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Missouri Gov. Jay Nixon issues state of emergency ahead of Ferguson grand jury decision

Missouri Gov. Jay Nixon declared a state of emergency and activated the National Guard Monday in advance of a grand jury decision about whether a white police officer will be charged in the fatal shooting of a black 18-year-old in the St. Louis suburb of Ferguson.
Nixon said the National Guard would assist state and local police as needed, in case there is civil unrest when the grand jury's decision is announced.
There was no indication an announcement is imminent. There is no specific date for a decision to be revealed about whether Ferguson Police Officer Darren Wilson should face charges for shooting Michael Brown on Aug. 9. The St. Louis County prosecutor has said that he expects the grand jury to reach a decision in mid-to-late November.
Meanwhile, police officials in Ferguson and other cities across America were bracing Monday for possible violence in the wake of the decision, one day after hundreds of people took to the streets of St. Louis briefly to block a major intersection to protest the death of Brown.
Dozens of protesters could be seen lying down in the street outside of a movie theater hosting a film festival, pretending to be shot in an action intended to evoke the memory of Brown, according to Reuters.
"This is a mature movement. It is a different movement than it was in August. Then it just had anger, justifiable anger," DeRay McKesson, a 29-year-old protest leader, told Reuters.
Both protests Sunday, which marked the 100th day of demonstrations, were peaceful.
Residents and officials in the region fear another wave of rioting if the grand jury decides not to indict Wilson.
"We are bracing for that possibility. That is what many people are expecting. The entire community is going to be upset," said Jose Chavez, 46, a leader of the Latinos en Axion community group.
For some cities, a decision in the racially-charged case will, inevitably, re-ignite long-simmering debates over local police relations within minority communities.
"It's definitely on our radar," said Lt. Michael McCarthy, police spokesman in Boston, where police leaders met privately Wednesday to discuss preparations. "Common sense tells you the timeline is getting close. We're just trying to prepare in case something does step off, so we are ready to go with it."
In Los Angeles, rocked by riots in 1992 after the acquittal of police officers in the beating of Rodney King, police officials say they've been in touch with their counterparts in Missouri.
"Naturally, we always pay attention," said Commander Andrew Smith, a police spokesman. "We saw what happened when there were protests over there and how oftentimes protests spill from one part of the country to another."
In Las Vegas, police joined pastors and other community leaders this week to call for restraint at a rally tentatively planned northwest of the casino strip when a decision comes.
In Boston, a group called Black Lives Matter, which has chapters in major cities, is organizing a rally in front of the police district office in the Roxbury neighborhood the day after the grand jury's decision.
In Albuquerque, N.M., police are expecting demonstrations after dealing with a string of angry protests following a March police shooting of a homeless camper and more than 40 police shootings since 2010.
Philadelphia police spokesman Lt. John Stanford said he anticipated his city will see demonstrations, regardless of what the grand jury returns.
But big-city police departments stressed they're well-equipped to handle crowds. Many saw large but mostly peaceful demonstrations following the 2013 not-guilty verdict in the case of Florida teen Trayvon Martin, who was shot and killed by neighborhood watch coordinator George Zimmerman. In New York, hundreds of protesters marched from Union Square north to Times Square, where a sit-in caused gridlock.
The New York Police Department, the largest in the nation, is "trained to move swiftly and handle events as they come up," spokesman Stephen Davis said.
In Boston, McCarthy said the city's 2,200 sworn police officers have dealt with the range of public actions, from sports fans spontaneously streaming into the streets following championship victories to protest movements like Occupy.
"The good thing is that our relationships here with the community are much better than they are around the world," he said. "People look to us as a model. Boston is not Ferguson."

