STORY OF THE WEEK: Everyone talks about waste and fraud, but no one does anything about it. That may sum up the view of many, if not most, supporters of President Donald Trump as his administration quickly moves to drastically reshape the federal government. “He campaigned on these promises and now he’s following through,” Rhode Island Senate GOP Leader Jessica de la Cruz (R-North Smithfield) said this week in an interview with my colleague Luis Hernandez.

But Trump also distanced himself during the campaign from Project 2025. Now, the architect of that plan, Russell Vought, will lead the powerful U.S. Office of Management and Budget, despite sharp opposition from U.S. Sen. Sheldon Whitehouse and other Senate Democrats.

For supporters, the alacrity with which the Trump administration is making big changes marks a welcome contrast from how generations of pols have cited the ambiguous catchall “waste and fraud” when asked how to trim government spending. The Government Accounting Office estimates annual government losses due to fraud to be between $233 billion and $521 billion.

But there’s a difference between cutting fraud and remaking the government with disregard for local control, fewer checks and balances, and a vast expansion of executive power -- all with a leading role for the world’s richest man, who wields enormous influence in his unelected post and is rife with potential conflicts of interest due to his extensive government contracts.

In the short term, taking a chainsaw to the federal government probably resonates with many Americans. Ronald Reagan got a lot of mileage with his line about the nine most terrifying words in the English language. (He nonetheless presided over a big boost in federal spending.) But Musk’s might is helping to galvanize Democrats, courts are blocking some of Trump’s envisioned changes, and people sometimes develop a different view of government when they realize it helps to promote health and wellness.

THE RESPONSE: A coalition composed of Indivisible RI, Climate Action RI, the RI Working Families Party, Common Cause of RI and Black Lives Matter RI attracted hundreds of people to gather outside U.S. Sen. Jack Reed’s Providence office on Saturday, Feb. 8, “to call on Rhode Island’s federal delegation to use every tool at their disposal to stand up to Elon Musk’s illegal takeover of the U.S. Treasury.” Organizers expected hundreds of people. According to a news release for the event, “The United States is in the midst of a five-alarm fire. Elon Musk has illegally taken over the mainframe of Treasury’s payment systems, and in doing so is seizing the means of cutting off spending to any federal program. He can delete the file that controls your Social Security payments, or the payments to your kid’s Head Start program. He can unilaterally shut down an agency’s funding, or cut off all benefits to blue states like Rhode Island. This is an unimaginably dangerous crisis.”

THE RESPONSE, PART II: Here’s a look at how some of Rhode Island’s Democratic elected officials are reacting to Trump initiatives and nominations.

• Sen. Whitehouse voted no on RFK Jr’s nomination to be Health and Human Services secretary. In a statement, Whitehouse said, “Mr. Kennedy has not come remotely close to providing adequate assurances that he will follow the well-established science on vaccines, nor remedy the ways CMS [Centers for Medicare and Medicaid Services] hurts Rhode Island, so I cannot support his nomination.”

• Attorney General Peter Neronha joined a coalition of 20 AGs urging the Senate to seek more answers from FBI nominee Kash Patel. With 14 other AGs, Neronha was also part of a group issuing a statement on protecting access to gender-affirming care.

• U.S. Rep. Gabe Amo criticized a shrinking commitment to scientific research. He asked Rhode Islanders to share how they are being affected by the new administration.

• U.S. Sen. Jack Reed signed onto a letter calling the Trump administration’s “deferred resignation” offer deceptive, legally dubious and a threat to important services.

• U.S. Rep. Seth Magaziner helped organize a protest against Elon Musk and DOGE and raised a flag about an apparent cut-off in funding for local health centers.

RI’S INTRACTABLE HEALTHCARE CHALLENGE: John Fernandez, president/CEO of Brown University Health (formerly Lifespan) and his counterpart at Care New England, Dr. Michael Wagner, are calling on the General Assembly to raise state spending on Medicaid by $90 million. With a two-to-one, federal match, that boost would unleash a total of $270 million to get at the heart of Rhode Island’s crisis in healthcare. As Fernandez and Wagner wrote in an op-ed released this week, “The state of Rhode Island allocates significantly less funding toward Medicaid than our neighboring states. Rhode Island has among the highest percentage of Medicaid enrollment in New England; and, our provider reimbursement rates are the lowest in the region. For example, a hip replacement in Massachusetts is reimbursed up to $7,670 by Medicaid. In Rhode Island, our state’s Medicaid program reimburses us $1,800 for the same procedure. That doesn’t even cover the hip implant itself which costs about $4,700.” But the timing for a bigger state spend on Medicaid couldn’t be worse, since Rhode Island is ensconced in a new era of perennial deficits. That helps explain why Gov. McKee is proposing a lower-than-expected boost on Medicaid spending, as Nancy Lavin pointed out in a superb overview on the local hospital landscape, and the General Assembly seems unlikely to unleash the spending sought by the top hospital executives. 

HEALTHCARE TALK: Fernandez joined me on Political Roundtable this week to talk about Medicaid reimbursement, the fiscal outlook for Brown University Health, the primary care shortage, why Costa Rica has a higher life expectancy than the U.S. and more.

