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Guests: Guest: Eric Jorgensen, Paul Harmatz

CHRIS HAYES: "THE RACHEL MADDOW SHOW" starts right now. Good evening, Rachel.

RACHEL MADDOW, MSNBC HOST:  You cut immediately to the question I have for you.  Same pants or --

HAYES:  Different pair. 

MADDOW:  -- new -- 

HAYES:  Oh, this is -- we`re not -- this is not -- we`re not just coasting here.  We`re working very hard.  There`s another pair of live show pants. 

MADDOW:  This is no fly by night operation. 

HAYES:  No, it is not. 

MADDOW:  There`s two pairs of pants. 

HAYES:  Yes.

MADDOW:  So, did you get these pants at the same time that you got the first pants, like --

HAYES:  I did. 

MADDOW:  -- same pants, different color? 

HAYES:  Basically, yes.  I`m glad there`s going to be a lot of scrutiny on how I look, and my body. 

MADDOW:  I`m sorry.  No, no, I don`t mean it that way.

HAYES:  So, thank you for inviting that. 

MADDOW:  You know, what it is, I`m projecting because I`m afraid of pants on television, which is why I never stand.

HAYES:  Hence, the sitting.  That`s right.  Yes.  Well, I`m standing. 

MADDOW:  All right.  I take it all back, man.  You`re going to be awesome. 

HAYES:  Thank you. 

MADDOW:  Nobody is going to look at your pants. 


MADDOW:  Thank you, my friend. 

HAYES:  Thank you.

MADDOW:  And thanks to you at home for joining us this hour. 

All right.  Big show tonight.  There`s a whole bunch of developing news we have been watching over the course of this afternoon and into tonight and we`ve got an update tonight on this story that we have covered pretty intensively over the course of this week, that until now, as far as I can tell, hadn`t received any other national news coverage. 

This is the story we`ve been covering on the show this week of this new policy by the Trump administration that they didn`t announce but it came to light when families of seriously ill children started getting letters last week from the Trump administration, telling these families that although they may have had permission to stay in this country before, specifically because their children were receiving advanced and life-saving medical treatment here, the Trump administration, according to these letters, no longer respects that and so these parents are now being told to take their kids out of medical treatment, which in some cases will result in the deaths of these children. 

Trump administration is now sending these letters telling these parents to take their kids out of medical treatment and get out of the country by next month. 

So this story perked in the local press in Massachusetts first, in the Boston area, and then in Florida yesterday -- well, as I said that we should maybe anticipate, we are now seeing big-time national coverage as people start to realize what exactly the Trump administration is doing here even though they never made a policy announcement that they`re doing it. 

Tonight, this story is now on the front page of "The New York Times."  It is breaking and expanding as a national story, as we knew it would.  So, we are going to have more on that tonight.  We actually have a doctor who`s going to be joining us tonight who has a story that you are definitely going to want to hear. 

We are also watching, of course, this projection of the possible track for Hurricane Dorian.  The islands that are in the immediate path of what is now a category 1 hurricane are the Bahamas.  But as you can see from the track there, one of the distinct possibilities here is that the storm will continue to barrel in this same direction into the weekend which could see it smashing into the eastern coast of Florida as a category 3 or even category 4 hurricane. 

Now this has been a storm that has been hard to forecast precisely, that`s part of why the Virgin Islands were somewhat taken by surprise by the direct hit the storm gave the Virgin Islands on its way to the Northwest.  There`s still a range of potential outcomes here both in terms of the path and in terms of the timing, but the planning right now for the southeastern United States is basically for the whole of Florida`s Atlantic Coast, like from Miami all the way up to Jacksonville to get ready for what may be a major hurricane, arriving as soon as Monday morning. 

So, we`ve got eyes on that right now and throughout the evening.  This is going to become increasingly an urgent situation for the southeastern United States over the next hours and days. 

Today, President Trump canceled a planned trip to Poland with a White House statement saying it was in response to the hurricane bearing down on the eastern coast of Florida.  And that hurricane may absolutely be why President Trump is canceling his planned trip to Poland, but whether or not it is, that cancellation also happens to have some really interesting knock-on consequences that are not about the storm at all.  So, we`ll be talking about that a little later on as well.  That is all ahead. 

First, tonight, do you remember when Vice President Dick Cheney accidentally shot a guy in the face?  Remember when that happened?  I know we play a lot of archival news footage on the show.  Usually, we get international news reels or network news footage from the time.  We could do that. 

