Canadian Prime Minister Mark Carney on Thursday warned that the United States is trying to sow discord as he urged Albertans not to vote for a separation referendum.

“The stakes are high. This referendum, it comes at the worst possible time. The world has become more dangerous and divided,” Carney said at a rally in Calgary ahead of Monday’s vote, which will see residents decide whether the oil-rich province should hold a referendum on independence. “There are some outside our borders who are working to break us, so they can own us.”

While Carney didn’t explicitly name the U.S., the remarks echoed his previous warnings of the dangers of American dominance. Carney's statement came a day after U.S. President Donald Trump revisited his ambitions to annex Canada, telling the crowd at a rally in Arizona that the country will “end up being the 51st state, because it's the only way it works.” Trump again accused Canada of treating the U.S. “very badly” and vowed he won’t allow it to happen anymore as “it’s a whole different ballgame now [that] Trump is in town.”

The U.S. and Canada remain in a contentious trade standoff after negotiations collapsed in August. Canada’s retaliatory tariffs came into effect last month, matching the economic pressure imposed by the U.S. Carney has encouraged Canadians to band together and take back their economic power by choosing Canadian products over those made in the U.S. The trade tussle comes after months of Trump repeatedly threatening Canada’s sovereignty—a move that has stoked tensions between the U.S. Administration and Canadian officials.

In light of Trump’s most recent remarks about possible annexation, Canada’s former deputy Prime Minister Chrystia Freeland said it would be dangerous to deepen or maintain close economic ties with a neighbor that “openly says they want to take you over.”

Carney admitted in an interview with the New York Times last month that he had studied the risk of a U.S. invasion, given Trump’s charged rhetoric. “I think you have a responsibility in these roles to look at extreme tail risk,” he said. “That’s just risk management. That’s not a base case, but it would be irresponsible not to [prepare].”

Amid the U.S.-Canada tensions, Carney is desperately trying to promote his “Canada Strong” strategy—one that he hopes will very much include Alberta. Polling conducted by 338Canada suggests that as of Oct. 11, 75% of Albertans would vote to remain part of Canada. But Carney’s resolve is being tested on more than one front, after the separatist Parti Québécois won Quebec's provincial election earlier this month. Incoming Premier Paul St-Pierre Plamondon has already stated his intention to hold a referendum on Quebec independence. While he has vowed not to initiate a vote so long as Trump is in office, the looming presence of a separatist movement undoubtedly complicates matters for Carney at a time when he is striving to show that Canada is strong enough to prosper without relying on the American market.

With the U.S. and Canada locked in a trade stalemate, and with annexation threats once again dominating the conversation, here’s a look at the reality Carney is facing as he deals with both domestic and international pressures.

Trump's remarks complicate Carney’s unity efforts

Trump’s accusations that Canada has taken advantage of the U.S. on matters of trade and security date back to before Carney became Prime Minister in March 2025, meaning the friction we’re currently seeing goes deeper than a simple clash between Trump and Carney. Trump would often refer to Carney's predecessor Justin Trudeau as the "governor" of the "great state of Canada."

In terms of any physical threat facing Canada, Patrick Leblond, a professor of public and international affairs at the University of Ottawa, says that Carney “put it best when he talked about tail risk” in his interview with the Times. “It’s the financial term for something that has potentially high impact, but low probability,” Leblond explains.

Trump’s economic actions and threats have proven to be far more damaging than his annexation remarks, experts note.

“He has weaponized market access to the U.S.,” says Leblond. “What we can expect is more economic pressure from the White House in the coming months. Trump and his acolytes certainly [appear to] see Canada as a small, weak country that the United States should try to squeeze further.”

The U.S. is Canada’s largest trading partner, with almost $2.6 billion worth of goods and services passing across the border daily in 2024. According to the Office for the U.S. Trade Representative, trade between the two was down 4.6% from 2024 to 2025, but still saw $872.3 billion worth of goods and services cross the border.

Still, there are concerns that any suggestion of annexation, however unlikely it may be, could damage Carney’s high-stakes domestic campaign to unite the country.

On the home front, the success of a separatist party in Quebec is another threat to the unity that Carney is striving for. However, despite the Parti Québécois' victory (they fell five seats short of securing a majority government), the desire for separatism among Quebec residents remains low—with only 31% in favor of sovereignty for the province, according to data from 338 Canada released on Oct. 11.

“If Quebec is on a path to separation or not, it would never be because they were looking for further alignment with the United States,” argues Lori Turnbull, a professor in political science at Dalhousie University. “Quebec has a variety of cultural protections in the Canadian federation. They would have none of that in the United States.”

