would be used to mobilize support from the German population for the start of World War II in Europe.[12]

The operation failed to convince international public opinion of the German claims, and both Britain and France—Poland’s allies—declared war two days after Germany invaded Poland.[13]

Winter War

On November 26, 1939, the Soviet armyshelled Mainila, a Russian village near the Finnish border. Soviet authorities blamed Finland for the attack and used the incident as a pretext to invade Finland, starting the Winter War, four days later.[14]

Cuban Revolution

Operation Northwoods

Operation Northwoods memorandum (13 March 1962)[15]

The proposed, but never executed, 1962 Operation Northwoods plot by the U.S. Department of Defense for a war with Cuba involved scenarios such as fabricating the hijacking or shooting down of passenger and military planes, sinking a U.S. ship in the vicinity of Cuba, burning crops, sinking a boat filled with Cuban refugees, attacks by alleged Cuban infiltrators inside the United States, and harassment of U.S. aircraft and shipping and the destruction of aerial drones by aircraft disguised as Cuban MiGs.[16] These actions would be blamed on Cuba, and would be a pretext for an invasion of Cuba and the overthrow of Fidel Castro‘s communist government. It was authored by the Joint Chiefs of Staff, but then rejected by President John F. Kennedy. The surprise discovery of the documents relating to Operation Northwoods was a result of the comprehensive search for records related to the assassination of President John F. Kennedy by the Assassination Records Review Board in the mid-1990s.[17] Information about Operation Northwoods was later publicized by James Bamford.[18]

As a tactic to undermine political opponents

Reichstag fire

Main article: Reichstag fire

The Reichstag fire was an arson attack on the Reichstag building in Berlin on 27 February 1933. The fire started in the Session Chamber,[19] and, by the time the police and firemen arrived, the main Chamber of Deputies was engulfed in flames. Police searched the building and found Marinus van der Lubbe, a young Dutchcouncil communist and unemployed bricklayer, who had recently arrived in Germany to carry out political activities.[citation needed]

The fire was used as evidence by the Nazis that the Communists were beginning a plot against the German government. Van der Lubbe and four Communist leaders were subsequently arrested. Adolf Hitler, who was sworn in as Chancellor of Germany four weeks before, on 30 January, urged President Paul von Hindenburg to pass an emergency decree to counter the “ruthless confrontation of the Communist Party of Germany“.[20] With civil liberties suspended, the government instituted mass arrests of Communists, including all of the Communist parliamentary delegates. With their bitter rival Communists gone and their seats empty, the National Socialist German Workers Party went from being a plurality party to the majority; subsequent elections confirmed this position and thus allowed Hitler to consolidate his power.[citation needed]

Historians disagree as to whether Van der Lubbe acted alone, as he said, to protest the condition of the German working class, or whether the arson was planned and ordered by the Nazis, then dominant in the government themselves, as a false flag operation.[21][22]

Project TP-Ajax

On 4 April 1953, the CIA was ordered to undermine the government of Iran over a four-month period, as a precursor to overthrowing Prime Minister Mohammad Mosaddegh.[23] One tactic used to undermine Mosaddegh was to carry out false flag attacks “on mosques and key public figures”, to be blamed on Iranian communists loyal to the government.[23]

The CIA project was code-named TP-Ajax, and the tactic of a “directed campaign of bombings by Iranians posing as members of the Communist party”,[24] involved the bombing of “at least” one well known Muslim’s house by CIA agents posing as Communists.[24] The CIA determined that the tactic of false flag attacks added to the “positive outcome” of Project TPAJAX.[23]

However, as “the C.I.A. burned nearly all of its files on its role in the 1953 coup in Iran”, the true extent of the tactic has been difficult for historians to discern.[25]

Pseudo-operations

Pseudo-operations are those in which forces of one power disguise themselves as enemy forces. For example, a state power may disguise teams of operatives as insurgents and, with the aid of defectors, infiltrate insurgent areas.[26] The aim of such pseudo-operations may be to gather short or long-term intelligence or to engage in active operations, in particularassassinations of important enemies. However, they usually involve both, as the risks of exposure rapidly increase with time and intelligence gathering eventually leads to violent confrontation. Pseudo-operations may be directed by military or police forces, or both. Police forces are usually best suited to intelligence tasks; however, military provide the structure needed to back up such pseudo-ops with military response forces. According to US military expert Lawrence Cline (2005), “the teams typically have been controlled by police services, but this largely was due to the weaknesses in the respective military intelligence systems.”[citation needed]

Charlemagne Péralte of Haiti was assassinated in 1919, after checkpoints were passed by military disguised as guerrilla fighters.

The State Political Directorate (OGPU) of the Soviet Union set up such an operation from 1921 to 1926. During Operation Trust, they used loose networks of White Army supporters and extended them, creating the pseudo-“Monarchist Union of Central Russia” (MUCR) in order to help the OGPU identify real monarchists and anti-Bolsheviks.[citation needed]

An example of a successful assassination was United States MarineSergeantHerman H. Hanneken leading a patrol of his HaitianGendarmerie disguised as enemy guerrillas in 1919. The Patrol successfully passed several enemy checkpoints in order to assassinate the guerilla leader Charlemagne Péralte near Grande-Rivière-du-Nord. Hanneken was awarded the Medal of Honor and was commissioned a Second Lieutenant for his deed.[citation needed]

During the Mau Mau uprising in the 1950s, captured Mau Mau members who switched sides and specially trained British troops initiated the pseudo-gang concept to successfully counter Mau Mau. In 1960 Frank Kitson, (who was later involved in the Northern Irish conflict and is now a retired British General), published Gangs and Counter-gangs, an account of his experiences with the technique in Kenya; information included how to counter gangs and measures of deception, including the use of defectors, which brought the issue a wider audience.[citation needed]

Another example of combined police and military oversight of pseudo-operations include the Selous Scouts in the former country Rhodesia (now Zimbabwe), governed by white minority rule until 1980. The Selous Scouts were formed at the beginning of Operation Hurricane, in November 1973, by Major (later Lieutenant Colonel) Ronald Reid-Daly. As with all Special Forces in Rhodesia, by 1977 they were controlled by COMOPS (Commander, Combined Operations) Commander Lieutenant General Peter Walls. The Selous Scouts were originally composed of 120 members, with all officers being white and the highest rank initially available for black soldiers being colour sergeant. They succeeded in turning approximately 800 insurgents who were then paid by Special Branch, ultimately reaching the number of 1,500 members. Engaging mainly in long-range reconnaissance and surveillance missions, they increasingly turned to offensive actions, including the attempted assassination of Zimbabwe People’s Revolutionary Army leader Joshua Nkomo in Zambia. This mission was finally aborted by the Selous Scouts, and attempted again, unsuccessfully, by the Rhodesian Special Air Service.[27]

Some offensive operations attracted international condemnation, in particular the Selous Scouts’ raid on a Zimbabwe African National Liberation Army (ZANLA) camp at Nyadzonya Pungwe, Mozambique in August 1976. ZANLA was then led by Josiah Tongogara. Using Rhodesian trucks and armored cars disguised as Mozambique military vehicles, 84 scouts killed 1,284 people in the camp-the camp was registered as a refugee camp by the United Nations (UN). Even according to Reid-Daly, most of those killed were unarmed guerrillas standing in formation for a parade. The camp hospital was also set ablaze by the rounds fired by the Scouts, killing all patients.[28] According to David Martin and Phyllis Johnson, who visited the camp shortly before the raid, it was only a refugee camp that did not host any guerrillas. It was staged for UN approval.[29]

According to a 1978 study by the Directorate of Military Intelligence, 68% of all insurgent deaths inside Rhodesia could be attributed to the Selous Scouts, who were disbanded in 1980.[30]

If the action is a police action, then these tactics would fall within the laws of the state initiating the pseudo, but if such actions are taken in a civil war or during a belligerent military occupation then those who participate in such actions would not be privileged belligerents. The principle of plausible deniability is usually applied for pseudo-teams. (See the above section Laws of war). Some false flag operations have been described by Lawrence E. Cline, a retired US Army intelligence officer, as pseudo-operations, or “the use of organized teams which are disguised as guerrilla groups for long- or short-term penetration of insurgent-controlled areas.”[citation needed]

Pseudo Operations should be distinguished, notes Cline, from the more common police or intelligence infiltration of guerrilla or criminal organizations. In the latter case, infiltration is normally done by individuals. Pseudo teams, on the other hand, are formed as needed from organized units, usually military or paramilitary. The use of pseudo teams has been a hallmark of a number of foreign counterinsurgency campaigns.”[26]

Similar false flag tactics were also employed during the Algerian civil war, starting in the middle of 1994. Death squads composed of Département du Renseignement et de la Sécurité (DRS) security forces disguised themselves as Islamist terrorists and committed false flag terror attacks. Such groups included the Organisation of Young Free Algerians (OJAL) or the Secret Organisation for the Safeguard of the Algerian Republic (OSSRA)[31] According to Roger Faligot and Pascal Kropp (1999), the OJAL was reminiscent of “the Organization of the French Algerian Resistance (ORAF), a group of counter-terrorists created in December 1956 by the Direction de la surveillance du territoire (Territorial Surveillance Directorate, or DST) whose mission was to carry out terrorist attacks with the aim of quashing any hopes of political compromise”.[32]

Espionage

Main article: False flag penetrator

In espionage the term “false flag” describes the recruiting of agents by operatives posing as representatives of a cause the prospective agents are sympathetic to, or even the agents’ own government. For example, during the Cold War, several female West German civil servants were tricked into stealing classified documents by agents of the East GermanStasi intelligence service, pretending to be members of West German peace advocacy groups (the Stasi agents were also described as “Romeos,” indicating that they also used their sex appeal to manipulate their targets, making this operation a combination of the false flag and “honey trap” techniques).[33]

The technique can also be used to expose enemy agents in one’s own service, by having someone approach the suspect and pose as an agent of the enemy. Earl Edwin Pitts, a 13-year veteran of the U.S. Federal Bureau of Investigation and an attorney, was caught when he was approached by FBI agents posing as Russian agents.[citation needed]

British intelligence officials in World War II allowed double agents to fire-bomb a power station and a food dump in the UK to protect their cover, according to declassified documents. The documents stated the agents took precautions to ensure they did not cause serious damage. One of the documents released also stated: “It should be recognised that friends as well as enemies must be completely deceived.”[34]

Civilian usage

While false flag operations originate in warfare and government, they also can occur in civilian settings among certain factions, such as businesses, special interest groups, religions, political ideologies and campaigns for office.[citation needed]

Businesses

In business and marketing, similar operations are being employed in some public relations campaigns (see Astroturfing). Telemarketing firms practice false flag type behavior when they pretend to be a market research firm (referred to as “sugging“). In some rare cases, members of an unsuccessful business will destroy some of their own property to conceal an unrelated crime (e.g., safety violations, embezzlement) but make it appear as though the destruction was done by a rival company.[citation needed]

Political campaigning

Political campaigning has a long history of this tactic in various forms, including in person, print media and electronically in recent years. This can involve when supporters of one candidate pose as supporters of another, or act as “straw men” for their preferred candidate to debate against. This can happen with or without the candidate’s knowledge. The Canuck letter is an example of one candidate creating a false document and attributing it as coming from another candidate in order to discredit that candidate.[citation needed]

In the final days of Florida’s 1994 gubernatorial campaign, Democratic Governor Lawton Chiles ran a false flag operation that paid for tens of thousands of calls to elderly voters using false organization names. The calls purported to be from Republican groups and told voters that Jeb Bush was against Social Security and seniors. Chiles denied his campaign was behind the calls. After winning re-election and facing an investigation, Chiles admitted the truth in November 1995.[35]

In 2006, individuals practicing false flag behavior were discovered and “outed” in New Hampshire[36][37] and New Jersey[38] after blog comments claiming to be from supporters of a political candidate were traced to the IP address of paid staffers for that candidate’s opponent.

On 19 February 2011, Indiana Deputy Prosecutor Carlos Lam sent a private email to Wisconsin Governor Scott Walker suggesting that he run a “‘false flag’ operation” to counter the protests against Walker’s proposed restrictions on public employees’ collective bargaining rights:

If you could employ an associate who pretends to be sympathetic to the unions’ cause to physically attack you (or even use a firearm against you), you could discredit the unions … Employing a false flag operation would assist in undercutting any support that the media may be creating in favor of the unions.[39][40]

The press had acquired a court order to access all of Walker’s emails and Lam’s email was exposed. At first, Lam vehemently denied it, but eventually admitted it and resigned.[40]

Ideological

A bomb threat forged by Scientology operatives.

Proponents of political or religious ideologies will sometimes use false flag tactics. This can be done to discredit or implicate rival groups, create the appearance of enemies when none exist, or create the illusion of organized and directed persecution. This can be used to gain attention and sympathy from outsiders, in particular the media, or to convince others within the group that their beliefs are under attack and in need of protection.

In retaliation for writing The Scandal of Scientology, some members of the Church of Scientology stole stationery from author Paulette Cooper‘s home and then used that stationery to forge bomb threats and have them mailed to a Scientology office. The Guardian’s Office also had a plan for further operations to discredit Cooper known as Operation Freakout, but several Scientology operatives were arrested in a separate investigation and the plan was exposed.[41]

See also

Concepts

Examples

https://en.wikipedia.org/wiki/False_flag

42 FALSE-FLAG ATTACKS OFFICIALY ADMITTED TO

Mirrored from Washington’s Blog (due to their server being swamped)

Presidents, Prime Ministers, Congressmen, Generals, Spooks, Soldiers and Police ADMIT to False Flag Terror

In the following instances, officials in the government which carried out the attack (or seriously proposed an attack) admit to it, either orally, in writing, or through photographs or videos:

(1) Japanese troops set off a small explosion on a train track in 1931, and falsely blamed it on China in order to justify an invasion of Manchuria. This is known as the “Mukden Incident” or the “Manchurian Incident”. The Tokyo International Military Tribunal found: “Several of the participators in the plan, including Hashimoto [a high-ranking Japanese army officer], have on various occasions admitted their part in the plot and have stated that the object of the ‘Incident’ was to afford an excuse for the occupation of Manchuria by the Kwantung Army ….” And see this.

(2) A major with the Nazi SS admitted at the Nuremberg trials that – under orders from the chief of the Gestapo – he and some other Nazi operatives faked attacks on their own people and resources which they blamed on the Poles, to justify the invasion of Poland.

(3) Nazi general Franz Halder also testified at the Nuremberg trials that Nazi leader Hermann Goering admitted to setting fire to the German parliament building in 1933, and then falsely blaming the communists for the arson.

(4) Soviet leader Nikita Khrushchev admitted in writing that the Soviet Union’s Red Army shelled the Russian village of Mainila in 1939 – while blaming the attack on Finland – as a basis for launching the “Winter War” against Finland. Russian president Boris Yeltsin agreed that Russia had been the aggressor in the Winter War.

(5) The Russian Parliament, current Russian president Putin and former Soviet leader Gorbachev all admit that Soviet leader Joseph Stalin ordered his secret police to execute 22,000 Polish army officers and civilians in 1940, and then falsely blamed it on the Nazis.

(6) The British government admits that – between 1946 and 1948 – it bombed 5 ships carrying Jews attempting to flee the Holocaust to seek safety in Palestine, set up a fake group called “Defenders of Arab Palestine”, and then had the psuedo-group falsely claim responsibility for the bombings (and see this, this and this).

(7) Israel admits that in 1954, an Israeli terrorist cell operating in Egypt planted bombs in several buildings, including U.S. diplomatic facilities, then left behind “evidence” implicating the Arabs as the culprits (one of the bombs detonated prematurely, allowing the Egyptians to identify the bombers, and several of the Israelis later confessed) (and see this and this).

(8) The CIA admits that it hired Iranians in the 1950’s to pose as Communists and stage bombings in Iran in order to turn the country against its democratically-elected prime minister.

(9) The Turkish Prime Minister admitted that the Turkish government carried out the 1955 bombing on a Turkish consulate in Greece – also damaging the nearby birthplace of the founder of modern Turkey – and blamed it on Greece, for the purpose of inciting and justifying anti-Greek violence.

(10) The British Prime Minister admitted to his defense secretary that he and American president Dwight Eisenhower approved a plan in 1957 to carry out attacks in Syria and blame it on the Syrian government as a way to effect regime change.

(11) The former Italian Prime Minister, an Italian judge, and the former head of Italian counterintelligence admit that NATO, with the help of the Pentagon and CIA, carried out terror bombings in Italy and other European countries in the 1950s and blamed the communists, in order to rally people’s support for their governments in Europe in their fight against communism. As one participant in this formerly-secret program stated: “You had to attack civilians, people, women, children, innocent people, unknown people far removed from any political game. The reason was quite simple. They were supposed to force these people, the Italian public, to turn to the state to ask for greater security” (and see this) (Italy and other European countries subject to the terror campaign had joined NATO before the bombings occurred). And watch this BBC special. They also allegedly carried out terror attacks in France, Belgium, Denmark, Germany, Greece, the Netherlands, Norway, Portugal, the UK, and other countries.

False flag attacks carried out pursuant to this program include – by way of example only:

(12) In 1960, American Senator George Smathers suggested that the U.S. launch “a false attack made on Guantanamo Bay which would give us the excuse of actually fomenting a fight which would then give us the excuse to go in and [overthrow Castro]”.

(13) Official State Department documents show that, in 1961, the head of the Joint Chiefs and other high-level officials discussed blowing up a consulate in the Dominican Republic in order to justify an invasion of that country. The plans were not carried out, but they were all discussed as serious proposals.

(14) As admitted by the U.S. government, recently declassified documents show that in 1962, the American Joint Chiefs of Staff signed off on a plan to blow up AMERICAN airplanes (using an elaborate plan involving the switching of airplanes), and also to commit terrorist acts on American soil, and then to blame it on the Cubans in order to justify an invasion of Cuba. See the following ABC news report; the official documents; and watch this interview with the former Washington Investigative Producer for ABC’s World News Tonight with Peter Jennings.

(15) In 1963, the U.S. Department of Defense wrote a paper promoting attacks on nations within the Organization of American States – such as Trinidad-Tobago or Jamaica – and then falsely blaming them on Cuba.

(16) The U.S. Department of Defense even suggested covertly paying a person in the Castro government to attack the United States: “The only area remaining for consideration then would be to bribe one of Castro’s subordinate commanders to initiate an attack on Guantanamo.”

(17) The NSA admits that it lied about what really happened in the Gulf of Tonkin incident in 1964 … manipulating data to make it look like North Vietnamese boats fired on a U.S. ship so as to create a false justification for the Vietnam war.

(18) A U.S. Congressional committee admitted that – as part of its “Cointelpro” campaign – the FBI had used many provocateurs in the 1950s through 1970s to carry out violent acts and falsely blame them on political activists.

(19) A top Turkish general admitted that Turkish forces burned down a mosque on Cyprus in the 1970s and blamed it on their enemy. He explained: “In Special War, certain acts of sabotage are staged and blamed on the enemy to increase public resistance. We did this on Cyprus; we even burnt down a mosque.” In response to the surprised correspondent’s incredulous look the general said, “I am giving an example”.

(20) A declassified 1973 CIA document reveals a program to train foreign police and troops on how to make booby traps, pretending that they were training them on how to investigate terrorist acts:

The Agency maintains liaison in varying degrees with foreign police/security organizations through its field stations ….

[CIA provides training sessions as follows:]

a. Providing trainees with basic knowledge in the uses of commercial and military demolitions and incendiaries as they may be applied in terrorism and industrial sabotage operations.

b. Introducing the trainees to commercially available materials and home laboratory techniques, likely to he used in the manufacture of explosives and incendiaries by terrorists or saboteurs.

c. Familiarizing the trainees with the concept of target analysis and operational planning that a saboteur or terrorist must employ.

d. Introducing the trainees to booby trapping devices and techniques giving practical experience with both manufactured and improvised devices through actual fabrication.

***

The program provides the trainees with ample opportunity to develop basic familiarity and use proficiently through handling, preparing and applying the various explosive charges, incendiary agents, terrorist devices and sabotage techniques.

(21) The German government admitted (and see this) that, in 1978, the German secret service detonated a bomb in the outer wall of a prison and planted “escape tools” on a prisoner – a member of the Red Army Faction – which the secret service wished to frame the bombing on.

(22) A Mossad agent admits that, in 1984, Mossad planted a radio transmitter in Gaddaffi’s compound in Tripoli, Libya which broadcast fake terrorist trasmissions recorded by Mossad, in order to frame Gaddaffi as a terrorist supporter. Ronald Reagan bombed Libya immediately thereafter.

(23) The South African Truth and Reconciliation Council found that, in 1989, the Civil Cooperation Bureau (a covert branch of the South African Defense Force) approached an explosives expert and asked him “to participate in an operation aimed at discrediting the ANC [the African National Congress] by bombing the police vehicle of the investigating officer into the murder incident”, thus framing the ANC for the bombing.

(24) An Algerian diplomat and several officers in the Algerian army admit that, in the 1990s, the Algerian army frequently massacred Algerian civilians and then blamed Islamic militants for the killings (and see this video; and Agence France-Presse, 9/27/2002, French Court Dismisses Algerian Defamation Suit Against Author).

(25) The United States Army’s 1994 publication Special Forces Foreign Internal Defense Tactics Techniques and Procedures for Special Forces – updated in 2004 – recommends employing terrorists and using false flag operations to destabilize leftist regimes in Latin America. False flag terrorist attacks were carried out in Latin America and other regions as part of the CIA’s “Dirty Wars“. And see this.

(26) Similarly, a CIA “psychological operations” manual prepared by a CIA contractor for the Nicaraguan Contra rebels noted the value of assassinating someone on your own side to create a “martyr” for the cause. The manual was authenticated by the U.S. government. The manual received so much publicity from Associated Press, Washington Post and other news coverage that – during the 1984 presidential debate – President Reagan was confronted with the following question on national television:

At this moment, we are confronted with the extraordinary story of a CIA guerrilla manual for the anti-Sandinista contras whom we are backing, which advocates not only assassinations of Sandinistas but the hiring of criminals to assassinate the guerrillas we are supporting in order to create martyrs.

(27) An Indonesian fact-finding team investigated violent riots which occurred in 1998, and determined that “elements of the military had been involved in the riots, some of which were deliberately provoked“.

(28) Senior Russian Senior military and intelligence officers admit that the KGB blew up Russian apartment buildings in 1999 and falsely blamed it on Chechens, in order to justify an invasion of Chechnya (and see this report and this discussion).

(29) As reported by BBC, the New York Times, and Associated Press, Macedonian officials admit that the government murdered 7 innocent immigrants in cold blood and pretended that they were Al Qaeda soldiers attempting to assassinate Macedonian police, in order to join the “war on terror”.

(30)  At the July 2001 G8 Summit in Genoa, Italy, black-clad thugs were videotaped getting out of police cars, and were seen by an Italian MP carrying “iron bars inside the police station”.  Subsequently, senior police officials in Genoa subsequently  admitted that police planted two Molotov cocktails and faked the stabbing of a police officer at the G8 Summit, in order to justify a violent crackdown against protesters.

(31) The U.S. falsely blamed Iraq for playing a role in the 9/11 attacks – as shown by a memo from the defense secretary – as one of the main justifications for launching the Iraq war. Even after the 9/11 Commission admitted that there was no connection, Dick Cheney said that the evidence is “overwhelming” that al Qaeda had a relationship with Saddam Hussein’s regime, that Cheney “probably” had information unavailable to the Commission, and that the media was not ‘doing their homework’ in reporting such ties. Top U.S. government officials now admit that the Iraq war was really launched for oil … not 9/11 or weapons of mass destruction. Despite previous “lone wolf” claims, many U.S. government officials now say that 9/11 was state-sponsored terror; but Iraq was not the state which backed the hijackers. (Many U.S. officials have alleged that 9/11 was a false flag operation by rogue elements of the U.S. government; but such a claim is beyond the scope of this discussion. The key point is that the U.S. falsely blamed it on Iraq, when it knew Iraq had nothing to do with it.).

(32) Although the FBI now admits that the 2001 anthrax attacks were carried out by one or more U.S. government scientists, a senior FBI official says that the FBI was actually told to blame the Anthrax attacks on Al Qaeda by White House officials (remember what the anthrax letters looked like). Government officials also confirm that the white House tried to link the anthrax to Iraq as a justification for regime change in that country.

(33) According to the Washington Post, Indonesian police admit that the Indonesian military killed American teachers in Papua in 2002 and blamed the murders on a Papuan separatist group in order to get that group listed as a terrorist organization.

(34) The well-respected former Indonesian president also admits that the government probably had a role in the Bali bombings.

(35) Police outside of a 2003 European Union summit in Greece were filmed planting Molotov cocktails on a peaceful protester

(36) Former Department of Justice lawyer John Yoo suggested in 2005 that the US should go on the offensive against al-Qaeda, having “our intelligence agencies create a false terrorist organization. It could have its own websites, recruitment centers, training camps, and fundraising operations. It could launchfake terrorist operations and claim credit for real terrorist strikes, helping to sow confusion within al-Qaeda’s ranks, causing operatives to doubt others’ identities and to question the validity of communications.”