But I`ve got to say, this particular moment in American politics, when Vice President Dick Cheney shot a guy in the face and we all found out about it through a really weird series of circumstances, it was so weird, it was so impossible to understand at the time that it happened that I feel like the best way to get a sense of what this was like when it unfolded at the time is actually to watch "The Daily Show" from the time. 


JON STEWART, HOST, THE DAILY SHOW:  Vice President Dick Cheney accidentally shot a man during a quail hunt at a political supporter`s ranch, making 78- year-old Harry Whittington the first person shot by a sitting veep since Alexander Hamilton.  Hamilton. 

Alexander Hamilton, of course, was shot in a duel with Aaron Burr over issues of honor, integrity and political maneuvering.  Whittington was mistaken for a bird. 

The other player in the drama, ranch owner and eye witness, Katharine Armstrong. 

KATHARINE ARMSTRONG, WITNESS:  We were shooting a covey of quail.  The vice president and two others got out of the car to walk up the covey.  A bird flushed.  The vice president took aim at the bird and shot and, unfortunately, Mr. Whittington was in the -- in the line of fired and got peppered pretty well. 

STEWART:  Cheney also discussed why nobody found out about the incident until ranch owner Katharine Armstrong went to a local paper the next day. 

DICK CHENEY, FORMER VICE PRESIDENT:  Katharine suggested, and I agreed, that she would go make the announcement, that is, that she put the story out.  I thought that made good sense.  She was the immediate past head of the Texas Wildlife Parks Department. 

STEWART:  So, she outranked you?  Is that how the government works? Is it the hierarchy basically, president, ex-head of the Texas Wildlife Parks Department, vice president? 


MADDOW:  Miss you, Jon Stewart. 

The man who Dick Cheney shot, for the record, he ended up OK.  He`s alive and kicking.  He`s in his early 90s now.  To this day, I believe he still does have some pellets lodged beneath his skin.

But the woman you saw in that "Daily Show" clip, the woman who outranks the vice president, the woman who initially reported to her local paper that the vice president had shot a guy in the face the previous day, Katharine Armstrong, it was her ranch, the Armstrong Ranch, where the shooting occurred.  "The Texas Observer" calls the Armstrong Ranch, quote, hallowed ground for Republican politicians. 

The Armstrongs of Armstrong Ranch fame, they are a storied, well-connected family in Texas Republican politics.  And you can see the connections in action years later, in 2014, when George W. Bush`s nephew, George P. Bush, was elected to manage Texas`s sprawling oil and gas resources. 

When George P. Bush was elected to that gig, he cleared house at his new office and he decided when he was looking to hire that he would reach out to the Armstrong family, from the ranch where Dick Cheney shot that guy when he was looking to find somebody to fill the top job at the state oil and gas agency.  He ended up hiring the daughter of Katharine Armstrong, a young woman named Anne Idsal. 

And from there, Ms. Idsal ultimately got herself hired into Donald Trump`s EPA in Washington, overseeing the environment of Texas and several other states.  She became the head of EPA Region 6. 

And when she was appointed to that job, again, to the EPA, she waxed poetic at the time to the "Texas Observer" about all of this climate change nonsense everybody`s been talking about.  She told the "Texas Observer" there is still, quote, a lot of ongoing science.  Hmm.  And she said that the climate has been changing since the dawn of time. 

Quote: I think it`s possible that humans have some type of impact on climate change.  I just don`t know the extent of that. 

So, obviously, she was the natural choice to get promoted from that EPA Region 6 job that Trump initially put her in to early this summer, Trump moved her up to take over the job of being our nation`s top clean air official.  She became the second person to hold that job in the Trump administration.  The first guy had to resign in the midst of an ethics investigation into his meetings with his formal oil and gas and lobbying clients which he was charged with regulating. 

That he had to go, let`s bring in the woman and say the climate has been changing since the dawn of time.  Have you visited my family`s ranch? 

Today, we got the Trump administration`s first big move on air quality under the stewardship of Anne Idsal.  Quote: The Trump administration is moving to erase owe boom ma-era rules on methane omissions from the oil and gas business, saying the federal government overstepped its authority when it set limits on what scientists say is a significant contributor to climate change. 

Methane, the primary component of natural gas, is about 25 times more potent than carbon dioxide in trapping the earth`s heat, according to estimates used by the EPA.  The Environmental Defense Fund estimates methane emissions cause about a quarter of the planet`s warming. 

A "Wall Street Journal" analysis recently found the U.S. oil and gas industry`s methane emissions alone were the equivalent to greenhouse gas emissions from more than 69 million cars, or about one quarter of all cars registered in the United States.  Methane emissions just from oil and gas companies are the equivalent to greenhouse gas emissions from 69 million tail pipes. 

