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Medicare, Cancer and the Tax Bill

Q: Is it true that under the GOP tax bill, Medicare will stop covering cancer treatment?

A: No. Nothing about the tax bill would end cancer treatment benefits. Increased deficits could lead to Medicare spending cuts, however.


There is a rumor floating around that the new tax bill has a hidden section included that will deny cancer treatment to patients on Medicare. Have you heard anything about it? It sounds absurd but so does so much else nowadays.


Several readers have asked us some variation of this question. Like many rumors, it began with a nugget of truth and then took on a far-fetched life of its own.

There is no “hidden section” in the Republican tax bill that denies cancer treatment, or any other kind of health treatment, to Medicare beneficiaries, or anyone with other types of insurance. Nor is it true that “Medicare may no longer cover cancer treatment,” as another reader inquired.

What could happen under congressional rules is a spending cut to some mandatory programs, including Medicare, because the tax bill increases the deficit.

A tax cut that isn’t paid for would trigger offsetting spending cuts under congressional “pay-go,” or “pay-as-you-go,” rules. Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan, however, have said that Congress would waive the pay-go requirement so that the across-the-board cuts to some mandatory spending programs wouldn’t happen.

The nonpartisan Congressional Budget Office said in a Nov. 14 report, requested by Democratic Rep. Steny Hoyer, that because of the pay-go rules, if legislation — like the tax bill — increases the deficit, the White House’s Office of Management and Budget “is required to order a sequestration to eliminate the overage. The authority to determine whether a sequestration is required (and if so, exactly how to make the necessary cuts in budget authority) rests solely with OMB.”

So, if the tax bill is enacted and would increase deficits by an estimated $1.5 trillion over 10 years, OMB would have to order spending reductions for fiscal 2018 of $136 billion, CBO estimated. That’s unless other legislation is enacted to offset the deficit increase or there’s a waiver of these pay-go rules, as McConnell and Ryan have promised. The pay-go law limits cuts to Medicare to 4 percentage points, which is about $25 billion for fiscal 2018.

This sparked news reports that the tax bill could prompt a $25 billion cut to Medicare.

What does that have to do with cancer treatment?

In 2013, when Medicare faced an automatic 2 percent cut under the sequester, some cancer clinics told the Washington Post that they couldn’t afford to continue administering pricey chemotherapy drugs and still stay in business. The Post‘s Sarah Kliff wrote: “Cancer patients turned away from local oncology clinics may seek care at hospitals, which also deliver chemotherapy treatments.”

Oncology clinics are again concerned about a potential cut to payments they receive from Medicare for these cancer drugs. The Community Oncology Alliance, a nonprofit advocacy group for these practices, said in a Nov. 30 press release that a further cut “will reduce access and increase costs for patients.”

Of course that’s not the same as Medicare “no longer” covering cancer treatments, as our readers have asked. One reader pointed to a headline on the liberal Daily Kos blog as the source of the claim. It said: “The Republican tax bill will end cancer treatment for Medicare patients.”

As we’ve explained, that’s not what the tax bill would do. There’s certainly concern, however, about the pay-go spending cut trigger and the potential impact.

McConnell and Ryan issued a joint statement on Dec. 1, saying Congress would waive the pay-go requirement.

McConnell and Ryan statement, Dec. 1: Critics of tax reform are claiming the legislation would lead to massive, across-the-board spending cuts in vital programs—including a four percent reduction in Medicare—due to the Pay-Go law enacted in 2010. This will not happen. Congress has readily available methods to waive this law, which has never been enforced since its enactment. There is no reason to believe that Congress would not act again to prevent a sequester, and we will work to ensure these spending cuts are prevented.

Republicans would need Democratic help to pass legislation to waive the requirement. Such a bill would need 60 votes in the Senate, and Republicans now have 52 seats, which will drop to 51 once the senator-elect from Alabama, Doug Jones, takes office.

Hoyer indicated in a statement that such a deal would be possible, with Democratic input. “While it is possible to avoid the PAYGO enforcement cuts triggered by their added deficits, Republicans would need Democratic votes to do it, requiring them to abandon their go-it-alone partisan strategy,” he said.

Medicare is hardly the only program that would face spending cuts if the pay-go rules weren’t waived, or the tax bill’s deficit spending wasn’t alleviated in another way. Maya MacGuineas, president of the nonpartisan Committee for a Responsible Federal Budget, wrote in a Dec. 12 op-ed for The Hill newspaper that automatic pay-go cuts would “apply to Medicare, agriculture subsidies, student loans, the Social Services Block Grant, parts of border security and mandatory spending in the Affordable Care Act other than exchange subsidies and Medicaid expansion. …. Most affected programs other than Medicare, would be wiped out.”

In fact, the CBO said in its letter to Hoyer that since the pay-go law exempts some programs, including Social Security, from automatic cuts, there aren’t enough available resources left to make all of the required spending cuts for an increase in the deficit of $1.5 trillion over 10 years. “Given that the required reduction in spending exceeds the estimated amount of available resources in each year over the next 10 years, in the absence of further legislation, OMB would be unable to implement the full extent of outlay reductions required by the PAYGO law,” CBO said.

MacGuineas, who notes she is “someone who believes spending cuts are in order and overdue,” wrote that allowing the pay-go triggered cuts to happen “wouldn’t be sensible at all — this would not be trimming the budget with a scalpel, a hammer or even a sledgehammer, but with a wrecking ball.”

The CRFB president gave suggestions on how to lessen the cost of the tax legislation. Republicans hope to vote on a final bill next week.


Letter to the Honorable Steny H. Hoyer. Effects of legislation that would raise deficits by an estimated $1.5 trillion over the 2018-2027 period. Congressional Budget Office. 14 Nov 2017.

“What is PAYGO?” Tax Policy Center. accessed 14 Dec 2017.

McConnell, Mitch. Joint Statement from Leader McConnell and Speaker Ryan on Misleading Democrat Claims About Tax Reform. 1 Dec 2017.

Long, Heather. “Democrats have leverage in one part of the GOP tax cut process.” Washington Post. 14 Nov 2017.

Rubin, Richard. “GOP Tax Bill Would Prompt Automatic Spending Cuts.” Wall Street Journal. 14 Nov 2017.