(37) Similarly, in 2005, Professor John Arquilla of the Naval Postgraduate School – a renowned US defense analyst credited with developing the concept of ‘netwar’ – called for western intelligence services to create new “pseudo gang” terrorist groups, as a way of undermining “real” terror networks. According to Pulitzer-Prize winning journalist Seymour Hersh, Arquilla’s ‘pseudo-gang’ strategy was, Hersh reported, already being implemented by the Pentagon:

“Under Rumsfeld’s new approach, I was told, US military operatives would be permitted to pose abroad as corrupt foreign businessmen seeking to buy contraband items that could be used in nuclear-weapons systems. In some cases, according to the Pentagon advisers, local citizens could be recruited and asked to join up with guerrillas or terrorists

The new rules will enable the Special Forces community to set up what it calls ‘action teams’ in the target countries overseas which can be used to find and eliminate terrorist organizations. ‘Do you remember the right-wing execution squads in El Salvador?’ the former high-level intelligence official asked me, referring to the military-led gangs that committed atrocities in the early nineteen-eighties. ‘We founded them and we financed them,’ he said. ‘The objective now is to recruit locals in any area we want. And we aren’t going to tell Congress about it.’ A former military officer, who has knowledge of the Pentagon’s commando capabilities, said, ‘We’re going to be riding with the bad boys.'”

(38) United Press International reported in June 2005:

U.S. intelligence officers are reporting that some of the insurgents in Iraq are using recent-model Beretta 92 pistols, but the pistols seem to have had their serial numbers erased. The numbers do not appear to have been physically removed; the pistols seem to have come off a production line without any serial numbers. Analysts suggest the lack of serial numbers indicates that the weapons were intended for intelligence operations or terrorist cells with substantial government backing. Analysts speculate that these guns are probably from either Mossad or the CIA. Analysts speculate that agent provocateurs may be using the untraceable weapons even as U.S. authorities use insurgent attacks against civilians as evidence of the illegitimacy of the resistance.

(39) Undercover Israeli soldiers admitted in 2005 to throwing stones at other Israeli soldiers so they could blame it on Palestinians, as an excuse to crack down on peaceful protests by the Palestinians.

(40) Quebec police admitted that, in 2007, thugs carrying rocks to a peaceful protest were actually undercover Quebec police officers (and see this).

(41) A 2008 US Army special operations field manual recommends that the U.S. military use surrogate non-state groups such as “paramilitary forces, individuals, businesses, foreign political organizations, resistant or insurgent organizations, expatriates, transnational terrorism adversaries, disillusioned transnational terrorism members, black marketers, and other social or political ‘undesirables.'” The manual specifically acknowledged that U.S. special operations can involve both counterterrorism and “Terrorism” (as well as “transnational criminal activities, including narco-trafficking, illicit arms-dealing, and illegal financial transactions.”)

(42)  The former head of Secret Services and Head of State of Italy (Francesco Cossiga) advised the 2008 minister in charge of the police, on how to deal with protests from teachers and students:

He should do what I did when I was Minister of the Interior … infiltrate the movement with agents provocateurs inclined to do anything …. And after that, with the strength of the gained population consent,  … beat them for blood and beat for blood also those teachers that incite them. Especially the teachers. Not the elderly, of course, but the girl teachers yes.

(43) At the G20 protests in London in 2009, a British member of parliament saw plain clothes police officers attempting to incite the crowd to violence.

(44) Egyptian politicians admitted (and see this) that government employees looted priceless museum artifacts in 2011 to try to discredit the protesters.

(45) Rioters who discredited the peaceful protests against the swearing in of the Mexican president in 2012 admitted that they were paid 300 pesos each to destroy everything in their path. According to Wikipedia, photos also show the vandals waiting in groups behind police lines prior to the violence.

(46) A Colombian army colonel has admitted that his unit murdered 57 civilians, then dressed them in uniforms and claimed they were rebels killed in combat.

(47) On November 20, 2014, Mexican agent provocateurs were transported by army vehicles to participate in the 2014 Iguala mass kidnapping protests, as was shown by videos and pictures distributed via social networks.

(48) The highly-respected writer for the Telegraph Ambrose Evans-Pritchard says that the head of Saudi intelligence – Prince Bandar – recently admitted that the Saudi government controls “Chechen” terrorists.

(49) High-level American sources admitted that the Turkish government – a fellow NATO country – carried out the chemical weapons attacks blamed on the Syrian government; and high-ranking Turkish government admitted on tape plans to carry out attacks and blame it on the Syrian government.

(50) The Ukrainian security chief admits that the sniper attacks which started the Ukrainian coup were carried out in order to frame others. Ukrainian officials admit that the Ukrainian snipers fired on both sides, to create maximum chaos.

(51) Britain’s spy agency has admitted (and see this) that it carries out “digital false flag” attacks on targets, framing people by writing offensive or unlawful material … and blaming it on the target.

(52) U.S. soldiers have admitted that if they kill innocent Iraqis and Afghanis, they then “drop” automatic weapons near their body so they can pretend they were militants

(53) Similarly, police frame innocent people for crimes they didn’t commit. The practice is so well-known that the New York Times noted in 1981:

In police jargon, a throwdown is a weapon planted on a victim.

Newsweek reported in 1999:

Perez, himself a former [Los Angeles Police Department] cop, was caught stealing eight pounds of cocaine from police evidence lockers. After pleading guilty in September, he bargained for a lighter sentence by telling an appalling story of attempted murder and a “throwdown”-police slang for a weapon planted by cops to make a shooting legally justifiable. Perez said he and his partner, Officer Nino Durden, shot an unarmed 18th Street Gang member named Javier Ovando, then planted a semiautomatic rifle on the unconscious suspect and claimed that Ovando had tried to shoot them during a stakeout.

Wikipedia notes:

As part of his plea bargain, Perez implicated scores of officers from the Rampart Division’s anti-gang unit, describing routinely beating gang members, planting evidence on suspects, falsifying reports and covering up unprovoked shootings.

(As a side note – and while not technically false flag attacks – police have been busted framing innocent people in many other ways, as well.)

(54) A former U.S. intelligence officer recently alleged:

Most terrorists are false flag terrorists or are created by our own security services.

(55) The head and special agent in charge of the FBI’s Los Angeles office said that most terror attacks are committed by the CIA and FBI as false flags.  Similarly, the director of the National Security Agency under Ronald Reagan – Lt. General William Odom said:

By any measure the US has long used terrorism. In ’78-79 the Senate was trying to pass a law against international terrorism – in every version they produced, the lawyers said the US would be in violation.

(audio here).

(56) Leaders throughout history have acknowledged the “benefits” of of false flags to justify their political agenda:

Terrorism is the best political weapon for nothing drives people harder than a fear of sudden death”.
– Adolph Hitler

“Why of course the people don’t want war … But after all it is the leaders of the country who determine the policy, and it is always a simple matter to drag the people along, whether it is a democracy, or a fascist dictatorship, or a parliament, or a communist dictatorship … Voice or no voice, the people can always be brought to the bidding of the leaders. That is easy. All you have to do is to tell them they are being attacked, and denounce the pacifists for lack of patriotism and exposing the country to danger. It works the same in any country.”
– Hermann Goering, Nazi leader.

“The easiest way to gain control of a population is to carry out acts of terror. [The public] will clamor for such laws if their personal security is threatened”.
– Josef Stalin

Postscript: Private parties – such as NBC News, as well as Muslims, Jews, Scientologists, African-Americans and Neo-Nazis – play this game as well.

www.whatreallyhappened.comhttp://www.whatreallyhappened.com/WRHARTICLES/42falseflags.php#ixzz4dVI2Q7La

The Red Line and the Rat Line

Seymour M. Hersh on Obama, Erdoğan and the Syrian rebels

In 2011 Barack Obama led an allied military intervention in Libya without consulting the US Congress. Last August, after the sarin attack on the Damascus suburb of Ghouta, he was ready to launch an allied air strike, this time to punish the Syrian government for allegedly crossing the ‘red line’ he had set in 2012 on the use of chemical weapons.Then with less than two days to go before the planned strike, he announced that he would seek congressional approval for the intervention. The strike was postponed as Congress prepared for hearings, and subsequently cancelled when Obama accepted Assad’s offer to relinquish his chemical arsenal in a deal brokered by Russia. Why did Obama delay and then relent on Syria when he was not shy about rushing into Libya? The answer lies in a clash between those in the administration who were committed to enforcing the red line, and military leaders who thought that going to war was both unjustified and potentially disastrous.

Obama’s change of mind had its origins at Porton Down, the defence laboratory in Wiltshire. British intelligence had obtained a sample of the sarin used in the 21 August attack and analysis demonstrated that the gas used didn’t match the batches known to exist in the Syrian army’s chemical weapons arsenal. The message that the case against Syria wouldn’t hold up was quickly relayed to the US joint chiefs of staff. The British report heightened doubts inside the Pentagon; the joint chiefs were already preparing to warn Obama that his plans for a far-reaching bomb and missile attack on Syria’s infrastructure could lead to a wider war in the Middle East. As a consequence the American officers delivered a last-minute caution to the president, which, in their view, eventually led to his cancelling the attack.

For months there had been acute concern among senior military leaders and the intelligence community about the role in the war of Syria’s neighbours, especially Turkey. Prime Minister Recep Erdoğan was known to be supporting the al-Nusra Front, a jihadist faction among the rebel opposition, as well as other Islamist rebel groups. ‘We knew there were some in the Turkish government,’ a former senior US intelligence official, who has access to current intelligence, told me, ‘who believed they could get Assad’s nuts in a vice by dabbling with a sarin attack inside Syria – and forcing Obama to make good on his red line threat.’

The joint chiefs also knew that the Obama administration’s public claims that only the Syrian army had access to sarin were wrong. The American and British intelligence communities had been aware since the spring of 2013 that some rebel units in Syria were developing chemical weapons. On 20 June analysts for the US Defense Intelligence Agency issued a highly classified five-page ‘talking points’ briefing for the DIA’s deputy director, David Shedd, which stated that al-Nusra maintained a sarin production cell: its programme, the paper said, was ‘the most advanced sarin plot since al-Qaida’s pre-9/11 effort’. (According to a Defense Department consultant, US intelligence has long known that al-Qaida experimented with chemical weapons, and has a video of one of its gas experiments with dogs.) The DIA paper went on: ‘Previous IC [intelligence community] focus had been almost entirely on Syrian CW [chemical weapons] stockpiles; now we see ANF attempting to make its own CW … Al-Nusrah Front’s relative freedom of operation within Syria leads us to assess the group’s CW aspirations will be difficult to disrupt in the future.’ The paper drew on classified intelligence from numerous agencies: ‘Turkey and Saudi-based chemical facilitators,’ it said, ‘were attempting to obtain sarin precursors in bulk, tens of kilograms, likely for the anticipated large scale production effort in Syria.’ (Asked about the DIA paper, a spokesperson for the director of national intelligence said: ‘No such paper was ever requested or produced by intelligence community analysts.’)

Last May, more than ten members of the al-Nusra Front were arrested in southern Turkey with what local police told the press were two kilograms of sarin. In a 130-page indictment the group was accused of attempting to purchase fuses, piping for the construction of mortars, and chemical precursors for sarin. Five of those arrested were freed after a brief detention. The others, including the ringleader, Haytham Qassab, for whom the prosecutor requested a prison sentence of 25 years, were released pending trial. In the meantime the Turkish press has been rife with speculation that the Erdoğan administration has been covering up the extent of its involvement with the rebels. In a news conference last summer, Aydin Sezgin, Turkey’s ambassador to Moscow, dismissed the arrests and claimed to reporters that the recovered ‘sarin’ was merely ‘anti-freeze’.

The DIA paper took the arrests as evidence that al-Nusra was expanding its access to chemical weapons. It said Qassab had ‘self-identified’ as a member of al-Nusra, and that he was directly connected to Abd-al-Ghani, the ‘ANF emir for military manufacturing’. Qassab and his associate Khalid Ousta worked with Halit Unalkaya, an employee of a Turkish firm called Zirve Export, who provided ‘price quotes for bulk quantities of sarin precursors’. Abd-al-Ghani’s plan was for two associates to ‘perfect a process for making sarin, then go to Syria to train others to begin large scale production at an unidentified lab in Syria’. The DIA paper said that one of his operatives had purchased a precursor on the ‘Baghdad chemical market’, which ‘has supported at least seven CW efforts since 2004’.

A series of chemical weapon attacks in March and April 2013 was investigated over the next few months by a special UN mission to Syria. A person with close knowledge of the UN’s activity in Syria told me that there was evidence linking the Syrian opposition to the first gas attack, on 19 March in Khan Al-Assal, a village near Aleppo. In its final report in December, the mission said that at least 19 civilians and one Syrian soldier were among the fatalities, along with scores of injured. It had no mandate to assign responsibility for the attack, but the person with knowledge of the UN’s activities said: ‘Investigators interviewed the people who were there, including the doctors who treated the victims. It was clear that the rebels used the gas. It did not come out in public because no one wanted to know.’

In the months before the attacks began, a former senior Defense Department official told me, the DIA was circulating a daily classified report known as SYRUP on all intelligence related to the Syrian conflict, including material on chemical weapons. But in the spring, distribution of the part of the report concerning chemical weapons was severely curtailed on the orders of Denis McDonough, the White House chief of staff. ‘Something was in there that triggered a shit fit by McDonough,’ the former Defense Department official said. ‘One day it was a huge deal, and then, after the March and April sarin attacks’ – he snapped his fingers – ‘it’s no longer there.’ The decision to restrict distribution was made as the joint chiefs ordered intensive contingency planning for a possible ground invasion of Syria whose primary objective would be the elimination of chemical weapons.

In the aftermath of the 21 August attack Obama ordered the Pentagon to draw up targets for bombing. Early in the process, the former intelligence official said, ‘the White House rejected 35 target sets provided by the joint chiefs of staff as being insufficiently “painful” to the Assad regime.’ The original targets included only military sites and nothing by way of civilian infrastructure. Under White House pressure, the US attack plan evolved into ‘a monster strike’: two wings of B-52 bombers were shifted to airbases close to Syria, and navy submarines and ships equipped with Tomahawk missiles were deployed. ‘Every day the target list was getting longer,’ the former intelligence official told me. ‘The Pentagon planners said we can’t use only Tomahawks to strike at Syria’s missile sites because their warheads are buried too far below ground, so the two B-52 air wings with two-thousand pound bombs were assigned to the mission. Then we’ll need standby search-and-rescue teams to recover downed pilots and drones for target selection. It became huge.’ The new target list was meant to ‘completely eradicate any military capabilities Assad had’, the former intelligence official said. The core targets included electric power grids, oil and gas depots, all known logistic and weapons depots, all known command and control facilities, and all known military and intelligence buildings.

Britain and France were both to play a part. On 29 August, the day Parliament voted against Cameron’s bid to join the intervention, the Guardian reported that he had already ordered six RAF Typhoon fighter jets to be deployed to Cyprus, and had volunteered a submarine capable of launching Tomahawk missiles. The French air force – a crucial player in the 2011 strikes on Libya – was deeply committed, according to an account in Le Nouvel Observateur; François Hollande had ordered several Rafale fighter-bombers to join the American assault. Their targets were reported to be in western Syria.

By the last days of August the president had given the Joint Chiefs a fixed deadline for the launch. ‘H hour was to begin no later than Monday morning [2 September], a massive assault to neutralise Assad,’ the former intelligence official said. So it was a surprise to many when during a speech in the White House Rose Garden on 31 August Obama said that the attack would be put on hold, and he would turn to Congress and put it to a vote.

At this stage, Obama’s premise – that only the Syrian army was capable of deploying sarin – was unravelling. Within a few days of the 21 August attack, the former intelligence official told me, Russian military intelligence operatives had recovered samples of the chemical agent from Ghouta. They analysed it and passed it on to British military intelligence; this was the material sent to Porton Down. (A spokesperson for Porton Down said: ‘Many of the samples analysed in the UK tested positive for the nerve agent sarin.’ MI6 said that it doesn’t comment on intelligence matters.)

The former intelligence official said the Russian who delivered the sample to the UK was ‘a good source – someone with access, knowledge and a record of being trustworthy’. After the first reported uses of chemical weapons in Syria last year, American and allied intelligence agencies ‘made an effort to find the answer as to what if anything, was used – and its source’, the former intelligence official said. ‘We use data exchanged as part of the Chemical Weapons Convention. The DIA’s baseline consisted of knowing the composition of each batch of Soviet-manufactured chemical weapons. But we didn’t know which batches the Assad government currently had in its arsenal. Within days of the Damascus incident we asked a source in the Syrian government to give us a list of the batches the government currently had. This is why we could confirm the difference so quickly.’

The process hadn’t worked as smoothly in the spring, the former intelligence official said, because the studies done by Western intelligence ‘were inconclusive as to the type of gas it was. The word “sarin” didn’t come up. There was a great deal of discussion about this, but since no one could conclude what gas it was, you could not say that Assad had crossed the president’s red line.’ By 21 August, the former intelligence official went on, ‘the Syrian opposition clearly had learned from this and announced that “sarin” from the Syrian army had been used, before any analysis could be made, and the press and White House jumped at it. Since it now was sarin, “It had to be Assad.”’

The UK defence staff who relayed the Porton Down findings to the joint chiefs were sending the Americans a message, the former intelligence official said: ‘We’re being set up here.’ (This account made sense of a terse message a senior official in the CIA sent in late August: ‘It was not the result of the current regime. UK & US know this.’) By then the attack was a few days away and American, British and French planes, ships and submarines were at the ready.

The officer ultimately responsible for the planning and execution of the attack was General Martin Dempsey, chairman of the joint chiefs. From the beginning of the crisis, the former intelligence official said, the joint chiefs had been sceptical of the administration’s argument that it had the facts to back up its belief in Assad’s guilt. They pressed the DIA and other agencies for more substantial evidence. ‘There was no way they thought Syria would use nerve gas at that stage, because Assad was winning the war,’ the former intelligence official said. Dempsey had irritated many in the Obama administration by repeatedly warning Congress over the summer of the danger of American military involvement in Syria. Last April, after an optimistic assessment of rebel progress by the secretary of state, John Kerry, in front of the House Foreign Affairs Committee, Dempsey told the Senate Armed Services Committee that ‘there’s a risk that this conflict has become stalemated.’

Dempsey’s initial view after 21 August was that a US strike on Syria – under the assumption that the Assad government was responsible for the sarin attack – would be a military blunder, the former intelligence official said. The Porton Down report caused the joint chiefs to go to the president with a more serious worry: that the attack sought by the White House would be an unjustified act of aggression. It was the joint chiefs who led Obama to change course. The official White House explanation for the turnabout – the story the press corps told – was that the president, during a walk in the Rose Garden with Denis McDonough, his chief of staff, suddenly decided to seek approval for the strike from a bitterly divided Congress with which he’d been in conflict for years. The former Defense Department official told me that the White House provided a different explanation to members of the civilian leadership of the Pentagon: the bombing had been called off because there was intelligence ‘that the Middle East would go up in smoke’ if it was carried out.

The president’s decision to go to Congress was initially seen by senior aides in the White House, the former intelligence official said, as a replay of George W. Bush’s gambit in the autumn of 2002 before the invasion of Iraq: ‘When it became clear that there were no WMD in Iraq, Congress, which had endorsed the Iraqi war, and the White House both shared the blame and repeatedly cited faulty intelligence. If the current Congress were to vote to endorse the strike, the White House could again have it both ways – wallop Syria with a massive attack and validate the president’s red line commitment, while also being able to share the blame with Congress if it came out that the Syrian military wasn’t behind the attack.’ The turnabout came as a surprise even to the Democratic leadership in Congress. In September the Wall Street Journal reported that three days before his Rose Garden speech Obama had telephoned Nancy Pelosi, leader of the House Democrats, ‘to talk through the options’. She later told colleagues, according to the Journal, that she hadn’t asked the president to put the bombing to a congressional vote.

bama’s move for congressional approval quickly became a dead end. ‘Congress was not going to let this go by,’ the former intelligence official said. ‘Congress made it known that, unlike the authorisation for the Iraq war, there would be substantive hearings.’ At this point, there was a sense of desperation in the White House, the former intelligence official said. ‘And so out comes Plan B. Call off the bombing strike and Assad would agree to unilaterally sign the chemical warfare treaty and agree to the destruction of all of chemical weapons under UN supervision.’ At a press conference in London on 9 September, Kerry was still talking about intervention: ‘The risk of not acting is greater than the risk of acting.’ But when a reporter asked if there was anything Assad could do to stop the bombing, Kerry said: ‘Sure. He could turn over every single bit of his chemical weapons to the international community in the next week … But he isn’t about to do it, and it can’t be done, obviously.’ As the New York Times reported the next day, the Russian-brokered deal that emerged shortly afterwards had first been discussed by Obama and Putin in the summer of 2012. Although the strike plans were shelved, the administration didn’t change its public assessment of the justification for going to war. ‘There is zero tolerance at that level for the existence of error,’ the former intelligence official said of the senior officials in the White House. ‘They could not afford to say: “We were wrong.”’ (The DNI spokesperson said: ‘The Assad regime, and only the Assad regime, could have been responsible for the chemical weapons attack that took place on 21 August.’)

*The full extent of US co-operation with Turkey, Saudi Arabia and Qatar in assisting the rebel opposition in Syria has yet to come to light. The Obama administration has never publicly admitted to its role in creating what the CIA calls a ‘rat line’, a back channel highway into Syria. The rat line, authorised in early 2012, was used to funnel weapons and ammunition from Libya via southern Turkey and across the Syrian border to the opposition. Many of those in Syria who ultimately received the weapons were jihadists, some of them affiliated with al-Qaida. (The DNI spokesperson said: ‘The idea that the United States was providing weapons from Libya to anyone is false.’)

In January, the Senate Intelligence Committee released a report on the assault by a local militia in September 2012 on the American consulate and a nearby undercover CIA facility in Benghazi, which resulted in the death of the US ambassador, Christopher Stevens, and three others. The report’s criticism of the State Department for not providing adequate security at the consulate, and of the intelligence community for not alerting the US military to the presence of a CIA outpost in the area, received front-page coverage and revived animosities in Washington, with Republicans accusing Obama and Hillary Clinton of a cover-up. A highly classified annex to the report, not made public, described a secret agreement reached in early 2012 between the Obama and Erdoğan administrations. It pertained to the rat line. By the terms of the agreement, funding came from Turkey, as well as Saudi Arabia and Qatar; the CIA, with the support of MI6, was responsible for getting arms from Gaddafi’s arsenals into Syria. A number of front companies were set up in Libya, some under the cover of Australian entities. Retired American soldiers, who didn’t always know who was really employing them, were hired to manage procurement and shipping. The operation was run by David Petraeus, the CIA director who would soon resign when it became known he was having an affair with his biographer. (A spokesperson for Petraeus denied the operation ever took place.)

The operation had not been disclosed at the time it was set up to the congressional intelligence committees and the congressional leadership, as required by law since the 1970s. The involvement of MI6 enabled the CIA to evade the law by classifying the mission as a liaison operation. The former intelligence official explained that for years there has been a recognised exception in the law that permits the CIA not to report liaison activity to Congress, which would otherwise be owed a finding. (All proposed CIA covert operations must be described in a written document, known as a ‘finding’, submitted to the senior leadership of Congress for approval.) Distribution of the annex was limited to the staff aides who wrote the report and to the eight ranking members of Congress – the Democratic and Republican leaders of the House and Senate, and the Democratic and Republicans leaders on the House and Senate intelligence committees. This hardly constituted a genuine attempt at oversight: the eight leaders are not known to gather together to raise questions or discuss the secret information they receive.

The annex didn’t tell the whole story of what happened in Benghazi before the attack, nor did it explain why the American consulate was attacked. ‘The consulate’s only mission was to provide cover for the moving of arms,’ the former intelligence official, who has read the annex, said. ‘It had no real political role.’

Washington abruptly ended the CIA’s role in the transfer of arms from Libya after the attack on the consulate, but the rat line kept going. ‘The United States was no longer in control of what the Turks were relaying to the jihadists,’ the former intelligence official said. Within weeks, as many as forty portable surface-to-air missile launchers, commonly known as manpads, were in the hands of Syrian rebels. On 28 November 2012, Joby Warrick of the Washington Post reported that the previous day rebels near Aleppo had used what was almost certainly a manpad to shoot down a Syrian transport helicopter. ‘The Obama administration,’ Warrick wrote, ‘has steadfastly opposed arming Syrian opposition forces with such missiles, warning that the weapons could fall into the hands of terrorists and be used to shoot down commercial aircraft.’ Two Middle Eastern intelligence officials fingered Qatar as the source, and a former US intelligence analyst speculated that the manpads could have been obtained from Syrian military outposts overrun by the rebels. There was no indication that the rebels’ possession of manpads was likely the unintended consequence of a covert US programme that was no longer under US control.

By the end of 2012, it was believed throughout the American intelligence community that the rebels were losing the war. ‘Erdoğan was pissed,’ the former intelligence official said, ‘and felt he was left hanging on the vine. It was his money and the cut-off was seen as a betrayal.’ In spring 2013 US intelligence learned that the Turkish government – through elements of the MIT, its national intelligence agency, and the Gendarmerie, a militarised law-enforcement organisation – was working directly with al-Nusra and its allies to develop a chemical warfare capability. ‘The MIT was running the political liaison with the rebels, and the Gendarmerie handled military logistics, on-the-scene advice and training – including training in chemical warfare,’ the former intelligence official said. ‘Stepping up Turkey’s role in spring 2013 was seen as the key to its problems there. Erdoğan knew that if he stopped his support of the jihadists it would be all over. The Saudis could not support the war because of logistics – the distances involved and the difficulty of moving weapons and supplies. Erdoğan’s hope was to instigate an event that would force the US to cross the red line. But Obama didn’t respond in March and April.’

There was no public sign of discord when Erdoğan and Obama met on 16 May 2013 at the White House. At a later press conference Obama said that they had agreed that Assad ‘needs to go’. Asked whether he thought Syria had crossed the red line, Obama acknowledged that there was evidence such weapons had been used, but added, ‘it is important for us to make sure that we’re able to get more specific information about what exactly is happening there.’ The red line was still intact.