GAO finds federal health websites not giving Medicare patients enough information

 A congressional investigation has found that federal websites meant to inform Medicare patients about healthcare costs and quality are failing in their mission. 
A report to be released this week by the nonpartisan Government Accountability Office (GAO) find that Medicare lacks clear procedures for getting useful information to consumers.
The report, obtained by The Associated Press before its public release, finds "critical weaknesses" in five consumer-information websites run by the Centers for Medicare and Medicaid Services that seek to inform how well hospitals, nursing homes, physicians and other Medicare providers are doing.
The GAO said a confusing layout, data gaps and lack of customized information make it virtually impossible for consumers to get the information they need and won't be fixed anytime soon, even as the federal government plans new websites on the quality of hospice, inpatient rehabilitation and long-term care.
It is the latest report to detail problems in the government's health care websites. The Obama administration has already grappled with the technology meltdown experienced last year by HealthCare.gov as well as glitches in the Sept. 30 rollout of data on payments doctors receive from drug companies.
"The GAO report reveals that there is a need to empower patients with better information on health care price and quality," said Sen. Pat Toomey, R-Pa., home to the nation's fourth-largest share of residents 65 and older, at roughly 1 in 7. Only Florida, West Virginia and Maine have higher percentages of seniors.
"Armed with the facts, it will be possible for consumers to obtain high quality care and drive down costs," he said.
The GAO cautioned that due to a lack of clear policies or performance measures, CMS will likely continue to have "limited effectiveness in conveying relevant and understandable information on cost and quality to consumers."
It cited a growing need for the information due to rising health care costs.
Jim Esquea, an assistant secretary at the Health and Human Services Department, concurred with the recommendations. He wrote that CMS, an agency of HHS, was planning to expand its star ratings, already in use on its "Nursing Home Compare" website.
He also said HHS was committed to providing detail on estimated out-of-pocket costs "to the extent feasible" and had developed many internal procedures, although GAO said it had found no evidence that was the case.
In the study, GAO compared data on CMS' websites with that of third-party vendors providing similar information on gallbladder surgery, magnetic resonance imaging, or MRIs, of the lower back and maternity care. They also examined documents and interviewed company and government officials and experts on best practices.
In all, the audit found wide variation in charges for the same medical procedures in the same geographic area regardless of quality — information it said was not readily available on the CMS sites. Esquea said there were challenges in providing cost information.
In addition, the CMS sites often lacked critical data on quality of care, such as patient-reported outcomes on common procedures such as a colonoscopy, according to the report. In interviews with the GAO, CMS officials said they plan to add patient-reported outcomes on a number of medical procedures.
The investigators cited a likelihood of continuing problems despite the government's 2011 pledge under the Affordable Care Act to provide consumers complete and understandable information. While CMS has said it will make improvements, GAO pointed to limitations due in part to resistance from medical providers.
In recent months, the American Medical Association has opposed Medicare's release of billing records for 880,000 physicians, citing the danger of data being reported inaccurately or taken out of context; much of that information was eventually released.
"People deserve to know information on the cost and quality of the health care services they need," said Sen. Jeanne Shaheen, D-N.H., one of the lawmakers who requested the report. "The new GAO study makes important recommendations on how to better empower consumers, and I look forward to working with this bipartisan group of senators to establish more transparency."

Obama orders full review of US hostage policy

President Obama has ordered a complete review of the government's policy regarding U.S. hostages taken overseas, the White House confirmed to Fox News late Monday. 
National Security Council (NSC) spokesman Alistair Baskey said the review was ordered over the summer in response to what he called "of the increasing number of U.S. citizens taken hostage by terrorist groups overseas and the extraordinary nature of recent hostage cases."
The review, which was first reported by The Daily Beast, became public one day after the White House confirmed that American aid worker and former Army Ranger Peter Kassig had been beheaded by ISIS in Syria. The terror group had posted a video claiming that it had beheaded Kassig to various social media sites early Sunday. Kassig is the third American to be beheaded by ISIS since August. The group is also holding an American woman, a 26-year-old aid worker whose identity has not been revealed by U.S. officials out of concern for her safety. 
The Daily Beast quoted a letter written last week by Undersecretary of Defense for Policy Christine Wormuth to Rep. Duncan Hunter, R-Calif., as saying that the review will include "specific emphasis on examining family engagement, intelligence collection, and diplomatic engagement policies."
The beheadings have sparked a fresh debate over the U.S. government's policy of not paying ransom to terror groups. The parents and brother of journalist James Foley, who was beheaded by ISIS in August, told Fox News in September that government officials had told them that they could face prosecution if they attempted to negotiate a ransom. U.S. law prohibits American citizens from paying money to terror groups. 
However, an October article in Foreign Policy magazine reported that U.S. efforts to free hostages held in Syria had become bogged down amid general confusion as to the exact policies of the U.S. government on issues such as ransom payments. 
"No one's really in charge," one person involved in negotiations told the magazine. The article also reported that U.S. officials had acknowledged that family members of hostages, such as the Foleys, had not received frequent enough updates on what the government was doing to free their loved ones. In addition, a lack of actionable intelligence about ISIS activities in Syria has also been deemed responsible for undercutting U.S. efforts. 
According to Foreign Policy, the debate over ransom payments pits the White House, NSC, and State Department against the Justice Department and the FBI. The former entities believe that paying ransoms to terror groups would encourage more kidnappings of Americans abroad. By contrast, the latter offices believe that the issue of whether to pay ransom should be made on a case-by-case basis, and reportedly are willing to aid families if they believe that paying up represents the best method to ensure the hostages' freedom. 
A U.S. policy on hostage negotiations signed by President Bush in 2002 states that ransoms can be paid if officials believe doing so would help gain intelligence about terror groups, but can not be paid for the sole purpose of freeing an American.