The more immediate risk for Carney lies in Alberta, with residents preparing to vote on whether the province should hold a referendum on independence.

Carney, who was raised in Edmonton, Alberta, on Thursday framed the referendum as an opportunity for voters to “stand up for Alberta, the heart of Canada” and “recognize that we're all responsible for each other.”

How Trump’s threats could also help Carney

The pressure and rhetoric from the U.S. could actually work in Carney’s favor, experts tell TIME.

“The effect of Trump's comments has been unifying,” says Turnbull. Despite discussions of independence in Alberta and Quebec, she says “there isn't widespread panic that the country is coming apart.”

In fact, research conducted by the Environics Institute for Survey Research in 2025 found that “in almost every province, the proportion of residents who are very attached to Canada is greater than the proportion who are very attached to their province.”

Between Trudeau’s resignation on Jan. 6, 2025, and a federal election in Canada months later on April 28, Carney’s Liberal Party went from 20% to 42.8% in the polls, according to CBC, with Carney’s message of defiance in the face of Trump proving to be a rallying point.

This falls in line with depleting favorable views of the U.S. among Canadians. In July, 44% of Canadians had a favorable opinion of China compared to 33% of Canadians who held the same view of the U.S., according to a Pew Research Center survey. “When China is more popular than the U.S. in a country like Canada, you have to ask yourself: ‘What's going on?’” says Leblond.

Continued annexation threats could bring Canadians even closer together.  “Already, trust is very low, and [more threats] would confirm even more that the United States is [perhaps] not a trustworthy partner at this time,” Leblond argues.

Since the U.S.-Canada trade war reignited in August, Carney has seen his domestic approval rating bounce back up. On Oct. 15, it stood at 62% according to Poliwave, compared to 56% in mid-July. Carney’s resistance against American economic pressures could help his cause, particularly in possible separatist provinces.

“In August, when Carney walked out of the negotiations with the U.S., the highest levels of support for him were found in Quebec,” says Leblond. Indeed, Carney’s approval rating in Quebec grew from 76% to 80% between Aug. 17, and Sep. 7, the highest in any province, according to Liaison Strategies.

Turnbull says the support behind Carney’s decision to walk away from negotiations prompted a strong sense of “patriotism and loyalty.” 

That attitude among Canadians has been reflected in the burgeoning “Buy Canadian” movement, in which consumers across the country have joined a boycott of U.S. products in an effort to feed back into the Canadian economy. 

Carney strengthens international alliances to end reliance on American market 

In September, European Commission president Ursula von der Leyen invited Canada to work toward becoming the bloc’s first “associate member,” in what she described as an “urgent” reimagining of partnerships.

While addressing the European Parliament as a guest of honor in Strasbourg, France, Carney insisted “Europe and Canada are stronger together” and said “Canada and the European Union can anchor our ground to hold our values while forming a protective canopy under which our citizens can thrive.”

Trump called the unique membership proposal “laughable” and has threatened economic punishments if the E.U. moves forward with von der Leyen’s plan.

Carney’s shift towards other partnerships “doesn't mean that Canada is not going to do business with the U.S., but it's no longer a preferred partner,” says Leblond, noting that Carney wants to build relations with partners that “share the same values in terms of rules-based trade and investment.”

In January, after meeting with Chinese President Xi Jinping, Carney announced a new strategic partnership with China, focused on “energy, agri-food, and trade.” Carney agreed to cut his country’s 100% tariff on Chinese electric cars in return for lower tariffs on Canadian farm products, including canola seeds, a major Canadian export.

These stronger international ties that diversify trade and security away from the U.S. are proving popular on the homefront, according to data. 

According to Abacus Data, a survey conducted in September found that 49% of Canadians would support Canada joining the E.U. An Ipsos poll conducted in January, in light of Carney’s visit to China, found that 54% of Canadians also said they support stronger trade ties with China.

Katie Zacharia is exiting her job as White House Press Secretary after just five days in the position, according to a person familiar with the situation. President Donald Trump on Friday said to reporters that he told Zacharia to reconsider her role, amid reports that she had already been relieved of the job.

“I said to her honestly, if I were you, I'd reconsider,” Trump said outside of the White House, adding, “Katie, do you need this? I don’t think you need this.”

Trump said that the decision was ultimately hers, and that he would speak with Zacharia following a trip to Georgia. “I just want her to be happy,” he said.

Zacharia’s brief stint as press secretary is bound to draw comparisons to Anthony Scaramucci’s 11-day run as Trump's White House communications director in 2017. Then-White House Chief of Staff John Kelly fired Scaramucci after he had given a fiery interview to The New Yorker in which he attacked his colleagues. In Washington parlance, the tenures of prominent White House officials have since been jokingly measured in “Scaramuccis.”