The foreign policy expert told me that the account he heard originated with Donilon. (It was later corroborated by a former US official, who learned of it from a senior Turkish diplomat.) According to the expert, Erdoğan had sought the meeting to demonstrate to Obama that the red line had been crossed, and had brought Fidan along to state the case. When Erdoğan tried to draw Fidan into the conversation, and Fidan began speaking, Obama cut him off and said: ‘We know.’ Erdoğan tried to bring Fidan in a second time, and Obama again cut him off and said: ‘We know.’ At that point, an exasperated Erdoğan said, ‘But your red line has been crossed!’ and, the expert told me, ‘Donilon said Erdoğan “fucking waved his finger at the president inside the White House”.’ Obama then pointed at Fidan and said: ‘We know what you’re doing with the radicals in Syria.’ (Donilon, who joined the Council on Foreign Relations last July, didn’t respond to questions about this story. The Turkish Foreign Ministry didn’t respond to questions about the dinner. A spokesperson for the National Security Council confirmed that the dinner took place and provided a photograph showing Obama, Kerry, Donilon, Erdoğan, Fidan and Davutoğlu sitting at a table. ‘Beyond that,’ she said, ‘I’m not going to read out the details of their discussions.’)

But Erdoğan did not leave empty handed. Obama was still permitting Turkey to continue to exploit a loophole in a presidential executive order prohibiting the export of gold to Iran, part of the US sanctions regime against the country. In March 2012, responding to sanctions of Iranian banks by the EU, the SWIFT electronic payment system, which facilitates cross-border payments, expelled dozens of Iranian financial institutions, severely restricting the country’s ability to conduct international trade. The US followed with the executive order in July, but left what came to be known as a ‘golden loophole’: gold shipments to private Iranian entities could continue. Turkey is a major purchaser of Iranian oil and gas, and it took advantage of the loophole by depositing its energy payments in Turkish lira in an Iranian account in Turkey; these funds were then used to purchase Turkish gold for export to confederates in Iran. Gold to the value of $13 billion reportedly entered Iran in this way between March 2012 and July 2013.

The programme quickly became a cash cow for corrupt politicians and traders in Turkey, Iran and the United Arab Emirates. ‘The middlemen did what they always do,’ the former intelligence official said. ‘Take 15 per cent. The CIA had estimated that there was as much as two billion dollars in skim. Gold and Turkish lira were sticking to fingers.’ The illicit skimming flared into a public ‘gas for gold’ scandal in Turkey in December, and resulted in charges against two dozen people, including prominent businessmen and relatives of government officials, as well as the resignations of three ministers, one of whom called for Erdoğan to resign. The chief executive of a Turkish state-controlled bank that was in the middle of the scandal insisted that more than $4.5 million in cash found by police in shoeboxes during a search of his home was for charitable donations.

Late last year Jonathan Schanzer and Mark Dubowitz reported in Foreign Policy that the Obama administration closed the golden loophole in January 2013, but ‘lobbied to make sure the legislation … did not take effect for six months’. They speculated that the administration wanted to use the delay as an incentive to bring Iran to the bargaining table over its nuclear programme, or to placate its Turkish ally in the Syrian civil war. The delay permitted Iran to ‘accrue billions of dollars more in gold, further undermining the sanctions regime’.*

The American decision to end CIA support of the weapons shipments into Syria left Erdoğan exposed politically and militarily. ‘One of the issues at that May summit was the fact that Turkey is the only avenue to supply the rebels in Syria,’ the former intelligence official said. ‘It can’t come through Jordan because the terrain in the south is wide open and the Syrians are all over it. And it can’t come through the valleys and hills of Lebanon – you can’t be sure who you’d meet on the other side.’ Without US military support for the rebels, the former intelligence official said, ‘Erdoğan’s dream of having a client state in Syria is evaporating and he thinks we’re the reason why. When Syria wins the war, he knows the rebels are just as likely to turn on him – where else can they go? So now he will have thousands of radicals in his backyard.’

A US intelligence consultant told me that a few weeks before 21 August he saw a highly classified briefing prepared for Dempsey and the defense secretary, Chuck Hagel, which described ‘the acute anxiety’ of the Erdoğan administration about the rebels’ dwindling prospects. The analysis warned that the Turkish leadership had expressed ‘the need to do something that would precipitate a US military response’. By late summer, the Syrian army still had the advantage over the rebels, the former intelligence official said, and only American air power could turn the tide. In the autumn, the former intelligence official went on, the US intelligence analysts who kept working on the events of 21 August ‘sensed that Syria had not done the gas attack. But the 500 pound gorilla was, how did it happen? The immediate suspect was the Turks, because they had all the pieces to make it happen.’

As intercepts and other data related to the 21 August attacks were gathered, the intelligence community saw evidence to support its suspicions. ‘We now know it was a covert action planned by Erdoğan’s people to push Obama over the red line,’ the former intelligence official said. ‘They had to escalate to a gas attack in or near Damascus when the UN inspectors’ – who arrived in Damascus on 18 August to investigate the earlier use of gas – ‘were there. The deal was to do something spectacular. Our senior military officers have been told by the DIA and other intelligence assets that the sarin was supplied through Turkey – that it could only have gotten there with Turkish support. The Turks also provided the training in producing the sarin and handling it.’ Much of the support for that assessment came from the Turks themselves, via intercepted conversations in the immediate aftermath of the attack. ‘Principal evidence came from the Turkish post-attack joy and back-slapping in numerous intercepts. Operations are always so super-secret in the planning but that all flies out the window when it comes to crowing afterwards. There is no greater vulnerability than in the perpetrators claiming credit for success.’ Erdoğan’s problems in Syria would soon be over: ‘Off goes the gas and Obama will say red line and America is going to attack Syria, or at least that was the idea. But it did not work out that way.’

The post-attack intelligence on Turkey did not make its way to the White House. ‘Nobody wants to talk about all this,’ the former intelligence official told me. ‘There is great reluctance to contradict the president, although no all-source intelligence community analysis supported his leap to convict. There has not been one single piece of additional evidence of Syrian involvement in the sarin attack produced by the White House since the bombing raid was called off. My government can’t say anything because we have acted so irresponsibly. And since we blamed Assad, we can’t go back and blame Erdoğan.’

Barring a major change in policy by Obama, Turkey’s meddling in the Syrian civil war is likely to go on. ‘I asked my colleagues if there was any way to stop Erdoğan’s continued support for the rebels, especially now that it’s going so wrong,’ the former intelligence official told me. ‘The answer was: “We’re screwed.” We could go public if it was somebody other than Erdoğan, but Turkey is a special case. They’re a Nato ally. The Turks don’t trust the West. They can’t live with us if we take any active role against Turkish interests. If we went public with what we know about Erdoğan’s role with the gas, it’d be disastrous. The Turks would say: “We hate you for telling us what we can and can’t do.”’

4 April

https://www.lrb.co.uk/v36/n08/seymour-m-hersh/the-red-line-and-the-rat-line

Ghouta chemical attack

From Wikipedia, the free encyclopedia
Ghouta chemical attack
Part of the Syrian Civil War
Ghouta massacre1.JPG

Some of the victims of the Ghouta chemical attack
Location Ghouta, Syria
Coordinates Eastern Ghouta: within 750 meters (2,460 ft) from[1]
33.5238301°N 36.3566995°E
Western Ghouta: within 500 meters (1,600 ft) from[1]
33.4602966°N 36.1972287°E
Date 21 August 2013[2]
Attack type
Chemical attack
Deaths Various estimates:
at least 281 (French intelligence)[3]
at least 350 (UK intelligence)[4]
355 (MSF)[5]
494 (Damascus Media Office)[6]
502 (SOHR)[7]
635 (SRGC)[8]
923 (VDC)[9]
1,300 (SNC)[10]
1,338 (LCC)[11]
1,429 (United States)[12][13]
1,729 (FSA)[14]
Non-fatal injuries
3,600 patients displaying neurotoxic symptoms in 3 hospitals supported by MSF[5]
Perpetrators Unknown

The Ghouta chemical attack occurred in Ghouta, Syria, during the Syrian Civil War in the early hours of 21 August 2013. Two opposition-controlled areas in the suburbs around Damascus, Syria were struck by rockets containing the chemical agent sarin. Estimates of the death toll range from at least 281 people[3] to 1,729.[14] The attack was the deadliest use of chemical weapons since the Iran–Iraq War.[15][16][17]

Inspectors from the United Nations Mission already in Syria to investigate an earlier alleged chemical weapons attack,[18](p6)[19] requested access to sites in Ghouta the day after the attack,[20][21][22][22][23][24] and called for a ceasefire to allow inspectors to visit the Ghouta sites.[20] The Syrian government granted the UN’s request on 25 August,[25][26][27] and inspectors visited and investigated Moadamiyah in Western Ghouta the next day, and Zamalka and Ein Tarma in Eastern Ghouta on 28 and 29 August.[18](p6)[28][29]

The UN investigation team confirmed “clear and convincing evidence” of the use of sarin delivered by surface-to-surface rockets,[18][30] and a 2014 report by the UN Human Rights Council found that “significant quantities of sarin were used in a well-planned indiscriminate attack targeting civilian-inhabited areas, causing mass casualties. The evidence available concerning the nature, quality and quantity of the agents used on 21 August indicated that the perpetrators likely had access to the chemical weapons stockpile of the Syrian military, as well as the expertise and equipment necessary to manipulate safely large amount of chemical agents.”[31] It also stated that the chemical agents used in the Khan al-Assal chemical attack “bore the same unique hallmarks as those used in Al-Ghouta.”[32][31][33]

The Syrian opposition,[34] as well as many governments, the Arab League and the European Union[35][36][37] stated the attack was carried out by forces of Syrian President Bashar al-Assad.[38] The Syrian and Russian governments blamed the opposition for the attack,[34] the Russian government calling the attack a false flag operation by the opposition to draw foreign powers into the civil war on the rebels’ side.[39]Åke Sellström, the leader of the UN Mission, characterized government explanations of rebel chemical weapons acquisition as unconvincing, resting in part upon “poor theories.”[40]

Several countries including France, the United Kingdom, and the United States debated whether to intervene militarily against Syrian government forces.[41][42][43][44] On 6 September 2013, the United States Senate filed a resolution to authorize use of military force against the Syrian military in response to the Ghouta attack.[45] On 10 September 2013, the military intervention was averted when the Syrian government accepted a US–Russian negotiated deal to turn over “every single bit” of its chemical weapons stockpiles for destruction and declared its intention to join the Chemical Weapons Convention.[46][47]

Background

The Ghouta area is composed of densely populated suburbs to the east and south of Damascus, part of the province of Rif Dimashq.[48] Ghouta is a primarily conservative Sunni region.[49] Since early in the civil war, civilians in rebel-held Eastern Ghouta have almost entirely sided with the opposition to Syria’s government.[50][51] The opposition has controlled much of Eastern Ghouta since 2012, partly cutting off Damascus from the countryside.[48]Muadamiyat al-Sham in Western Ghouta had been under government siege since April 2013.[52] Ghouta had been the scene of continuing clashes for more than a year before the chemical attack, with government forces launching repeated missile assaults trying to dislodge the rebels. The week of the attack, the Syrian government launched an offensive to capture opposition-held Damascus suburbs.[51]

The attack came one year and one day after US President Barack Obama‘s 20 August 2012 “red line” remarks, in which he warned: “We have been very clear to the Assad regime, but also to other players on the ground, that a red line for us is we start seeing a whole bunch of chemical weapons moving around or being utilized. That would change my calculus. That would change my equation.”[53][54][55] Syria was one of five non-signatories to the 1997 Chemical Weapons Convention at the time. After the “red line” remarks, and before the chemical attack in Ghouta, chemical weapons were suspected to have been used in four attacks in the country.[56]

Khan al-Assal chemical attack

The Khan al-Assal chemical attack occurred on 19 March 2013, when a government-controlled area of Khan al-Asal, a district of Aleppo in northern Syria, was struck by a rocket containing the nerve agent sarin. According to the Syrian Observatory for Human Rights the attack resulted in at least 26 fatalities, including 16 government soldiers and 10 civilians.[57] The Syrian government later reported to the United Nations that one soldier and 19 civilians died and that 17 soldiers and 107 civilians were injured.[2](p32) A medic at the local civilian hospital said he personally had witnessed Syrian army soldiers helping the wounded and dealing with fatalities at the scene.[58]

The sarin used in the Khan al-Assal attack “bore the same unique hallmarks” as the sarin used in the Ghouta attack.[32][31](p19)

Independent International Commission of Inquiry

The United Nations Human Rights Council established the Independent International Commission of Inquiry on the Syrian Arab Republic on 22 August 2011 to investigate human rights violations during the Syrian civil war. One of the topics the commission investigated was possible use of chemical weapons. In early June 2013, the Fifth Report of the Commission of Inquiry stated that there were reasonable grounds to believe that limited amounts of toxic chemicals were used in four attacks, but more evidence was needed “to determine the precise chemical agents used, their delivery systems or the perpetrator.”[59](p21)[60][61] On 22 June, the head of the Commission of Inquiry, Paulo Pinheiro, said the UN could not determine who used chemical weapons in Syria based on evidence sent by the United States, Britain and France.[62]

Assessments prior to the attack

US assessment

US Secretary of Defense Chuck Hagel stated on 25 April that US intelligence showed the Assad government had likely used sarin on a small scale.[63] However, the White House announced that “much more” work had to be done to verify the intelligence assessments.[64]

On 13 June 2013, the United States government publicly announced it had concluded that the Assad government had used limited amounts of chemical weapons on multiple occasions against rebel forces, killing 100 to 150 people. US officials stated that sarin was the agent used.[65] Deputy National Security Advisor Ben Rhodes did not say whether this showed that Syria had crossed the “red line” established by President Obama in August 2012. Rhodes stated: “The president has said that the use of chemical weapons would change his calculus, and it has.”[66] The French government announced that its own tests confirmed US assertions.[67]

Russian assessment

Russian Foreign Minister Sergei Lavrov said “the accusations of Damascus using chemical weapons put forth by the USA are not backed by credible facts.”[68] Lavrov further stated that the Syrian government had no motive to use chemical weapons since the government already maintained a military advantage over the rebel fighters.[69]

Attacks

The attacks affected two separate opposition-controlled districts in the Damascus suburbs, located 16 kilometres apart.[1](p1)

Eastern Ghouta attack

The first attack took place around 2:30 a.m. on 21 August 2013[70][71] in Eastern Ghouta, a rebel-held suburb to the east of Damascus.[72] The area was on a rebel weapons supply route from Jordan and had been under siege by the Syrian military and Hezbollah for months.[73][74]

At least 8, and possibly 12, rockets struck within a 1500 by 500 meter area in the Zamalka and nearby Ein Tarma neighborhoods.[note 1] The rockets were all of the same improvised type, each with an estimated capacity to carry 50–60 liters (11–13 imp gal; 13–16 U.S. gal) of sarin.[1](p9)[18](p24) The rocket engine was similar in type and parameters to a 122 mm GRAD unguided surface-to-surface rocket, while the chemical warhead and the stabilization fin was of an artisan-type.[1][75] One (or both) of the labs examining the environmental samples taken from Zamalka (and Ein Tarma[18](pp28–29)) found at least traces of sarin in 14 of the 17 cases.[2](pp45–49) One of the labs described the sarin level as a “high level concentration” in 4 of the 17 samples.[2](pp45–49)

Western Ghouta attack

The second attack took place in the Western Ghouta area around 5:00 in the morning on 21 August. On 22 August, a witness who works for Moadamiya media center said he had counted seven rockets that fell in two areas of Moadamiya during the early morning of 21 August. He said four rockets hit next to the Rawda Mosque and another three in the area between Qahweh Street and Zeytouneh Street, which he said was approximately 500 meters to the east of the Rawda Mosque. He said all the rockets were of the same type.[1]

While no chemical warhead was ever found in the Western Ghouta area, one rocket engine has been identified as a 140mm M-14 unguided surface-to-surface rocket. This type of rocket can be fitted with three types of warheads: high explosive-fragmentation, white phosphorus smoke, or a chemical warhead containing 2 liters (0.44 imp gal; 0.53 U.S. gal) of sarin.[1](p5) None of the 13 environmental samples taken from Western Ghouta tested positive for sarin, although three had “degradation and/or by-products.”[2](pp43–45)

Chemical weapons capability

At the time of the attack, Syria was not a party to the Chemical Weapons Convention,[76] which prohibits the development, production, stockpiling, transfer and use of chemical weapons, although in 1968 it acceded to the 1925 Geneva Protocol for the Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases. In 2012 Syria publicly stated it possessed chemical and biological weapons and would use them if it faced a foreign attack.[77]

According to French intelligence, the Syrian Scientific Studies and Research Center (SSRC) is responsible for producing toxic agents for use in war. A group named “Branch 450” is allegedly responsible for filling munitions with chemicals and maintaining security of the chemical agent stockpiles.[78] As of September 2013, French intelligence estimated the Syrian stockpile at 1,000 tonnes, including Yperite, VX and “several hundred tonnes of sarin.”[78]

The UK’s Joint Intelligence Committee publicly dismissed the possibility of rebel responsibility for the attack in Ghouta, stating that rebels are incapable of an attack of its scale.[79] The Committee stated that “there is no credible intelligence or evidence to substantiate the claims or the possession of CW by the opposition.”[80]

Åke Sellström, a Swedish scientist who led the UN mission to investigate the attacks, said it was difficult to see how rebels could have weaponized the toxins,[81] but admitted that he didn’t know who the perpetrator was.[40]According to the Associated Press, “chemical and biological weapons experts have been relatively consistent in their analysis, saying only a military force with access to and knowledge of missile delivery systems and the sarin gas suspected in Ghouta could have carried out an attack capable of killing hundreds of people.”[82]

Initial claims

Both the opposition and the Syrian government said a chemical attack was carried out in the suburbs around Damascus on 21 August 2013. Anti-government activists said the Syrian government was to blame for the attack, while the Syrian government said foreign fighters and their international backers were to blame.[71][83]

Opposition claims

On the day of the attack, George Sabra, the head of the Syrian National Council, said 1,300 people had been killed as shells loaded with poisonous gas rained down on the capital’s eastern suburbs of Douma, Jobar, Zamalka, Arbeen and Ein Tarma.[84] A spokesman for the Free Syrian Army’s Supreme Military Council, Qassim Saadeddine, said, “people are growing desperate as they watch another round of political statements and UN meetings without any hope of action.”[72]Ahmad Jarba, who was the president of the Syrian National Coalition at the time of the attack, called on the UN investigators to travel to “the site of the massacre” and for an urgent United Nations Security Council meeting on the subject.[10] The Syrian Observatory for Human Rights said the attack was committed by the Syrian regime and called on Ban Ki-moon, Secretary-General of the United Nations, “to apply all pressure within his powers to pressure the Syrian regime.”[85][86]

The next day, a spokesman for the Syrian National Coalition, Khaled al-Saleh, said at least six doctors died after treating victims, and that they didn’t yet have the number of dead first responders.[87]

Government claims

Syria’s Deputy Prime Minister for Economic Affairs, Qadri Jamil, said foreign fighters and their international backers were to blame for the attack.[83] Syrian state television, SANA, said the accusations were fabricated to distract a team of UN chemical weapons experts which had arrived three days before the attacks.[6] Syrian President Bashar al-Assad said the claims that his government had used chemical weapons would go against elementary logic and that “accusations of this kind are entirely political.”[88][89]

UN investigation

On 19 March 2013, the Syrian government reported to the UN Security Council that the rebels had fired a rocket containing chemical materials into a government controlled part of Khan al-Asal, a district of Aleppo in northern Syria,[90] and requested a UN mission to investigate it.[91][92] As a response, the UN Secretary-General Ban Ki-moon created the “United Nations Mission to Investigate Alleged Uses of Chemical Weapons in the Syrian Arab Republic.”[92][93] The Syrian government first refused to allow the UN mission to be expanded to places outside Khan al-Assal,[94] but agreed in July 2013 to also allow investigation of the alleged attack in Sheikh Maqsood on 13 April 2013 and the alleged attack in Saraqib on 29 April 2013.[95][2](p7)

On 23 April 2013, the New York Times reported that the British and French governments had sent a confidential letter to the UN Secretary-General, stating there was evidence that the Syrian government had used chemical weapons in Aleppo, Homs and perhaps Damascus. Israel also claimed that the Syrian government had used chemical weapons on 19 March near Aleppo and Damascus.[96] On 24 April, Syria blocked UN investigators from entering Syria, while UN Under-Secretary for Political Affairs Jeffrey Feltman said this would not prevent an inquiry from being carried out.[97]

On 18 August 2013, three days before the Ghouta attack, a UN mission headed by Åke Sellström[18] arrived in Damascus with permission from the Syrian government to investigate earlier alleged chemical weapons use.[98] On the day of the attack, UN Secretary-General Ban Ki-moon expressed “the need to investigate [the Ghouta incident as] soon as possible,” hoping for consent from the Syrian government.[98] The next day, UN High Commissioner for Human Rights Navi Pillay urged government and opposition forces to allow an investigation[99] and Ban requested the government provide immediate access.[25][100] On 23 August, clashes between rebel and government forces continued in and around Ghouta, government shelling continued and UN inspectors were denied access for a second day.[22][24]White House officials were convinced that the Syrian government was trying to hide the evidence of chemical weapons use by shelling the sites and delaying their inspection.[25] Ban called for a ceasefire to allow the inspectors to visit the attack sites.[20] On 25 August the government and various rebel factions agreed to a ceasefire for five hours each day from 26 to 29 August.[101][102]

Early in the morning of 26 August several mortars hit central Damascus, including one that fell near the Four Seasons Hotel where the UN inspectors were staying.[103] Later in the day the UN team came under sniper fire en route to Moadamiyah in western Ghouta (to the southwest of central Damascus), forcing them to return to their hotel and replace one of their vehicles before continuing their investigation four hours later.[104][105] The attack prompted a rebuke from Ban toward the fighters.[106][107] After returning to Moadamiyah the UN team visited clinics and makeshift field hospitals, collected samples and conducted interviews with witnesses, survivors and doctors.[104] The inspectors spoke with 20 victims of the attacks and took blood and hair samples, soil samples, and samples from domestic animals.[107] As a result of the delay caused by the sniper attack, the team’s time in Moadamiyah was substantially shortened, with the scheduled expiry of the daily cease-fire leaving them around 90 minutes on the ground.[102][107][108]

On 28 and 29 August the UN team visited Zamalka and Ein Tarma in Eastern Ghouta, east of central Damascus, for a total time of five-and-a-half hours.[18](p6) On 30 August the team visited a Syrian government military hospital in Mazzeh and collected samples.[109] The mission left Syria early on August 31,[110] promising to return to complete the original objective to investigate the previously alleged attack sites. The Syrian government wanted the mission to stay and investigate them at that time.[111]

UN Ghouta Area report

The UN report on the investigation into the Ghouta chemical attacks was published on 16 September 2013. The report stated: “the environmental, chemical and medical samples we have collected provide clear and convincing evidence that surface-to-surface rockets containing the nerve agent sarin were used in Ein Tarma, Moadamiyah and Zamalka in the Ghouta area of Damascus.”[18](p8)[30] UN Secretary-General Ban Ki-moon called the findings “beyond doubt and beyond the pale,” and clear evidence of a war crime. “The results are overwhelming and indisputable,” he said. Ban stated a majority of the blood samples, environmental samples and rockets or rocket fragments recovered tested positive for sarin.[112] The report, which was “careful not to blame either side,” said that during the mission’s work in areas under rebel control, “individuals arrived carrying other suspected munitions indicating that such potential evidence is being moved and possibly manipulated.”[113] The UN investigators were accompanied by a rebel leader:

A leader of the local opposition forces … was identified and requested to take ‘custody’ of the Mission … to ensure the security and movement of the Mission, to facilitate the access to the most critical cases/witnesses to be interviewed and sampled by the Mission and to control patients and crowd in order for the Mission to focus on its main activities.[18](p13)

The British UN Ambassador stated that the report’s lead author, Åke Sellström, said the quality of the sarin used in the attack was higher than that used by Iraq in the Iran-Iraq war,[114] implying a purity higher than the Iraqi chemical weapons program‘s low purity of 45–60%.[115] (By comparison, Aum Shinrikyo used nearly pure sarin in the 1994 Matsumoto incident.[116])

Responses

According to Human Rights Watch, hundreds of kilograms of sarin were used in the attack, which it said suggested government responsibility, as opposition forces were not known to possess significant amounts of sarin.[117]

The Russian government dismissed the initial UN report after it was released, calling it “one-sided” and “distorted.”[118] On 17 September, Russian Foreign Minister Sergei Lavrov reiterated his government’s belief that the opposition carried out the attacks as a “provocation.”[119] The United Nations High Representative for Disarmament Affairs Angela Kane said the inspection team would review Russia’s objections.[111]

An August 2013 Scientific American article described difficulties that could arise when attempting to identify the manufacturer of sarin from soil or tissue samples.[120]

An Iranian chemical weapons expert, Abbas Foroutan, said in October 2013 that the UN should publish more details about the investigation than were provided in the report, including victims’ pulse rates and blood pressure and their response to the atropine treatment, the victims’ levels of acetylcholinesterase (sarin is an acetylcholinesterase inhibitor) and more technical details on the lab testing process.[121][122]

Final UN Mission report

The UN inspection team returned to Syria to continue investigations into other alleged chemical attacks in late September 2013. A final report on Ghouta and six other alleged attacks (including three alleged to have occurred after the Ghouta attack) was released in December 2013.[111] The inspectors wrote that they “collected clear and convincing evidence that chemical weapons were used also against civilians, including children, on a relatively large scale in the Ghouta area of Damascus on 21 August 2013.” The conclusion was based on:

  • Impacted and exploded surface-to-surface rockets, capable to carry a chemical payload, were found to contain sarin;
  • Close to the rocket impact sites, in the area where patients were affected, the environment was found to be contaminated by sarin;
  • The epidemiology of over fifty interviews given by survivors and health care workers provided ample corroboration of the medical and scientific results;
  • A number of patients/survivors were clearly diagnosed as intoxicated by an organophosphorous compound;
  • Blood and urine samples from the same patients were found positive for sarin and sarin signatures.[2](p19)

UN Human Rights Council report

The 7th Report of the Independent International Commission of Inquiry on the Syrian Arab Republic, a different group than the UN fact-finding mission, stated the sarin used in the Ghouta attack bore the “same unique hallmarks” as the sarin used in the Khan al-Assal attack. The report, dated 12 February 2014, also indicated that the perpetrators likely had access to the chemical weapons stockpile of the Syrian military. These conclusions were based on the fact-finding mission’s evidence, as the Commission of Inquiry did not conduct its own investigation of either chemical attack.[31]

Aftermath

The continuous fighting has severely limited the quality of medical care for injured survivors of the attack. A month after the attack, approximately 450 survivors still required medical attention for lingering symptoms such as respiratory and vision problems.[123] By early October 2013, the 13,000 residents of Moadhamiya, one of the places targeted in the August attack, had been surrounded by pro-government forces and under siege for five months. Severe malnourishment and medical emergencies become pressing as all supply lines had stopped.[124] Care for chronic symptoms of sarin exposure had become “just one among a sea of concerns.”[123]

As countries such as the United States and the United Kingdom debated their response to the attacks, they encountered significant popular and legislative resistance to military intervention. In particular, British Prime Minister David Cameron’s request to the House of Commons to use military force was declined by a 285–272 margin.[125][126] UK government policy subsequently focused on providing humanitarian assistance inside Syria and to refugees in neighboring countries.[127]

Within a month of the attacks, Syria agreed to join the Chemical Weapons Convention and allow all its stockpiles to be destroyed.[128]The destruction began under OPCW supervision on 6 October 2013.[129] On 23 June 2014, the last shipment of Syria’s declared chemical weapons was shipped out of the country for destruction.[130] By 18 August 2014, all toxic chemicals were destroyed aboard the US naval vessel MV Cape Ray.[131]

Nine months after the attack, there is evidence that mothers from the affected areas are giving birth to children with defects and as stillborn.[132][133]

Evidence

Witness statements and victim symptoms

Syrian human rights lawyer Razan Zaitouneh, who was present in Eastern Ghouta, stated, “Hours [after the shelling], we started to visit the medical points in Ghouta to where injured were removed, and we couldn’t believe our eyes. I haven’t seen such death in my whole life. People were lying on the ground in hallways, on roadsides, in hundreds.”[134] Several medics working in Ghouta reported the administration of large quantities of atropine, a common antidote for nerve agent toxicity, to treat victims.[135][136]

Doctors Without Borders said the three hospitals it supports in Eastern Ghouta reported receiving roughly 3,600 patients with “neurotoxic symptoms” over less than three hours during the early morning of 21 August. Of those, 355 died.[137] The Local Coordination Committees of Syria claimed that of the 1,338 victims, 1,000 were in Zamalka, of which 600 bodies were transferred to medical points in other towns and 400 remained at a Zamalka medical center.[11] Some of the fatalities were rebel fighters.[138] The deadliness of the attack is believed to have been increased due to civilians reacting to the chemical attack as if it was typical government bombardment. For conventional artillery and rocket attacks, residents usually went to the basements of buildings, where in this case the heavier-than-air sarin sank into these below-ground, poorly ventilated areas.[139] Some of the victims died while sleeping.[72]

Abu Omar of the Free Syrian Army told The Guardian that the rockets involved in the attack were unusual because “you could hear the sound of the rocket in the air but you could not hear any sound of explosion” and no obvious damage to buildings occurred.[140] Human Rights Watch’s witnesses reported “symptoms and delivery methods consistent with the use of chemical nerve agents.”[19] Activists and local residents contacted by The Guardian said that “the remains of 20 rockets [thought to have been carrying neurotoxic gas] were found in the affected areas. Many [remained] mostly intact, suggesting that they did not detonate on impact and potentially dispersed gas before hitting the ground.”[141]

Child frothing at the mouth.

A child in Ghouta froths from the mouth, a medical condition “associated with exposure to nerve agents such as Sarin.”[142][143]

Doctors Without Borders also reported seeing a “large number of victims arriving with symptoms including convulsions, excessive saliva, pinpoint pupils, blurred vision and respiratory distress.”[144] Symptoms reported by Ghouta residents and doctors to Human Rights Watch included “suffocation, muscle spasms and frothing at the mouth.”[19]

Witness statements to The Guardian about symptoms included “people who were sleeping in their homes [who] died in their beds,” headaches and nausea, “foam coming out of [victims’] mouths and noses,” a “smell something like vinegar and rotten eggs,” suffocation, “bodies [that] were turning blue,” a “smell like cooking gas” and redness and itching of the eyes.[140]Richard Spencer of The Telegraph summarised witness statements, stating, “The poison … may have killed hundreds, but it has left twitching, fainting, confused but compelling survivors.”[145]

On 22 August, the Center for Documentation of Violations in Syria published numerous testimonies. It summarised doctors’ and paramedics’ descriptions of the symptoms as “vomiting, foamy salivation, severe agitation, [pinpoint] pupils, redness of the eyes, dyspnea, neurological convulsions, respiratory and heart failure, blood out of the nose and mouth and, in some cases, hallucinations and memory loss”.[146]

Analysis of symptoms

Dr. Amesh Adalja, a senior associate for the Center for Biosecurity at the University of Pittsburgh Medical Center, said the reported symptoms are a textbook case of nerve-agent poisoning.[144]

Médecins Sans Frontières Director of Operations Bart Janssens stated that MSF “can neither scientifically confirm the cause of these symptoms nor establish who is responsible for the attack. However, the reported symptoms of the patients, in addition to the epidemiological pattern of the events – characterised by the massive influx of patients in a short period of time, the origin of the patients, and the contamination of medical and first aid workers – strongly indicate mass exposure to a neurotoxic agent.”[5]

Gwyn Winfield, Editorial Director at CBRNe World, analysed some videos from the day of the attack and wrote on the magazine’s website: “It is difficult to define [an] agent by the signs and symptoms. Clearly respiratory distress, some nerve spasms and a half hearted washdown (involving water and bare hands?!), but it could equally be a riot control agent as a [chemical warfare agent].”[147]

Rockets

A RPU-14 multiple rocket launcher, of a type that may have launched M-14 munitions found by UN inspectors on 26 August at a site in Moadamiyah.[148]

Human Rights Watch reported that two types of rockets were used: in Western Ghouta, a 140mm rocket made in the Soviet Union in 1967 and exported to Syria;[1](p5) and in Eastern Ghouta, a 330mm rocket of unknown origin.[1](p9) HRW also reported that at the time of the attack, Syrian rebels were not known to be in possession of the rockets used.[1](p20)[149]

Seymour Hersh has suggested that the 330mm rockets may have been produced locally, and with a limited range.[150] Blogger Eliot Higgins has looked at the munitions linked to the attack and analysed footage of the putative launchers inside government territory.[151]

According to a study published in January 2014 by Theodore Postol and Richard Lloyd, of the Massachusetts Institute of Technology, the rockets used in the attack had a range of about two kilometers, indicating the munitions could not have been fired from the ‘heart’ or from the Eastern edge of the Syrian Government Controlled Area shown in the Intelligence Map published by the White House on 30 August 2013.[75][152][153] A response from Higgins and Kaszeta included an observation that the Russian-language news site ANNA News had posted videos showing a Syrian government military operation running from June to August 2013 to clear positions between Jobar and Qaboun, a strip of land about 2 km away from the 21 August impact sites.[154] MIT Professor Theodore Postol contacted Dan Kaszeta and asked him how he came to the conclusion that Hexamine was the “smoking gun” regarding the alleged culpability of the Syrian Government. Åke Sellström told Postol that indeed “the presence of hexamine may mean that this substance was used as scavenger for protons when producing sarin” but that it was a common substance and not conclusive evidence implicating the Syrian government.[155]

Many of the munitions and their fragments had been moved; however, in two cases, the UN could identify the likely launch azimuths.[156] Triangulating rocket trajectories suggests that the origin of the attack may have been within government or rebel-held territory. Consideration of missile ranges influences calculations as to whether rockets originated from the government or rebel-held regions.[150][157]

Communications

Two purported intercepts of communications that appeared to implicate the Syrian government received prominent media coverage. One was a phone call allegedly between Syrian officials which Israel’s Unit 8200 was said to have intercepted and passed to the US.[158] The other was a phone call which the German Bundesnachrichtendienst said it had intercepted, between a high-ranking representative of Hezbollah and the Iranian embassy, in which the purported Hezbollah official said that poison gas had been used and that Assad’s order to attack with chemical weapons had been a strategic error.[159][160]

On 29 August the Associated Press reported that, according to two U.S. intelligence officials and two other U.S. officials, the U.S. intercept was a conversation between “low-level” Syrian officials with no direct link to the upper echelons of the government or military.[161]

The Bild am Sonntag newspaper subsequently reported that German intelligence indicated that Assad had likely not ordered the attacks.[162] According to Bild, “intelligence interception specialists” relying on communications intercepted by the German vessel Oker said that Syrian military commanders had repeatedly been asking permission to launch chemical attacks for around four months, with permission always being denied from the presidential palace. The sources concluded that 21 August attack had probably not been approved by Bashar al-Assad.[162][163][164]

Video

Murad Abu Bilal, Khaled Naddaf and other Center for Documentation of Violations in Syria and Local Coordination Committees of Syria (LCC) media staff went to Zamalka soon after the attacks to film and obtain other documentary evidence. Almost all the journalists died from inhalation of the neurotoxins, except Murad Abu Bilal, who was the only Zamalka LCC media member to survive.[165][166] The videos were published on YouTube, attracting worldwide media attention.[167]

Experts who have analysed the first video said it shows the strongest evidence yet consistent with the use of a lethal toxic agent. Visible symptoms reportedly included rolling eyes, foaming at the mouth, and tremors. There was at least one image of a child suffering miosis, the pin-point pupil effect associated with the nerve agent Sarin, a powerful neurotoxin reportedly used before in Syria. Ralph Trapp, a former scientist at the Organisation for the Prohibition of Chemical Weapons, said the footage showed what a chemical weapons attack on a civilian area would look like, and went on to note “This is one of the first videos I’ve seen from Syria where the numbers start to make sense. If you have a gas attack you would expect large numbers of people, children and adults, to be affected, particularly if it’s in a built-up area.”[167]

Some experts, among them Jean Pascal Zanders, initially stated that evidence that sarin was used, as claimed by pro-rebel sources, was still lacking and highlighted the lack of second-hand contaminations typically associated with use of weapons-grade nerve agents: “I remain sceptical that it was a nerve agent like sarin. I would have expected to see more convulsions,” he said. “The other thing that seems inconsistent with sarin is that, given the footage of first responders treating victims without proper protective equipment, you would expect to see considerable secondary casualties from contamination – which does not appear to be evident.” However, after Zanders saw footage imminently after the attack, he changed his mind, saying: “The video footage and pictures this time are of a far better quality. You can clearly see the typical signs of asphyxiation, including a pinkish blueish tinge to the skin colour. There is one image of an adult woman where you can see the tell-tale blackish mark around her mouth, all of which suggests death from asphyxiation.”[167] Zanders however cautioned that these symptoms covered a range of neurotoxicants, including some available for civilian use as pest control agents, and said that until the UN reported its analysis of samples, “I can’t make a judgement. I have to keep an open mind.”[168]

According to a report by The Daily Telegraph, “videos uploaded to YouTube by activists showed rows of motionless bodies and medics attending to patients apparently in the grip of seizures. In one piece of footage, a young boy appeared to be foaming at the mouth while convulsing.”[84]

Hamish de Bretton-Gordon, a former commander of British Chemical and Biological counterterrorism forces,[169] told BBC that the images were very similar to previous incidents he had witnessed, although he could not verify the footage.[170]

Foreign government assessments

According to public statements, intelligence agencies in Israel,[171] the United Kingdom,[172] the United States,[12] France,[173]Turkey,[174] and Germany[175] concluded that the Syrian government was most likely responsible for the attacks. Western intelligence agencies agreed that video evidence is consistent with the use of a nerve agent, such as sarin. Laboratory tests showed traces of sarin, in blood and hair samples collected from emergency workers who responded to the attacks.[176]

Russia said there was no evidence tying the Syrian government to the attack and that it was likely carried out by an opposition group.[177]

France

On 2 September, the French government published a nine-page intelligence report blaming the Syrian government for the Ghouta attacks.[3][78][178] An unnamed French government official said that the analysis was carried out by the Directorate-General for External Security (DGSE) and Direction du renseignement militaire (DRM) based on satellite and video images, on-the-ground sources, and samples collected from two April attacks.[179] The report said analysis of samples collected from attacks in Saraqeb and Jobar in April 2013 had confirmed the use of sarin.[78]

The Guardian reported that French intelligence had images that showed rocket attacks on opposition neighborhoods from government-controlled areas to the east and west of Damascus. The report said that the government later launched conventional bombing of those neighborhoods in order to destroy evidence of a chemical attack.[180] Based on analysis of 47 videos, the report said at least 281 fatalities occurred. Using other sources and extrapolation a chemical attack model estimated the total number of death at approximately 1,500.[3]

Germany

The Bundesnachrichtendienst said it intercepted a phone call between a Hezbollah official and the Iranian Embassy in which the Hezbollah representative criticised Assad’s decision to attack with poison gas, apparently confirming its use by the Syrian government.[159][160] German newspaper Der Spiegel reported on 3 September that BND President Gerhard Schindler told them that based on the agency’s evidence, Germany now shared the United Kingdom, United States, and France’s view that the attacks were carried out by the Syrian government. However, they also said the attack may have been much more potent than intended, speculating that there may have been an error in mixing the chemical weapons used.[181][182]

Israel

Without going into detail, Israeli Intelligence Minister Yuval Steinitz said on 22 August 2013 that Israel’s intelligence assessment was that the Syrian government used chemical weapons in the Damascus area.[171] Defense Minister Moshe Ya’alon said the Syrian government had already used chemical weapons against the rebels on a smaller scale multiple times prior to the Ghouta attacks.[183]Fox News reported that Unit 8200 helped provide intelligence to the United States, Israel’s closest international ally, implicating the Syrian government in the attacks.[184] Prime Minister Benjamin Netanyahu said at the General debate of the sixty-eighth session of the United Nations General Assembly that Syrian government used the chemical weapons against its own people.[185]

Russia

Russian officials said that there was no proof that the government of Syria had a hand in the chemical attacks. Russian Foreign Minister Sergei Lavrov described the American, British and French intelligence reports as “unconvincing”[186] and said at a joint news conference with his French counterpart Laurent Fabius after the release of the United Nations report in mid-September that he continued to believe the rebels carried out the attack.[177]Russian President Vladimir Putin said he wanted to see evidence that would make it “obvious” who used chemical weapons in Ghouta.[187]

In a commentary published in The New York Times on 11 September 2013, Putin wrote that “there is every reason to believe [poison gas] was used not by the Syrian Army, but by opposition forces, to provoke intervention by their powerful foreign patrons,”.[39] Lavrov said on 18 September that “new evidence” given to Russia by the Syrian government would be forthcoming.[188]

Turkey

The Turkish government-run Anadolu Agency published an unconfirmed report on 30 August 2013, pointing to the Syrian 155th Missile Brigade and the 4th Armored Division as the perpetrators of the two attacks. It said the attack had involved 15 to 20 missiles with chemical warheads at around 02:45 on 21 August, targeting residential areas between Douma and Zamalka in Eastern Ghouta. It claimed that the 155th Missile Brigade had used 9K52 Luna-M missiles, M600 missiles, or both, fired from Kufeyte, while other rockets with a 15- to 70-kilometer range were fired by the 4th Armored Division from Mount Qasioun. The agency did not explain its source.[189]

United Kingdom

A report on the attacks by the United Kingdom’s Joint Intelligence Committee (JIC) was published on 29 August 2013 prior to a vote on intervention by the House of Commons of the United Kingdom. The report said at least 350 people were killed and that it was “highly likely” that the attacks had been carried out by the Syrian government, resting in part on the firm view that the Syrian opposition was not capable of carrying out a chemical weapons attack on this scale, and on the JIC view that the Syrian government had used chemical weapons in the Syrian civil war on a small scale on 14 previous occasions.[4] Analysis of the Ghouta attacks themselves was based largely on reviewing video footage and publicly available witness evidence. The report conceded problems with motivation for the attacks, saying there was “no obvious political or military trigger for regime use of CW on an apparently larger scale now.”[79][190][191][192] British officials said they believe the Syrian military used chemical weapons, including the nerve agent sarin, on a small scale against the opposition on at least 14 times prior to the Ghouta attacks and described “a clear pattern of regime use” of the nerve agent since 2012.[193]

The report was met with substantial scepticism in the British media, with the Daily Mail explicitly comparing it with the “dodgy dossier” the UK government had published in 2003 prior to the Iraq War.[194] A vote in the House of Commons to approve UK participation in military action against Syria was narrowly rejected, with some MPs arguing that the case for Syrian government culpability was not sufficiently strong to justify approving action.[195][196]Prime Minister David Cameron himself had been forced to concede that “in the end there is no 100 percent certainty about who is responsible.”[197][198]

United States

The map of “Areas of Influence” and “Areas Reportedly affected by the 21 August Chemical Attack” that was published by the White House on 30 August 2013.[12]

A controversial “US government assessment of the Ghouta attacks” was published by the White House on 30 August 2013, with a longer classified version made available to members of Congress. The report blamed the chemical attacks on the Syrian government, saying rockets containing a nerve agent were fired from government-held territory into neighborhoods in the early morning, impacting at least 12 locations. It stated 1,429 people were killed, including at least 426 children. It dismissed the possibility that evidence supporting the US government’s conclusion could have been manufactured by the opposition, stating it “does not have the capability” to fabricate videos, eyewitness accounts, and other information. The report also said that the US believed Syrian officials directed the attacks, based on “intercepted communications.”[12] A major element, as reported by news media, was an intercepted telephone call between a Syrian Ministry of Defense official and a Syrian 155th Brigade chemical weapons unit commander in which the former demanded answers for the attacks.[199] According to some reports, this phone intercept was provided to the U.S. by Israeli Intelligence CorpsUnit 8200.[158]

The U.S. government assessment suggested a motive for the attack, describing it as “a desperate effort to push back rebels from several areas in the capital’s densely packed eastern suburbs.” The report then states that evidence suggests “the high civilian death toll surprised and panicked senior Syrian officials, who called off the attack and then tried to cover it up.”[200] Secretary of State John Kerry later announced that hair, blood, soil, and cloth samples collected from the attack sites had tested positive for sarin or its immediate breakdown products.[201][202]

At least three members of Congress, including at least one member of President Barack Obama‘s Democratic Party, expressed skepticism about the US intelligence report, calling the evidence circumstantial and thin.[203][204][205][206] Obama’s request that Congress authorize military force was not put to a vote of either the House of Representatives or the Senate, and the president ultimately admitted that “I wouldn’t say I’m confident” that he could convince Congress to support strikes against Syria.[207]

Democratic Party Representative Alan Grayson offered some details regarding the classified report, which he described as 12 pages long, and criticized both the four-page public summary and the classified report. Grayson said the unclassified summary relied on “intercepted telephone calls, ‘social media’ postings and the like, but not one of these is actually quoted or attached … (As to whether the classified summary is the same, I couldn’t possibly comment, but again, draw your own conclusion.)” Grayson cited as a problematic example the intercepted phone call between a Syrian Ministry of Defense official and the Syrian 155th Brigade, the transcript of which was not provided in the classified report, leaving Grayson unable to judge the accuracy of a report in The Daily Caller that the call’s implications had been misrepresented in the report.[205][206]

The AP quoted anonymous US intelligence officials as saying that the evidence presented in the report linking Assad to the attack was “not a slam dunk.”[161]Jeffrey Goldberg also reported that James Clapper, the Director of National Intelligence, personally told President Obama that the case for the Syrian government’s responsibility was strong but not a “slam dunk.”[208] The AP later characterized the evidence released by the administration as circumstantial and said the government had denied its requests for more direct evidence, including satellite imagery and communications intercepts cited in the government assessment.[209]

IPS news analyst Gareth Porter questioned why the report was released by the White House as a “government assessment” as opposed being released by the Office of the Director of National Intelligence as an “intelligence community assessment.” Porter quoted former intelligence officials who said the report was “evidently an administration document” and who also suggested evidence was “cherry-picked” to support the conclusion that the Syrian government carried out the attacks.[210]

On 8 September 2013, the then White House Chief-of-Staff, Denis McDonough said the administration lacks the “irrefutable, beyond-a-reasonable-doubt evidence”, but that a “common-sense test” implicates Assad.[211] The U.S. publicly stated there was no “reliable” evidence that the opposition had access to chemical weapons, although Seymour Hersh reported that U.S. intelligence agencies privately assessed some rebel factions to be capable of sarin production.[150]

Legal status

Attack

At the time of the attack, Syria was not a member of the Chemical Weapons Convention. However, Human Rights Watch argues that the Ghouta chemical attack was illegal under a different international agreement:

Syria is a party to the 1925 Geneva Gas protocol, which bans the use in war of asphyxiating, poisonous or other gases, and of all analogous liquids, materials or devices. The use of chemical weapons is also prohibited as a matter of customary international humanitarian law, or the laws of war. The prohibition on the use of chemical weapons applies to all armed conflicts, including so-called non-international armed conflicts such as the current fighting in Syria. The International Criminal Tribunal for the former Yugoslavia, in the Tadic case, stated “there undisputedly emerged a general consensus in the international community on the principle that the use of [chemical] weapons is also prohibited in internal armed conflicts.”[1](p21)

International Criminal Court referral

Human Rights Watch stated that the UN Security Council should refer the Syria situation to the International Criminal Court (ICC) “to ensure accountability for all war crimes and crimes against humanity.”[136]Amnesty International also said that the Syria situation should be referred to the ICC because “the best way for the United States to signal its abhorrence for war crimes and crimes against humanity and to promote justice in Syria, would be to reaffirm its support for the Rome Statute establishing the International Criminal Court.”[212] However, as the amendment to the Rome Statute of the International Criminal Court explicitly making it a war crime to use chemical weapons in an internal conflict has not been ratified by any major state nor Syria, the legal situation is complex and reliant on the attack being a part of a wider war crime.[213]

Reactions

Domestic

Information Minister Omran al-Zoubi was quoted by the official state news agency, Syrian Arab News Agency (SANA), as saying that the government did not and would not use such weapons, if in fact they even existed. Al-Zoubi said, “everything that has been said is absurd, primitive, illogical and fabricated. What we say is what we mean: there is no use of such things (chemical weapons) at all, at least not by the Syrian army or the Syrian state, and it’s easy to prove and it is not that complicated.”[214] SANA called the reports of chemical attacks as “untrue and designed to derail the ongoing UN inquiry.” A Syrian military official appeared on state television denouncing the reports as “a desperate opposition attempt to make up for rebel defeats on the ground.”[71] Deputy Foreign Minister Faisal Mekdad declared it a tactic by the rebels to turn around the civil war which he said “they were losing” and that, though the government had admitted to having stocks of chemical weapons, stated they would never be used “inside Syria”.[215]Democratic Union Party leader Salih Muslim said he doubted that the Syrian government carried out the chemical attack.[216]

The National Coalition called the attack a “coup de grace that kills all hopes for a political solution in Syria.”[217] In a statement on Facebook, the Coventry-based Syrian Observatory for Human Rights, an anti-government activist network, blamed the attack on the Syrian military and said of the incident that “we assure the world that silence and inaction in the face of such gross and large-scale war crimes, committed in this instance by the Syrian regime, will only embolden the criminals to continue in this path. The international community is thus complicit in these crimes because of its [polarisation], silence and inability to work on a settlement that would lead to the end of the daily bloodshed in Syria.”[218]

International

The international community condemned the attacks. United States President Barack Obama said the US military should strike targets in Syria to retaliate for the government’s purported use of chemical weapons, a proposal publicly supported by French President François Hollande, but condemned by Russia and Iran.[219][220] The Arab League stated it would support military action against Syria in the event of UN support, though member states Algeria, Egypt, Iraq, Lebanon, and Tunisia opposed it.[221]

At the end of August, the House of Commons of the United Kingdom voted against military intervention in Syria.[222] In early September, the United States Congress began debating a proposed authorisation to use military force, although votes on the resolution were indefinitely postponed amid opposition from many legislators[223] and tentative agreement between Obama and Russian President Vladimir Putin on an alternative proposal, under which Syria would declare and surrender its chemical weapons to be destroyed under international supervision.[224]

In contrast to the positions of their governments, polls in early September indicated that most people in the US, UK, Germany and France opposed military intervention in Syria.[225][226][227][228][229] One poll indicated that 50% of Americans could support military intervention with cruise missiles only, “meant to destroy military units and infrastructure that have been used to carry out chemical attacks.”[230] In a survey of American military personnel, around 75% said they opposed air strikes on Syria, with 80% saying an attack would not be “in the U.S. national interest”.[231] Meanwhile, a Russian poll suggested that most Russians supported neither side in the conflict, with less than 10% saying they supported Assad.[232]

Allegations of false flag attack

The attacks prompted some U.S. intelligence officials to speculate they were meant to draw the West into the war,[161] a concept dismissed by others.[233][234] In December 2013 Seymour Hersh wrote that in the days before and after the attack, sensors notifying U.S. intelligence agencies of Syrian chemical weapons deployment did not activate, and intelligence briefings shown to the U.S. president contained no information about an impending government chemical weapons attack.[150] Publicly, the U.S. government cited classified intercepts of communications it said were between Syrian officials, unavailable to the public, which they state prove Syrian government forces carried out the chemical attack.[12] Criticizing what they called a misleading presentation of intelligence, a former senior U.S. intelligence official quoted by Seymour Hersh said the transcript actually included intercepts from many months prior to the attack, collated to make them appear related to the Ghouta attacks.[150]

In April 2014 Hersh wrote an article proposing the attacks were committed by Al-Qaeda affiliate Al-Nusra Front, whom Hersh writes were supplied with sarin by Turkey.[235][236] Hersh’s argument received some support,[237][238]but was dismissed by other commentators.[239][240] The US and Turkish governments denied the accuracy of Hersh’s article.[241] On October 20, 2015, Republican People’s Party deputy Eren Erdem stated that documents from a Turkish government investigation showed that ISIL and affiliated groups received help from Turkish intelligence to carry out the Ghouta chemical attack.[242][243]

See also

https://en.wikipedia.org/wiki/Ghouta_chemical_attack

The victims of a bombing in northern Syria this week were exposed to sarin, a banned but easily manufactured poison that has been widely used in chemical weapons, Turkish officials who conducted autopsies on the victims said on Thursday.