'Cruel murder': Terror attack on Jerusalem synagogue kills four, injures six

Four worshippers at a Jerusalem synagogue were killed and six were wounded Tuesday when two Palestinians armed with meat cleavers and a gun stormed the building and began attacking people before they were killed in a shootout with police. 
The attack in the ultra-Orthodox Har Nof neighborhood in the western part of Jerusalem, was the deadliest in Israel's capital since 2008, when a Palestinian gunman shot eight people in a religious seminary school. 
Prime Minister Benjamin Netanyahu vowed that Israel will "respond harshly" to the attack, which he denounced as a "cruel murder of Jews who came to pray and were killed by despicable murderers." U.S. Secretary of State John Kerry said he spoke to Netanyahu after the assault and denounced it as an "act of pure terror and senseless brutality and violence."
Kerry blamed the attack on Palestinian calls for "days of rage," and said Palestinian leaders must take serious steps to refrain from such incitement. He also urged Palestinian leaders to condemn the attack "in the most powerful terms."
Hours after Kerry spoke, Palestinian President Mahmoud Abbas condemned the attack, the first time he has done so since a recent spike in deadly violence against Israelis began. He also called for an end to Israeli "provocations" surrounding the sacred site.
In a statement, Abbas' office said he "condemns the killing of the worshippers in a synagogue in west Jerusalem." The statement called for an end to the "invasion" of the mosque at a contested holy site in the city and a halt to "incitement" by Israeli ministers.
Israeli police spokeswoman Luba Samri said the attackers were cousins from east Jerusalem, which has been the scene of relentless clashes between Israeli police and Palestinian protesters in recent months. She identified the assailants as Ghassan and Oday Abu Jamal from the Jabal Mukaber neighborhood.
Soon after the attack, clashes broke out outside the Abu Jamals' home where dozens of police had gathered to carry out arrests in connection with the attack. Residents hurled stones at police who responded using riot dispersal weapons.
The Popular Front for the Liberation of Palestine, a militant group, said the cousins were its members. A PFLP statement did not specify whether the group instructed the cousins to carry out the attack.
Hamas, the militant group that runs the Gaza Strip, praised the attack as retaliation for what it claimed was the murder of a Palestinian bus driver who was found hanged in his vehicle late Sunday. Israeli police, citing autopsy results, have classified the man's death as a suicide, but that has not been accepted by the man's family. 
Police spokesman Micky Rosenfeld said two police officers were among the six wounded, four of whom were reported in serious condition. He said police were searching the area for other suspects.
Associated Press footage from the scene showed the synagogue surrounded by police and rescue workers following the attack.  Wounded worshippers were being assisted by paramedics and a bloodied meat cleaver lay near the scene of the attack. Initially, police had described the weapons used as knives and axes.
The Times of Israel cited witnesses who said the two men shouted "Allahu Akbar" during the attack and entered the synagogue without their faces covered. 
"I tried to escape. The man with the knife approached me. There was a chair and table between us ... my prayer shawl got caught. I left it there and escaped," a man who identified himself as Yossi, who was praying at the synagogue at the time of the attack, told Israeli Channel 2 TV. He declined to give his last name.
Another witness, identified only as Zohar described panic at the scene.
"I heard shooting and one of the worshipers came out covered in blood and shouted 'There’s a massacre,'" he told The Times of Israel. 
A photo in Israeli media from inside the synagogue showed what appeared to be a body on the floor draped in a prayer shawl, with blood spattered nearby.
Jerusalem has seen a spate of attacks by Palestinians against Israelis, most of which have involved cars being driven into pedestrians. At least six people had been killed in Jerusalem, the West Bank and Tel Aviv prior to Tuesday.
Jerusalem residents have already been fearful of what appeared to be lone wolf attacks, but Tuesday's early morning attack on a synagogue harkens back to the gruesome attacks during the Palestinian uprising of the last decade.
Israel's police chief said Tuesday's attack was likely not organized by militant groups, similar to other recent incidents, making it more difficult for security forces to prevent the violence.
"These are individuals that decide to do horrible acts. It's very hard to know ahead of time about every such incident," Yohanan Danino told reporters at the scene.
Tensions appeared to have been somewhat defused last week following a meeting between Netanyahu, U.S. Secretary of State John Kerry and Jordan's King Abdullah II in Jordan. The meeting was an attempt to restore calm after months of violent confrontations, with Israel and the Palestinians saying they would take steps to reduce tensions that might lead to an escalation.
The Jerusalem holy site is referred to by Jews as the Temple Mount because of the Jewish temples that stood there in biblical times. It is the most sacred place in Judaism; Muslims refer to it as the Noble Sanctuary, and it is their third holiest site, after Mecca and Medina in Saudi Arabia.
The site is so holy that Jews have traditionally refrained from going there, instead praying at the adjacent Western Wall. Israel's chief rabbis have urged people not to ascend to the area, but in recent years, a small but growing number of Jews, including ultranationalist lawmakers, have begun regularly visiting the site.