This rule rollback from the Trump administration is so draconian, right, so hard line and so unexpected, even the oil and gas industry isn`t cool with it.  Quote: Some companies, including ExxonMobil and Royal Dutch Shell, have warned the Trump administration that a lack of government-backed minimum requirements to curb emissions could undermine the argument that natural gas is a cleaner fuel than coal or oil.

It`s kind of an amazing argument, right?  Oil and gas industry is like, we`ve been trying to make fracking for natural gas seem like an ecologically good idea.  We`ve been trying to make natural gas seemed like it`s a good thing, it`s a green fuel, as people start to really about climate change.  That has always been a pretty tenuous argument. 

But if natural gas is going to be allowed to willy-nilly spew into the atmosphere the most potent greenhouse gases without any constraint at all, it`s going to be really hard for us to maintain that fiction about how awesome and green natural gas is.  You`re going to make it really hard for us to make that case. 

I mean, even with the goal and gas industry arguing that this is probably not a good decision, I mean, what with all the concern about the climate and everything, it`s interesting, even the Trump administration as they are doing this, they don`t seem to understand what the problem is. 

Anne Idsal, the heir to Dick Cheney`s favorite shooting ranch fortune and it`s all who remarkably is now our nation`s top air clean official, thanks to the Trump administration`s scrupulous hiring practices, Anne Idsal told "The Wall Street Journal" today, quote, I don`t see there`s going to be some big climate concern here. 

Climate?  Why?  What?  What does -- what does methane have to do with -- what?  Why is this even a climate thing?  Nobody said climate to me. 

And, I mean, this rollback would be an unfortunate idea at any time given what`s going on in terms of climate change.  Even the fill-in gas industry says so. 

But at this particular moment like this week, really?  I mean, literally, this week, the Amazon rainforest, this giant natural mitigator of climate change among other things, because of all the carbon it sucks out of the atmosphere, right this second, the Amazon is literally on fire, having its worst year on fires in nearly a decade, causing a global freak out over the implications of those uncontrolled fires. 

While the world`s largest tropical rainforest is ablaze in the Amazon, the Trump administration this week also moved to chop down the world`s largest temperate rainforest.  From "The Washington Post", quote, President Trump has instructed Agriculture Secretary Sonny Perdue to exempt Alaska`s 16.7 million acre Tongass National Forest from logging restrictions imposed nearly 20 years ago.  The move would affect more than half of the world`s largest intact temperate rain forest, opening it to potential logging and energy and mining projects. 

The Tongass is a massive stretch of southern Alaska, replete with old growth spruce, hemlock and cedar, rivers running with salmon, and dramatic fjords.  But in addition to being massive and 40 percent of the salmon in the western United States, the Tongass is also a massive buffer against climate change for the whole globe. 

And you don`t have to take my word for it, just believe it based on those pictures.  I mean, that is how it`s described in research from Donald Trump`s own department of agriculture, the very department he has reported now ordered to let the Tongass not just be drilled and mined, but chopped down.  This was a briefing paper from the USDA`s forest service last summer titled "Addressing Climate Change on the Tongass National Forest". 

Quote: The coastal temperate forest in southeast Alaska currently sequester and store large quantities of carbon.  As a result, southeast Alaska pays an important role in the global climate and carbon cycle.  The Tongass supports about 8 percent of the carbon stored in all forest in the lower 48.

The good news for southeast Alaska and the temperate rainforests in Alaska in general is the relative stability of coastal rain forest biomes.  The climate niche of most of dominant tree species is particularly resilient to expected changes in climate in the region over the next 30 to 50 years.  So, yes, good news, the Tongass is doing really important work.  The Tongass is stable and resilient, says the USDA, right?  That`s a really good thing since the Tongass eats up tons and tons and tons of climate change accelerating carbon from the atmosphere. 

How resilient is it against mining, oil and natural gas, and logging, right?  Because the USDA produced that report about the importance of that Tongass forest, and now this past week, President Trump has reportedly ordered USDA secretary, tell Sonny Perdue to let that forest be chopped down. 

But just -- take a slightly wider view on this for a second.  I mean, this isn`t like the Trump administration acting writ large.  Part of what is going on here is the silent catastrophe of one specific part of the Trump administration.  I don`t know why this hasn`t had more sort of national attention.  But there is a governing catastrophe inside the Trump administration that hasn`t had much attention and it is called the USDA, U.S. Department of Agriculture. 