What is sarin?

Sarin is a nerve agent, one of a class of chemical weapons that affect the brain’s ability to communicate with the body’s organs through the nervous system. It is a colorless, tasteless, odorless liquid that was first synthesized in Germany in 1938 as a potential pesticide.

Sarin is considered “the most volatile of the nerve agents,” according to the Centers for Disease Control and Prevention. “This means it can easily and quickly evaporate from a liquid into a vapor and spread into the environment.”

Sarin vapor does not last long, but it can be deadly if inhaled. Contact with sarin liquid on exposed surfaces, in food, or in water can also be fatal. Its effects may strike quickly or be delayed after exposure.

How does it work?

All nerve agents belong to a class of organic compounds that contain phosphorous, and work in essentially the same way, by inhibiting the action of a crucial enzyme in the body that allows muscles and organs to contract. Without the enzyme’s action, the muscles and organs are constantly stimulated and stop working properly; asphyxiation soon follows.

How is it weaponized?

Sarin is dangerous to handle and has a short shelf life, so it is usually stored in the form of two separate precursor compounds that will produce sarin when mixed together.

On the battlefield, sarin and other nerve agents can be used against targets by spraying them as a liquid or an aerosol. Chemical bombs are designed to spray out the liquid on detonation. The Syrian government is believed to have used such a bomb this week in Idlib Province.

The United Nations Chemical Convention, which bans the use of sarin in war, went into effect in 1997. The Syrian government agreed in 2013 to destroy its chemical weapons stockpile, including sarin.

How toxic is it?

According to the United States military, sarin is 81 times as toxic as cyanide and 543 times as toxic as chlorine, which has been used in Syria as a chemical weapon. Chlorine has legitimate commercial uses and is not banned.

What are the symptoms of exposure?

Symptoms of exposure may include the pupils of the eyes shrinking to pinpoints, rapid breathing, vomiting, convulsions, paralysis and respiratory failure. Swift medical attention can reverse the effects of low levels of exposure.

https://www.nytimes.com/2017/04/06/world/middleeast/sarin-nerve-agent.html?&moduleDetail=section-news-1&action=click&contentCollection=Middle%20East&region=Footer&module=MoreInSection&version=WhatsNext&contentID=WhatsNext&pgtype=article

Sarin

From Wikipedia, the free encyclopedia
For other uses, see Sarin (disambiguation).
Not to be confused with Serine, Sarrin, or Saran (disambiguation).
Sarin[1]
Sarin-2D-by-AHRLS-2011.png
Sarin-3D-balls-by-AHRLS-2012.png
Names
Preferred IUPAC name

(RS)-Propan-2-yl methylphosphonofluoridate
Other names

(RS)-O-Isopropyl methylphosphonofluoridate; IMPF;
GB;[2]
2-(Fluoro-methylphosphoryl)oxypropane;
Phosphonofluoridic acid, P-methyl-, 1-methylethyl ester
Identifiers
3D model (Jmol)
ChEBI
ChemSpider
UNII
Properties
C4H10FO2P
Molar mass 140.09 g·mol−1
Appearance Clear colorless liquid
Odor Odorless in pure form. Impure sarin can smell like mustard or burned rubber.
Density 1.0887 g/cm3 (25 °C)
1.102 g/cm3 (20 °C)
Melting point −56 °C (−69 °F; 217 K)
Boiling point 158 °C (316 °F; 431 K)
Miscible
log P 0.30
Hazards
Main hazards It is a lethal cholinergic agent.
Safety data sheet Lethal Nerve Agent Sarin (GB)
Extremely Toxic (T+)[3]
NFPA 704
Flammability code 1: Must be pre-heated before ignition can occur. Flash point over 93 °C (200 °F). E.g., canola oil Health code 4: Very short exposure could cause death or major residual injury. E.g., VX gas Reactivity code 0: Normally stable, even under fire exposure conditions, and is not reactive with water. E.g., liquid nitrogen Special hazards (white): no code

NFPA 704 four-colored diamond

Lethal dose or concentration (LD, LC):
550 ug/kg (rat, oral) [4]
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
 verify (what is Yes ?)
Infobox references

Sarin, or GB (G-series, ‘B’), is a colorless, odorless liquid,[5] used as a chemical weapon due to its extreme potency as a nerve agent. It is generally considered a weapon of mass destruction. Production and stockpiling of sarin was outlawed as of April 1997 by the Chemical Weapons Convention of 1993, and it is classified as a Schedule 1 substance. In June 1994, the UN Special Commission on Iraqi disarmament destroyed the nerve agent sarin under Security Council resolution 687 (1991) concerning the disposal of Iraq’s weapons of mass destruction.[6]

Sarin is an organophosphorus compound with the formula [(CH3)2CHO]CH3P(O)F. It can be lethal even at very low concentrations, where death can occur within one[7][8] to ten minutes after direct inhalation of a lethal dose, due to suffocation from lung muscle paralysis, unless some antidotes, typically atropine and an oxime, such as pralidoxime, are quickly administered.[5] People who absorb a non-lethal dose, but do not receive immediate medical treatment, may suffer permanent neurological damage.

Production and structure

Sarin is a chiral molecule because it has four chemically distinct substituents attached to the tetrahedral phosphorus center.[9] The SP form (the (–) optical isomer) is the more active enantiomer due to its greater binding affinity to acetylcholinesterase.[10][11] The P-F bond is easily broken by nucleophilic agents, such as water and hydroxide. At high pH, sarin decomposes rapidly to nontoxic phosphonic acid derivatives.

It is usually manufactured and weaponized as a racemic mixture—an equal mixture of both enantiomeric forms, as this is a simpler process and provides an adequate weapon.

A number of production pathways can be used to create sarin. The final reaction typically involves attachment of the isopropoxy group to the phosphorus with an alcoholysis with isopropyl alcohol. Two variants of this process are common. One is the reaction of methylphosphonyl difluoride with isopropyl alcohol, which produces hydrofluoric acid as a byproduct:

Sarin synth with racemic stereochemistry.png

The second process, uses equal quantities of methylphosphonyl difluoride and methylphosphonic dichloride, a mixture “Di-Di” in this process, rather than just the difluoride. This reaction also gives sarin, but hydrochloric acid as a byproduct instead. The Di-Di process was used by the United States for the production of its unitary sarin stockpile.[12]

The scheme below describes an example of Di-Di process. The selection of reagents is arbitrary and reaction conditions and product yield depend on the selected reagents. Inert atmosphere and anhydrous conditions are used for synthesis of sarin and other organophosphates.

An example of

As both reactions leave considerable acid in the product, bulk sarin produced without further treatment has a very poor shelf life and would be rather destructive to containers or weapon systems. Various methods have been tried to resolve these problems. In addition to industrial refining techniques to purify the chemical itself, various additives have been tried to combat the effects of the acid, such as:

Another byproduct of these two chemical processes is diisopropyl methylphosphonate, formed when a second isopropyl alcohol reacts with the sarin itself. This chemical degrades into isopropyl methylphosphonic acid.[19]

Biological effects

Sarin (red), acetylcholinesterase (yellow), acetylcholine (blue)

Like all other nerve agents, sarin attacks the nervous system by interfering with the degradation of the neurotransmitter acetylcholine at neuromuscular junctions. Death will usually occur as a result of asphyxia due to the inability to control the muscles involved in breathing function.

Specifically, sarin is a potent inhibitor of acetylcholinesterase,[20] an enzyme that degrades the neurotransmitter acetylcholine after it is released into the synaptic cleft. In vertebrates, acetylcholine is the neurotransmitter used at the neuromuscular junction, where signals are transmitted between neurons from the central nervous systems to muscle fibres. Normally, acetylcholine is released from the neuron to stimulate the muscle, after which it is degraded by acetylcholinesterase, allowing the muscle to relax. A build-up of acetylcholine in the synaptic cleft, due to the inhibition of cholinesterase, means the neurotransmitter continues to act on the muscle fibre, so that any nerve impulses are effectively continually transmitted.

Sarin acts on cholinesterase by forming a covalent bond with the particular serine residue at the active site. Fluoride is the leaving group, and the resulting phosphoester is robust and biologically inactive.[21][22]

Its mechanism of action resembles that of some commonly used insecticides, such as malathion. In terms of biological activity, it resembles carbamate insecticides, such as Sevin, and the medicines pyridostigmine, neostigmine, and physostigmine.

Degradation and shelf life

Rabbit used to check for leaks at former sarin production plant (Rocky Mountain Arsenal), 1970

The most important chemical reactions of phosphoryl halides is the hydrolysis of the bond between phosphorus and the fluoride. This P-F bond is easily broken by nucleophilic agents, such as water and hydroxide. At high pH, sarin decomposes rapidly to nontoxic phosphonic acid derivatives.[23][24] The initial breakdown of sarin is into isopropyl methylphosphonic acid (IMPA), a chemical that is not commonly found in nature except as a breakdown product of sarin (this is useful for detecting the recent deployment of sarin as a weapon). IMPA then degrades into methylphosphonic acid (MPA), which can also be produced by other organophosphates.[25]

Sarin without the residual acid removed degrades after a period of several weeks to several months. The shelf life can be shortened by impurities in precursor materials. According to the CIA, some Iraqi sarin had a shelf life of only a few weeks, owing mostly to impure precursors.[26]

Along with nerve agents such as tabun and VX, sarin can have a maximum shelf-life of five years.[27] Sarin’s otherwise-short shelf life can be extended by increasing the purity of the precursor and intermediates and incorporating stabilizers such as tributylamine. In some formulations, tributylamine is replaced by diisopropylcarbodiimide (DIC), allowing sarin to be stored in aluminium casings. In binary chemical weapons, the two precursors are stored separately in the same shell and mixed to form the agent immediately before or when the shell is in flight. This approach has the dual benefit of solving the stability issue and increasing the safety of sarin munitions.

Effects and treatment]

Sarin has a high volatility (ease with which a liquid can turn into a gas) relative to similar nerve agents, therefore inhalation can be very dangerous and even vapor concentrations may immediately penetrate the skin. A person’s clothing can release sarin for about 30 minutes after it has come in contact with sarin gas, which can lead to exposure of other people.[28]

Even at very low concentrations, sarin can be fatal. Death may follow in 1 to 10 minutes after direct inhalation of a lethal dose unless antidotes, typically atropine and pralidoxime, are quickly administered.[5] Atropine, an antagonist to muscarinic acetylcholine receptors, is given to treat the physiological symptoms of poisoning. Since muscular response to acetylcholine is mediated through nicotinic acetylcholine receptors, atropine does not counteract the muscular symptoms. Pralidoxime can regenerate cholinesterases if administered within approximately five hours. Biperiden, a synthetic acetylcholine antagonist, has been suggested as an alternative to atropine due to its better blood–brain barrier penetration and higher efficacy.[29]

As a nerve gas, sarin in its purest form is estimated to be 26 times more deadly than cyanide.[30] The LD50 of subcutaneously injected sarin in mice is 172 μg/kg.[31] Treatment measures have been described.[32]

Initial symptoms following exposure to sarin are a runny nose, tightness in the chest and constriction of the pupils. Soon after, the victim has difficulty breathing and experiences nausea and drooling. As the victim continues to lose control of bodily functions, the victim vomits, defecates and urinates. This phase is followed by twitching and jerking. Ultimately, the victim becomes comatose and suffocates in a series of convulsive spasms. Moreover, common mnemonics for the symptomatology of organophosphate poisoning, including sarin gas, are the “killer B’s” of bronchorrhea and bronchospasm because they are the leading cause of death,[33] and SLUDGE – Salivation, Lacrimation, Urination, Defecation, Gastrointestinal distress, and Emesis.

Diagnostic tests

Controlled studies in healthy men have shown that a nontoxic 0.43 mg oral dose administered in several portions over a 3-day interval caused average maximum depressions of 22 and 30%, respectively, in plasma and erythrocyte cholinesterase levels. A single acute 0.5 mg dose caused mild symptoms of intoxication and an average reduction of 38% in both measures of cholinesterase activity. Sarin in blood is rapidly degraded either in vivo or in vitro. Its primary inactive metabolites have in vivo serum half-lives of approximately 24 hours. The serum level of unbound isopropylmethylphosphonic acid (IMPA), a sarin hydrolysis product, ranged from 2-135 µg/L in survivors of a terrorist attack during the first 4 hours post-exposure. Sarin or its metabolites may be determined in blood or urine by gas or liquid chromatography, while cholinesterase activity is usually measured by enzymatic methods.[34]

A newer method called “Fluoride Regeneration” or “Fluoride Reactivation” detects the presence of nerve agents for a longer period after exposure than the methods described above. Fluoride reactivation is a technique has been explored since at least the early 2000s. This technique obviates some of the deficiencies of older procedures. Sarin not only reacts with the water in the blood plasma through hydrolysis (forming so-called ‘free metabolites’), but also reacts with various proteins to form ‘protein adducts’. These protein adducts are not so easily removed from the body, and remain for a longer period of time than the free metabolites. One clear advantage of this process is that the period, post-exposure, for determination of Sarin exposure is much longer, possibly 5 to 8 weeks according to at least one study.[35][36]

Toxicity

Sarin is highly toxic, whether by respiratory or dermal exposure. The toxicity of sarin in humans is largely based on calculations from studies with animals. The general consensus is that the lethal concentration of sarin in air is approximately 35 mg per cubic meter per minute for a two-minute exposure time by a healthy adult breathing normally (exchanging 15 liters of air per minute). This number represents the estimated lethal concentration for 50% of exposed victims, the LCt50 value. There are many ways to make relative comparisons between toxic substances. The list below compares some current and historic chemical warfare agents with sarin, with a direct comparison to the respiratory Lct50:

History

Sarin was discovered in 1938 in Wuppertal-Elberfeld in Germany by scientists at IG Farben who were attempting to create stronger pesticides; it is the most toxic of the four G-Series nerve agents made by Germany. The compound, which followed the discovery of the nerve agent tabun, was named in honor of its discoverers: Schrader, Ambros, Gerhard Ritter, and von der Linde.[39]

Use as a weapon

In mid-1939, the formula for the agent was passed to the chemical warfare section of the German Army Weapons Office, which ordered that it be brought into mass production for wartime use. Pilot plants were built, and a high-production facility was under construction (but was not finished) by the end of World War II. Estimates for total sarin production by Nazi Germany range from 500 kg to 10 tons.[40] Though sarin, tabun and soman were incorporated into artillery shells, Germany did not use nerve agents against Allied targets.

U.S. Honest John missile warhead cutaway, showing M134 sarin bomblets (c. 1960)

  • 1950s (early): NATO adopted sarin as a standard chemical weapon, and both the USSR and the United States produced sarin for military purposes.
  • 1953: 20-year-old Ronald Maddison, a Royal Air Force engineer from Consett, County Durham, died in human testing of sarin at the Porton Down chemical warfare testing facility in Wiltshire, England. Ten days after his death an inquest was held in secret which returned a verdict of “misadventure”. In 2004, the inquest was reopened and, after a 64-day inquest hearing, the jury ruled that Maddison had been unlawfully killed by the “application of a nerve agent in a non-therapeutic experiment”.[41]
  • 1957: Regular production of sarin chemical weapons ceased in the United States, though existing stocks of bulk sarin were re-distilled until 1970.[42]
  • 1976: Chile’s intelligence service, DINA, assigns biochemist Eugenio Berríos to develop sarin gas within its program Proyecto Andrea, to be used as a weapon against its opponents.[43]One of DINA’s goals was to package it in spray cans for easy use, which, according to testimony by former DINA agent Michael Townley, was one of the planned procedures in the 1976 assassination of Letelier.[43] Berríos later testified that it was used in a number of assassinations.[44][45]
  • March 1988: Over two days in March, the ethnic Kurd city of Halabja in northern Iraq (population 70,000) was bombarded with chemical bombs, which included sarin, in the Halabja poison gas attack. An estimated 5,000 people died.[46]
  • April 1988: Sarin was used four times against Iranian soldiers at the end of the Iran–Iraq War, helping Iraqi forces to retake control of the al-Faw Peninsula during the Second Battle of al-Faw.
  • 1993: The United Nations Chemical Weapons Convention was signed by 162 member countries, banning the production and stockpiling of many chemical weapons, including sarin. It went into effect on April 29, 1997, and called for the complete destruction of all specified stockpiles of chemical weapons by April 2007.[47] When the convention entered force, the parties declared worldwide stockpiles of 15,047 tonnes of sarin. As of December 2015, 89% of the stockpiles had been destroyed.[48]
  • 1994: Matsumoto incident; the Japanese religious sect Aum Shinrikyo released an impure form of sarin in Matsumoto, Nagano, killing eight people and harming over 200. The Australian sheep station Banjawarn was a testing ground.
  • 1995: Tokyo subway sarin attack; the Aum Shinrikyo sect released an impure form of sarin in the Tokyo Metro. Twelve people died.[49]
  • 2004: Iraqi insurgents detonated a 155 mm shell containing binary precursors for sarin near a U.S. convoy in Iraq. The shell was designed to mix the chemicals as it spun during flight. The detonated shell released only a small amount of sarin gas, either because the explosion failed to mix the binary agents properly or because the chemicals inside the shell had degraded with age. Two United States soldiers were treated after displaying the early symptoms of exposure to sarin.[50]
  • 2013: Ghouta chemical attack; sarin was used in an attack in the Ghouta region of the Rif Dimashq Governorate of Syria during the Syrian civil war.[51] Varying[52] sources gave a death toll of 322[53] to 1,729.[54]
  • 2017: Khan Shaykhun chemical attack; sarin gas was allegedly used on the rebel-held Idlib Province in Syria. Civilian death toll of ~100 reported, over 300 more injured.[55][56]

https://en.wikipedia.org/wiki/Sarin

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The Pronk Pops Show 865, March 31, 2017, Story 1: Conservative and Libertarian Talk Radio Could Turn On Trump For Attacking Freedom Caucus and Failure To Completely Repeal Obamacare By Law (Statute) Not Discretion of Secretary of Health and Human Services Dr. Thomas Price — Establishment Republican House Speaker Ryan’s Bad Faith, Bad Process, Bad Bill — Socialized Medicine Obamacare Lite vs. Good Faith, Good Process, Good Bill — Free Enterprise Market Capitalism Competitive Health Insurance Premiums and Deductibles Decreases! — Close The Deal Mr. President — Videos — Story 2: Obama Administration Spied On American Citizens Including Trump and Trump Team — Obama Scandal Far Worse Than Nixon’s Cover-up of Watergate Break-in — Legacy Fading Fast — Grand Jury Should Be Impaneled Now! — Videos

Posted on March 31, 2017. Filed under: American History, Applications, Blogroll, Breaking News, Business, Communications, Computers, Congress, Consitutional Law, Countries, Crime, Culture, Donald J. Trump, Donald Trump, Economics, Education, Empires, Employment, Federal Bureau of Investigation (FBI), Federal Government, Foreign Policy, Fourth Amendment, Freedom of Speech, Government, Government Dependency, Government Spending, Hardware, Health, Health Care, Health Care Insurance, High Crimes, History, House of Representatives, Human, Independence, Insurance, Investments, Language, Law, Life, Media, Medicare, Mike Pence, National Security Agency, News, Nixon, Obama, Philosophy, Photos, Politics, Polls, President Barack Obama, Progressives, Radio, Raymond Thomas Pronk, Regulation, Rule of Law, Scandals, Second Amendment, Security, Senate, Servers, Social Networking, Social Security, Software, Spying, Surveillance and Spying On American People, Terror, Terrorism, Unemployment, United States Constitution, United States of America, Welfare Spending | Tags: , , , , , , , , , , , , , , , , , |

 

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Story 1: Conservative and Libertarian Talk Radio Could Turn On Trump For Attacking Freedom Caucus and Failure To Completely Repeal Obamacare By Law (Statute) Not Discretion of Secretary of Health and Human Services Dr. Thomas Price — Establishment Republican House Speaker Ryan’s Bad Faith, Bad Process, Bad Bill — Socialized Medicine Obamacare Lite  vs. Good Faith, Good Process, Good Bill — Free Enterprise Market Capitalism Competitive Health Insurance Premiums and Deductibles Decreases! — Close The Deal Mr. President — Videos —

 

“Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted,”

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Rep. Mo Brooks Files A Bill To Repeal Obamacare

Published on Mar 27, 2017

On the same day that the House of Representatives canceled its vote on Ryancare, Alabama Rep. Mo Brooks filed a simple one-line bill to repeal Obama’s signature health care law.
The Huntsville Republican titled the bill ‘Obamacare Repeal Act.” It is short and to the point, AI.com reported.
“Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted,” the bill reads.
Brooks, a member of the House Freedom Caucus, told constituents last week that he was a “no” vote on the Obamacare repeal/replace bill offered by Republican Speaker of the House Paul Ryan.
Also last week, in an interview with SiriusXM host Alex Marlow, Brooks called the Speaker’s bill “a horrible replacement bill.”

Rep. Brooks: We need a bill that repeals Obamacare

Rep. Mo Brooks: ‘Deceptive’ to call GOP’s plan a repeal of Obamacare

Donald Trump THREATENS The Freedom Caucus, said Rush Limbaugh

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Freedom Caucus’s reasonable demand on Obamacare repeal

Poll: Just 17 percent of voters back ObamaCare repeal plan

 

Poll: Just 17 percent of voters back ObamaCare repeal plan

A majority of American voters oppose the Republicans’ plan to repeal and replace ObamaCare, while very few voters support it, a new poll finds.

A poll published Thursday by Quinnipiac University found that 56 percent of voters disapprove of the GOP healthcare plan, while just 17 percent support it.

Even among Republicans, only 41 percent support the American Health Care Act, while 24 percent oppose it. And 80 percent of Democrats and 58 percent of Independent voters disapprove of the plan.

Republicans are scrambling to shore up support for the repeal-and-replace bill ahead of an expected House vote later Thursday. President Trump is meeting with members of the conservative Freedom Caucus, who are seeking a number of changes to the bill in exchange for their support.But centrist Republicans are fleeing from the bill as it changes to fit the conservatives’ desires, complicating efforts to get the bill passed in the House.

The poll found that 46 percent of voters say they will be less likely to vote for their Congressional representative if they vote to approve the GOP health insurance plan.

The Quinnipiac University poll was conducted from March 16 to 21 and surveyed 1,056 voters. The margin of error is 3 percentage points.

http://thehill.com/policy/healthcare/325448-poll-majority-of-voters-disapprove-of-gop-obamacare-repeal-plan

 

Essential health benefits

From Wikipedia, the free encyclopedia

In the context of health care in the United States, essential health benefits (EHBs) are a set of benefits that certain health insurance plans are required to cover for patients.[1]

Essential health benefits must be offered by health plans in individual and small group markets, both inside and outside of the Health Insurance Marketplace.[2][3] Large-group health plans, self-insured ERISA plans, and ERISA-governed multiemployer welfare arrangements not subject to state insurance law are exempt from the EHB requirement.[4]

Essential health benefits

The ACA sets forth the following ten categories of essential health benefits,[5][6] at Section 1302(b)(1) of the Affordable Care Act, codified at 42 U.S.C. § 18022(b):[7]

  1. Ambulatory patient services. [outpatient care]
  2. Emergency services.
  3. Hospitalization. [inpatient care]
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment.
  6. Prescription drugs.
  7. Rehabilitative and habilitative services and devices.
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management;
  10. Pediatric services, including oral and vision care.