Cotton hints at specific GOP spending bill tactic to counter Obama executive action

Arkansas Sen.-elect Tom Cotton hinted on Sunday at exactly what he and fellow Republicans might do in response to President Obama's vow to use executive action on immigration reform: selectively block the president's spending like the GOP did on the Guantanamo Bay prison issue.
Cotton, a House member recently elected to the Senate, told “Fox News Sunday” that the GOP-controlled lower chamber could pass a spending bill that limits the president’s ability to spend on Social Security cards for illegal immigrants, who may be granted some type of U.S. residency status through executive action.
Cotton compared the strategy to House Republicans passing a Defense spending bill in June that included a provision that barred funding for transferring detainees in the U.S. prison in Guantanamo Bay, Cuba, established after the 9/11 terror attacks.
Republicans have opposed Obama’s plan to shutter the facility in part by sending detainees to federal prisons on American soil.
Congressional Republicans have been considering several strategies should Obama proceed before the new year with executive action, as he has vowed to do several times in the past couple of weeks.
Among the most drastic is to submit a spending bill that Obama would assuredly veto, which would temporarily shut down parts of the federal government after Dec. 11.
Cotton and Oklahoma Sen.-elect James Lankford, another GOP House member, each told Fox News on Sunday that they are not pushing for a shutdown, which is largely unpopular with Americans.
“I don’t think anybody wants to shut down government,” Cotton said.
Lankford said: “We’re not pursing some government shutdown.”
The president is expected, by as early as next week, to announce executive action on U.S. immigration law that would protect roughly 5 million illegal immigrants from deportation, change federal law-enforcement programs and expand business visas for non-citizens.
Among the other strategies Republicans are pushing are a temporary spending bill into next year when they control the Senate, suing the president to overturn his action, passing a stand-alone bill to try to stop him and House Republicans writing their own immigration bill to show they are serious about acting and pre-empt Obama.
The Democrat-controlled Senate last year passed bipartisan, comprehensive immigration-reform legislation.
The Defense spending bill also imposed a one-year moratorium on moving detainees to a foreign country, a sharp response to Obama’s decision to trade five Taliban leaders who had been held at Guantanamo Bay for more than a decade for Army Sgt. Bowe Bergdahl, a captive for five years in Afghanistan.
Republicans said Obama broke the law by failing to notify Congress at least 30 days before the swap and increased the terrorism risk to the United States with the exchange.
“President Obama’s recent exchange of five high-level terrorists without notifying Congress illustrates his blatant disregard for its role as a co-equal branch of government,” Cotton said at the time.