And it`s not just a catastrophe in terms of what it`s being used to do to places like the Tongass forest, which even that agency itself acknowledges it`s hugely important and must be left to do its thing.  I mean, even on Donald Trump`s own terms, his USDA is a disaster. 

Donald Trump and his campaign, of course, he thinks he can count on rural folks in general, farmers in particular to be a key constituency heading into Trump reelection, right?  But his trade policies and his agriculture policies are a disaster for rural America and American farmers.  And they are quite obviously making that constituency a problem for him right now. 

I mean, just scan the headlines right now that Trump`s getting out of farm country.  Trump`s frustration with Trump grows as U.S. escalates China fight.  National farmers union condemns new tariffs.  Quote. Trump is making things worse.  Trump`s trade war could cost him with a key constituency, farmers. 

This from the Iowa Corn Producers Association.  Iowa corn farmers to Trump: the government put us in one hell of a bad situation.  Agriculture is in one hell of a bad situation right now.  The government has put us in this situation. 

A soy bean farmer in Ohio saying, quote: I couldn`t vote for Trump again.  I have to protect my business. 

A farmer in North Dakota, quote: Every time I go to the grain elevator, it`s fricking Trump this and fricking Trump that. 

I mean, as for the president`s solution to all the problems he has caused in rural America, all the problems he has caused for American farmers, his proposed solution has been to, sort of go socialist on the issue, right?  To actually pay off, directly pay farmers.  Give farmers billions of dollars in cash bailouts to make up for how badly the Trump administration`s policies are hurting American culture. 

But the Trump administration is apparently having trouble pulling that off as well.  NBC News reporting that tens of thousands of U.S. farmers still haven`t gotten payouts they have promised.  The administration has had to pay out over a million dollars on interest on the late payments, simply because they can`t get it together to actually pay the farmers the way they said they would. 

One county director to Farm Service Agency in Missouri telling NBC, quote, we had farmers waiting at the door from 7:00 in the morning to 7:00 at night to get their payments, and they`re not getting them. 

So amidst all of this, and this is a real problem for the president in terms of how he thinks of his political base, amid all of these sort of worsening headlines and this increasingly bad situation that the president has created for American farmers, the president recently dispatched his agriculture secretary, Sonny Perdue, to try to soothe some of the tensions that have been created with American farmers. 

Well, how did that go? 


SONNY PERDUE, SECRETARY OF AGRICULTURE:  What do you call two farmers in a basement?  I said, I don`t know, what do you call them?  He said, a whine cellar. 




MADDOW:  A whine, W-H-I-N-E.  Two farmers in a basement, that`s what -- initial laughter being over taken by the boo -- the increasingly loud booing there. 

Donald Trump`s agriculture secretary getting roundly booed at the annual Minnesota farm fest for talking about American farmers as a bunch of whiners.  You get two farmers together, you know what that is?  Whining. 

Get them in a basement, that`s a whine cellar.  Isn`t that hilarious?  To a room full of farmers. 

That`s what counts as political outreach right now in Donald Trump`s U.S. Department of Agriculture.  One of the stories that we`ve been covering here for the last couple of months now is about this fubar situation the USDA got themselves into with trying to get rid of all the scientists at that agency. 

USDA scientists are an impressive lot.  They`ve done a very, very impressive work for generations at USDA.  It`s one of the scientific cores of the U.S. federal government. 

Well, under Sonny Perdue and Donald Trump, USDA announced that all the Agriculture Department scientists would have to move halfway across the country on zero notice or be fired.  They described it as a cost-saving move, even though it wouldn`t actually save any money.

The Trump administration went out of its way to say this definitely wasn`t an attempt to get all of the scientists to quit.  No, no, no, all these scientists are producing all kinds of inconvenient research about climate change and trade policy and how the Trump administration`s policies weren`t hurting farmers. 

They definitely weren`t just trying to get rid of all the farmers.  This was just about efficiency.  This was about saving money.  This was about running the USDA as a more efficient, more effective administration.  That was their line on that forced move for all the agency`s scientists, until Trump Budget Director Mick Mulvaney let the cat out of the bag while talking to a bunch of Republicans at a fundraiser earlier this month. 


MICK MULVANEY, ACTING WHITE HOUSE CHIEF OF STAFF:  You`ve heard about drain the swamp.  What you probably haven`t heard is what we`re actually doing.  I don`t know if you saw the news the other day, but the USDA just tried to move, or did move two offices out of Washington I think to Kansas City, Missouri.  Yes, you can applaud that one because that`s what we`re talking about doing. 

Guess what happened?  Guess what happened?  More than half the people quit.  Now, it`s nearly impossible to fire a federal worker.  I know that because a lot of them work for me, and I`ve tried.  You can`t do it. 