Kliff, Sarah. “Cancer clinics are turning away thousands of Medicare patients. Blame the sequester.” Washington Post. 3 Apr 2013.

McCarter, Joan. “The Republican tax bill will end cancer treatment for Medicare patients.” Daily Kos. 29 Nov 2017.

MacGuineas, Maya. “Avoid budgetary wrecking ball by making key changes to tax bill.” The Hill. 12 Dec 2017.

Community Oncology Alliance. “Community Oncologists Hold Emergency Hill Day to Warn Congress on Medicare Sequester.” Press release. 30 Nov 2017.

Levy, Adam. “Alabama’s Doug Jones may not take office until 2018.” 13 Dec 2017.

Hoyer, Steny. Hoyer Statement on the CBO’s Analysis that the GOP Tax Bill Will Trigger Statutory PAYGO Sequester Cuts. Press release. 14 Nov 2017.

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Why Donate? Because Facts Matter

The 2017 fiscal year was very good for

The enthusiasm for fact-based reporting and holding politicians accountable had never been greater.

We received a record amount of individual donations — 1,777 gifts totaling $201,311 — from our readers.

We received postcards from a group of Vermont residents who simply thanked us for our work. Many of those postcards displayed a quote from U.S. Supreme Court Justice Hugo Black in New York Times Co. v. the United States“The press was to serve the governed, not the governors,” Black wrote.

We even had one supporter offer to donate a portion of his profits from the sale of hats emblazoned with the word “Facts.” It was an offer that we respectfully declined.

But maintaining such enthusiasm is not easy. Our 2018 fiscal year began on July 1, and in the first three months of the fiscal year, we have received a little more than $9,000.

So please consider a donation to

Without your continued support, we cannot cut through the political spin and provide the facts to tens of millions of our readers and viewers. started 13 years ago with a founding grant from the Annenberg Foundation, and we continue to draw on that grant to operate. That founding grant is dwindling, but we have been able to extend the life of with the help of individual donations.

Our future is increasingly in your hands.

We do not accept advertising. We do not accept any funds from unions, partisan organizations or advocacy groups. We do not accept donations from corporations with the exception of Facebook, which provides funding as part of Facebook’s initiative to combat the spread of so-called “fake news.” We rely on a shrinking founding grant and your generosity.

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Thank you for reading Have a happy holiday season, and a safe and healthy new year.

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Distorted NATO Funding Figure

The United States does not pay 80 percent of the cost of operating the North Atlantic Treaty Organization, or NATO, as President Donald Trump claimed.

The U.S. spends a lot more on its own defense compared with other nations in the international security alliance, but its share of the commonly funded NATO budget is less than one quarter.

Trump, who has long complained that other members of NATO should be spending more, made his claim during a speech in Pensacola, Florida, where he took credit for getting NATO countries to spend more money on defense.

Trump, Dec. 9: Now tomorrow morning you’ll see from these fakers back there, Donald Trump again disrespects NATO. I don’t disrespect NATO. I think NATO is wonderful. But you know what? We’re paying for 80% of NATO – could be higher. They say 72%. So, we’re paying for 80% of NATO. Now I can only tell you one thing – it helps them a hell of a lot more than it helps us, okay?

Trump conflates two kinds of spending by NATO countries — direct and indirect – to wrongly claim that the U.S. is “paying 80% for NATO.”

As for direct costs, the U.S. currently pays about 22 percent of NATO’s “principal budgets” that are funded by all alliance members based on a cost-sharing formula that factors in the gross national income of each country. The principal budget categories include the civil budget, the military budget and the NATO Security Investment Programme.

“Direct contributions are made to finance requirements of the Alliance that serve the interests of all 29 members — and are not the responsibility of any single member — such as NATO-wide air defence or command and control systems,” NATO says. “Costs are borne collectively, often using the principle of common funding.”

Direct spending may also include other “joint funding” projects that are arranged by participating NATO countries, but that are still overseen politically and financially by NATO.

“Jointly funded programmes vary in the number of participating countries, cost-share arrangements and management structures,” NATO says.

Trump, on the other hand, is referring to so-called indirect spending — that is, the amount that the U.S. willingly spends on its defense budget compared with what other NATO countries spend on theirs.

In its June 2017 update on spending, NATO said: “Today, the volume of the US defence expenditure effectively represents 72 per cent of the defence spending of the Alliance as a whole.” That disparity “has been a constant,” NATO says, and has only grown since the U.S. began increasing its defense spending after the terrorist attacks on Sept. 11, 2001.

The 29 alliance members together spent an estimated $946 billion on defense in 2017, and more than $683 billion of that amount was spent by the U.S.

Trump, however, mischaracterized what that means.

As NATO said in the June update: “This does not mean that the United States covers 72 per cent of the costs involved in the operational running of NATO as an organisation, including its headquarters in Brussels and its subordinate military commands, but it does mean that there is an over-reliance by the Alliance as a whole on the United States for the provision of essential capabilities, including for instance, in regard to intelligence, surveillance and reconnaissance; air-to-air refuelling; ballistic missile defence; and airborne electronic warfare.”

In 2006, NATO members agreed to try to spend at least 2 percent of their gross domestic product on defense spending. In 2014, they agreed again to aim to meet that standard by 2024.

As of now, though, only the U.S., Greece, Estonia, Britain, Romania and Poland meet the 2 percent target, which led Trump to argue that our allies are not paying their “fair share.”

But other countries have been spending more in recent years. The estimated 4.3 percent bump in 2017 was the third straight year that defense spending by Canada and European allies increased, according to NATO.

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Trump’s Baseless Immigration Claim

Arguing for a merit-based immigration system, President Donald Trump offered a muddled, inaccurate and unsubstantiated critique of a program that annually provides visas by lottery to qualified and screened applicants from countries with low immigration rates.

Trump said that other countries are gaming the Diversity Immigrant Visa Program to “take their worst” and “put them in the bin” so that when the lottery occurs, “they have the real worst in their hands. … And we end up getting them.”

There’s no evidence for that.

The Diversity Immigrant Visa Program, or DV program, uses a computer lottery system to randomly issue up to 50,000 immigrant visas each year to applicants from countries with low rates of immigration to the United States. Millions of applicants apply annually for the diversity visas.