Hagel says US speeding up training of Iraqi forces to fight ISIS

Defense Secretary Chuck Hagel said Sunday that the U.S. military is speeding up its training and advising of Iraqi forces who are fighting the Islamic State militants after a recommendation from the commander of U.S. Central Command.
Hagel's announcement came the same day the White House confirmed a third American, aid worker and former Army Ranger Peter Kassig, had been beheaded by members of the militant group.
The Pentagon chief spoke to reporters after observing Army training in California's Mojave Desert on Sunday. He said U.S. special operations troops in Iraq's western Anbar province are getting an early start on the train-and-advise effort.
Hagel said the effort began a few days ago but did not provide any other details.
According to plans laid out last week, the U.S. expects to train nine Iraqi security forces brigades and three Kurdish Peshmerga brigades. Hagel said the speed-up was recommended by Gen. Lloyd Austin, the commander of U.S. Central Command.
Hagel's spokesman, Navy Rear Adm. John Kirby, said later that Austin believes getting an early start on training Iraqi forces in Anbar may prompt other countries with a stake in the fight against Islamic State to commit trainers to Iraq.
Approaching the problem of ill-trained and poorly motivated Iraqi soldiers as a coalition rather than as a unilateral U.S. undertaking is a key pillar of U.S. strategy. Partnership is seen as a way of undermining the ideological appeal of Islamic State.
Kirby said a number of countries have made verbal commitments to provide trainers, but he said he could not identify them because they have yet to publicly announce their intended contributions.
On Thursday, Hagel told Congress that the U.S. and coalition forces are making progress in the fight against the militant group, also known as ISIS of ISIL, but the American people must prepare for a long and difficult struggle.
"ISIL's advance in parts of Iraq has stalled, and in some cases been reversed, by Iraqi, Kurdish, and tribal forces supported by U.S. and coalition airstrikes," Hagel said in testimony to the House Armed Services Committee. "But ISIL continues to represent a serious threat to American interests, our allies, and the Middle East ... and wields influence over a broad swath of territory in western and northern Iraq and eastern Syria."
The testimony of Hagel and Army Gen. Martin Dempsey, the chairman of the Joint Chiefs of Staff, came just days after President Barack Obama asked Congress for a new $5.6 billion plan to expand the U.S. mission in Iraq and send up to 1,500 more American troops to the war-torn nation.
Kassig is the fifth Western hostage killed by ISIS in less than three months, and the third American. Previous Western beheading victims were American journalists James Foley and Steven Sotloff, as well as Britons David Haines, a former Royal Air Force engineer, and Alan Henning, a taxi driver from northwest England. The group is also holding British photojournalist John Cantlie, who has appeared in several other videos released by the group functioning as a de facto spokesman.
The group has declared a self-styled Islamic caliphate in areas under its control, which it governs according to its violent interpretation of Shariah law, including massacring rebellious tribes and selling women and children of religious minorities into slavery.
The group's militants have also beheaded and shot dead hundreds of captives, mostly Syrian and Iraqi soldiers, during its sweep across the two countries, and has celebrated its mass killings in extremely graphic videos.
The Islamic State group has its roots in Al Qaeda's Iraqi affiliate but was expelled from the global terror network over its brutal tactics and refusal to obey orders to confine its activities to Iraq. It became even more extreme amid the bloody civil war in neighboring Syria and grew strong enough to launch a lightning offensive across Iraq.
Syria's war began as an uprising against President Bashar Assad. Activists say that conflict has killed more than 200,000 people.