Trump said that Zacharia has been treated “pretty nastily” and “very unfairly” by the media since taking over for former Press Secretary Karoline Leavitt. 

“I said you should reconsider because you don't want to go through this,” he said in reference to the critical media response Zacharia received following her first press briefing on Tuesday.

Trump called Zacharia “an attorney” in his Truth Social post announcing her position, and Zacharia has described herself as a lawyer. But when asked by a reporter where she had passed the bar, Zacharia responded “when I moved to China.” She later said that she had misheard the question. Zacharia then acknowledged while speaking on Fox that she had failed the bar exam.

"You went to Pepperdine law school but you did not pass the bar exam, correct?" Fox host Sean Hannity asked Zacharia on Thursday.

"Correct," Zacharia replied.

When asked whether she regretted never having told the White House that she failed the bar, Zacharia responded “those questions weren’t asked,” and “I’m being hired as White House press secretary, not White House counsel.”

Zacharia previously worked as a general counsel at a the conservative non-profit Fix California. She also has experience working as a communications adviser at Trump Media and Technology Group, which houses the President’s social media platform Truth Social. She previously worked as a spokesperson for former Homeland Security Secretary Kristi Noem, and is a regular on conservative media outlets like Fox News and Newsmax.

Zacharia received a wave of criticism following her first press briefing, which lasted just 14 minutes and during which she only took questions from three reporters. 

Leavitt, the youngest press secretary in White House history, stepped down in August after returning from maternity leave. She recently joined Fox News as an on-air contributor. 

 

Lately, AI data centers are public enemy No. 1. The concerns are legion: how much water and electricity they consume, the noise they generate, the sprawling buildings they bring to communities, and the technology they’re powering that may or may not take all of our jobs and usher in the robot apocalypse.

Earlier this year, Gallup found that 71 percent of Americans oppose building data centers that support AI in their communities. And the backlash is bipartisan: Majorities of Democrats, Republicans, and independents opposed local construction.

Even in Texas, where data center development has been booming, Republican Gov. Greg Abbott has hit the brakes. In September, he directed state regulators to halt permits for data centers pending audits examining their effects on the power grid and water resources.

But while many data center projects have run aground, others are still getting built — and the companies behind them are employing experts like Nicole Thomas to smooth the way.

Thomas is the senior vice president of media and community engagement at JSA, a marketing and public relations firm that represents data center companies. She spoke with Today, Explained co-host Sean Rameswaram about how the industry is responding to public opposition — and why she argues that these facilities can still be good neighbors.

Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify. 

You’ve been at this for 21 years. Obviously, 21 years ago, data centers were not the hot-button issue they are today. When did you notice the shift?

I’d say about two years ago. I came into this industry myself about four and a half years ago. I come from a state transportation background where community engagement is just paramount. When you’re putting a new traffic intersection up, they expect you to interact with the public. 

When I got to this industry, I said, “Oh, what’s your community engagement like?” And they said, “We don’t even have any community engagements in this industry.” And they weren’t wrong. Because 21 years ago, [data centers] were just like infrastructure. It was like building a warehouse for your computers. And so it was very similar to the way that you would build a Costco.

You would just go in, request a zoning permit, the zoning board would say, “Yeah, that works. Stamp, boom.” And you build your data center. And as a matter of fact, it was very secretive before, because data, and having that data in the wrong hands, has a lot of [cybersecurity] implications. About two years ago is when we started noticing the mainstream journalists coming around asking questions about data centers. And that’s, to me, when it started.

It still feels secretive, I think, to a lot of people, and that’s why people are mad. If you read about this data center that was proposed in Utah by Mr. Wonderful, Kevin O’Leary, it caught a lot of people off guard. Seventy percent of Americans, at the moment, do not want them in their backyards. How do you go about trying to change that 70 percent’s minds? 

First and foremost, I think education is really important. And so one of the things that we did notice very early on because of the previously secretive nature of data centers, there wasn’t a lot of education out there about what they even are. And so that’s something we need to change. We need to make the connection between [phones] and data centers so that people understand what a data center means to their life on a daily basis.

Every app on your cellphone requires a data center to save your information in there. When you put your password into anything, you are interacting with a data center, which will verify your password and then let you into that app. Not to mention all of the information about you that you store in that app is then stored in a data center so that it can be recalled at any time. 

We could not be having this call without digital infrastructure. It doesn’t work that way. We can’t have email without digital infrastructure. And that stat about 70 percent of people not wanting the data center in their backyard — I’d be interested in seeing the stat of how many people actually live near a data center and don’t realize it. 