Trump has thrown his support behind the RAISE Act, a bill that seeks to halve legal immigration into the U.S. by reducing the number who gain entry based on family ties, capping the yearly number of refugees admitted and emphasizing a “merit-based” immigration system. It also would do away with the Diversity Immigrant Visa Program.

Trump’s most recent critique of the DV program came during a rally in Pensacola, Florida, on Dec. 8.

Trump, Dec. 8: How about the lottery system, folks? Do you see that? That’s the guy in New York City, the lottery system, where they put names in a bin. You know, you think these countries are legit when they do their lottery system. So what they do, I would say, but more than just saying, they take their worst and they put them in the bin. And then when they pick the lottery, they have the real worst in their hands, oh, here they go. And we end up getting them. No more lottery system. We are going to end that. We have already started the process. We want people coming into our country who love our people, support our economy, and embrace our values. It’s time to get our priorities straight.

Trump’s reference to “the guy in New York City” is to Sayfullo Habibullaevic Saipov, an Uzbekistan-born immigrant charged with killing eight people in New York City on Oct. 31. Trump rightly notes that Saipov came to the U.S. legally in 2010 through the diversity visa program, as was confirmed by the Department of Homeland Security.

But his appraisal of the program unravels after that.

Let’s start with the claim that the DV program is bringing “the real worst” from other countries.

There were nearly 9.4 million qualified entries in the lottery in 2015, and the DV program ended up bringing 47,934 new legal permanent residents to the U.S. — about 4.6 percent of all of those who obtained lawful permanent resident status through various immigration programs that year.

In order to be eligible for the lottery, applicants must demonstrate that they have a high school education or its equivalent or “two years of work experience within the past five years in an occupation that requires at least two years of training or experience to perform.”

But that’s not all. If one is selected through the lottery, he or she still has to go through a background security vetting process.

“It is a complicated and lengthy process,” explained Stephen W. Yale-Loehr, who teaches immigration law at Cornell Law School. “Among other things, the consular officer must make sure the individual is not ‘inadmissible.’ This means that the person has not committed a crime, doesn’t have a serious health problem, isn’t a terrorist, hasn’t committed fraud, and hasn’t overstayed in the U.S. before.”

There are more than a dozen grounds of inadmissibility, including, as Yale-Loehr said, health issues, criminal activity, national security concerns and the “likelihood of becoming a public charge,” meaning “a person who is primarily dependent on the government for subsistence.”

“National security is our top priority when adjudicating visa applications,” a State Department official told us via email. “Every prospective traveler to the United States undergoes extensive security screening. No visa can be issued unless all concerns raised by the screening are fully resolved.

“Applicants are continuously screened, both at the time of their visa application and afterwards, to ensure they remain eligible to travel to the United States,” the official said. “This screening draws on information from the full range of U.S. government agencies, including thorough biographic and biometric screening against U.S. law enforcement and counterterrorism databases. Biometric screening includes checks based on fingerprints and/or facial recognition software.”

The screening process also includes an interview by consular officers with a line of questioning “tailored to the circumstances of each applicant,” the State Department official said.

In a press briefing on Dec. 12, Francis Cissna, the director of U.S. Citizenship and Immigration Services, contended “the criteria [for the DV program] are very low.” As a result, he said, “either you have no education at all and very little skills, or you have a minimum of education and no skills at all.”

But that’s not borne out by the statistics.

According to a 2011 report from the Congressional Research Service, a higher percentage of immigrants who entered the U.S. through the DV program had managerial and professional occupations than green card holders overall. Specifically, the report states, 24 percent of diversity immigrants reported managerial and professional occupations in 2009, compared with 10 percent among all green card holders that year. Diversity immigrants also had a lower unemployment rate (3 percent) than all green card holders (8 percent) that year.

More recent data from the Department of Homeland Security’s 2015 Yearbook of Immigration Statistics show 32 percent of those who came through the DV program in 2015 were employed in management, professional and related occupations; another 36 percent were students or children. That’s a lower percentage in management, professional and related occupations than among immigrants who came to the U.S. via employment-based preferences (41 percent). But it’s far higher than the percentage among those who came via family-sponsored preferences (12 percent) or among those who were granted green cards because they were immediate relatives of U.S. citizens (9 percent). That year, 497 of the 47,934 DV immigrants were listed as unemployed, or about 1 percent. That’s far lower than the percentage of unemployed people among all green card recipients (5.1 percent).

It is unclear, exactly, how Trump is suggesting other countries “take their worst and they put them in the bin” so that after the lottery, “we [the U.S.] end up getting them.” The White House press office did not respond to our email seeking clarification.

But there is no evidence to support Trump’s claim of any sort of organized effort by foreign governments to steer their “real worst” to the U.S.

“The diversity lottery is a true lottery,” Yale-Loehr told us via email. “There is no way a foreign government can game the lottery to offload the worst of their citizenry.”

Cissna noted that in 2003, the State Department’s Office of the Inspector General warned about problems with fraud in the program and cautioned that the DV program “contains significant risks to national security from hostile intelligence officers, criminals, and terrorists attempting to use the program for entry into the United States as permanent residents.”

A 2007 Government Accountability Office report warned that the DV program was “particularly vulnerable to manipulation” and fraud risk, even though researchers had found “no documented evidence of DV immigrants from state sponsors of terrorism committing terrorist acts.” The authors note that the State Department, then under President George W. Bush, “was disappointed with the report’s findings and did not agree with the recommendations” and rejected them.

A 2011 Congressional Research Service report similarly said that “[c]ritics of the diversity lottery warn that it is vulnerable to fraud and misuse and is potentially an avenue for terrorists, citing the difficulties of performing background checks in many of the countries eligible for the diversity lottery. Supporters respond that background checks for criminal and national security matters are performed on all prospective immigrants seeking to come to the United States, including those winning diversity visas.”

At the start of his remarks on Dec. 12, Cissna noted that there was also a DV connection related to Akayed Ullah, who is alleged to have set off a pipe bomb in a bungled suicide attack at a bus terminal in New York on Dec. 11. Ullah came to the U.S. based on a family connection to an uncle who originally came to the U.S. through the DV program. But Ullah is not an example of a terrorist who sneaked into the country through any immigration program. According to the criminal complaint filed against Ullah, he came to the U.S. in 2011 and his radicalization began about three years later, in at least 2014.