But by saying simply to people, you know what?  We`re going to take you outside the bubble, outside the beltway, outside this liberal haven of Washington, D.C., and move you out of the real part of the country, and they quit.  What a wonderful way to sort of streamline government and do what we haven`t been able to do for a long time. 


MADDOW:  The Trump administration was so excited to tell Republican donors about this.  You know how hard it is to get rid of terrible, pesky federal employees?  Thank goodness we have finally figure out a way to shed that dead weight.  We are so psyche to be able to get rid of these federal employees.

They have been so psyched to do it to the part where they have been just adding insult to injury, not only shutting down the scientific core of the Agriculture Department, but then in the middle of doing so, they told the workers they were trying to get rid of, by the way, we told you we would pay you $25,000 buyouts to leave?  Actually we`re making it $10,000 now.  You still want it?  We could fire you if you`d rather. 

Funny thing is happening with that, though.  Now, the Trump administration is starting to realize that all those workers they got to quit their jobs, all those workers they streamlined out of the federal government, it`s possible maybe they needed them.  I mean, not that they could have seen it coming.

Earlier this month, "The Washington Post" reported that, quote: The many departures also look likely to leave the USDA`s research service unable to produce reports required by law, required by statute.

For example, this fall, the research service is slated to update its estimates for the input costs needed to grow wheat in the United States.  Congress uses these estimates to determine how to help farmer become more competitive with their counterparts overseas.  But the entire existing team that produces reports is either retiring or otherwise departing, because the Trump administration came up with this awesome way to streamline them out of their jobs and get rid of them. 

But now, that means they`re faced with having none of these highly qualified, experienced, scientific workers that need to do the work that the agency is required by statute to do and paid by Congress to do.  So what are they going to do?  Now they have to get back all of the workers. 

Well, we found out this week that the Trump administration is now scrambling, literally trying to rehire retired USDA employees, some of whom they just forced to quit, in order to fill these sudden gaps in their workforce for these jobs they now realized were actually things they needed people to do.  Come on back.  Come on back part time for half the pay. 

Apparently there`s still stuff that needs to be done.  Apparently, these scientists who work for USDA were actually doing stuff, they weren`t just dead weight and getting rid of them didn`t just make us more efficient.  They made us able to do the work of this agency, which we`re required by law to do.

So what the Trump administration is doing to the USDA is a catastrophe for the workers and for the ability of that agency to do what it does.  It`s turning out to be a catastrophe for American farmers. 

But this latest thing that the president has apparently ordered USDA to do, to roll back these protections on these huge wilderness in Alaska, that isn`t just going to have ramifications for the president or this country, that could have ramifications globally.  Hold that thought.


MADDOW:  Last month, July 2019 was the warmest month ever recorded in the state of Alaska.  The average temperature was more than five degrees above normal.  "The A.P." reports that with the sea ice melting sooner than usual, several thousand walruses came to shore on July 30th, first time anybody had seen that in the month of July ever. 

To the extent that Alaska and the rest of the planet have any way to slow the march of climate change, that reprieve will come from places like the Tongass National Forest, the world`s biggest temperate rainforest, which is in southeastern Alaska. 

Even the Trump administration`s own USDA says the coastal forest land of Alaska is a globally important sponge for carbon sequestering it and staving off more warming literally worldwide. 

Therefore, naturally, the president has reportedly just ordered his USDA to open up the Tongass National Forest to new oil and gas drilling, and mining, and logging, just chop it down. 

Joining us now from Juno, Alaska, is Eric Jorgensen.  He`s managing attorney for the Alaska regional office of Earth Justice.  He`s worked on environmental cases for three decades, including a recent case to try to keep the Trump administration from opening up the Arctic to oil drilling. 

Mr. Jorgensen, I really appreciate you being here tonight.  Thanks for making time for us. 


MADDOW:  As far as you understand this decision-making process around the Tongass National Forest, do you believe that this is in motion?  Is this being floated as a trial balloon?  Does it seem to you that the Trump administration has a plan for actually doing this? 

JORGENSEN:  We do believe that they`re in process to attempt to exempt the Tongass from the protection of the Roadless Rule.  The Forest Service is apparently preparing an environmental review document and preparing to go out for public comment on this proposed rule as soon as early this fall. 

MADDOW:  Can you describe for us the consequences of this kind of development in the Tongass?  I mean, starting locally, but expanding outward we`ve been talking a little bit about how valuable the Tongass has seemed in terms of its global mitigating impact on global warming. 

But what would it mean in Alaska? 