Because there are nondescript data centers doing work quietly in your neighborhood that have been there for decades and you don’t even know it. And so in some ways I feel, and I think the industry does as a whole, but I won’t speak for them, that the pushback on data centers is somewhat related to the pushback on AI, because people can’t control AI.

You even have Sam Altman telling us that AI will destroy society. So you have this concern about AI and you don’t know how to control it, but you can push back on data centers. And so it becomes the physical manifestation of AI are these data centers that people are trying to get overturned or get to not be in their neighborhoods. 

It’s understandable. I’m a citizen too. You’re a citizen, and if things come into my neighborhood, I want to know about them. I have questions. There’s a big data center that just came to my community not long ago and their community engagement was horrible, absolutely horrible. 

Can I ask where you are?

I’m in Indiana and I won’t say which hyperscaler it is, but a hyperscaler came into — I would say, not my neighborhood, into my city. They’re definitely not in my backyard, but they’re in my city. And so we took them to task because their community engagement was basically non-existent.

Wait, you work in data center PR, but you took a data center in your community to task for not being transparent enough?

Yeah, absolutely. 

Which side are you on?

I’m on the side of responsible development.

We’ve all kind of accepted that we need a cloud for X, Y, and Z. And that it’s worth it so I can take lots of photos. I think everyone’s cool with that.

But the issue here is that people aren’t necessarily cool with AI, but we’re barreling forward anyway. How do you separate this essential need we have from AI, which people don’t necessarily feel is essential to their lives?

I think it goes back to education. Educating consumers on the difference between data centers: a small data center, a medium data center, a large data center. Educating them on why data centers exist and how they interact with data centers on a daily basis multiple times.

I hear you. But again, I feel like the issue here is not the data centers my cellphone needs, but instead is the data centers these AI companies need and these AI companies who the public doesn’t necessarily trust because they keep telling us that they’re going to kill us, and who the public is wary of because they don’t want their jobs being replaced by AI. 

There’s all sorts of reasons that people are skeptical of new technology. So how do you specifically respond to that fear and to those people?

I think it’s, again, understanding the actual data center that’s being built in your community. Is it a 5-megawatt data center? That’s never going to house AI. That’s not enough power to house AI. Is it a one-gigawatt data center like Mr. Wonderful in Utah? That’s different.

But I think that AI is probably going to be something that is a lightning rod in the American public for a very long time. There are going to be people who are going to be anti-AI and pro-AI, and there’s going to be some people in the middle. I think it’s just, again, for us, it’s education, educating the community.

Have you ever been part of a project that a community rejected and you guys just packed up and said, “Okay, we’ll go find another community?”

Yeah. We have some clients who have had pushback from residents and they have said, “Let’s do a one-on-one community meeting where people can come in and ask us questions.”

And after the questions were answered, the community leaves and says, “Okay, this isn’t as bad as I thought it was.” Or we have a community that says, “No, we now have a moratorium and we’re pushing all data centers away.“ 

Sometimes they’ll wait for their client — my client is a developer and they’ve got clients that they’re developing for. If that client will wait, then maybe it is something that we’ll try to work out with the community. But oftentimes, they’ll just say, there’s communities who are literally raising their hand saying, “We’ll take a data center. We’ll take one. We’ll take two. Bring it here.” 

So there are communities who recognize the benefits of data centers. And there are going to be other communities who say, “No, we don’t want this.” And then in five, six, eight years, they’re going to be like, “Wow, that county has a lot of tax dollars. They have a lot of really cool stuff. Why don’t we have that?” And the answer will be data centers. 

I don’t think this ends anytime soon though, right? I counsel my clients that we could still be here in three to five years, really trying to help the American public understand the benefit of data centers. But it’s going to take a lot of education across the industry, and once we get those seeds planted, I’m a firm believer that they grow into educated community members who make educated decisions to bring community-minded data centers to their community.

Twelve years ago, Vermont Democrats tried to make their state the first in the nation to have a single-payer government-financed healthcare system — a bold experiment to push the limits of American health coverage when Obamacare was just being launched.

Their plan failed, and rebooting it became politically impossible, even in Vermont: The Democrats lost the governorship to Republican Phil Scott for what turned out to be a decade.

This year, that could finally change. A progressive political newcomer named Amanda Janoo is taking on Scott in what polls show is a tight governor’s race.

And if she wins, the state could be poised to try a whole new national experiment: One of Janoo’s central campaign promises is to create a pioneering health system where the state pays the full tab for primary and preventive care, while leaving the rest to the existing system.

Janoo’s candidacy is an example of the policy experiments that are becoming possible nationwide in a projected “blue wave” year, when Democrats could sweep into power in a number of states. But in the healthcare universe, her plan is also an example of how even progressive policy idealists are trying to learn from past failures and focus on what they think can actually be achieved.