The State Department warns about the possibility of fraudulent emails sent to lottery applicants that purport to be from the U.S. government “in an attempt to extract payment from DV applicants.”

“So even if a government tried to game the lottery, it should be caught,” Yale-Loehr said. “If people are caught committing fraud, they can’t immigrate. I have never heard of a foreign government trying to game the diversity lottery system. … The bottom line: President Trump’s statements about how the diversity visa program works are false. ”

The DV program has been in Trump’s crosshairs for months, but he renewed calls for its elimination in the wake of Saipov’s attack in New York City. At the time, Trump criticized Sen. Chuck Schumer for helping to create the DV program. As we wrote, Schumer was instrumental in helping to create the program back in 1990 — which was initially intended in large part to benefit Irish immigrants. Schumer, the Democratic leader in the Senate, also was part of the bipartisan Gang of Eight in 2013 that sponsored an immigration overhaul that would have done away with the DV program.

The demographics of those who benefit from the DV program have changed dramatically since its inception. In 2015, DV program visas were offered to residents of 182 different countries, with the largest contingent coming from the African countries of Cameroon, Egypt, Ethiopia, Liberia and the Democratic Republic of Congo, as well as from Nepal and Iran. Excluded are those from countries with high rates of immigration to the U.S. In 2015, that included 19 countries, such as Mexico, India, the Philippines, China, Canada and the United Kingdom.

The program may not enjoy the political support it once did, and Trump is, of course, entitled to his opinion about the need to pivot to a more merit-based immigration system. But we find no basis for his warning that countries are gaming the lottery system and sending “the real worst” of their citizens to the U.S.

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Fake Report of Voter Fraud in Alabama

Q: Did voters in Alabama’s special Senate election get “caught voting multiple times with fake IDs”?

A: No. The Alabama Secretary of State’s office has received no such report.


Alabama elected its first Democratic U.S. senator in 25 years on Dec. 12 in a narrow victory over a Republican candidate who had been beset by allegations of sexual misconduct.

The next day, a popular story on Facebook claimed that 60,000 votes cast in a heavily Democratic area might be invalid. The story was flagged by Facebook users as potentially false. It is.

Jefferson County, which includes the city of Birmingham, voted overwhelmingly in favor of Democrat Doug Jones. Of the 219,541 people who voted in the county, 68 percent voted for Jones and 30 percent voted for Republican Roy Moore, according to the unofficial numbers from the secretary of state.

The made-up story ran under a headline that said, “BREAKING: Black People In Birmingham Caught Voting Multiple Times With Fake IDs,” and suggested that the outcome of the election was in question. It’s not.

The Alabama Secretary of State’s office hasn’t received reports of voter fraud of any significant scale, said Communications Director John Bennett, and it has heard of nothing that would sway the outcome of the election.

The false story began by claiming: “The FEC has announced that it may have to recommend invalidating more than 60K votes from the Birmingham area to the Alabama Secretary of State.”

But the Federal Election Commission enforces federal campaign finance law; it does not have jurisdiction over voting irregularities in statewide elections. The Alabama Secretary of State’s office does oversee elections in Alabama, but it has received no reports of widespread voter fraud in Birmingham, Bennett told us.

The made-up story later uses a quote it claims was posted on the conservative news site Breitbart, but the quote didn’t actually appear on that site. And the link provided goes to a picture of donkey poop.

The story originated on a website called Reagan Was Right, which describes itself as satirical and includes a disclaimer that says: “Everything on this website is fiction.”

But the story was picked up and posted by several other sites that have no such disclaimer.

Editor’s note: is one of several organizations working with Facebook to help identify and label viral fake news stories flagged by readers on the social media network.


Doug Jones elected Alabama Senator; Roy Moore won’t concede: What we know today.” 13 Dec 2017.

McCrummen, Stephanie and Reinhard, Beth. “Woman says Roy Moore initiated sexual encounter when she was 14, he was 32.” Washington Post. 9 Nov 2017.

BREAKING: Black People In Birmingham Caught Voting Multiple Times With Fake IDs.” Reagan Was Right. 13 Dec 2017.

Bennett, John. Communications director, Alabama Secretary of State. Interview with 13 Dec 2017.

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Sessions Wrong About Drugged Driving

Attorney General Jeff Sessions claimed that more car accidents were “caused” by drugs than alcohol for the first time in 2016. But the report his office cited as support didn’t show that.

The report shows alcohol — not drugs — was present in the system of more drivers killed in car crashes. It also doesn’t say the fatal accidents were “caused” by drugs. It’s more difficult to prove a person is under the influence of drugs than alcohol while driving. Unlike alcohol, testing positive for a drug — marijuana in particular — doesn’t prove intoxication. Marijuana can be detected days or even weeks after consumption.

Sessions made his claim on June 22 during a private Q&A with interns at the Department of Justice. ABC News made a video of the event public on Dec. 7, after obtaining it through a Freedom of Information Act request.

In response to a question about marijuana legalization, Sessions said there’s “this view that marijuana is harmless,” adding that car accidents were “caused more by drugs than by alcohol” in 2016.

Questioner, June 22: Since guns kill more people than marijuana, why lax laws on one and harsh laws on the other?
Sessions: Well that’s apples and oranges question I would say first and foremost. But the Second Amendment, you’re aware of that, guarantees the right of the American people to keep and bear arms and I intend to defend that Second Amendment. It’s as valid as the First Amendment. So that’s my basic philosophical view about it. Look, there’s this view that marijuana is harmless and it does no damage. I believe last year was the first year that automobile accidents that occurred were found to have been caused more by drugs than by alcohol. Marijuana is not a healthy substance, in my opinion. The American Medical Association is crystal clear on that. Do you believe that?
Questioner: I, I don’t.

The American Medical Association has publicly stated that “cannabis is a dangerous drug and as such is a public health concern.” So there is support for Sessions’ claim that the AMA says marijuana is “not a healthy substance.”

When we contacted the Department of Justice for support for Sessions’ claim about car accidents, spokeswoman Lauren Ehrsam sent us a link to a Washington Post article from April 26 that outlines the findings of a report by two nonprofits — the Governors Highway Safety Association and the Foundation for Advancing Alcohol Responsibility.

The association represents state and territorial highway safety offices that implement federal grants to improve traffic safety. The foundation, funded by eight major alcohol companies including Bacardi U.S.A. Inc. and Beam Suntory, says its mission is to “fight against drunk driving and underage drinking.”