The essential health benefits are a minimum standard: “Qualified health plans are not barred from offering additional benefits, and states may require that qualified health plans sold in state health insurance exchanges also cover state-mandated benefits.”[8]

The ACA’s list of essential health benefits is defined in terms of ten broad classes.[9] The act gives “considerable discretion” to the Secretary of Health and Human Services to determine, through regulation, what specific services within these classes are essential. However, the Act provides certain parameters for the secretary to consider. The secretary (1) must “ensure that such essential health benefits reflect an appropriate balance among the categories … so that benefits are not unduly weighted toward any category”; (2) may “not make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life”; (3) must take into account “the health care needs of diverse segments of the population, including women, children, persons with disabilities, and other groups”; and (4) must ensure that essential benefits “not be subject to denial to individuals against their wishes on the basis of the individuals’ age or expected length of life or the individuals’ present or predicted disability, degree of medical dependency, or quality of life.”[10]

According to a Commonwealth Fund report in 2011:

As it stands, federal regulations for 2014 and 2015 do not establish a single, nationally uniform package of health services. Instead, the U.S. Department of Health and Human Services (HHS) gave states discretion to determine the specific benefits they deem essential. This approach was well-received by many state officials, who valued the opportunity to tailor benefit standards to reflect state priorities, and by insurers, who retained more control over benefit design. Groups representing consumers and providers were less supportive, however, expressing concern that the degree of flexibility found in the rules undermines the law’s promise of consistent, meaningful coverage.[11]

History

Coverage of essential health benefits was first required by the Patient Protection and Affordable Care Act (PPACA or ACA) of 2010, which was a major piece of health care reform legislation.[1] The EHB provisions of the ACA was an amendment to the Public Health Service Act.[12]

Dr. Shana Alex Lavarreda, the director of health insurance studies for the UCLA Center for Health Policy Research, explains that before the ACA’s passage, U.S. health insurance sector experienced “a race to the bottom, with insurers cutting benefits to lower premiums.”[1] The establishment of essential health benefits “set a standard for insurance. Anything below that is not true health insurance.”[1] The EHB requirement came into effect on January 1, 2014.[1]

Revision and repeal of essential health benefits coverage was proposed in the Republican part American Health Care Act of 2017.[13] House Freedom Caucus members lobbied during legislation discussion with House Speaker Paul Ryan to remove EHBs as a condition for approval of the AHCA bill.[14]

Comparison with minimum essential coverage

Essential health benefits should not be confused with minimum essential coverage (MEC). MEC is the minimum amount of coverage that an individual must carry to meet the individual health insurance mandate, while EHBs are a set of benefits that qualified health plans (QHPs) must offer.[15] MEC is a low threshold; many forms of coverage that do not provide essential health benefits are nevertheless considered minimum essential coverage.[15]

Notes

  1. ^ Jump up to:a b c d e Frank Lalli, The Health Care Law’s 10 Essential Benefits: The Affordable Care Act ensures you’ll have access to these medical and wellness services, AARP The Magazine (August/September 2013).
  2. Jump up^ Essential Health Benefits, HealthCare.gov (accessed November 12, 2015).
  3. Jump up^ Rosenbaum, Teitelbaum & Hayes, p. 2.
  4. Jump up^ Rosenbaum, Teitelbaum & Hayes, p. 3.
  5. Jump up^ 10 health care benefits covered in the Health Insurance Marketplace, HealthCare.gov (accessed November 12, 2015).
  6. Jump up^ Alexandra Ernst, 10 Essential Health Benefits Insurance Plans Must Cover Starting in 2014, FamiliesUSA (March 28, 2013).
  7. Jump up^ 42 U.S. Code § 18022 – Essential health benefits requirements
  8. Jump up^ Rosenbaum, Teitelbaum & Hayes, p. 3.
  9. Jump up^ Rosenbaum, Teitelbaum & Hayes, p. 3.
  10. Jump up^ Rosenbaum, Teitelbaum & Hayes, pp. 3-4
  11. Jump up^ Giovannelli, Lucia & Corlette, p. 2.
  12. Jump up^ Rosenbaum, Teitelbaum & Hayes, p. 2.
  13. Jump up^ “Republicans may gut an overlooked provision of Obamacare — and disrupt health insurance”. Business Insider. Retrieved 2017-03-26.
  14. Jump up^ Luhby, Tami. “Essential Health Benefits and why they matter”. CNN. Retrieved 2017-03-26.
  15. ^ Jump up to:a b Susan Grassli & Lisa Klinger, Understanding the Difference between Minimum Essential Coverage, Essential Health Benefits, Minimum Value, and Actuarial Value, Leavitt Group (January 27, 2014).

Sources

External links

Patient Protection and Affordable Care Act

From Wikipedia, the free encyclopedia
Patient Protection and Affordable Care Act
Great Seal of the United States
Long title The Patient Protection and Affordable Care Act
Acronyms(colloquial) PPACA, ACA
Nicknames Affordable Care Act, Health Insurance Reform, Healthcare Reform, Obamacare
Enacted by the 111th United States Congress
Effective March 23, 2010; 7 years ago
Most major provisions phased in by January 2014; remaining provisions phased in by 2020
Citations
Public law 111–148
Statutes at Large 124 Stat.119through 124 Stat.1025(906 pages)
Legislative history
  • Introduced in the Houseasthe “Service Members Home Ownership Tax Act of 2009” (H.R. 3590) byCharles Rangel (DNY) on September 17, 2009
  • Committee consideration byWays and Means
  • Passed the House on October 8, 2009 (416–0)
  • Passed the Senate as the “Patient Protection and Affordable Care Act” on December 24, 2009 (60–39) with amendment
  • House agreed to Senate amendment on March 21, 2010 (219–212)
  • Signed into law by PresidentBarack Obamaon March 23, 2010
Major amendments
Health Care and Education Reconciliation Act of 2010
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
United States Supreme Court cases
National Federation of Independent Business v. Sebelius
Burwell v. Hobby Lobby
King v. Burwell

The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by PresidentBarack Obama on March 23, 2010. Under the act, hospitals and primary physicians would transform their practices financially, technologically, and clinically to drive better health outcomes, lower costs, and improve their methods of distribution and accessibility.

The Affordable Care Act was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage and reduce the costs of healthcare. It introduced mechanisms including mandates, subsidies and insurance exchanges.[1][2] The law requires insurers to accept all applicants, cover a specific list of conditions and charge the same rates regardless of pre-existing conditions or sex.[3]

The ACA has caused a significant reduction in the number and percentage of people without health insurance, with estimates ranging from 20-24 million additional persons covered during 2016.[4][5] Increases in overall healthcare spending have slowed since the law was implemented, including premiums for employer-based insurance plans.[6] The Congressional Budget Office reported in several studies that the ACA would reduce the budget deficit, and that repealing it would increase the deficit.[7][8]

As implementation began, first opponents, then others, and finally the president himself adopted the term “Obamacare” to refer to the ACA.[9]

The law and its implementation faced challenges in Congress and federal courts, and from some state governments, conservativeadvocacy groups, labor unions, and small business organizations. The United States Supreme Court upheld the constitutionality of the ACA’s individual mandate as an exercise of Congress’s taxing power,[10]found that states cannot be forced to participate in the ACA’s Medicaid expansion,[11][12][13] and found that the law’s subsidies to help individuals pay for health insurance are available in all states, not just in those that have set up state exchanges.[14]

Together with the Health Care and Education Reconciliation Act amendment, it represents the U.S. healthcare system‘s most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.[15][16][17][18]

Contents

 [show] 

Provisions

The President and White House Staff react to the House of Representatives passing the bill on March 21, 2010.

The ACA includes provisions to take effect between 2010 and 2020, although most took effect on January 1, 2014. Few areas of the US health care system were left untouched, making it the most sweeping health care reform since the enactment of Medicare and Medicaid in 1965.[15][16][17][19][18] However, some areas were more affected than others. The individual insurance market was radically overhauled, and many of the law’s regulations applied specifically to this market,[15] while the structure of Medicare, Medicaid, and the employer marketwere largely retained.[16] Most of the coverage gains were made through the expansion of Medicaid,[20] and the biggest cost savings were made in Medicare.[16] Some regulations applied to the employer market, and the law also made delivery system changes that affected most of the health care system.[16] Not all provisions took full effect. Some were made discretionary, some were deferred, and others were repealed before implementation.

Individual insurance

Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions. States were required to ensure the availability of insurance for individual children who did not have coverage via their families.

States were required to expand Medicaid eligibility to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities or dependent children.[21] The law provides a 5% “income disregard”, making the effective income eligibility limit for Medicaid 138% of the poverty level.[22]

The State Children’s Health Insurance Program (CHIP) enrollment process was simplified.[21]

Dependents were permitted to remain on their parents’ insurance plan until their 26th birthday, including dependents that no longer live with their parents, are not a dependent on a parent’s tax return, are no longer a student, or are married.[23][24]

Among the groups who remained uninsured were:

  • Illegal immigrants, estimated at around 8 million—or roughly a third of the 23 million projection—are ineligible for insurance subsidies and Medicaid.[25][26] They remain eligible for emergency services.
  • Eligible citizens not enrolled in Medicaid.[27]
  • Citizens who pay the annual penalty instead of purchasing insurance, mostly younger and single.[27]
  • Citizens whose insurance coverage would cost more than 8% of household income and are exempt from the penalty.[27]
  • Citizens who live in states that opt out of the Medicaid expansion and who qualify for neither existing Medicaid coverage nor subsidized coverage through the states’ new insurance exchanges.[28]

Subsidies

Households with incomes between 100% and 400% of the federal poverty level were eligible to receive federal subsidies for policies purchased via an exchange.[29][30] Subsidies are provided as an advanceable, refundable tax credit[31][32] Additionally, small businesses are eligible for a tax credit provided that they enroll in the SHOP Marketplace.[33] Under the law, workers whose employers offer affordable coverage will not be eligible for subsidies via the exchanges. To be eligible the cost of employer-based health insurance must exceed 9.5% of the worker’s household income.

Subsidies (2014) for Family of 4[34][35][36][37][38]
Income % of federal poverty level Premium Cap as a Share of Income Incomea Max Annual Out-of-Pocket Premium Premium Savingsb Additional Cost-Sharing Subsidy
133% 3% of income $31,900 $992 $10,345 $5,040
150% 4% of income $33,075 $1,323 $9,918 $5,040
200% 6.3% of income $44,100 $2,778 $8,366 $4,000
250% 8.05% of income $55,125 $4,438 $6,597 $1,930
300% 9.5% of income $66,150 $6,284 $4,628 $1,480
350% 9.5% of income $77,175 $7,332 $3,512 $1,480
400% 9.5% of income $88,200 $8,379 $2,395 $1,480
a.^ Note: In 2014, the FPL was $11,800 for a single person and $24,000 for family of four.[39][40] See Subsidy Calculator for specific dollar amount.[41] b.^ DHHS and CBO estimate the average annual premium cost in 2014 would have been $11,328 for a family of 4 without the reform.[36]

Premiums were the same for everyone of a given age, regardless of preexisting conditions. Premiums were allowed to vary by enrollee age, but those for the oldest enrollees (age 45-64 average expenses $5,542) could only be three times as large as those for adults (18-24 $1,836).[42]

Mandates

Individual

The individual mandate[43] is the requirement to buy insurance or pay a penalty for everyone not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs (such as Tricare). Also exempt were those facing a financial hardship or who were members in a recognized religious sect exempted by the Internal Revenue Service.[44]

The mandate and the limits on open enrollment[45][46] were designed to avoid the insurance death spiral in which healthy people delay insuring themselves until they get sick. In such a situation, insurers would have to raise their premiums to cover the relatively sicker and thus more expensive policies,[43][47][48] which could create a vicious cycle in which more and more people drop their coverage.[49]

The purpose of the mandate was to prevent the healthcare system from succumbing to adverse selection, which would result in high premiums for the insured and little coverage (and thus more illness and medical bankruptcy) for the uninsured.[47][50][51] Studies by the CBO, Gruber and Rand Health concluded that a mandate was required.[52][53][54] The mandate increased the size and diversity of the insured population, including more young and healthy participants to broaden the risk pool, spreading costs.[55] Experience in New Jersey and Massachusetts offered divergent outcomes.[50][53][56]

Business

Businesses that employ 50 or more people but do not offer health insurance to their full-time employees pay a tax penalty if the government has subsidized a full-time employee’s healthcare through tax deductions or other means. This is commonly known as the employer mandate.[57][58] This provision was included to encourage employers to continue providing insurance once the exchanges began operating.[59] Approximately 44% of the population was covered directly or indirectly through an employer.[60][61]

Excise taxes

Excise taxes for the Affordable Care Act raised $16.3 billion in fiscal year 2015 (17% of all excise taxes collected by the Federal Government). $11.3 billion was an excise tax placed directly on health insurers based on their market share. The ACA was going to impose a 40% “Cadillac tax” on expensive employer sponsored health insurance but that was postponed until 2018. Annual excise taxes totaling $3 billion were levied on importers and manufacturers of prescription drugs. An excise tax of 2.3% on medical devices and a 10% excise tax on indoor tanning services were applied as well.[62]

Insurance standards

Essential health benefits

The National Academy of Medicine defined the law’s “essential health benefits” as “ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care”[63][64][65][66][67][68][69] and others[70] rated Level A or B by the U.S. Preventive Services Task Force.[71] In determining what would qualify as an essential benefit, the law required that standard benefits should offer at least that of a “typical employer plan”.[68] States may require additional services.[72]

Contraceptives

One provision in the law mandates that health insurance cover “additional preventive care and screenings” for women.[73] The guidelines mandate “[a]ll Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity”.[74] This mandate applies to all employers and educational institutions except for religious organizations.[75][76] These regulations were included on the recommendations of the Institute of Medicine.[77][78]

Risk management

ACA provided three ways to control risk for insurers in the individual and business markets: temporary reinsurance, temporary risk corridors, and permanent risk adjustment.

Risk corridor program

The risk-corridor program was a temporary risk management device defined under the PPACA section 1342[79]:1 to encourage reluctant insurers into the “new and untested” ACA insurance market during the first three years that ACA was implemented (2014-2016). For those years the Department of Health and Human Services (HHS) “would cover some of the losses for insurers whose plans performed worse than they expected. Insurers that were especially profitable, for their part, would have to return to HHS some of the money they earned on the exchanges”[80][81] According to an article in Forbes, risk corridors “had been a successful part of the Medicare prescription drug benefit, and the ACA’s risk corridors were modeled after Medicare’s Plan D.”[82] They operated on the principle that “more participation would mean more competition, which would drive down premiums and make health insurance more affordable” and “[w]hen insurers signed up to sell health plans on the exchanges, they did so with the expectation that the risk-corridor program would limit their downside losses.”[80] The risk corridors succeeded in attracting ACA insurers. The program did not pay for itself as planned with “accumulated losses” up to $8.3 billion for 2014 and 2015 alone. Authorization had to be given so that HHS could pay insurers from “general government revenues”. Congressional Republicans “railed against” the program as a ‘bailout’ for insurers. Then-Rep. Jack Kingston (R-Ga.), on the Appropriations Committee that funds the Department of Health and Human Services and the Labor Department “[slipped] in a sentence” — Section 227 — in the “massive” appropriationsConsolidated Appropriations Act, 2014 (H.R. 3547) that said that no funds in the discretionary spending bill “could be used for risk-corridor payments.” This effectively “blocked the administration from obtaining the necessary funds from other programs”[83] and placed Congress in a potential breach of contract with insurers who offered qualified health plans, under the Tucker Act[79] as it did not pay the insurers.[84][84] On February 10, 2017, in the Moda Health v the US Government, Moda, one of the insurers that struggled financially because of the elimination of the risk corridor program, won a “$214-million judgment against the federal government”. Justice Thomas C. Wheeler stated, “the Government “made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, ‘to say to [Moda], ‘The joke is on you. You shouldn’t have trusted us,’ is hardly worthy of our great government.”[85]

Temporary reinsurance

Temporary reinsurance for insurance for insurers against unexpectedly high claims was a program that ran from 2014 through 2016. It was intended to limit insurer losses.[citation needed]

Risk adjustment

Of the three risk management programs, only risk adjustment was permanent. Risk adjustment attempts to spread risk among insurers to prevent purchasers with good knowledge of their medical needs from using insurance to cover their costs (adverse selection). Plans with low actuarial risk compensate plans with high actuarial risk.[citation needed]

Other provisions

In 2012 Senator Sheldon Whitehouse created this summary to explain his view on the act.

The ACA has several other provisions:

  • Annual and lifetime coverage caps on essential benefits were banned.[86][87]
  • Prohibits insurers from dropping policyholders when they get sick.[88]
  • All health policies sold in the United States must provide an annual maximum out of pocket (MOOP) payment cap for an individual’s or family’s medical expenses (excluding premiums). After the MOOP payment cap is reached, all remaining costs must be paid by the insurer.[89]
  • A partial community rating requires insurers to offer the same premium to all applicants of the same age and location without regard to gender or most pre-existing conditions (excluding tobacco use).[90][91][92] Premiums for older applicants can be no more than three times those for the youngest.[93]
  • Preventive care, vaccinations and medical screenings cannot be subject to co-payments, co-insurance or deductibles.[94][95][96] Specific examples of covered services include: mammograms and colonoscopies, wellness visits, gestational diabetes screening, HPV testing, STI counseling, HIV screening and counseling, contraceptive methods, breastfeeding support/supplies and domestic violence screening and counseling.[97]
  • The law established four tiers of coverage: bronze, silver, gold and platinum. All categories offer the essential health benefits. The categories vary in their division of premiums and out-of-pocket costs: bronze plans have the lowest monthly premiums and highest out-of-pocket costs, while platinum plans are the reverse.[68][98] The percentages of health care costs that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).[99]
  • Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[88]
  • Insurers must spend at least 80–85% of premium dollars on health costs; rebates must be issued to policyholders if this is violated.[100][101]

Exchanges

Established the creation of health insurance exchanges in all fifty states. The exchanges are regulated, largely online marketplaces, administered by either federal or state government, where individuals and small business can purchase private insurance plans.[102][103][104]

Setting up an exchange gives a state partial discretion on standards and prices of insurance.[105][106] For example, states approve plans for sale, and influence (through limits on and negotiations with private insurers) the prices on offer. They can impose higher or state-specific coverage requirements—including whether plans offered in the state can cover abortion.[107] States without an exchange do not have that discretion. The responsibility for operating their exchanges moves to the federal government.[105]

State waivers

From 2017 onwards, states can apply for a “waiver for state innovation” that allows them to conduct experiments that meet certain criteria.[108] To obtain a waiver, a state must pass legislation setting up an alternative health system that provides insurance at least as comprehensive and as affordable as ACA, covers at least as many residents and does not increase the federal deficit.[109] Such states can exempt states from some of ACA’s central requirements, including the individual and employer mandates and the provision of an insurance exchange.[110] The state would receive compensation equal to the aggregate amount of any federal subsidies and tax credits for which its residents and employers would have been eligible under ACA plan, if they cannot be paid out due to the structure of the state plan.[108]

In May 2011, Vermont enacted Green Mountain Care, a state-based single-payer system for which they intended to pursue a waiver to implement.[111][112][113] In December 2014, Vermont decided not to continue due to high expected costs.[114]

Accountable Care Organizations

The Act allowed the creation of Accountable Care Organizations (ACOs), which are groups of doctors, hospitals and other providers that commit to give coordinated, high quality care to Medicare patients. ACOs were allowed to continue using a fee for service billing approach. They receive bonus payments from the government for minimizing costs while achieving quality benchmarks that emphasize prevention and mitigating chronic disease. If they fail to do so, they are subject to penalties.[115]

Unlike Health Maintenance Organizations, ACO patients are not required to obtain all care from the ACO. Also, unlike HMOs, ACOs must achieve quality of care goals.[115]

Others

Legislative history

President Obama signing the Patient Protection and Affordable Care Act on March 23, 2010

Background

An individual mandate coupled with subsidies for private insurance as a means for universal healthcare was considered the best way to win the support of the Senate because it had been included in prior bipartisan reform proposals. The concept goes back to at least 1989, when the conservativeHeritage Foundation proposed an individual mandate as an alternative to single-payer health care.[125] It was championed for a time by conservative economists and Republican senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems. Specifically, because the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) requires any hospital participating in Medicare (nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay.[126][127][128]

President Bill Clintonproposed a healthcare reform bill in 1993 that included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations. Republican Senators proposed an alternative that would have required individuals, but not employers, to buy insurance.[127]Ultimately the Clinton plan failed amid an unprecedented barrage of negative advertising funded by politically conservative groups and the health insurance industry and due to concerns that it was overly complex.[129] Clinton negotiated a compromise with the 105th Congress to instead enact the State Children’s Health Insurance Program (SCHIP) in 1997.[130]

John Chafee

The 1993 Republican alternative, introduced by Senator John Chafee as the Health Equity and Access Reform Today Act, contained a “universal coverage” requirement with a penalty for noncompliance—an individual mandate—as well as subsidies to be used in state-based ‘purchasing groups’.[131] Advocates for the 1993 bill included prominent Republicans such as Senators Orrin Hatch, Chuck Grassley, Bob Bennett and Kit Bond.[132][133] Of 1993’s 43 Republican Senators, 20 supported the HEART Act.[125][134] Another Republican proposal, introduced in 1994 by Senator Don Nickles (R-OK), the Consumer Choice Health Security Act, contained an individual mandate with a penalty provision;[135] however, Nickles subsequently removed the mandate from the bill, stating he had decided “that government should not compel people to buy health insurance”.[136] At the time of these proposals, Republicans did not raise constitutional issues with the mandate; Mark Pauly, who helped develop a proposal that included an individual mandate for George H. W. Bush, remarked, “I don’t remember that being raised at all. The way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax.”[125]

Mitt Romney’s Massachusetts went from 90% of its residents insured to 98%, the highest rate in the nation.[137]

In 2006, an insurance expansion bill was enacted at the state level in Massachusetts. The bill contained both an individual mandate and an insurance exchange. Republican Governor Mitt Romney vetoed the mandate, but after Democrats overrode his veto, he signed it into law.[138] Romney’s implementation of the ‘Health Connector’ exchange and individual mandate in Massachusetts was at first lauded by Republicans. During Romney’s 2008 presidential campaign, Senator Jim DeMint praised Romney’s ability to “take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured”. Romney said of the individual mandate: “I’m proud of what we’ve done. If Massachusetts succeeds in implementing it, then that will be the model for the nation.”[139]

In 2007, a year after the Massachusetts reform, Republican Senator Bob Bennett and Democratic Senator Ron Wyden introduced the Healthy Americans Act, which featured an individual mandate and state-based, regulated insurance markets called “State Health Help Agencies”.[128][139] The bill initially attracted bipartisan support, but died in committee. Many of the sponsors and co-sponsors remained in Congress during the 2008 healthcare debate.[140]

By 2008 many Democrats were considering this approach as the basis for healthcare reform. Experts said that the legislation that eventually emerged from Congress in 2009 and 2010 bore similarities to the 2007 bill[131] and that it was deliberately patterned after Romney’s state healthcare plan.[141]

Healthcare debate, 2008–10

Healthcare reform was a major topic during the 2008 Democratic presidential primaries. As the race narrowed, attention focused on the plans presented by the two leading candidates, Hillary Clinton and the eventual nominee, Barack Obama. Each candidate proposed a plan to cover the approximately 45 million Americans estimated to not have health insurance at some point each year. Clinton’s proposal would have required all Americans to obtain coverage (in effect, an individual mandate), while Obama’s proposal provided a subsidy but rejected the use of an individual mandate.[142][143]

During the general election, Obama said that fixing healthcare would be one of his top four priorities as president.[144] Obama and his opponent, Sen. John McCain, proposed health insurance reforms though they differed greatly. Senator John McCain proposed tax credits for health insurance purchased in the individual market, which was estimated to reduce the number of uninsured people by about 2 million by 2018. Obama proposed private and public group insurance, income-based subsidies, consumer protections, and expansions of Medicaid and SCHIP, which was estimated at the time to reduce the number of uninsured people by 33.9 million by 2018.[145]

President Obama addressing Congress regarding healthcare reform, September 9, 2009

After his inauguration, Obama announced to a joint session of Congress in February 2009 his intent to work with Congress to construct a plan for healthcare reform.[146][147] By July, a series of bills were approved by committees within the House of Representatives.[148] On the Senate side, from June to September, the Senate Finance Committee held a series of 31 meetings to develop a healthcare reform bill. This group — in particular, Democrats Max Baucus, Jeff Bingaman and Kent Conrad, along with Republicans Mike Enzi, Chuck Grassley and Olympia Snowe — met for more than 60 hours, and the principles that they discussed, in conjunction with the other committees, became the foundation of the Senate healthcare reform bill.[149][150][151]

Congressional Democrats and health policy experts like MIT economics professor Jonathan Gruber[152] and David Cutler argued that guaranteed issue would require both community rating and an individual mandate to ensure that adverse selection and/or “free riding” would not result in an insurance “death spiral”.[153] This approach was taken because the president and congressional leaders had concluded that more progressive plans, such as the (single-payer)Medicare for All act, could not obtain filibuster-proof support in the Senate. By deliberately drawing on bipartisan ideas — the same basic outline was supported by former Senate majority leaders Howard Baker, Bob Dole, Tom Daschle and George J. Mitchell—the bill’s drafters hoped to garner the votes necessary for passage.[154][155]

However, following the adoption of an individual mandate, Republicans came to oppose the mandate and threatened to filibuster any bills that contained it.[125] Senate minority leader Mitch McConnell, who led the Republican congressional strategy in responding to the bill, calculated that Republicans should not support the bill, and worked to prevent defections:[156]

It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out.[157]

Republican Senators, including those who had supported previous bills with a similar mandate, began to describe the mandate as “unconstitutional”. Journalist Ezra Klein wrote in The New Yorker that “a policy that once enjoyed broad support within the Republican Party suddenly faced unified opposition.”[128] Reporter Michael Cooper of The New York Times wrote that: “the provision … requiring all Americans to buy health insurance has its roots in conservative thinking.”[127][134]

Tea Party protesters at the Taxpayer March on Washington, September 12, 2009

The reform negotiations also attracted attention from lobbyists,[158] including deals between certain lobby groups and the advocates of the law to win the support of groups that had opposed past reforms, as in 1993.[159][160] The Sunlight Foundation documented many of the reported ties between “the healthcare lobbyist complex” and politicians in both parties.[161]

During the August 2009 summer congressional recess, many members went back to their districts and held town hall meetings on the proposals. The nascent Tea Party movement organized protests and many conservative groups and individuals attended the meetings to oppose the proposed reforms.[147] Many threats were made against members of Congress over the course of the debate.[162][163]

When Congress returned from recess, in September 2009 President Obama delivered a speech to a joint session of Congress supporting the ongoing Congressional negotiations.[164] He acknowledged the polarization of the debate, and quoted a letter from the late Senator Edward “Ted” Kennedy urging on reform: “what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”[165] On November 7, the House of Representatives passed the Affordable Health Care for America Act on a 220–215 vote and forwarded it to the Senate for passage.[147]

Senate

The Senate began work on its own proposals while the House was still working. The United States Constitution requires all revenue-related bills to originate in the House.[166] To formally comply with this requirement, the Senate used H.R. 3590, a bill regarding housing tax changes for service members.[167] It had been passed by the House as a revenue-related modification to the Internal Revenue Code. The bill became the Senate’s vehicle for its healthcare reform proposal, discarding the bill’s original content.[168] The bill ultimately incorporated elements of proposals that were reported favorably by the Senate Health and Finance committees. With the Republican Senate minority vowing to filibuster, 60 votes would be necessary to pass the Senate.[169] At the start of the 111th Congress, Democrats had only 58 votes; the Senate seat in Minnesota ultimately won by Al Franken was still undergoing a recount, while Arlen Specter was still a Republican (he became a Democrat in April, 2009).