Compared to the sweeping ambition of Vermont’s 2014 effort, or Bernie Sanders’s signature “Medicare-for-all” idea, Janoo’s proposal for single-payer has very specific limits. Under Janoo’s proposal for “universal primary and preventive care” (she typically avoids the term “single-payer”), the state government would pay for Vermonters seeing primary care providers such as doctors and nurse practitioners. This government coverage would be universal and free for patients, and insurance companies would be cut out.

However, other parts of the health system — such as hospitals, specialists, and prescription drug companies — would remain under the existing insurance system, for now.

Every effort so far to enact full single-payer at the state level has failed — even in blue states, bills and ballot initiatives have regularly gone down to defeat. Vermont’s previous single-payer experiment made it the furthest — it was signed into law but abandoned before being implemented, when the governor concluded it was unworkable. Wherever it’s gained steam, politicians and voters have blanched at the high costs of moving their health systems onto state budgets, and the high taxes that would be necessary to fund them.

Now, Janoo is making an attempt to refurbish single-payer as something more achievable, by cutting off a smaller slice of it.

“I think it’s clear at this point that a profit-oriented healthcare system is a terrible idea,” Janoo told me in an interview on Monday. But after assessing that the state budget made it “unrealistic” to do single-payer immediately, she concluded, “we could do universal primary and preventive care,” financed by a tax on the wealthiest.

Indeed, single-payer for primary care seems more achievable precisely because primary care is a relatively less expensive part of the healthcare system. But Janoo hopes it will pay major dividends — that better preventive care will improve Vermonters’ health, reducing costs elsewhere in the system by, for instance, making some hospital visits unnecessary.

In speaking to health policy experts about this idea, I heard much sympathy for the goal of universal primary care, but many questions about the details. Would Janoo’s plan be sufficient to bring more primary care doctors to Vermont — and, not unrelatedly, would it pay them more? Would her hoped-for cost savings from preventive care actually materialize? Is picking up the tab for a relatively less expensive part of the healthcare system the best use of sparse state funding?

These questions are becoming national ones, as healthcare gains traction as a political issue again. It isn’t just Vermont where primary care reform ideas are gaining steam: Democrats in Minnesota, Washington state, and elsewhere have discussed them. “There is growing interest in a number of states across the country in doing a universal primary care for all program,” Kevin Grumbach, a family physician and a professor of family and community medicine at the University of California San Francisco, told me. Even Scott, Janoo’s opponent, signed a law calling for a study of universal primary care.

One dividing line emerging, though, is whether to keep insurers involved, or to clear them out with a single-payer system, as Janoo wants. Insurers are unpopular with the public, but they can be a formidable political opponent when they argue that the benefits voters currently enjoy might be lost. Scott has said that the idea of universal primary care is appealing — but that if universal is “just code for single payer, I’m not interested. We’ve already been through that.”

Yet Janoo is hoping that single-payer for primary care will be a stepping stone — a trial run for eventually making the rest of the state’s health system single-payer down the road.

“I think about this often,” Janoo told me. “How do you build the new system as you transition the old — or hospice the old?”

Amanda Janoo is tired of “corporate neoliberal bullshit”

Janoo has long been an unorthodox economic policy thinker. Her rise is part of a broader trend in which progressives and leftists are winning primaries and gaining influence in the Democratic Party — but she doesn’t fit the prototype of the democratic socialist candidates in New York City, Colorado, and elsewhere who’ve gotten much attention this year. Instead, she comes from a different strand of the left, a movement based on a dissident strain of economics and openly skeptical of the benefits of economic growth.

Dating back to when she graduated from college in 2010, in the aftermath of the financial crisis, she was part of a younger cohort rebelling against what seemed the glaring failures of the economic establishment. “The one thing coming out of university I was clear on was that neoliberalism was the worst,” Janoo said on a podcast last year. “This whole idea that governments should just take a hands-off approach to the economy and trust in sort of the disciplinary powers of the global free market to lead them to infinite growth seemed highly problematic and very anti-democratic.”

So for graduate school, Janoo attended Cambridge to study development economics under the “heterodox” economist Ha-Joon Chang. She then spent several years working abroad in international development for the United Nations and other organizations, before moving back to Vermont and working as an economic policy consultant.

In recent years, Janoo became deeply involved with the “well-being economy” movement: an international group of advocates, academics, and experts who criticize what they deem modern capitalism’s obsession with economic growth, and say the “well-being” of humans and the environment should be prioritized instead. They overlap with the “degrowth” movement, which outright argues economic growth should be reduced; last year, Janoo led a workshop at a DeGrowth Institute event on “Degrowth Policy Design.”