The report actually looks at data from 2015, not 2016, as Sessions said. The data were compiled from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System. The NHTSA is part of the U.S. Department of Transportation.

The report does say that NHTSA data from 2015 show “drugs were present in 43% of the fatally-injured drivers with a known test result, more frequently than alcohol was present.” For alcohol, the report cites the figure 37.3 percent. The report doesn’t provide the actual quantities of people who tested positive for drugs or alcohol, however.

And the report doesn’t quite support the idea that drugs led to more fatal car crashes than alcohol.

The report says 70.9 percent of fatally-injured drivers were tested for alcohol. Of that 70.9 percent, 37.3 percent tested positive for some level of alcohol. That means 26.4 percent of all fatally-injured drivers tested positive for alcohol.

Only 57 percent of fatally-injured drivers were tested for drugs. Of that 57 percent, 41.7 percent tested positive for some drug. That would mean 23.8 percent of all fatally-injured drivers tested positive for a drug, which is less than those who tested positive for alcohol.

(The figure of 43 percent noted a few paragraphs up comes from dividing 41.7 percent by 97.1 percent, the proportion of fatally-injured drivers with a “known” test result, Governors Highway Safety Association spokeswoman Madison Forker told us by email.)

But Sessions was answering a question about marijuana, not drugs in general. The report’s figure for marijuana is even lower.

Of the 57 percent of fatally-injured drivers who were tested for drugs, 34.3 percent had a positive test for a drug specifically coded for in the NHTSA’s system. An additional 7.4 percent tested positive for a drug in the system, which comes to 41.7 percent who tested positive for some drug. Of that 34.3 percent, 36.5 percent tested positive for marijuana.

That would mean 7.1 percent of all fatally-injured drivers tested positive for marijuana, compared with 26.4 percent who tested positive for alcohol.

(The report actually includes the figures 36.5 percent and 35.6 percent for marijuana, but Forker confirmed that the latter figure was a typo.)

But here’s the thing about drug tests for marijuana — unlike alcohol breathalyzers, they don’t prove a driver was intoxicated at the time of the accident.

As we wrote back in August 2016, marijuana can remain in the body for days, even weeks, after a person consumes the drug. The same goes for some other drugs, such as prescription pain killers.  In fact, the report referenced by Sessions and provided to us by the DOJ cites this fact, stating that “marijuana metabolites can be detected in the body for weeks after use.”

“Alcohol is far simpler because it is quickly absorbed into the body and impairment is directly related to BAC [blood alcohol concentration],” the report by the Governors Highway Safety Association and the Foundation for Advancing Alcohol Responsibility says.

This is why experts don’t say marijuana, and some other drugs, caused traffic fatalities. Instead, they say marijuana use was associated with traffic fatalities. Sessions used the term “caused,” and that’s misleading.

The report cited by the DOJ adds that the data it used have other “critical limitations.” For example, the data come from individual states, and, “States vary considerably in how many and which drivers are tested, what tests are used, and how test results are reported.”

For all of these reasons, Sessions’ claim that drugs “caused” more car accidents than alcohol was inaccurate. The report DOJ cited doesn’t support that.

What about other research on the topic?

The National Academies of Sciences, Engineering and Medicine concluded in a January 2017 report: “There is substantial evidence of a statistical association between cannabis use and increased risk of motor vehicle crashes” (our italics).

The report emphasized that this is not necessarily marijuana use at the time of the accident, but use generally. The increased risk also isn’t necessarily large. The report didn’t consider whether marijuana was associated with more crashes than alcohol.

One meta-analysis published in the journal Addiction in April 2016, which weighed heavily on the report, found that marijuana use increased crash risk by 1.04 to 1.18 times, after controlling for alcohol use. This analysis took into account studies that had been conducted both within and outside of the United States.

Conversely, a February 2015 study by the National Highway Traffic Safety Administration found that a statistically significant crash risk for drivers who tested positive for THC disappeared after the study authors controlled for a number of variables, including alcohol concentration level. The academies’ 2017 report didn’t consider this study.

For comparison, the NHTSA says a blood alcohol level of 0.07, which is below the legal limit of 0.08, increases crash risk by 3.22 times. That would be the equivalent of two drinks for a 140-pound woman or three drinks for a 160-pound man.

There’s also some evidence that suggests medical marijuana laws may be associated with decreasing traffic fatalities.

One study published in The Journal of Law & Economics in 2013 reviewed traffic fatalities in the 19 states that had passed medical marijuana laws by 2010 and found that “legalization is associated with an 8–11 percent decrease in traffic fatalities” for the year after the laws took effect.

Another study, published in the American Journal of Public Health in July found: “Three years after recreational marijuana legalization, changes in motor vehicle crash fatality rates for Washington and Colorado were not statistically different from those in similar states without recreational marijuana legalization.”

Still, there is evidence that “marijuana significantly impairs judgment, motor coordination, and reaction time,” according to the National Institute on Drug Abuse.

Overall, experts disagree about the relationship between marijuana and driving. But there’s little to no disagreement over whether drinking alcohol before driving increases crash risk. And at this point, there isn’t sufficient evidence to conclude more drivers are dying in car crashes because of drugs than alcohol.

Editor’s Note: SciCheck is made possible by a grant from the Stanton Foundation. 

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Mailbag: Alabama Senate Race, Uranium One Deal

This week, we feature emails readers sent to us regarding the Alabama Senate race and the Obama administration deal allowing a Russian nuclear energy agency to acquire a controlling stake in Uranium One, a Canadian-based company with mining stakes in the Western United States.

In the FactCheck Mailbag, we feature some of the email we receive. Readers can send comments to Letters may be edited for length.

GOP Support for Roy Moore

Regarding your Dec. 7 article about Sen. Franken’s claim that Roy Moore was running for Senate with “the full support of his party.” [“Al Franken on GOP Support for Roy Moore,” Dec. 7.] You labelled that statement an exaggeration, but I don’t think it was. As your article acknowledges, the RNC ended up officially endorsing Roy Moore. That official endorsement is the Republican Party’s “full support,” even if a lot of prominent Republicans disagree.