Negotiations were undertaken attempting to satisfy moderate Democrats and to bring Republican senators aboard; particular attention was given to Republicans Bennett, Enzi, Grassley and Snowe. On July 7 Franken was sworn into office, providing a potential 60th vote. On August 25 Ted Kennedy—a longtime healthcare reform advocate—died. Paul Kirk was appointed as Senator Kennedy’s temporary replacement on September 24.

After the Finance Committee vote on October 15, negotiations turned to moderate Democrats. Majority leader Harry Reid focused on satisfying centrists. The holdouts came down to Joe Lieberman of Connecticut, an independent who caucused with Democrats, and conservative Nebraska Democrat Ben Nelson. Lieberman’s demand that the bill not include a public option[153][170] was met,[171] although supporters won various concessions, including allowing state-based public options such as Vermont’s Green Mountain Care.[171][172]

Senate vote by state.

  Democratic yes (58)
  Independent yes (2)
  Republican no (39)
 Republican not voting (1)

The White House and Reid addressed Nelson’s concerns[173] during a 13-hour negotiation with two concessions: a compromise on abortion, modifying the language of the bill “to give states the right to prohibit coverage of abortion within their own insurance exchanges”, which would require consumers to pay for the procedure out of pocket if the state so decided; and an amendment to offer a higher rate of Medicaid reimbursement for Nebraska.[147][174] The latter half of the compromise was derisively termed the “Cornhusker Kickback”[175] and was repealed in the subsequent reconciliation amendment bill.

On December 23, the Senate voted 60–39 to end debate on the bill: a cloture vote to end the filibuster. The bill then passed, also 60–39, on December 24, 2009, with all Democrats and two independents voting for it, and all Republicans against (except Jim Bunning, who did not vote).[176] The bill was endorsed by the AMA and AARP.[177]

On January 19, 2010, Massachusetts Republican Scott Brown was elected to the Senate in a special election to replace Kennedy, having campaigned on giving the Republican minority the 41st vote needed to sustain Republican filibusters.[147][178][179] His victory had become significant because of its effects on the legislative process. The first was psychological: the symbolic importance of losing Kennedy’s traditionally Democratic Massachusetts seat made many Congressional Democrats concerned about the political cost of passing a bill.[180][181]

House

House vote by congressional district.

  Democratic yes (219)
  Democratic no (34)
  Republican no (178)
  No representative seated (4)

Brown’s election meant Democrats could no longer break a filibuster in the Senate. In response, White House Chief of StaffRahm Emanuel argued that Democrats should scale back to a less ambitious bill; House SpeakerNancy Pelosi pushed back, dismissing Emanuel’s scaled-down approach as “Kiddie Care”.[182][183]

Obama remained insistent on comprehensive reform. The news that Anthem Blue Cross in California intended to raise premium rates for its patients by as much as 39% gave him new evidence of the need for reform.[182][183] On February 22, he laid out a “Senate-leaning” proposal to consolidate the bills.[184] He held a meeting with both parties’ leaders on February 25. The Democrats decided that the House would pass the Senate’s bill, to avoid another Senate vote.

House Democrats had expected to be able to negotiate changes in a House-Senate conference before passing a final bill. Since any bill that emerged from conference that differed from the Senate bill would have to pass the Senate over another Republican filibuster, most House Democrats agreed to pass the Senate bill on condition that it be amended by a subsequent bill.[181] They drafted the Health Care and Education Reconciliation Act, which could be passed by the reconciliation process.[182][185][186]

As per the Congressional Budget Act of 1974, reconciliation cannot be subject to a filibuster. But reconciliation is limited to budget changes, which is why the procedure was not used to pass ACA in the first place; the bill had inherently non-budgetary regulations.[187][188] Although the already-passed Senate bill could not have been passed by reconciliation, most of House Democrats’ demands were budgetary: “these changes—higher subsidy levels, different kinds of taxes to pay for them, nixing the Nebraska Medicaid deal—mainly involve taxes and spending. In other words, they’re exactly the kinds of policies that are well-suited for reconciliation.”[185]

The remaining obstacle was a pivotal group of pro-life Democrats led by Bart Stupak who were initially reluctant to support the bill. The group found the possibility of federal funding for abortion significant enough to warrant opposition. The Senate bill had not included language that satisfied their concerns, but they could not address abortion in the reconciliation bill as it would be non-budgetary. Instead, Obama issued Executive Order 13535, reaffirming the principles in the Hyde Amendment.[189] This won the support of Stupak and members of his group and assured the bill’s passage.[186][190] The House passed the Senate bill with a 219–212 vote on March 21, 2010, with 34 Democrats and all 178 Republicans voting against it.[191] The next day, Republicans introduced legislation to repeal the bill.[192] Obama signed ACA into law on March 23, 2010.[193] Since passage, Republicans have voted to repeal all or parts of the Affordable Care Act over sixty times; no such attempt by Republicans has been successful.[194] The amendment bill, The Health Care and Education Reconciliation Act, cleared the House on March 21; the Senate passed it by reconciliation on March 25, and Obama signed it on March 30.

Impact

Coverage rate, employer market cost trends, budgetary impact, and income inequality aspects of the Affordable Care Act.

This chart illustrates several aspects of the Affordable Care Act, including number of persons covered, cost before and after subsidies, and public opinion.

Coverage

The law has caused a significant reduction in the number and percentage of people without health insurance. The CDC reported that the percentage of people without health insurance fell from 16.0% in 2010 to 8.9% during the January–June 2016 period.[195] From Q4-2013 to Q1-2016, a Gallup survey found that the uninsured rate among adults declined from 17.1% to 11.0%, a decline of 6.1 percentage points.[196] In a 2016 review, Obama presented data showing that the uninsured rate had declined by 43%, from 16.0% in 2010 to 9.1% in 2015, mostly in 2014.[197] The uninsured rate dropped in every congressional district in the U.S. between 2013 and 2015.[198]

In March 2016, the CBO reported that there were approximately 27 million people without insurance in 2016, a figure they expected would range from 26-28 million through 2026. CBO also estimated the percentage of insured among all U.S. residents would remain at 90% through that period, 92-93% excluding unauthorized immigrants.[4]

Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64.[199] As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not.[200]

The Congressional Budget Office reported in March 2016 that there were approximately 12 million people covered by the exchanges (10 million of whom received subsidies to help pay for insurance) and 11 million made eligible for Medicaid by the law, a subtotal of 23 million people. An additional 1 million were covered by the ACA’s “Basic Health Program,” for a total of 24 million.[4] CBO also estimated that the ACA would reduce the net number of uninsured by 22 million in 2016, using a slightly different computation for the above figures totaling ACA coverage of 26 million, less 4 million for reductions in “employment-based coverage” and “non-group and other coverage.”[4] The Department of Health and Human Services (HHS) estimated that 20.0 million adults (aged 18–64) gained healthcare coverage via ACA as of February 2016, a 2.4 million increase over September 2015. HHS estimated that this 20.0 million included: a) 17.7 million from the start of open enrollment in 2013-2016; and b) 2.3 million young adults aged 19–25 who initially gained insurance from 2010-2013, as they were allowed to remain on their parent’s plans until age 26. Of the 20.0 million, an estimated 6.1 million were aged 19–25.[5]

By 2017, nearly 70% of those on the exchanges could purchase insurance for less than $75/month after subsidies, which rose to offset significant pre-subsidy price increases in the exchange markets.[201] Healthcare premium cost increases in the employer market continued to moderate. For example, healthcare premiums for those covered by employers rose by 69% from 2000-2005, but only 27% from 2010 to 2015,[6] with only a 3% increase from 2015 to 2016.[202]

The ACA also helps reduce income inequality measured after taxes, due to higher taxes on the top 5% of income earners and both subsidies and Medicaid expansion for lower-income persons.[203] CBO estimated that subsidies paid under the law in 2016 averaged $4,240 per person for 10 million individuals receiving them, roughly $42 billion. For scale, the subsidy for the employer market, in the form of exempting from taxation those health insurance premiums paid on behalf of employees by employers, was approximately $1,700 per person in 2016, or $266 billion total in the employer market. The employer market subsidy was not changed by the law.[4]

Insurance exchanges

As of August 2016, 15 states operated their own exchanges. Other states either used the federal exchange, or operated in partnership with or supported by the federal government.[204]

Medicaid expansion

Medicaid expansion by state.[205]

  Adopted the Medicaid expansion
  Medicaid expansion under discussion
  Not adopting Medicaid expansion

As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not.[200] Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64.[199] Following the Supreme Court ruling in 2012, which held that states would not lose Medicaid funding if they didn’t expand Medicaid under the ACA, several states rejected expanded Medicaid coverage. Over half of the national uninsured population lived in those states.[206] In a report to Congress, the Centers for Medicare and Medicaid Services (CMS) estimated that the cost of expansion was $6,366 per person for 2015, about 49 percent above previous estimates. An estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults.[207] The Kaiser Family Foundation estimated in October 2015 that 3.1 million additional people were not covered because of states that rejected the Medicaid expansion.[208]

States that rejected the Medicaid expansion could maintain their Medicaid eligibility thresholds, which in many states were significantly below 133% of the poverty line.[209]Many states did not make Medicaid available to childless adults at any income level.[210] Because subsidies on exchange insurance plans were not available to those below the poverty line, such individuals had no new options.[211][212] For example, in Kansas, where only able-bodied adults with children and with an income below 32% of the poverty line were eligible for Medicaid, those with incomes from 32% to 100% of the poverty level ($6,250 to $19,530 for a family of three) were ineligible for both Medicaid and federal subsidies to buy insurance. Absent children, able-bodied adults were not eligible for Medicaid in Kansas.[206]

Studies of the impact of state decisions to reject the Medicaid expansion calculated that up to 6.4 million people could fall into this status.[213] The federal government initially paid for 100% of the expansion (through 2016). The subsidy tapered to 90% by 2020 and continued to shrink thereafter.[214] Several states argued that they could not afford their 10% contribution.[214][215] Studies suggested that rejecting the expansion would cost more than expanding Medicaid due to increased spending on uncompensated emergency care that otherwise would have been partially paid for by Medicaid coverage,[216]

A 2016 study led by Harvard University health economics professor Benjamin Sommers found that residents of Kentucky and Arkansas, which both accepted the Medicaid expansion, were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills than before the expansion. Residents of Texas, which did not accept the Medicaid expansion, did not see a similar improvement during the same period.[217] Kentucky opted for increased managed care, while Arkansas subsidized private insurance. The new Arkansas and Kentucky governors have proposed reducing or modifying their programs. Between 2013 and 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with 39% to 32% in Texas. Specific improvements included additional primary and preventive care, fewer emergency departments visits, reported higher quality care, improved health, improved drug affordability, reduced out-of-pocket spending and increased outpatient visits, increased diabetes screening, glucose testing among diabetes patients and regular care for chronic conditions.[218]

A 2016 DHHS study found that states that expanded Medicaid had lower premiums on exchange policies, because they had fewer low-income enrollees, whose health on is worse than that of those with higher income.[219]

Healthcare insurance costs

U.S. healthcare cost information, including rate of change, per-capita, and percent of GDP. (Data source: Centers for Medicare and Medicaid Services[220])

The law is designed to pay subsidies in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas.[221] However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the Kaiser Foundation reported that for the second-lowest cost “Silver plan” (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.[222]

Healthcare premium cost increases in the employer market continued to moderate after the implementation of the law. For example, healthcare premiums for those covered by employers rose by 69% from 2000-2005, but only 27% from 2010 to 2015,[6] with only a 3% increase from 2015 to 2016.[202] From 2008-2010 (prior to Obamacare) health insurance premiums rose by an average of 10% per year.[223]

Several studies found that the financial crisis and accompanying recession could not account for the entirety of the slowdown and that structural changes likely share at least partial credit.[224][225][226][227] A 2013 study estimated that changes to the health system had been responsible for about a quarter of the recent reduction in inflation.[228] Paul Krawzak claimed that even if cost controls succeed in reducing the amount spent on healthcare, such efforts on their own may be insufficient to outweigh the long-term burden placed by demographic changes, particularly the growth of the population on Medicare.[229]

In a 2016 review of the ACA published in JAMA, Barack Obama himself wrote that from 2010 through 2014 mean annual growth in real per-enrollee Medicare spending was negative, down from a mean of 4.7% per year from 2000 through 2005 and 2.4% per year from 2006 to 2010; similarly, mean real per-enrollee growth in private insurance spending was 1.1% per year over the period, compared with a mean of 6.5% from 2000 through 2005 and 3.4% from 2005 to 2010.[230]

Effect on deductibles and co-payments

While health insurance premium costs have moderated, some of this is because of insurance policies that have a higher deductible, co-payments and out-of-pocket maximums that shift costs from insurers to patients. In addition, many employees are choosing to combine a health savings account with higher deductible plans, making the impact of the ACA difficult to determine precisely.

For those who obtain their insurance through their employer (“group market”), a 2016 survey found that:

  • Deductibles grew by 63% from 2011 to 2016, while premiums increased 19% and worker earnings grew by 11%.
  • In 2016, 4 in 5 workers had an insurance deductible, which averaged $1,478. For firms with less than 200 employees, the deductible averaged $2,069.
  • The percentage of workers with a deductible of at least $1,000 grew from 10% in 2006 to 51% in 2016. The 2016 figure drops to 38% after taking employer contributions into account.[231]

For the “non-group” market, of which two-thirds are covered by the ACA exchanges, a survey of 2015 data found that:

  • 49% had individual deductibles of at least $1,500 ($3,000 for family), up from 36% in 2014.
  • Many marketplace enrollees qualify for cost-sharing subsidies that reduce their net deductible.
  • While about 75% of enrollees were “very satisfied” or “somewhat satisfied” with their choice of doctors and hospitals, only 50% had such satisfaction with their annual deductible.
  • While 52% of those covered by the ACA exchanges felt “well protected” by their insurance, in the group market 63% felt that way.[232]

Health outcomes

Insurance coverage helps save lives, by encouraging early detection and prevention of dangerous medical conditions. According to a 2014 study, the ACA likely prevented an estimated 50,000 preventable patient deaths from 2010 to 2013.[233]City University public health professors David Himmelstein and Steffie Woolhandler wrote in January 2017 that a rollback of the ACA’s Medicaid expansion alone would cause an estimated 43,956 deaths annually.[234]

Federal deficit

CBO estimates of revenue and impact on deficit

The CBO reported in several studies that the ACA would reduce the deficit, and that repealing it would increase the deficit.[7][8][235][236] The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period:[8][237] it calculated the law would result in $604 billion in total outlays offset by $813 billion in total receipts, resulting in a $210 billion net deficit reduction.[8] The CBO separately predicted that while most of the spending provisions do not begin until 2014,[238][239] revenue would exceed spending in those subsequent years.[240] The CBO claimed that the bill would “substantially reduce the growth of Medicare’s payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs”[241]—ultimately extending the solvency of the Medicare trust fund by 8 years.[242]

This estimate was made prior to the Supreme Court’s ruling that enabled states to opt out of the Medicaid expansion, thereby forgoing the related federal funding. The CBO and JCT subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion.[243][244][245]

The CBO in June 2015 forecasted that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic feedback effects. The CBO also forecasted that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2015, mainly by boosting the supply of labor.[7]

Major new sources of increased tax receipts include:[95] higher Medicare taxes; annual fees on insurance providers; fees on the healthcare industry such as manufacturers and importers of brand-name pharmaceutical drugs and certain medical devices; limits on tax deductions of medical expenses and flexible spending accounts; a 40% excise tax on plans with annual insurance premiums in excess of $10,200 for an individual or $27,500 for a family; revenue from mandate penalty payments; a 10% federal sales tax on indoor tanning services. Predicted spending reductions included a reduction in Medicare reimbursements to insurers and drug companies for private Medicare Advantage policies that the Government Accountability Office and Medicare Payment Advisory Commission found to be excessively costly relative to government Medicare;[246][247] and reductions in Medicare reimbursements to hospitals that failed standards of efficiency and care.[246]

Although the CBO generally does not provide cost estimates beyond the 10-year budget projection period because of the degree of uncertainty involved in the projection, it decided to do so in this case at the request of lawmakers, and estimated a second decade deficit reduction of $1.2 trillion.[241][248] CBO predicted deficit reduction around a broad range of one-half percent of GDP over the 2020s while cautioning that “a wide range of changes could occur”.[249]

Opinions on CBO projections

The CBO cost estimates were criticized because they excluded the effects of potential legislation that would increase Medicare payments by more than $200 billion from 2010 to 2019.[250][251][252] However, the so-called “doc fix” is a separate issue that would have existed whether or not ACA became law – omitting its cost from ACA was no different from omitting the cost of other tax cuts.[253][254][255]

Uwe Reinhardt, a Princeton health economist, wrote. “The rigid, artificial rules under which the Congressional Budget Office must score proposed legislation unfortunately cannot produce the best unbiased forecasts of the likely fiscal impact of any legislation”, but went on to say “But even if the budget office errs significantly in its conclusion that the bill would actually help reduce the future federal deficit, I doubt that the financing of this bill will be anywhere near as fiscally irresponsible as was the financing of the Medicare Modernization Act of 2003.”[256]Douglas Holtz-Eakin, CBO director during the George W. Bush administration, who later served as the chief economic policy adviser to U.S. Senator John McCain‘s 2008 presidential campaign, alleged that the bill would increase the deficit by $562 billion because, he argued, it front-loaded revenue and back-loaded benefits.[257]

Scheiber and Cohn rejected critical assessments of the law’s deficit impact, arguing that predictions were biased towards underestimating deficit reduction. They noted that for example, it is easier to account for the cost of definite levels of subsidies to specified numbers of people than account for savings from preventive healthcare, and that the CBO had a track record of overestimating costs and underestimating savings of health legislation;[258][259] stating, “innovations in the delivery of medical care, like greater use of electronic medical records[260] and financial incentives for more coordination of care among doctors, would produce substantial savings while also slowing the relentless climb of medical expenses… But the CBO would not consider such savings in its calculations, because the innovations hadn’t really been tried on such large scale or in concert with one another—and that meant there wasn’t much hard data to prove the savings would materialize.”[258]

In 2010 David Walker, former U.S. Comptroller General then working for The Peter G. Peterson Foundation, stated that the CBO estimates are not likely to be accurate, because they were based on the assumption that the law would not change.[261] The Center on Budget and Policy Priorities objected that Congress had a good record of implementing Medicare savings. According to their study, Congress followed through on the implementation of the vast majority of provisions enacted in the past 20 years to produce Medicare savings, although not the payment reductions addressed by the annual “doc fix”.[262][263]

Economic consequences

CBO estimated in June 2015 that repealing the ACA would:

  • Decrease aggregate demand (GDP) in the short-term, as low-income persons who tend to spend a large fraction of their additional resources would have fewer resources (e.g., ACA subsidies would be eliminated). This effect would be offset in the long-run by the labor supply factors below.
  • Increase the supply of labor and aggregate compensation by about 0.8 and 0.9 percent over the 2021-2025 period. CBO cited the ACA’s expanded eligibility for Medicaid and subsidies and tax credits that rise with income as disincentives to work, so repealing the ACA would remove those disincentives, encouraging workers to supply more hours of labor.
  • Increase the total number of hours worked by about 1.5% over the 2021-2025 period.
  • Remove the higher tax rates on capital income, thereby encouraging additional investment, raising the capital stock and output in the long-run.[7]

In 2015 the Center for Economic and Policy Research found no evidence that companies were reducing worker hours to avoid ACA requirements[264] for employees working over 30 hours per week.[265]

The CBO estimated that the ACA would slightly reduce the size of the labor force and number of hours worked, as some would no longer be tethered to employers for their insurance. Cohn, citing CBO’s projections, claimed that ACA’s primary employment effect was to alleviate job lock: “People who are only working because they desperately need employer-sponsored health insurance will no longer do so.”[266] He concluded that the “reform’s only significant employment impact was a reduction in the labor force, primarily because people holding onto jobs just to keep insurance could finally retire”, because they have health insurance outside of their jobs.[267]

Employer mandate and part-time work

For more details on health insurance mandates, see Health insurance mandate.

The employer mandate requires employers meeting certain criteria to provide health insurance to their workers. The mandate applies to employers with more than 50 employees that do not offer health insurance to their full-time workers.[268] Critics claimed that the mandate created a perverse incentive for business to keep their full-time headcount below 50 and to hire part-time workers instead.[269][270] Between March 2010 and 2014 the number of part-time jobs declined by 230,000, while the number of full-time jobs increased by 2 million.[271][272] In the public sector full-time jobs turned into part-time jobs much more than in the private sector.[271][273] A 2016 study found only limited evidence that ACA had increased part-time employment.[274]

Several businesses and the state of Virginia added a 29-hour-a-week cap for their part-time employees,[275][unreliable source?][276][unreliable source?] to reflect the 30-hour-or-more definition for full-time worker.[268] As of yet, however, only a small percent of companies have shifted their workforce towards more part-time hours (4% in a survey from the Federal Reserve Bank of Minneapolis).[270] Trends in working hours[277] and the effects of the Great Recession correlate with part-time working hour patterns.[278][279] The impact of this provision may have been offset by other factors, including that health insurance helps attract and retain employees, increases productivity and reduces absenteeism; and the lower training and administration costs of a smaller full-time workforce over a larger part-time work force.[270][277][280] Relatively few firms employ over 50 employees[270] and more than 90% of them offered insurance.[281] Workers without employer insurance could purchase insurance on the exchanges.[282]

Most policy analysts (on both right and left) were critical of the employer mandate provision.[269][281] They argued that the perverse incentives regarding part-time hours, even if they did not change existing plans, were real and harmful;[283][284] that the raised marginal cost of the 50th worker for businesses could limit companies’ growth;[285] that the costs of reporting and administration were not worth the costs of maintaining employer plans;[283][284] and noted that the employer mandate was not essential to maintain adequate risk pools.[286][287] The effects of the provision generated vocal opposition from business interests and some unions not granted exemptions.[284][288]

A 2013/4 survey by the National Association for Business Economics found that about 75 percent of those surveyed said ACA hadn’t influenced their planning or expectations for 2014, and 85 percent said the law wouldn’t prompt a change in their hiring practices. Some 21 percent of 64 businesses surveyed said that the act would have a harmful effect and 5 percent said it would be beneficial.[289]

Hospitals

From the start of 2010 to November 2014, 43 hospitals in rural areas closed. Critics claimed that the new law caused these hospitals to close. Many of these rural hospitals were built using funds from the 1946 Hill–Burton Act, to increase access to medical care in rural areas. Some of these hospitals reopened as other medical facilities, but only a small number operated emergency rooms (ER) or urgent care centers.[290]

Between January 2010 and 2015, a quarter of emergency room doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed that they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured patients.[291]

Insurers claimed that because they have access to and collect patient data that allow evaluations of interventions, they are essential to ACO success. Large insurers formed their own ACOs. Many hospitals merged and purchased physician practices. The increased market share gave them more leverage in negotiations with insurers over costs and reduced patient care options.[115]

Public opinion

Prior to the law’s passage, polling indicated the public’s views became increasingly negative in reaction to specific plans discussed during the legislative debate over 2009 and 2010. Polling statistics showed a general negative opinion of the law; with those in favor at approximately 40% and those against at 51%, as of October 2013.[292][293] About 29% of whites approve of the law, compared with 61% of Hispanics and 91% of African Americans.[294]Opinions were divided by age of the person at the law’s inception, with a solid majority of seniors opposing the bill and a solid majority of those younger than forty years old in favor.[295]

Congressional Democrats celebrating the 6th anniversary of the Affordable Care Act in March 2016 on the steps of the U.S. Capitol.

Congressional Democrats celebrating the 6th anniversary of the Affordable Care Act in March 2016 on the steps of the U.S. Capitol.