States hurry to fix healthcare exchange websites in new enrollment period

Several states whose health exchange websites failed their first test during last year's inaugural ObamaCare open enrollment period have adopted different approaches for the second round, which began Saturday.
Some, like Oregon and Nevada, folded and decided to go with the federal exchange. Others, like Maryland and Massachusetts, fired their technology contractors and are hoping for better results this time.
It hasn't been cheap.
The original cost of Massachusetts' website was estimated at $174 million. That has jumped to $254 million. When launched, the website, designed by the same contractor that worked on the troubled Healthcare.gov, was incompatible with some browsers and was riddled with error messages and navigational problems. The problems were so bad, federal officials gave the state three extra months to meet the requirements of the Affordable Care Act. Gov. Deval Patrick issued a public apology and health care officials were forced to adopt a series of manual workarounds, creating a backlog of more than 50,000 paper applications.
Patrick told the Associated Press that there won't be a repeat of the disastrous roll-out this time around, saying the state has "been testing and retesting" the revamped website.
Minnesota's state-run exchange, MNsure, wasn't ready for prime time when it launched in 2013. Some of the technical glitches that frustrated consumers remained unresolved by the time the open enrollment period closed. MNsure officials are promising a better experience this time -- with more call center workers and a website that's 75 percent faster. But they also acknowledge the system won't be perfect.
California's exchange also was ill-prepared to handle the high volume of calls, triggering long wait times at help centers and forcing the state to extend open enrollment for two weeks beyond the original March 31 deadline.
"It swamped us," said Covered California Executive Director Peter Lee, promising increased website capacity and extra call center staff.
Maryland's website crashed on the day it opened last year. The state decided there were too many bugs to completely fix Maryland's original system for the new enrollment period, and the board overseeing the exchange fired its prime information technology contractor and is transitioning to a new system with technology used by Connecticut.
The problems at Washington state's health care exchange occurred after people signed up for insurance. At least 24,000 people who obtained private insurance couldn't use that coverage when they went to the doctor because of problems crediting payments and sending those dollars on to insurance companies.  It took about nine months to fix those problems.
In Vermont, officials announced in August they were scaling back their relationship with the prime contractor on the state's exchange, CGI, reducing the company's role from developing and hosting the Vermont Health Connect site to just hosting it.
Development of the site was switched to another contractor, Optum, the same health care technology firm retained by Massachusetts to revamp its website after it also cut ties with CGI.
Other states fared better.
Colorado's exchange experienced minimal disruptions and the state was able to sign up about 148,000 people.
Kentucky also had a successful rollout, signing up more than 421,000 people for health insurance during the first round of open enrollment. Obama even pointed to Kentucky as an example of the success of his health care law during his State of the Union address this year.
The states were so successful that when Massachusetts was casting around for solutions to its website troubles, it looked to Kentucky and Colorado for what it called "a proven, off-the-shelf solution."
Connecticut was also able to claim bragging rights: After the launch of its marketplace, Access Health CT, officials there predicted the state's uninsured rate would drop to from 7.9 percent to 6.5 percent. Instead it fell to 4 percent.
"We had an office pool going on about what this percentage was going to look like," said Access Health CT CEO Kevin Counihan. "No one expected we'd be down to 4 percent."
In Massachusetts, the experience of finding insurance through the website is beginning to turn around for some.
Christopher Doty lost his insurance when he lost his job in marketing last month. The 32-year-old Boston resident, who has asthma and needs medicine on a regular basis, said he was quickly able to sign up for insurance through MassHealth, the state's Medicaid program.
"Losing my job and knowing I needed some kind of health insurance at first was super-stressful," Doty said. "I basically had coverage within a couple of days."
On Sunday, Health and Human Services Secretary Sylvia M. Burwell told NBC's "Meet the Press" that 100,000 people had submitted new applications this weekend via the federal website serving 37 states. That's a big difference from last year, when only a handful of customers managed to enroll on the first day.
Burwell also said that a half-million people who already have coverage through the program were able to log into their accounts this time.
There were reports Saturday that returning customers had problems, but some of that may have been confusion trying to remember user names and passwords.
Patrick said one way to avoid future problems is heightened vigilance.
"Outsourcing and privatizing -- this is not the solution." Patrick said. "The solution is to make sure that there's very close oversight even when we use an outside vendor."