But the bigger issue I have with your fact check is that the supposed exaggeration doesn’t undermine the valid point Sen. Franken was making. Even if Moore doesn’t enjoy the “full support” of his party, the difference between each party’s treatment of alleged sexual improprieties is stark. The Republicans nominated a man for president who had been publicly accused of sexual assault by more than a dozen women and are now endorsing for Senate a man who has been accused of improper sexual conduct with underage girls. The Democrats, in contrast, have quickly pressured Sen. Franken to resign over conduct that was juvenile and unacceptable, but far less predatory. Highlighting this difference was the primary point Sen. Franken was making, and it was an important one.

I think your fact check did the national conversation about sexual harassment a disservice by drawing attention away from Franken’s valid primary point to challenge the details on a peripheral fact that didn’t matter.

Jon G. Lycett
Carlsbad, California

The Uranium One Deal

I covered this story as a reporter for Fuel Cycle Week, which is a nuclear energy trade press newsletter that covers uranium mining, uranium enrichment, spent fuel and nuclear reactor markets generally.

The current dust-up in the news media has been painful to watch because so many have no expertise and simply repeat the ridiculous claims being made about the case.

At the time (2010), it appeared to me and others who followed such issues that the Uranium One deal was not remarkable from a business perspective and that the level of U.S. government scrutiny on such a deal was an administrative headache for the firm, but it didn’t rise to being a national security issue.

Even today the U.S. is swimming in uranium for which there is no market with the price of yellowcake at record low levels of $21/lb. The economic or profitable price point for producers is $45/lb more or less. Why anyone would worry, on a technical/business basis, about Uranium One’s role in the market doesn’t understand the market.

One of the reasons for the global surplus of uranium for use as fuel in commercial nuclear reactors is that Japan took all its reactors offline after Fukushima in March 2011. This is like everyone in New York City deciding not to buy hot dogs. The market for Nathans would collapse.

One thing you passed over [“The Facts on Uranium One,” Oct. 26] is that the Uranium deal was about consolidating holdings related to properties in Kazakhstan.

World Nuclear Association, October 2017: The uranium exploration and mining JVs Akbastau and Karatau with Tenex started with Budenovskoye in the Stepnoye area of south Kazakhstan, which commenced production in 2008. These complemented the Zarechnoye JV 250 km to the south which was set up in June 2006. However, in 2009 and 2010 the 50% ARMZ equity in these three was traded for an eventual 51% share of Canadian-based Uranium One Inc, which subsequently became wholly-owned by ARMZ. Uranium One Holdings (U1H) is now the holding company for all Russian uranium mining interests in Kazakhstan (and its equity in an acid plant).

Hope this helps. The rest of the cited article has more detail, but it may not be germane for your purposes.

Dan Yurman
Cleveland, Ohio

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Trump’s Rare Apology

Sen. Bernie Sanders wrongly said President Donald Trump has never apologized for his comments on the “Access Hollywood” tape in which he bragged about sexually inappropriate behavior.

Trump did apologize at the time for his comments in a press release, a video statement and during a presidential debate. Some have questioned the sincerity or quality of the apology, but he did apologize.

Sanders’ comment came during an interview on NBC’s “Meet the Press” on Dec. 10 after he responded to questions about the resignation of Democratic Sen. Al Franken amid allegations of sexual misconduct.

“The point is that we have the absurdity now of a president of the United States who basically says on a tape that everybody in this country has seen, his pride in a sense in assaulting women, and he has not apologized for that, and he has, you know, not offered his resignation,” Sanders said. “So I think that’s the absurdity.”

Sanders is, of course, referring to the “Access Hollywood” tape released a month before the election that caught Trump on a hot microphone in 2005 bragging about forcing himself on women. “When you’re a star, they let you do it,” Trump said at the time. “Grab ’em by the p***y. You can do anything.”

Despite Sanders’ comment on “Meet the Press,” though, Trump did issue a rare apology for his comments on the tape. Trump’s campaign initially released a public response from Trump which stated, “This was locker room banter, a private conversation that took place many years ago. Bill Clinton has said far worse to me on the golf course — not even close. I apologize if anyone was offended.”

The following day, Trump issued a longer video response in which he said, “I said it, I was wrong, and I apologize.”

Trump, Oct. 8, 2016: I’ve never said I’m a perfect person, nor pretended to be someone that I’m not. I’ve said and done things I regret, and the words released today on this more than a decade-old video are one of them. Anyone who knows me, know these words don’t reflect who I am. I said it, I was wrong, and I apologize. … I’ve said some foolish things, but there is a big difference between the words and actions of other people. Bill Clinton has actually abused women and Hillary has bullied, attacked, shamed and intimidated his victims. We will discuss this more in the coming days. See you at the debate on Sunday.”

The issue was raised at the second presidential debate two days later. And Trump again described his words as “locker room talk” but he again said the words, “I apologize.”

Trump, Oct. 10, 2016: This was locker room talk. I am not proud of it. I apologize to my family, I apologize to the American people. Certainly, I am not proud of it. But this is locker room talk. … Yes, I am very embarrassed by it and I hate it, but it’s locker room talk and it’s one of those things.

Trump repeatedly changed the conversation to the need to defeat ISIS. But debate moderator Anderson Cooper of CNN asked Trump whether he had ever actually kissed or groped women without their consent — as he had said on the tape — and Trump responded, “No, I have not.”

Trump later apologized in the debate again for his words on the tape, even as he tried to draw a distinction between his words and the actions of Bill and Hillary Clinton.

Trump, Oct. 10, 2016: That was locker room talk. I’m not proud of it. I am a person who has great respect for people, for my family, for the people of this country and certainly I am not proud of it, but that was something that happened. If you look at Bill Clinton, far worse. Mine are words and his was action. His words, what he has done to women. There’s never been anybody in the history of politics in this nation that has been so abusive to women. So you can say any way you want to say it, but Bill Clinton is abusive to women. Hillary Clinton attacked those same women, and attacked them viciously, four of them here tonight. One of the women, who is a wonderful woman at 12 years old was raped. At 12. Her client, she represented, got him off and she is seen laughing on two occasions laughing at the girl who was raped. Kathy Shelton, that young woman, is here with us tonight. So don’t tell me about words. I am, absolutely, I apologize for those words, but it is things that people say, but what President Clinton did, he was impeached, he lost his license to practice law, he had to pay an $850,000 fine to one of the women. Paula Jones who is also here tonight. And I will tell you that when Hillary brings up a point like that and she talks about words that I said 11 years ago, I think it’s disgraceful and I think she should be ashamed of herself, if you want to know the truth.