JORGENSEN:  The Tongass is so important for so many reasons, both people here in Alaska and people around the country and the planet as you recognize.  The forests of the Tongass provide habitat for wildlife that are important for people around the globe and people here in the region, grizzly bears, and wolves, other creatures that are rare in other parts of the globe are more common here and depend on a healthy old growth rain forest. 

The salmon that you mentioned earlier that are in Alaska`s waters still wild are a key part of the economy of southeast Alaska and are important for people who make their way of life based on salmon in the region. 

In addition, the unique Tongass National Forest and its wild areas draw visitors from around the country and around the world every year.  Last year, more than a million visitors through the Tongass National Forest to see the spectacular space.  And together with the fishing industry, the visitor -- tourism is the mainstay of southeast Alaska`s economy, and important to preserve going forward, and are dependent on protecting the wild areas, the roadless areas that are now currently protected by the Roadless Rule.

MADDOW:  Do you anticipate -- 

JORGENSEN:  These are also very important to --

MADDOW:  Sorry to interrupt you.  I know we have a long delay between here and Juno.  That`s my fault.  I should have anticipated that. 

Let me ask you briefly, Mr. Jorgensen.  I`m sorry.  If you anticipate that there is going to be a legal fight with the Trump administration if they move forward to try to make this change? 

JORGENSEN:  Well, before they can make this change they have to go through the substantial public process and they have to justify the change and explain the reversal, of course.  You know, this rule is popular nationally.  We know it has bipartisan majorities in favor of it around the country and here in southeast Alaska.  There will be an opportunity for the American people to speak out in favor of the Tongass and protecting this area going forward. 

And if the administration proceeds in the end with a rule to exempt the Tongass and removes these protections of these wild wilderness areas, there can be litigation to challenge it.  And in that litigation, the question will be, has the administration justified this major change?  Have they explained this about course?  Have they defined the new science that justifies this change of course? 

MADDOW:  Eric Jorgensen, managing attorney for the Alaska regional office of Earth Justice -- thanks for helping us understand the impact up there and around the globe.  Really appreciate you being here tonight, sir. 

All right.  We`ve got much more ahead tonight.  Do stay with us. 


MADDOW:  Here`s a heads up for something to watch for tomorrow that could be a big development and a very, very big story.  In 1996, a new painkiller hit the market.  Take the next step in pain relief.  OxyContin. 

OxyContin turned out to be a highly addictive painkiller.  OxyContin came on the market in `96.  In `97, the company that made it already knew that it was being abused. 

So, the president of that company, a company called Purdue Pharma responded with a plan.  He wrote an email to executives at his company in early 1997, quote: We may need to start a campaign to focus on the untreated patient in severe pain who is mobilized and given his life back by our products. 

The company gets word that their new pain drug is being abused, in other words, and the president of the company, Richard Sackler, suggests this new plan not to address the abuse or the addictiveness of their drug, it was his own idea for a PR plan to push the drug harder, to try to drown out those early concerns that they knew about. 

That email from Richard Sacker was among the documents gathered by prosecutors in 2006 as they prepared federal criminal fraud charges against executives at Purdue Pharma.  This month, "The New York Times" published new excerpts of the prosecution memo from that time.  Even though that prosecution was brutal, prosecutors recommended felony charges against multiple Purdue executives that could have put them all in jail. 

Ultimately, Purdue`s lawyers bargained the prosecutors down, but ended up in the end -- what resulted in the end was one charge for the company and just misdemeanors for the executives.  Purdue ultimately had to pay $600 million. 

That minor nuisance for a company that had made billions of dollars on Oxy, it was barely a pothole on the road to the multibillion dollar national opioid catastrophe that would roll on seamlessly from that day in court to ultimately kill more than 400,000 Americans. 

Purdue escaping basically unscathed all those years ago with the help of lawyers including the president`s personal lawyer, Rudy Giuliani.  That clear the way for the opioid epidemic to continue unabated for another decade plus, but that didn`t stop thousands of cities and counties and states from suing Purdue Pharma themselves, for among other things, fraudulently marketing OxyContin, misleading the public about the risks of abuse. 

Well, now, here in 2019, it`s all coming to a head, which is going to be worth watching in tomorrow`s news and over the next few days, because there is this federal judge in Ohio who`s currently overseeing a combined docket of more than 2,000 of these lawsuits against Purdue and other companies, arguing that they should be held liable for fueling the opioid disaster.  These companies have insisted that they haven`t done anything wrong, that if these cases go to trial, they`re sure they`ll win, they`re innocent, they`re happy to fight. 