Trump’s return to power horrified Janoo. “I’m feeling angry about the rise of fascism and the growing threat of world war, because I feel like we don’t have time for this shit,” she said in a speech at an environmental event last year. ”The planet is on fire and ecosystems are collapsing, and that should really be the focus of all of our attention.” But, she said, “I believe I was born in this moment of history for a reason” and vowed “to fight for democracy — for life.”

So Janoo decided to jump in the race for governor of Vermont. While she is not running on a degrowth platform, her campaign is deeply informed by aspects of the movement’s thought: skepticism about growth’s benefits, a sense that untrammeled capitalism is leading the world to disaster, and that localism provides a better way. For instance, candidates for governor typically pledge that they’d help bring business investment in, but Janoo said in a July debate: “A lot of the problems we’re facing is because we focus so much on attracting external business.” 

“Our economy is not super-diversified, and it is not really centered in the most essential kinds of goods and services you want to make sure people have access to no matter what happens — because honestly, things are bad now and they’re going to get worse,” Janoo told me. “I feel a little bit like a collective prepper right now. My motto is, protect what we love, produce what we need.”

In the Democratic primary, Janoo’s opponent, Aly Richards, had closer ties to the party establishment and led in fundraising. But Janoo ran as a progressive outsider; she promised to advance a “more economically populist vision” instead of “corporate neoliberal bullshit.” Her health plan became a point of contrast with Richards, who said she wouldn’t run on “magical thinking,” and that she wanted a version of universal primary care that would keep insurance companies involved. Janoo won the primary by 2.5 percentage points.

Now, she’s facing Governor Scott, who’s long been viewed as politically untouchable in the state — in 2024, he won his fifth two-year term by a margin of 52 points. But polls show a much closer race this time around, and Janoo could have a national blue wave at her back. If that wave helps carry her into the governor’s mansion. And if she makes it there, Vermont will have its first Democratic trifecta in a decade — and with it, the opportunity for major progressive policy change.

Amanda Janoo’s plan: Single-payer for primary care

Advocates for primary care reform argue that it should be at the top of Democrats’ agenda, in Vermont and elsewhere, because the system is in crisis.

Primary care providers are overwhelmed and underfunded, they say — and, as a result, there aren’t enough. Grumbach, the family physician and UCSF professor, said “the workload, the lack of resources, and the gap in compensation” — as compared to more highly paid specialists — “has made it very hard to recruit people coming out of medical school to want to be family doctors like me.” 

Patients, then, are having trouble finding doctors they like, and aren’t getting sufficient access to preventive care that could help them be healthier. “The emergency rooms are functioning and doing a lot of the work that normally primary care would do,” Janoo told me. “People are waiting a really long time to see anyone, and so often health issues that could have been caught sooner become more serious and dangerous.” 

Finally, both providers and patients complain that insurance companies make the preceding problems worse, by adding administrative burdens and bureaucratic hassle. 

So what would Janoo’s plan do?

First, her plan would guarantee free, government-paid primary and preventive healthcare for all in the state, by cutting insurers out of that part of the system.

Second, she wants to phase out the “fee-for-service” model of care, where primary care providers are paid based on specific services. She’s suggested, instead, either government-paid annual salaries, or per-patient per-month payments.

Third, she wants to try and try and make sure there are more primary care providers in the state, via more spending. “We would need some relocation incentives, so maybe $100 grand if you want to move here, or a student loan repayment program,” she told me. “My hope would also be that we could be a place for foreign-trained medical professionals to come here and be safe and accepted and to bring some cultural diversity,” she added.

As for how it would be paid for, Janoo proposes an income tax increase on the wealthiest Vermonters that, she said, would be comparable to the tax break they got in President Trump’s One Big Beautiful Bill Act last year. Though she hasn’t settled on a final amount, she hopes these new taxes would raise hundreds of millions of dollars.

Would Janoo’s plan work in practice?

In speaking with health policy experts both inside and outside Vermont, though, I heard various questions and doubts about Janoo’s plan.

Some of the problems mix the practical and political. For instance, under this plan, primary care visits would be free, but tests such as MRIs would likely still require the existing insurance system, as would most prescription drugs. Janoo acknowledged to me that deciding how many things the government should pay for would “always be a challenge,” but said her first priority was access to getting people at least some healthcare.

There are also questions about whether this primary spending is really targeted at patients’ most urgent problems. Erasing the copay for your doctor visit might be nice, but those copays weren’t driving people into medical bankruptcy. Janoo’s reform plan leaves the bulk of hefty health spending from hospitals and treatments for very sick people untouched.

