Your Paperwork Is Under Review

The government demands proof from patients, voters and states, while war, nuclear proliferation and presidential power remain conveniently self-certifying.

I’d like to start by saying I’m sorry there was no post yesterday. My poor girl was sick, and I spent the day where I needed to be, beside her at the emergency room.

She is doing much better today. In fact, she insisted on going to ballet this morning, because apparently recovery can be measured in pliés and a four-year-old’s absolute refusal to miss something involving a leotard. There is nothing like sitting beside your sick child to clarify what government is for.

Hospitals, medicine, electricity, safe roads, clean water, and people trained to help when something is wrong. These are the structures we build together because everyday life is fragile, children get sick, bodies fail, disasters happen, and no family should have to construct an emergency response from whatever happens to be available in the kitchen drawer.

While I was occupied with one very real emergency, the federal government was busy manufacturing several more. Defense Secretary Pete Hegseth told senators that the war with Iran has already cost approximately $37.5 billion. Eighteen American service members have been killed since the war began. President Trump traveled to Dover Air Force Base today for the dignified transfer of four of them, soldiers killed in recent attacks in Jordan and Iraq.

Those deaths deserve the solemnity the administration’s policy has not. Lawmakers from both parties pressed Hegseth about the absence of an exit strategy, a clear endpoint or any convincing explanation of what victory is supposed to look like. The answers remain elusive, but House Republicans are nevertheless advancing another $95 billion package.

The bill contains $60 billion for the Pentagon, $13 billion for other national security programs, $12 billion for farmers harmed by Trump’s tariffs and $10 billion connected to new proof-of-citizenship voting requirements.

This is an impressively efficient cycle of governance. The president creates an expensive problem, Congress funds the problem, Congress compensates some of the people injured by the problem, and then everyone asks the public to produce additional identification.

At the emergency room, doctors generally try to determine what is wrong before prescribing another $95 billion worth of treatment. In Washington, diagnosis has apparently become an optional administrative burden.

The administration may not know how the war ends, but Trump has developed a detailed rewards program for escalation. He announced that the United States would destroy an Iranian bridge or power plant for every attack on a ship in the Strait of Hormuz.

Bridges and power plants are civilian or dual-use infrastructure. Destroying them does not merely inconvenience the Iranian government. It disrupts transportation, hospitals, water systems and the people who depend upon them.

I spent yesterday watching nurses check vital signs and doctors make decisions beneath fluorescent lights powered by an electrical grid most of us barely notice until it fails. A power plant is not an abstraction to the premature baby in an incubator, the patient on a ventilator or the frightened parent waiting for test results.

International law doesn’t become optional because the president has decided to administer collective punishment through a punch card. Trump’s threat also gives Iran every incentive to retaliate against infrastructure elsewhere in the region. Apparently, the administration’s plan for stabilizing the Middle East is to make sure nobody can turn on a light.

Meanwhile, after months of bombing Iran in the name of nuclear security, Trump has approved a 30-year civil nuclear agreement with Saudi Arabia that may allow the kingdom to enrich uranium.

Enrichment can produce fuel for nuclear power, but it also creates a path toward weapons-grade material. Which is why such agreements traditionally include strict safeguards, this one reportedly does not require Saudi Arabia to adopt the International Atomic Energy Agency’s Additional Protocol, which permits more intrusive inspections.

Secretary of State Marco Rubio insists the agreement will not lead to nuclear proliferation, which is reassuring if one believes nuclear proliferation can be prevented through tone of voice.

Saudi Crown Prince Mohammed bin Salman has previously said the kingdom would pursue a nuclear weapon if Iran acquired one. The administration’s position appears to be that uranium enrichment is an intolerable danger when conducted by a hostile authoritarian government, but an exciting commercial opportunity when conducted by a friendly authoritarian government.

At the hospital, nobody offered to waive the safety protocols because they liked us personally. Nuclear danger, however, is apparently geographically flexible and highly responsive to invoices.

Back at home, where scrutiny remains plentiful, the administration is deferring more than $1 billion in Medicaid payments to California and Minnesota. The Department of Health and Human Services says California must provide additional documentation for $867.5 million in claims, while Minnesota must substantiate another $199 million. Officials describe the money as delayed rather than permanently cut and say the action is intended to prevent fraud.

Fraud should be investigated, public money should be accounted for, and that is precisely what makes the contrast so extraordinary. When Medicaid dollars support home care for elderly and disabled people, every claim must be examined before the check clears. When tens of billions fund a war with no articulated conclusion, Congress is asked to approve another enormous package before anyone has successfully explained the first one.

Yesterday, I was reminded that healthcare isn’t a line in a political speech. It’s a sick little girl curled against her mother, the nurse who brings a warm blanket, the machine that works when it is supposed to and the relief of waking the next morning to a child who feels well enough to argue passionately for ballet.

The federal standard is apparently simple: if the money may help someone bathe, eat, recover or remain in their home, locate the supporting documents. If it may purchase missiles, please respect the urgency of the situation.

Arizona Republicans completed the day’s theme by nominating two men who previously worked to overturn election results. Representative Andy Biggs, a central figure in the effort to reverse Trump’s 2020 defeat, won the Republican nomination for governor. Alex Kolodin, an attorney who helped lead failed legal challenges to Arizona’s 2020 and 2022 results, won the nomination for secretary of state.

The secretary of state is Arizona’s top election official. This means voters will decide whether to place a man who tried to discredit prior elections in charge of administering future ones. It’s the democratic equivalent of hiring the person who kept pulling the fire alarm to inspect whether it’s working correctly.

Arizona became a focal point of election denialism after Trump narrowly lost the state in 2020. Six years later, the Republican Party is still asking democracy to resubmit its paperwork because it didn’t like the original determination.

Taken together, these stories don’t reveal a government without standards, but rather, a government that has carefully decided who must meet them. Patients must prove their care was legitimate, states must prove every payment, citizens must prove their eligibility to vote, and elections must prove themselves until Republicans win.

The president may spend, bomb, threaten and negotiate nuclear agreements first, then explain himself later, assuming the explanation department has not lost power in the next round of airstrikes.

My daughter is better today. She went to ballet because the people and systems we relied upon yesterday did what they were supposed to do. That should be the ordinary promise of a functioning society: when people are frightened, vulnerable or sick, the machinery of government turns toward preserving life.

We were lucky, considering this administration keeps subjecting care to investigation while treating destruction as an emergency expenditure. I can’t help but hear a monotone voice on the other line: “Your request for accountability remains important to us. Please stay on the line.”

P.S. Our subscription rates for new paid subscribers will increase on [DATE]. Upgrade before then to lock in our current price of $7/month or $70/year. Existing paid subscribers will keep their current rate. Learn more here:

An Important Subscription Update