But in the wake of a big verdict against one opioid manufacturer this week in Oklahoma, NBC News broke the news that Purdue pharma is actually trying to work out a way to open its checkbook and make this problem go away once and for all.  Under the proposed settlement it`s being reported that the Sackler family would hand over $3 billion personally as a family, don`t worry, they`d still be billionaires.  They`d also have their company declare bankruptcy. 

Now, it`s interesting, those terms were supposed to be private.  The judge in this case had imposed a strict gag order barring anybody from speaking to the press or the public about any settlement negotiations.  But somehow, the news broke anyway.  The "A.P." furthers the story today with reporting that the Sackler family want this settlement to not only get them off the hook for those combined 2,000 cases in federal court in Ohio, they want this settlement to settle all the cases against them in federal court everywhere, and in every state court in the country too. 

Now, whatever you think of this as a potential fate for the company that brought us OxyContin and the family that helped sell us all of it, whatever you think about what their multibillion dollar offer might amount to and divvied up among every jurisdiction with the claim to it, it`s frankly not supposed to be a matter for public contemplation and public consideration.  This is supposed to be something mulled over just by the plaintiffs.

And tomorrow, as best as we can tell, those plaintiffs are going to have to tell the judge in the case what they think about the offer.  There are going to be many, many, many judgment days when it comes to true reckoning for these companies that killed hundreds of thousands of our fellow Americans, and made billions of dollars while they were doing it. 

But one of the judgment days, potentially a very important one, looks like it`s going to be tomorrow behind closed doors in a very important Ohio courtroom.  So, we shall see.

Watch this. 


MADDOW:  University of California-San Francisco has a really, really good children`s hospital, which is called the Benioff Children`s Hospital.

When Isabel was 7 years old, she was invited by UCSF Children`s Hospital to come to that facility for treatment.  Isabel had been born with a rare genetic disease called MPS6.  It means basically that her body is lacking an enzyme that it needs for all sorts of things and that causes severe damage to her body and her cells in a way that`s not going to get better on its own, and not going to get better overtime. 

UCSF wanted to launch an important clinical trial to try to develop a treatment for that rare genetic disease.  But they needed her to be in the trial to do it.  Rare is an important word in this story, right?  Her rare disease. 

By definition, for any rare disease, there just aren`t that many people who have it.  There aren`t that many patients.  The way you get new cures for rare diseases is to find patients who have those diseases and get them involved in testing potential cures.  You need to be able to find patients to be able to develop the cures, to be able to beat those diseases.  That`s how it works. 

So, Isabel, who had this rare disease, she and her family were invited to come to San Francisco, to come to UCSF for this experimental treatment.  Because they were able to do that, the clinical trial was able to go ahead, and ultimately, the treatment that Isabel received in that trial, it got FDA approval as a way to manage this disease, to keep patients who have this disease alive. 

That FDA approval basically would not have happened had Isabel not been able to come to UCSF to take part in that crucial trial. 

Well, today she continues to be treated at UCSF.  She gets weekly intravenous infusions.  Remember, again, she came in for the first time when she was 7 years old.  Because of her illness, her family was told that she might never make it to see age 8. 

Isabel is now 24 years old.  She`s a summa cum laude college graduate.  She was director of the student government organization at her college.  She started a scholarship fund for students with disabilities.  She says she may want to go to grad school. 

She teaches dance to other kids who are also patients at the children`s hospital that saved her life.  She still needs treatment.  Again, she needs weekly intravenous infusions of this treatment.  She also needs additional surgery. 

She also has a tracheotomy which is a delicate thing and needs consistent and expert care.  But she is alive well past what would have been her life expectancy.  She is alive.  That is a contingent thing. 

Her doctors say if she stops treatment, she will die and not on some distant horizon but in a matter of months. 

The Trump administration has just sent Isabel and her family a letter ordering them to get out of the United States in 33 days or she and her family will be forced out by deportation. 

For Isabel, this is very simply a death sentence.  I mean, the treatment that is keeping her alive at UCSF Children`s Hospital is literally not approved for distribution in the country her family is from.  That`s the treatment that is keeping her alive -- weekly I.V. infusions.  She doesn`t get that treatment, she`ll die.  She`s been told to get out of the country. 

Trump administration`s offering no appeals process.  Her member of Congress, Democratic Congressman Mark DeSaulnier, her U.S. Senator Kamala Harris have written to the Trump administration trying to advocate with the federal government on her behalf.

But there`s no process for them to do that.  There`s no appeal.  There`s been a pronouncement from the Trump administration to Isabel and her family, get out and get out now. 