The core challenge to Janoo’s reform will be the one that has dogged single-payer reform attempts everywhere: money.

Other questions are about whether Janoo’s hoped-for benefits from better preventive care — she’s said the state could save as much as $300 million a year — will materialize.

“There’s no question that better access to primary and preventive care makes people healthier in the end,” Larry Levitt, executive vice president of the health policy nonprofit KFF, told me. “But advocates have long tried to sell prevention as saving money. I think it’s more likely that it costs money, but keeps people healthier.” One reason for this, he said, is that better preventive care could help identify more underlying illnesses and conditions in patients, and spur more spending to try and address them.

The shift to a salaried model for providers could bring other practical challenges. Though Janoo hopes that ditching fee-for-service will free up providers to see more patients, others suspect a guaranteed salary might incentivize them to see fewer, and wonder what role the government would play in trying to hold such providers accountable.

Finally, I also heard some disconnect between what providers said they wanted, and what Janoo thought they wanted. When we talked, she told me her impression was that primary care providers were most eager for changes in their work environment. “I’ve asked them, ‘If you could get paid a good annual salary — like, average for the nation — and you didn’t have to deal with insurance and the fee-for-service structure, would you do that?’ They say, ‘Absolutely.’”

Yet Grumbach told me that, for the primary care system, “Problem number one is not enough money, problem two is not enough money, and problem three is not enough money.” In his telling, it’s more money that’s the real key to incentivize more new doctors to practice primary care, and help pay other staff and health workers who could actually deliver good preventive care.

If so, the core challenge to Janoo’s reform will be the one that has dogged single-payer reform attempts everywhere: money.

If the government takes on the responsibility of paying primary care providers and setting salaries for them, providers will want those salaries to be high. If they aren’t high enough, the shortfall in primary care providers will worsen. But the higher such salaries are, the higher the taxes the state would need to raise to pay them. Essentially, taxpayers would be asked to shore up doctors’ salaries to keep them in the state — turning the healthcare argument from one kind of difficult political issue to another.

Getting the balance right would be a challenge for the government, with much at stake. But Janoo says her background in industrial policy has convinced her that it’s possible. Furthermore, she hopes, it will be just a starting point for the full single-payer system she still thinks is urgently needed.

“​​My hope is, when I’m governor, that I can start to work with some of our neighboring states,” Janoo said. “Because if we could create a New England-wide system, we could move to universal healthcare really quickly. “I think it’s a moment where people recognize we need a universal healthcare system.”

And, she added, “If we had done it previously, it would be much cheaper than it is now.”

This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.

Welcome to The Logoff: Donald Trump wants to deport a member of Congress. 

What’s happening? On Monday, Homeland Security officers raided the Washington, DC, home of US Rep. Ilhan Omar (D-MN) in an investigation reportedly tied to immigration paperwork filled out by her father when she was a minor.

That was, at the time, more than enough cause for alarm. Trump’s animosity toward Omar, who is Somali-American and an outspoken critic of the administration, is well-known, and the raid is an extraordinary violation of the Justice Department’s usual rule to avoid taking visible action around politically sensitive cases within 60 days of an election. 

On Wednesday evening, however, we learned more about the raid from the Wall Street Journal. The Omar investigation, the Journal reported, is explicitly aimed at stripping Omar of her citizenship — and thus her ability to hold office — and deporting her. 

How would they do that? Omar came to the US as a refugee when she was 12 and became a US citizen when she was 17. The Trump administration’s investigation is said to focus on whether she or her family misrecorded her age in order to more easily gain citizenship. 

The government cannot unilaterally denaturalize a citizen, however; it would have to ask a court to do so.

What’s the context? Historically, it’s rare for the US to strip citizenship from naturalized US citizens. But doing so at volume has been a major, if less visible, priority for the second Trump administration. 

As of earlier this year, NBC News reported, DOJ was targeting hundreds of people for possible denaturalization, and has reportedly hoped to put forward hundreds of new cases per month (though successfully stripping them of citizenship is another matter).

Why does this matter? Trump’s campaign to bend the traditionally nonpartisan DOJ into a tool to punish and harass his enemies has been one of the major stories of his second term. 

Even if it never advances beyond Monday’s raid, an investigation targeting Omar’s citizenship with the eventual goal of deporting her from the US represents a new and even more dangerous evolution of that effort — and it threatens to move the US to a far darker place, where citizenship and the rights it guarantees are predicated on the president’s goodwill.

And with that, it’s time to log off…

Hi readers — if you’ll allow me to depart a little from my normal approach to this section, I have a story about politics to share. It’s not, however, about the politics we’re currently dealing with, but about what could be: Democrats’ plan for a quietly ambitious “Project 2029” should they win the White House in 2028. You can read it with a gift link here.