As we wrote at the time, Trump distorted the facts when he accused Hillary Clinton of “laughing at” a rape victim. And, we should note, numerous women have come forward to accuse Trump of sexually inappropriate behavior. The Washington Post Fact Checker has a running list of the more than a dozen women who have publicly claimed that Trump “physically touched them inappropriately in some way.”

We reached out to Sanders’ Senate office and asked if Trump hadn’t apologized for the remarks on the tape.

“If you consider the video he recorded accusing Bill Clinton of abusing women and Hillary of bullying victims an apology,” Josh Miller-Lewis, a spokesman for Sanders told us via email. “Two days after that supposed apology he said at the debate that he was proud of what he said on the tape. He also now reportedly calls the ‘Access Hollywood’ tape ‘fake news.’”

In the debate, Trump said he was “not proud” of his comments on the tape, contrary to what Miller-Lewis told us.

The New York Times on Nov. 28 reported that Trump has privately challenged the authenticity of the tape, and whether it was his voice on it. But Trump has not publicly done so.

In a press briefing on Nov. 27, White House Press Secretary Sarah Huckabee Sanders said Trump’s position on the tape had not changed since his initial statements owning up to the comments.

Reporter, Nov. 27: Does the president still accept the authenticity of the “Access Hollywood” tape that he apologized for during the campaign?

Sanders: Look, the president addressed this. This was litigated and certainly answered during the election by the overwhelming support for the president and the fact that he’s sitting here in the Oval Office today. He’s made his position on that clear at that time, as have the American people and his support of him.

Reporter: So he apologized for it, which would seem to acknowledge its authenticity. And that position hasn’t changed?

Sanders: No. Like I just said, the president hasn’t changed his position. I think if anything that the president questions it’s the media’s reporting on that accuracy.

Again, some people don’t like the way Trump apologized. They question his sincerity and his quickness to pivot to the misdeeds of the Clintons. We can’t speak to that. We can only say that Trump said the words “I apologize” — a rare event for Trump — and expressed regret and embarrassment for his words on the video.

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False Stories About Roy Moore Accusers

Q: Did Roy Moore accusers “Mary Lynne Davies” and “Harley Hannah” lie? Did Beverly Young Nelson admit she “forged” a yearbook message from Moore?

A: No. The first two names are not among Moore’s accusers. And Nelson said she added a date and location to a yearbook message written by Moore.


The news cycle surrounding the Dec. 12 special Alabama Senate election between Republican Roy Moore and Democrat Doug Jones has been dominated by stories about accusations of sexual misconduct made against Moore, the former chief judge of the state’s Supreme Court.

The first accusations surfaced in early November, when four women told the Washington Post that Moore had pursued them decades ago, when they were teenagers and he was in his 30s. Since then, five more women have come forward with similar stories about Moore, who denies the allegations.

Several stories circulating online about Moore’s accusers aren’t legitimate, and Facebook users rightly flagged them as potentially false. We found that some of them were were purportedly written as satire, but were run on websites that did not label them as such.


Claim: Moore accuser “Mary Lynne Davies” was arrested for “falsification.”

Flagged on: Daily Deals, Conservative Times, American Revolution and others.

None of the women who have come forward to accuse Moore of sexual misconduct is named Mary Lynne Davies.

Nevertheless, a bogus story claiming that an accuser with that name has been arrested for “falsification” has been shared more than 15,000 times on Facebook.

The fake story originated on a website called No Fake News Online, which is part of a network of self-described satirical websites.

A disclaimer on says: “Everything on this website is fiction.”

But several unaffiliated websites that carry no such disclaimer have also posted the story — one of those sites is registered to an owner in Serbia

The bogus article actually combines details from the accounts given by two of Moore’s real accusers — Leigh Corfman, who alleges that Moore touched her sexually when she was 14 and he was 32, and Beverly Young Nelson, who alleges that Moore attempted to force her into having sex in his car when she was 16 and he was in his 30s.

The story also refers to the Alabama attorney general as “John Simmons,” when the state’s real attorney general is Steve Marshall.

And the picture of a woman’s mugshot that was published with the story is from a 2015 drug arrest in Georgia, and is unrelated to the allegations made against Moore.

Claim: Moore accuser “Harley Hannah” admitted that Moore didn’t touch her.

Flagged on: American Life, Road Life, American News and others.

This is another completely bogus story about a fictional accuser that has been posted by at least a dozen websites and shared more than 100,000 times on Facebook.

It was originally published by the website Reagan Was Right, which belongs to the same network of pseudo-news publications as No Fake News Online.

Two of the sites that picked up the story (Pride of America and Road Life) and ran it without a “satire” disclaimer are registered to an owner in Kosovo, and another site (American Life) is registered to an owner in Kazakhstan.

The made-up story claims that “Harley Hannah” appeared on MSNBC and told “host Dan Fitzpatrick” that she didn’t actually remember what Moore had done to her. But that is not the name of any of the women who have accused Moore publicly, nor is there record of a “Dan Fitzpatrick” hosting a show on MSNBC. There is also no record of an interview with anyone named “Harley Hannah.”

And the featured image in the story is actually a photo from a 2016 interview with a British reality television star, Charlotte Crosby.

Reagan Was Right also fabricated the story that invented Moore accuser “Helen Marikova-Spindlesmith” has “admitted to being paid more than $100K in cash from an anonymous source” to make false claims about Moore.

Claim: Beverly Young Nelson admitted she “forged” a yearbook note from Roy Moore.

Flagged on: America News Hub, Silence Is Consent, Info USA News and others.

Beverly Young Nelson is one of Moore’s accusers, but she has not admitted to forging a note that she says Moore wrote in her high school yearbook in 1977.

That false claim was made in dozens of headlines and stories published after Nelson acknowledged adding text to the yearbook specifying the date and location of Moore’s message. She still maintains the message itself was written and signed by Moore.

A post on the Silence Is Consent blog, for example, wrongly says: “Beverly Nelson, the woman who has accused GOP Senatorial candidate Roy Moore of sexual assault, has admitted that she forged his inscription inside her high school yearbook.”