The Trump administration`s plan, in other words, is to kill this young woman.  She was, again, invited to the hospital for this clinical trial which could not have happened without her.  That clinical trial, because she was in it and because it worked, produced an FDA-approved treatment that not only saved her life, it will now save the lives of other people who have this rare genetic disease.

Her family pays for her medical treatment with private medical insurance.  Her family came to this country legally.  She has never done an illegal thing in her life. 

But the Trump administration plan is apparently to kill her. 

One of her doctors joins us next. 


MADDOW:  In 2005, the FDA approved a new treatment for a rare genetic disease.  It was a hard road to hoe to get there because the disease in question is rare, so finding enough patients to test it in clinical trials was a hard thing.  Eventually, doctors at UCSF`s Benioff Children`s Hospital in San Francisco found a young woman in Guatemala named Isabel Bueso who was eligible to participate and willing to participate. 

Dr. Paul Harmatz told "The New York Times", quote, we could not have done the clinical trials without her.  Ms. Bueso and her family have just been told by the Trump administration that they need to get out of this country within 33 days.  That among other things will end her access to the drug that is still keeping her alive and that she helped developed for everyone else in the world who also has this rare genetic illness. 

Joining us now is Dr. Paul Harmatz, the UCSF doctor who has treated Ms. Bueso since she was 7 years old and who led the clinical trial to treat her disease. 

Doctor, thank you very much for being with us tonight. 

DR. PAUL HARMATZ, UCSF BENIOFF CHILDREN`S HOSPITAL:  Thank you, Rachel.  It`s really -- this has been a devastating two-week feared and we appreciate your help trying to tell Isabel`s story. 

MADDOW:  It`s absolutely horrifying.  I have to ask you, first of all, if I have basically explained this accurately, if this is the situation her family is facing. 

HARMARTZ:  You did beautifully, even without a biochemistry background, it was -- it is remarkable.  But we feel like we have given Isabel a death sentence, just as you described it. 

When we surveyed in the early 2000s, 2001, and Isabel participated, a hundred patients worldwide, which we figured was 10 percent of the population, we didn`t find any patients much beyond age 20.  This was sort of the cut off in the survival with her type of disease.

And so, at this point, my prediction would be if we stop enzymes, she`s going to rapidly move into that category of disease level, and whether it`s months or one to two years, you`re really handing her a death sentence.  It`s as if we`re pulling the plug on a respirator or stopping feedings for a patient that needs that type of support.  And I think we -- you know, have really devastated this family. 

So, you know, we couldn`t do these trials.  The families are unbelievable in their willingness to move from around the world to a site that`s experienced in these very sophisticated trials.  They relocate, they live one to two years at the home site and sometimes the option to go back to their home country does not materialize, the countries can`t offer the therapies.  And as you described, she only had the option of staying, and she stayed for now, most of her life -- I mean, she`s really grown up through the grade school, high school, college, now she`s looking at graduate school, and what sort of career and jobs she can pursue.

And she`s a really amazing child and young adult.  She`s one of the leaders in our program and the entire nation in terms of MPS, and it, I think -- you know, I hope we can see a change in policy so they`re able to move back to their normal life. 

MADDOW:  Dr. Paul Harmatz, pediatric gastroenterologist at UCSF Benioff Children`s Hospital -- I can`t imagine this is not going to continue to be national news until this is resolved.  I know that you and your colleagues being able to talk about it is important of that. 

We`ll be back with you in coming days hopefully to talk about how this case is progressing.  Thanks for being with us tonight.

HARMATZ:  Excellent, thank you.

MADDOW:  We`ll be right back.  Stay with us. 


MADDOW:  That`s going to do it for us tonight. 

I will just say one note about the last story that we covered tonight.  Over the course of the week, we have been following what started off as local reporting and is now national news about this unannounced policy change by the Trump administration where they do appear to be targeting the families of kids with cancer, kids with cystic fibrosis, kids with rare genetic diseases and other kids who need life-saving advanced medical care and have been given permission to live in this country on that basis. 

This story, credit to WBUR in Boston, "The Boston Globe" in Boston, "Commonwealth Magazine" in Massachusetts, for being the first news outlets to report that, it then moved to "Miami Herald" who started reporting it out.  And today, it`s on the front page of "The New York Times" and we expect in coming days to now see this become basically a lightning rod of a national story. 

But credit where credit is due to the New England papers and radio outlets that reported this story.  We would not have known about it without you.  Now, I expect the national uproar will and truly commence. 

All right.  That`s it for us tonight.  We`ll see you again tomorrow. 


Good evening, Lawrence.

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