Alternatively, if you’d prefer to just log off, here’s an adorable snow leopard cub with massive paws. Thanks for reading, have a great evening, and we’ll see you tomorrow!

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

Throughout his second term, President Donald Trump has saddled his party with no shortage of political liabilities — from the mass pardons of January 6 convictions to ICE killings of US citizens to questionable Reflecting Pool redesign choices.

For voters, however, there is one stain on Trump’s record more unsightly than all the rest: his failure to reduce Americans’ cost of living.

As the midterm campaign enters its home stretch, Americans’ expenses are rising — and the GOP’s prospects are consequently dimming.

Last month, consumer prices were 3.7 percent higher than they had been one year earlier, according to a Consumer Price Index report released on Wednesday. That represented an acceleration in the inflation rate, one driven largely by skyrocketing fuel prices: Gasoline was 9.1 percent more expensive in September than it had been in August. As a result, America’s average real wage has fallen by 44 cents since January.

In less than three weeks, Americans will head to the polls to decide which party controls Congress, along with a slew of state and local offices. As we count down to that momentous and potentially messy day, this newsletter is partnering with our colleague Astead Herndon and Vox’s The Midterms, Actually team for weekly editions on the biggest issues shaping the midterms. We’re breaking down one issue each week and suggesting further reading and races to watch in November.

Last week, we tackled the data center backlash. And this week, we’re digging into affordability.

Go a little deeper

These upward trends in prices aren’t lost on voters. In a recent Pew Research survey, just 21 percent of Americans said economic conditions were “excellent” or “good” — while 65 percent said that Trump’s policies had made the economy worse.

The high cost of living is weighing on Republican candidates in all battleground races. Maine provides just one example of how potent the issue could prove on Election Day.

From one angle, the state’s Senate race might seem like a gimme for Democrats. Kamala Harris won Maine by nearly 7 points in 2024. Thus, in 2026 — when Democrats are poised to win in a national landslide — one might expect the party to easily triumph.

But Republican incumbent Susan Collins is an unusually formidable foe. The race has been a dead heat, with Democratic nominee Troy Jackson leading by just 2 points in a recent Suffolk University poll.

Fortunately for Jackson, Mainers’ energy bills are expected to soar in the campaign’s final weeks, plausibly increasing voters’ appetite for change in the process. 

Maine is America’s second coldest state and unusually reliant on oil for home heat. As autumn advances, its residents will use more heating oil, thereby driving up both their personal bills and market prices. Thanks to the global energy crunch, a gallon of such fuel is already nearly twice as expensive as it was this time last year. 

Jackson has been hitting Collins on the issue relentlessly. That could put a chill in Collins’s reelection odds — and thus, the GOP’s hopes of retaining Senate control.

➨ Other races to watch:

• Similar dynamics are playing out in perennially icy Alaska, where Democratic Senate candidate Mary Peltola has hammered incumbent Republican Dan Sullivan for his complicity in sky-high diesel prices, which many Alaskans use for home heat.  
• In Ohio’s Senate race, Democrat Sherrod Brown has tried to pin rising electricity bills on Republican Sen. Jon Husted, due to his support for data center development. 
• And in Texas, Democratic Senate candidate James Talarico has attacked his Republican rival, state Attorney General Ken Paxton, for supporting “this disastrous war in Iran that’s driving up our costs.” 

In other news

• A brief ceasefire ends: Ukrainian drones attacked a Russian oil refinery early Thursday, days after Trump demanded both Russia and Ukraine halt such attacks.
• Execution livestream canceled: Trump canceled a plan to livestream the execution of Fort Hood shooter Nidal Malik Hasan by firing squad.
• On the podcast: A recent rash of violence between Saudi Arabia and Yemen’s Houthis threatens to destabilize the region — and make the Iran war much larger. Listen to the whole thing here.

One link for later

Rethink confidence. Research shows confidence is good for your job and good for your romantic prospects. Unsurprisingly, then, a whole industry has sprung up teaching people to be more confident. One writer signed up to work with a confidence coach for the first time, and ended up doubting that her self-doubt was all that bad.

Before you go…

• Did you know…there are four state laws regarding real estate and paranormal activity in the US? That’s because purported hauntings are just one of many factors that can affect home prices.
• Today’s trivia: What is the answer to the ultimate question of life, the universe, and everything in The Hitchhiker’s Guide to the Galaxy? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
• Yesterday’s trivia: We asked which percussion instrument is famously played by Mississippi State University fans at home football games. That would be the cowbell.