HEALTH PACKAGE: For the second consecutive year, the Rhode Island Senate has unveiled a group of bills aimed at improving healthcare access and affordability. Here’s an excerpt from my report: “In a statement, Sen. Melissa Murray (D-Woonsocket), chairwoman of the Senate Committee on Health and Human Services, said the new package would remove burdensome administrative requirements that pose barriers for patient care, protect patients from medical debt, and lower costs while improving access. A bill sponsored by Murray as part of the nine pieces of legislation would eliminate the ability of insurance companies to demand prior authorization requirements for primary care providers. ‘It is the doctors, not insurers, who know best what care is needed for their patients. And we need our primary care doctors focused on providing care, not haggling with insurance companies.’ ”

MCKEEWORLD: Kathy Gregg reports Gov. McKee’s re-election announcement is on for March 3 …. McKee announced this week that Deloitte, at his request, “provided Rhode Island with $5 million to help pay for expenses related to the RIBridges data breach. Separately, Deloitte is covering the cost of the data breach call center, credit monitoring, and identity protection for impacted customers.” …. Ted Nesi and Tim White report on how public records show that the governor’s staff pushed to block public access to the Statehouse rotunda fewer than 90 minutes before a planned protest tied to his State of the State address last month.

G-MEN: Policing political corruption has long been a priority for the FBI, and the most high-profile instance of that in Rhode Island is probably the Plunder Dome probe that brought down Buddy Cianci. The FBI agent most associated with that investigation is Mississippi native W. Dennis Aiken, whose experience in Providence went back to Buddy I. I was curious about what Aiken thought about how the Trump administration is targeting the FBI – some GOP senators call it “ripe for real reform” – and how the president’s nominee to lead the FBI, Kash Patel, has characterized it as a captive of the Deep State. Aiken mostly declined comment, although he told me via email, “I will say that I have not seen anything like this at the FBI since Richard Nixon appointed Patrick Gray as Director after Hoover’s death. Gray didn’t last long.”

For comment, Aiken referred me to a letter sent on behalf of groups including the FBI Agents Association, representing more than 14,000 active and retired agents. Excerpt: “Put simply, Special Agents who risk their lives protecting this country from criminals and terrorists are now being placed on lists and having their careers jeopardized simply for carrying out the orders they were given by their superiors in the FBI. These actions, which lack transparency and due process, are creating dangerous distractions, imperiling ongoing investigations, and undermining the Bureau’s ability to work with state, local, and international partners to make America safe again. Furthermore, these actions are wholly inconsistent with commitments made by the President, and his chosen leaders of the Department of Justice and the FBI to guide the Bureau in a non-political manner that prioritizes national security and supports ethical law enforcement officers. As Kash Patel, President Trump’s nominee for FBI Director, stated at his confirmation hearing, ‘no one will be terminated for case assignments’ and ‘all FBI employees will be protected against political retribution.’ The recent actions from the Acting Deputy Attorney General directly contradict these assurances.”  

PSYCHIC SCAN: Hasbro is moving closer to a decision about its future headquarters -- and the perception is that Rhode Island still has a shot. If the company stays, that will accrue as a win for the state. But if Hasbro goes, it will join the PawSox and Benny’s as other vital local brands that have passed from the scene, and it would hurt both economically and psychologically, due to the relatively small number of big corporations headquartered here. 

JAMMED UP: State Rep. Enrique Sanchez (D-Providence) has maintained radio silence since being arrested on a charge of operating under the influence this week. The RI Young Republicans issued a statement calling on him to resign. Via statement, House Speaker Joe Shekarchi said, “This is a serious charge that Representative Sanchez faces and I will let the legal process play itself out.  At the appropriate time, he owes an explanation to his House colleagues, and most importantly, to his constituents.”

NEO-LUDDITES: Will more Americans take up the call to give up scrolling in favor of other pursuits? Elsewhere in the NYT, artist and anti-tech activist August Lamm argues that people should ditch their smartphones for a flip phone. Excerpt: “What could possibly be more inconvenient than our current situation? Studies report that Americans spend an average of three to five hours per day on their smartphones. That figure is much higher for teenagers. We don’t need statistics to tell us how easy it is to slip into scrolling, and how hard it is to resist. My encounters with aspiring downgraders illustrate not only the scale of the problem but also the scale of our discontent. Not a day goes by that I don’t receive a desperate email from someone seeking help in overcoming tech dependency. Recently, though, I’ve begun hearing from people who have broken the cycle. A cultural shift is underway.”

NEW HIRE: A big Rhody welcome to Noah Boucher, the new DC-based comms director for Rep. Magaziner. He previously worked in comms for Reps. Eric Sorensen of Illinois and Tim Ryan of Ohio after starting as an intern with Rep. Emanuel Cleaver of Missouri.

DIGITAL ADDICTION: Via NPR Fresh Air -- “The trouble with ‘donating our dopamine’ to our phones, not our friends.”

PIGSKIN: Mike Szostak has you covered with a look back at Rhode Island connections to the Super Bowl. Excerpt: “A defensive tackle from Warwick won four Super Bowl rings with the Pittsburgh Steelers, a fullback from Cranston picked up two with the Oakland Raiders, and a long snapper who played at Brown won a pair with the New York Giants. A return specialist from Cranston got a ring with the Giants, and a special teams star from Brown earned one with the Steelers. A former Brown and UMass coach earned a ring as an assistant with the Steelers. The new coach of the Jacksonville Jaguars, who played his high school football at La Salle Academy, coached in the Super Bowl with the Los Angeles Rams. But a defensive end from Pawtucket helped win the Super Bowl that changed professional football forever.”

BIRD FLU: Avian bird flu has been detected in RI. Here’s what you need to know.

KICKER: A new biography by Ricky Riccardi makes the case that the great Louis Armstrong was the first black pop star. Armstrong survived growing up in a dangerous New Orleans neighborhood and discovered his gift for music at an orphanage, went on to global acclaim, and while battling health issues near the end of his life, insisted on performing twice-nightly for two weeks at a newly renovated nightclub in New York. When his doctor tried to stop him as Armstrong was showing signs of heart failure, “he said Armstrong almost got into a possessed state. And he said, ‘doc, my whole soul, my whole spirit is to blow that horn. The people are waiting for me. I can't let them down.’” Armstrong made it through the two-week gig, suffered a major heart attack two days later and died later that year.