She has made no such admission.

It’s true that Nelson originally attributed all of the yearbook inscription to Moore, who she said offered to sign her yearbook at a restaurant where she worked.

In a Nov. 13 press conference, Nelson said: “He wrote in my yearbook as follows: ‘To a sweeter more beautiful girl, I could not say Merry Christmas, Christmas, 1977, Love, Roy Moore, Olde Hickory House.’ And signed it ‘Roy Moore, DA.’”

But on Dec. 8, in an interview that aired on ABC’s “Good Morning America,” Nelson acknowledged that she — not Moore —  wrote the date, “12-22-77,” and the name of the restaurant, “Olde Hickory House,” that appear after the signature in the yearbook.

ABC News’ Tom Llamas, Dec. 8: Beverly, he signed your yearbook?

Nelson: He did sign it.

Llamas: And you made some notes underneath?

Nelson: Yes.

In a press conference the same day, Gloria Allred, Nelson’s attorney, said that her client made the additions “to remind herself of who Roy Moore was and when and where Mr. Moore signed her yearbook.” Allred, though, did not say when the notes were added.

Several of the stories that made the false forgery claim referred to a story published on the conservative Breitbart website under the misleading headline: “Bombshell: Roy Moore Accuser Beverly Nelson Admits She Forged Yearbook.”

Others were based on a Fox News story that was originally headlined: “Roy Moore accuser admits she forged part of yearbook inscription attributed to Alabama Senate candidate.”

Fox News changed the headline and its story to reflect that “Nelson admits to writing part of the inscription herself, rather than forging part of it,” according to an update.

Editor’s note: is one of several organizations working with Facebook to help identify and label viral fake news stories flagged by readers on the social media network.


McCrummen, Stephanie and Reinhard, Beth. “Woman says Roy Moore initiated sexual encounter when she was 14, he was 32.” Washington Post. 9 Nov 2017.

Kupfer, Theodore. “Roy Moore Responds to Allegations.” National Review. 10 Nov 2017.

Reilly, Mollie. “Mitch McConnell Tells Roy Moore To Leave Senate Race, Says ‘I Believe The Women.’” Huff Post. 16 Nov 2017.

Trump, Donald. Tweet supporting Roy Moore. Twitter. 8 Dec 2017.

Kranz, Michael. “All the women who have accused Roy Moore of sexual misconduct.” Business Insider. 4 Dec 2017.

BREAKING: Roy Moore’s Accuser Arrested And Charged With Falsification.” NoFakeNews.Online. 8 Dec 2017.

Young Nelson, Beverly. “Text of Beverly Young Nelson’s Accusation Against Roy Moore.” New York Times. 13 Nov 2017.

Woman arrested after meth, other drugs found.” WFXL Fox 31. 11 Aug 2015.

BREAKING: Roy Moore’s Lying Accuser Admits He Didn’t Ever Touch Her.” 12 Nov 2017.

Henman, Ellie. “DUMPED AND DONE: Charlotte Crosby ‘crying all day’ as she struggles to cope after being dumped by Stephen Bear just one day after finding out ex Gaz Beadle is having a baby.” The Sun. 24 Aug 2017.

Saunders, Emmeline. “Charlotte Crosby: My ectopic pregnancy tragedy.” Heat. 30 May 2016.

Text of Beverly Young Nelson’s Accusation Against Roy Moore.” New York Times. 13 Nov 2017.

Roy Moore accuser speaks out just before Election Day.” ABC News. 8 Dec 2017.

New accusations against Roy Moore.” CBS News. YouTube video. 13 Nov 2017.

Gloria Allred holds news conference on Roy Moore accuser’s yearbook.” CBS News. 8 Dec 2017.

Scherer, Michael. “Roy Moore accuser alters part of her account about inscription.” Washington Post. 8 Dec 2017.

Nolte, John. “Bombshell: Roy Moore Accuser Beverly Nelson Admits She Forged Yearbook.” Breitbart. 8 Dec 2017.

Roy Moore accuser admits she wrote part of yearbook inscription attributed to Alabama Senate candidate.” Fox News. 8 Dec 2017.

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Trump’s False Black Home Ownership Claim

President Donald Trump made the false claim that “black home ownership just hit the highest level it has ever been in the history of our country.” That’s not remotely accurate.

The National Association of Realtors referred us to the Census Bureau, which has quarterly survey data by race dating to 1994 (table 16). The black home ownership rate was 42 percent for the third quarter of 2017 — the 87th lowest quarterly rate since 1994, according to the Census Bureau.

The president raised the issue of black home ownership during a Make America Great Again rally in Pensacola, Florida, where he urged neighboring Alabamians to vote for Republican Roy Moore in the Dec. 12 special U.S. Senate election. Moore has been accused of sexual misconduct with teenagers — including one as young as 14 — when he was a younger man in his 30s.

“So get out and vote for Roy Moore,” Trump said of the former state judge, who has denied the allegations.

At one point in the rally, Trump spotted a “blacks for Trump sign.”

Trump, Dec. 8: I love these guys. Look at these guys, “blacks for Trump.” I love you. I love you. By the way, now that you bring it up, black home ownership just hit the highest level it has ever been in the history of our country. Congratulations.

The audience roared with approval. But hold the applause.

The White House did not respond to our request for evidence to support the president’s claim. But we checked with the National Association of Realtors for the best home ownership statistics, and it referred us to census data — which we summarized above.

The Census Bureau website provides 95 quarters of home ownership data since 1994. After we sorted the census figures, the 42 percent black home ownership rate for the third quarter of 2017 clocked in at 87th lowest.

The highest rate during that nearly 24-year span was 49.7 percent in the second quarter of 2004. The lowest rate was 41.2 percent in the third quarter of 1995.

In fact, the most recent third quarter rate isn’t even the highest this year, let alone “in the history of our country.” The rate was 42.7 percent in the first quarter and 42.3 percent in the second quarter, so if anything there has been a slight downward trend in 2017.

The Census Bureau also has decennial census data on home ownership by race dating to 1950. The black home ownership rate was higher in 1980 (44.4 percent) and 1990 (43.4 percent) than in the most recent quarter. It was lower in 1970 (41.6 percent) and 1950 (34.5 percent). There was no rate provided for 1960.

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