Specific elements were popular across the political spectrum, while others, such as the mandate to purchase insurance, were widely disliked. In a 2012 poll 44% supported the law, with 56% against. By party affiliation, 75% of Democrats, 27% of Independents and 14% of Republicans favored the law overall. 82% favored banning insurance companies from denying coverage to people with pre-existing conditions, 61% favored allowing children to stay on their parents’ insurance until age 26, 72% supported requiring companies with more than 50 employees to provide insurance for their employees, and 39% supported the individual mandate to own insurance or pay a penalty. By party affiliation, 19% of Republicans, 27% of Independents, and 59% of Democrats favored the mandate.[296] Other polls showed additional provisions receiving majority support, including the creation of insurance exchanges, pooling small businesses and the uninsured with other consumers so that more people can take advantage of large group pricing benefits and providing subsidies to individuals and families to make health insurance more affordable.[297][298]

In a 2010 poll, 62% of respondents said they thought ACA would “increase the amount of money they personally spend on health care”, 56% said the bill “gives the government too much involvement in health care”, and 19% said they thought they and their families would be better off with the legislation.[299] Other polls found that people were concerned that the law would cost more than projected and would not do enough to control costs.[300]

Some opponents believed that the reform did not go far enough: a 2012 poll indicated that 71% of Republican opponents rejected it overall, while 29% believed it did not go far enough; independent opponents were divided 67% to 33%; and among the much smaller group of Democratic opponents, 49% rejected it overall and 51% wanted more.[296] In June 2013, a majority of the public (52–34%) indicated a desire for “Congress to implement or tinker with the law rather than repeal it”.[301] After the Supreme Court upheld the individual mandate, a 2012 poll held that “most Americans (56%) want to see critics of President Obama’s health care law drop efforts to block it and move on to other national issues”.[302]A 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA vs. 38.3% who had a favorable view (of more than 5,500 individuals).[303]

A 2014 poll reported that 26% of Americans support ACA.[304] Another held that 8% of respondents say that the Affordable Care Act “is working well the way it is”.[305] In late 2014, a Rasmussen poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%, i.e., 65% wanted to leave ACA alone or improve upon it.[306]

In 2015, a CBS News / New York Times poll reported that 47% of Americans approved the health care law. This was the first time that a major poll indicated that more respondents approved ACA than disapproved of it.[307] The recurring Kaiser Health Tracking Poll from December 2016 reported that: a) 30% wanted to expand what the law does; b) 26% wanted to repeal the entire law; c) 19% wanted to move forward with implementing the law as it is; and d) 17% wanted to scale back what the law does, with the remainder undecided.[308]

Separate polls from Fox News and NBC/WSJ both taken during January 2017 indicated more people viewed the law favorably than did not for the first time. One of the reasons for the improving popularity of the law is that Democrats who opposed it in the past (many prefer a “Medicare for All” approach) have shifted their positions since the ACA is under threat of repeal.[309]

A January 2017 Morning Consult poll showed that 35% of respondents either believed that Obamacare and the Affordable Care Act were different or did not know.[310] Approximately 45% were unsure whether the repeal of Obamacare also meant the repeal of the Affordable Care Act.[310] 39% did not know that “many people would lose coverage through Medicaid or subsidies for private health insurance if the A.C.A. were repealed and no replacement enacted,” with Democrats far more likely (79%) to know that fact than Republicans (47%).[310]

A 2017 study found that personal experience with public health insurance programs leads to greater support for the Affordable Care Act, and the effects appear to be most pronounced among Republicans and low-information voters.[311]

Political aspects

“Obamacare”

The term “Obamacare” was originally coined by opponents as a pejorative. The term emerged in March 2007 when healthcare lobbyist Jeanne Schulte Scott used it in a health industry journal, writing “We will soon see a ‘Giuliani-care’ and ‘Obama-care’ to go along with ‘McCain-care’, ‘Edwards-care’, and a totally revamped and remodeled ‘Hillary-care‘ from the 1990s”.[9][312] According to research by Elspeth Reeve, the expression was used in early 2007, generally by writers describing the candidate’s proposal for expanding coverage for the uninsured.[313] It first appeared in a political campaign by Mitt Romney in May 2007 in Des Moines, Iowa. Romney said, “In my state, I worked on healthcare for some time. We had half a million people without insurance, and I said, ‘How can we get those people insured without raising taxes and without having government take over healthcare?’ And let me tell you, if we don’t do it, the Democrats will. If the Democrats do it, it will be socialized medicine; it’ll be government-managed care. It’ll be what’s known as Hillarycare or Barack Obamacare, or whatever you want to call it.”[9]

By mid-2012, Obamacare had become the colloquial term used by both supporters and opponents. In contrast, the use of “Patient Protection and Affordable Care Act” or “Affordable Care Act” became limited to more formal and official use.[313] Use of the term in a positive sense was suggested by Democrat John Conyers.[314] Obama endorsed the nickname, saying, “I have no problem with people saying Obama cares. I do care.”[315]

In March 2012, the Obama reelection campaign embraced the term “Obamacare”, urging Obama’s supporters to post Twitter messages that begin, “I like #Obamacare because…”.[316]

In October 2013 the Associated Press and NPR began cutting back on use of the term.[317] Stuart Seidel, NPR’s managing editor, said that the term “seems to be straddling somewhere between being a politically-charged term and an accepted part of the vernacular”.[318]

Common misconceptions

“Death panels”

Main article: Death panel

On August 7, 2009, Sarah Palin pioneered the term “death panels” to describe groups that would decide whether sick patients were “worthy” of medical care.[319] “Death panel” referred to two claims about early drafts.

One was that under the law, seniors could be denied care due to their age[320] and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an Independent Payment Advisory Board (IPAB).[321] IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when the statutory levels set for Medicare were exceeded within any given 3-year period. In fact, the Board was prohibited from recommending changes that would reduce payments to certain providers before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.[322][323]

The other related issue concerned advance-care planning consultation: a section of the House reform proposal would have reimbursed physicians for providing patient-requested consultations for Medicare recipients on end-of-life health planning (which is covered by many private plans), enabling patients to specify, on request, the kind of care they wished to receive.[324] The provision was not included in ACA.[325]

In 2010, the Pew Research Center reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls.[326] A poll in August 2012 found that 39% of Americans believed the claim.[327] The allegation was named PolitiFact‘s “Lie of the Year”,[319][328] one of FactCheck.org‘s “whoppers”[329][330] and the most outrageous term by the American Dialect Society.[331]AARP described such rumors as “rife with gross—and even cruel—distortions”.[332]

Members of Congress

ACA requires members of Congress and their staffs to obtain health insurance either through an exchange or some other program approved by the law (such as Medicare), instead of using the insurance offered to federal employees (the Federal Employees Health Benefits Program).[333][334][335][336][337]

Illegal immigrants

ACA does not provide benefits to illegal immigrants.[338] It explicitly denies insurance subsidies to “unauthorized (illegal) aliens”.[25][26][339]

Exchange “death spiral”

One argument against the ACA is that the insurers are leaving the marketplaces, as they cannot profitably cover the available pool of customers, which contains too many unhealthy participants relative to healthy participants. A scenario where prices rise, due to an unfavorable mix of customers from the insurer’s perspective, resulting in fewer customers and fewer insurers in the marketplace, further raising prices, has been called a “Death Spiral.”[340]During 2017, the median number of insurers offering plans on the ACA exchanges in each state was 3.0, meaning half the states had more and half had fewer insurers. There were five states with one insurer in 2017; 13 states with two; 11 states with three; and the remainder had four insurers or more. Wisconsin had the most, with 15 insurers in the marketplace. The median number of insurers was 4.0 in 2016, 5.0 in 2015, and 4.0 in 2014.[341]

Further, the CBO reported in January 2017 that it expected enrollment in the exchanges to rise from 10 million during 2017 to 13 million by 2027, assuming laws in place at the end of the Obama administration were continued.[342] Following a 2015 CBO report that reached a similar conclusion, Paul Krugman wrote: “But the truth is that this report is much, much closer to what supporters of reform have said than it is to the scare stories of the critics–no death spirals, no job-killing, major gains in coverage at relatively low cost.”[343]

Opposition

Opposition and efforts to repeal the legislation have drawn support from sources that include labor unions,[344][345]conservative advocacy groups,[346][347] Republicans, small business organizations and the Tea Party movement.[348] These groups claimed that the law would disrupt existing health plans, increase costs from new insurance standards, and increase the deficit.[349] Some opposed the idea of universal healthcare, viewing insurance as similar to other unsubsidized goods.[350][351] President Donald Trump has repeatedly promised to “repeal and replace” it.[352][353]

As of 2013 unions that expressed concerns about ACA included the AFL-CIO,[354] which called ACA “highly disruptive” to union health care plans, claiming it would drive up costs of union-sponsored plans; the International Brotherhood of Teamsters, United Food and Commercial Workers International Union, and UNITE-HERE, whose leaders sent a letter to Reid and Pelosi arguing, ” ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour work week that is the backbone of the American middle class.”[345] In January 2014, Terry O’Sullivan, president of the Laborers’ International Union of North America (LIUNA) and D. Taylor, president of Unite Here sent a letter to Reid and Pelosi stating, “ACA, as implemented, undermines fair marketplace competition in the health care industry.”[344]

In October 2016, Mark Dayton, the governor of Minnesota and a member of the Minnesota Democratic–Farmer–Labor Party, said that the ACA had “many good features” but that it was “no longer affordable for increasing numbers of people” and called on the Minnesota legislature to provide emergency relief to policyholders.[355] Dayton later said he regretted his remarks after they were seized on by Republicans seeking to repeal the law.[356]

Legal challenges

National Federation of Independent Business v. Sebelius

Opponents challenged ACA’s constitutionality in multiple lawsuits on multiple grounds.[357][358][not in citation given] In National Federation of Independent Business v. Sebelius, the Supreme Court ruled on a 5–4 vote that the individual mandate was constitutional when viewed as a tax, although not under the Commerce Clause.

The Court further determined that states could not be forced to participate in the Medicaid expansion. ACA withheld all Medicaid funding from states declining to participate in the expansion. The Court ruled that this withdrawal of funding was unconstitutionally coercive and that individual states had the right to opt out without losing preexisting Medicaid funding.[359]

Contraception mandate

In March 2012 the Roman Catholic Church, while supportive of ACA’s objectives, voiced concern through the United States Conference of Catholic Bishops that aspects of the mandate covering contraception and sterilization and HHS‘s narrow definition of a religious organization violated the First Amendment right to free exercise of religion and conscience. Various lawsuits addressed these concerns.[360][361]

On June 25, 2015, the U.S. Supreme Court ruled 6–3 that federal subsidies for health insurance premiums could be used in the 34 states that did not set up their own insurance exchanges.[362]

House v. Burwell

In United States House of Representatives v. Burwell the House sued the administration alleging that the money for premium subsidy payments to insurers had not been appropriated, as required for any federal government spending. The Obamacare subsidy that helps customers pay premiums was not part of the suit. Without the cost-sharing subsidies, the government estimated that premiums would increase by 20 percent to 30 percent for silver plans.[363]

Non-cooperation

Officials in Texas, Florida, Alabama, Wyoming, Arizona, Oklahoma and Missouri opposed those elements of ACA over which they had discretion.[364][365] For example, Missouri declined to expand Medicaid or establish a health insurance marketplace engaging in active non-cooperation, enacting a statute forbidding any state or local official to render any aid not specifically required by federal law.[366] Other Republican politicians discouraged efforts to advertise the benefits of the law. Some conservative political groups launched ad campaigns to discourage enrollment.[367][368]

Repeal efforts

ACA was the subject of unsuccessful repeal efforts by Republicans in the 111th, 112th, and 113th Congresses: Representatives Steve King (R-IA) and Michele Bachmann (R-MN) introduced bills in the House to repeal ACA the day after it was signed, as did Senator Jim DeMint (R-SC) in the Senate.[369] In 2011, after Republicans gained control of the House of Representatives, one of the first votes held was on a bill titled “Repealing the Job-Killing Health Care Law Act” (H.R. 2), which the House passed 245–189.[370] All Republicans and 3 Democrats voted for repeal.[371] House Democrats proposed an amendment that repeal not take effect until a majority of the Senators and Representatives had opted out of the Federal Employees Health Benefits Program; Republicans voted down the measure.[372] In the Senate, the bill was offered as an amendment to an unrelated bill, but was voted down.[373] President Obama had stated that he would have vetoed the bill even if it had passed both chambers of Congress.[374]

2017 House Budget

Following the 2012 Supreme Court ruling upholding ACA as constitutional, Republicans held another vote to repeal the law on July 11;[375] the House of Representatives voted with all 244 Republicans and 5 Democrats in favor of repeal, which marked the 33rd, partial or whole, repeal attempt.[376][377] On February 3, 2015, the House of Representatives added its 67th repeal vote to the record (239 to 186). This attempt also failed.[378]

2013 federal government shutdown

Strong partisan disagreement in Congress prevented adjustments to the Act’s provisions.[379] However, at least one change, a proposed repeal of a tax on medical devices, has received bipartisan support.[380] Some Congressional Republicans argued against improvements to the law on the grounds they would weaken the arguments for repeal.[284][381]

Republicans attempted to defund its implementation,[365][382] and in October 2013, House Republicans refused to fund the federal government unless accompanied with a delay in ACA implementation, after the President unilaterally deferred the employer mandate by one year, which critics claimed he had no power to do. The House passed three versions of a bill funding the government while submitting various versions that would repeal or delay ACA, with the last version delaying enforcement of the individual mandate. The Democratic Senate leadership stated the Senate would only pass a “clean” funding bill without any restrictions on ACA. The government shutdown began on October 1.[383][384][385] Senate Republicans threatened to block appointments to relevant agencies, such as the Independent Payment Advisory Board[386] and Centers for Medicare and Medicaid Services.[387][388]

2017 repeal effort

During a midnight congressional session starting January 11, 2017, the Senate of the 115th Congress of the United States voted to approve a “budget blueprint” which would allow Republicans to repeal parts of the law “without threat of a Democraticfilibuster.”[389][390] The plan, which passed 51-48 is a budget blueprint named by Senate Republicans the “Obamacare ‘repeal resolution.'”[391] Democrats opposing the resolution staged a protest during the vote.[392]

House Republicans announced their replacement for the ACA, the American Health Care Act, on March 6, 2017.[393] On March 24, 2017 the effort, led by Paul Ryan and Donald Trump, to repeal and replace the ACA failed amid a revolt among Republican representatives.[394]

Implementation history

Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.

Existing individual health plans

Plans purchased after the date of enactment, March 23, 2010, or old plans that changed in specified ways would eventually have to be replaced by ACA-compliant plans.[citation needed]

At various times during and after the ACA debate, Obama stated that “if you like your health care plan, you’ll be able to keep your health care plan”.[395][396] However, in fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated,[397] and several million more risked seeing their current plans cancelled.[398][399][400]

Obama’s previous unambiguous assurance that consumers’ could keep their own plans became a focal point for critics, who challenged his truthfulness.[401][402] On November 7, 2013, President Obama stated: “I am sorry that [people losing their plans] are finding themselves in this situation based on assurances they got from me.”[403] Various bills were introduced in Congress to allow people to keep their plans.[404]

In the fall of 2013, the Obama Administration announced a transitional relief program that would let states and carriers allow non-compliant individual and small group policies to renew at the end of 2013. In March 2014, HHS allowed renewals as late as October 1, 2016. In February 2016, these plans were allowed to renew up until October 1, 2017, but with a termination date no later than December 31, 2017.[citation needed]

2010

In June small business tax credits took effect. For certain small businesses, the credits reached up to 35% of premiums. At the same time uninsured people with pre-existing conditions could access the federal high-risk pool. Also, participating employment-based plans could obtain reimbursement for a portion of the cost of providing health insurance to early retirees.[405]

In July the Pre-Existing Condition Insurance Plan (PCIP) took effect to offer insurance to those that had been denied coverage by private insurance companies because of a pre-existing condition. Despite estimates of up to 700,000 enrollees, at a cost of approximately $13,000/enrollee, only 56,257 enrolled at a $28,994 cost per enrollee.[405]

2011

As of September 23, 2010, pre-existing conditions could no longer be denied coverage for children’s policies. HHS interpreted this rule as a mandate for “guaranteed issue“, requiring insurers to issue policies to such children.[citation needed] By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.[406]

The average beneficiary in the prior coverage gap would have spent $1,504 in 2011 on prescriptions. Such recipients saved an average $603. The 50 percent discount on brand name drugs provided $581 and the increased Medicare share of generic drug costs provided the balance. Beneficiaries numbered 2 million[407]

2012

In National Federation of Independent Business v. Sebelius decided on June 28, 2012, the Supreme Court ruled that the individual mandate was constitutional when the associated penalties were construed as a tax. The decision allowed states to opt out of the Medicaid expansion. Several did so,[408] although some later accepted the expansion.[409]

2013

In January 2013 the Internal Revenue Service ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold. This was estimated to leave 2–4 million Americans unable to afford family coverage under their employers’ plans and ineligible for subsidies.[410][411]

A June 2013 study found that the MLR provision had saved individual insurance consumers $1.2 billion in 2011 and $2.1 billion in 2012, reducing their 2012 costs by 7.5%.[412] The bulk of the savings were in reduced premiums, but some came from MLR rebates.

On July 2, 2013, the Obama Administration announced that it would delay the implementation of the employer mandate until 2015.[281][413][414]

The Community Living Assistance Services and Supports Act (or CLASS Act) was enacted as Title VIII of Obamacare. It would have created a voluntary and public long-term care insurance option for employees.[121][123] In October 2011 the administration announced it was unworkable and would be dropped.[415] The CLASS Act was repealed January 1, 2013.[416]

The launch for both the state and federal exchanges was troubled due to management and technical failings. HealthCare.gov, the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered endless problems.[417] Operations stabilized in 2014, although not all planned features were complete.[418][419]

CMS reported in 2013 that, while costs per capita continued to rise, the rate of increase in annual healthcare costs had fallen since 2002. Per capita cost increases averaged 5.4% annually between 2000 and 2013. Costs relative to GDP, which had been rising, had stagnated since 2009.[420] Several studies attempted to explain the reductions. Reasons included:

  • Higher unemployment due to the 2008-2010 recession, which limited the ability of consumers to purchase healthcare;
  • Out-of-pocket costs rose, reducing demand for healthcare services.[421] The proportion of workers with employer-sponsored health insurance requiring a deductible climbed to about three-quarters in 2012 from about half in 2006.[224]
  • ACA changes[224] that aim to shift the healthcare system from paying-for-quantity to paying-for-quality. Some changes occurred due to healthcare providers acting in anticipation of future implementation of reforms.[120][225]

2014

On July 30, 2014, the Government Accountability Office released a non-partisan study that concluded that the administration did not provide “effective planning or oversight practices” in developing the website.[422]

In Burwell v. Hobby Lobby the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.[423] In Wheaton College vs Burwell the Court issued an injunction allowing the evangelical college and other religiously affiliated nonprofit groups to completely ignore the contraceptive mandate.[424]

A study found that average premiums for the second-cheapest silver plan were 10-21% less than average individual market premiums in 2013, while covering many more conditions. Credit for the reduced premiums was attributed to increased competition stimulated by the larger market, greater authority to review premium increases, the MLR and risk corridors.[citation needed]

Many of the initial plans featured narrow networks of doctors and hospitals.[425][not in citation given]

A 2016 analysis found that health care spending by the middle class was 8.9% of household spending in 2014.[426]

2015

By the beginning of the year, 11.7 million had signed up (ex-Medicaid).[427] On December 31, 2015, about 8.8 million consumers had stayed in the program. Some 84 percent, or about 7.4 million, were subsidized.[428]

Bronze plans were the second most popular in 2015, making up 22% of marketplace plan selections. Silver plans were the most popular, accounting for 67% of marketplace selections. Gold plans were 7%. Platinum plans accounted for 3%. On average across the four metal tiers, premiums were up 20% for HMOs and 18% for EPOs. Premiums for POS plans were up 15% from 2015 to 2016, while PPO premiums were up just 8%.[citation needed]

A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out-of-network provider in the context of an overall in-network treatment event. Such out-of-network care is not subject to the lower negotiated rates of in-network care, increasing out-of-pocket costs. Another 2015 study found that the average out-of-network charges for the majority of 97 medical procedures examined “were 300% or higher compared to the corresponding Medicare fees” for those services.[citation needed]

Some 47% of the 2015 ACA plans sold on the Healthcare.gov exchange lacked standard out-of-network coverage. Enrollees in such plans, typically received no coverage for out-of-network costs (except for emergencies or with prior authorization). A 2016 study on Healthcare.gov health plans found a 24 percent increase in the percentage of ACA plans that lacked standard out-of-network coverage.[citation needed]

The December spending bill delayed the onset of the “Cadillac tax” on expensive insurance plans by two years, until 2020.[429]

The average price of non-generic drugs rose 16.2% in 2015 and 98.2% since 2011.[426]

2016

As of March 2016 11.1 million people had purchased exchange plans,[citation needed] while an estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults.[207] 11.1 million were still covered, a decline of nearly 13 percent.[430] 6.1 million uninsured 19-25 year olds gained coverage.[431]

Employers

A survey of New York businesses found an increase of 8.5 percent in health care costs, less than the prior year’s survey had expected. A 10 percent increase was expected for 2017. Factors included increased premiums, higher drug costs, ACA and aging workers. Some firms lowered costs by increasing cost-sharing (for higher employee contributions, deductibles and co-payments). 60% planned to further increase cost-sharing. Coverage and benefits were not expected to change. Approximately one fifth said ACA had pushed them to reduce their workforce. A larger number said they were raising prices.[432]

Insurers

The five major national insurers expected to lose money on ACA policies in 2016.[433] UnitedHealth withdrew from the Georgia and Arkansas exchanges for 2017, citing heavy losses.[204] Humana exited other markets, leaving it operating in 156 counties in 11 states for 2017.[434] 225 counties across the country had access to only a single ACA insurer. A study released in May estimated that 664 counties would have one insurer in 2017.[435][not in citation given]

Aetna cancelled planned expansion of its offerings and following an expected $300 million loss in 2016 and then withdrew from 11 of its 15 states.[436] In August 2016 Anthem said that its offerings were losing money, but also that it would expand its participation if a pending merger with Cigna was approved.[437] Aetna and Humana’s exit for 2017 left 8 rural Arizona counties with only Blue Cross/Blue Shield.[438]

Blue Cross/Blue Shield Minnesota announced that it would exit individual and family markets in Minnesota in 2017, due to financial losses of $500 million over three years.[439]

Another analysis found that 17 percent of eligibles may have a single insurer option in 2017. North Carolina, Oklahoma, Alaska, Alabama, South Carolina and Wyoming were expected to have a single insurer,[440] while only 2 percent of 2016 eligibles had only one choice.[441]

Aetna, Humana, UnitedHealth Group also exited various individual markets. Many local Blue Cross plans sharply narrowed their networks. In 2016 two thirds of individual plans were narrow-network HMO plans.[425]

One of the causes of insurer losses is the lower income, older and sicker enrollee population. One 2016 analysis reported that while 81% of the population with incomes from 100-150% of the federal poverty level signed up, only 45% of those from 150-200% did so. The percentage continued to decline as income rose: 2% of those above 400% enrolled.[442]

Costs

The law is designed to pay subsidies in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas.[221] However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the Kaiser Foundation reported that for the second-lowest cost “Silver plan” (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.[222]

Cooperatives

The number of ACA nonprofit insurance cooperatives for 2017 fell from 23 originally to 7 for 2017. The remaining 7 posted annual losses in 2015. A General Accountability Report found that co-ops’ 2015 premiums were generally below average. At the end of 2014, money co-ops and other ACA insurers had counted on risk corridor payments that didn’t materialize. Maryland’s Evergreen Health claims that ACA’s risk-adjustment system does not adequately measure risk.[citation needed]

Medicaid

Newly elected Louisiana Governor John Bel Edwards issued an executive order to accept the expansion, becoming the 32nd state to do so. The program was expected to enroll an additional 300,000 Louisianans.[443]

2017

More than 9.2 million people signed up for care on the national exchange (healthcare.gov) for 2017, down some 400,000 from 2016. This decline was due primarily to the election of President Trump, who pulled advertising encouraging people to signup for coverage, issued an executive order that attempts to eliminate the mandate, and has created significant uncertainty about the future of the ACA. Enrollments had been running ahead of 2016 prior to President Obama leaving office, with 9.8 million expected to sign-up, so President Trump’s actions potentially cost about 600,000 national enrollments (i.e., 9.8 million expected – 9.2 million actual = 0.6 million impact).[444]Of the 9.2 million, 3.0 million were new customers and 6.2 million were returning. The 9.2 million excludes the 11 states that run their own exchanges, which have signed up around 3 million additional people.[444] These figures also exclude the additional coverage due to the Medicaid expansion, which covers another approximately 10 million persons, as described in the impact section above.

In February, Humana announced that it would withdraw from the individual insurance market in 2018, citing “further signs of an unbalanced risk pool.”[445] That month the IRS announced that it would not require that tax returns indicate that a person has health insurance, reducing the effectiveness of the individual mandate, in response to an executive order from President Donald Trump.[446]

Aetna CEO Mark Bertolini stated that ACA was in a “death spiral” of escalating premiums and shrinking, skewed enrollment.[447] However, a U.S. judge found that the Aetna CEO misrepresented why his company was leaving the exchanges; an important part of the reason was the Justice Department’s opposition to the intended merger between Aetna and Humana. Aetna actually pulled out of states where it was making money on the exchanges, while remaining in some states where it was not.[448] Further, the CBO reported in March 2017 that the healthcare exchanges were expected to be stable; i.e., they were not in a “death spiral.”[449]

Molina Healthcare, a major Medicaid provider, said that it was considering exiting some markets in 2018, citing “too many unknowns with the marketplace program.” Molina lost $110 million in 2016 due to having to contribute $325 million more than expected to the ACA “risk transfer” fund that compensated insurers with unprofitable risk pools. These pools were establish to help prevent insurers from artificially selecting lower-risk pools.[450]

https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

 

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