State lawmaker's bill seeks to limit use of drones to fight crime

SPRINGFIELD — As the Obama administration comes under fire for its use of unmanned drones in foreign lands, a state senator is pressing to have Illinois join the national debate on whether states should regulate drones to ensure the high-tech snooping isn't used to invade the privacy of ordinary citizens on U.S. soil.

Democratic Sen. Daniel Biss has introduced legislation that would require police to get a search warrant before using a drone to gather evidence. Along with banning the use of lethal and nonlethal weapons on the drones — except in emergencies — the proposal would require information a drone gathers to be destroyed unless it is part of an investigation.

Under the legislation, Illinois would step up to combat the issue of drones flying over U.S. airspace. President Barack Obama signed a Federal Aviation Administration mandate last year requesting the agency integrate unmanned aircraft into the national system.

With the possibility of drones becoming the latest aircraft traversing the skies, Biss said this is "the exact moment states should be looking into" unmanned aircraft legislation.

"We're heading into a world where technology surveillance is unreal," the Evanston lawmaker said.

More than 20 states are pursuing similar legislation, according to the National Conference of State Legislatures. While some states are trying to regulate unmanned aircraft use, others are trying to impose moratoriums that ban them, Biss said.

Virginia lawmakers approved a two-year moratorium on the aircraft in the state last week to allow time for a study. The legislation awaits the governor's signature.

In Illinois, authorities in Cook and Champaign counties are considering the use of drones to combat crime.

Cook County Sheriff Tom Dart is in the "exploratory stages" of looking into drone technology for future operations, spokesman Frank Bilecki said. If the county were to employ any drones, they would be "specifically for law enforcement use" and not to invade personal privacy, Bilecki said.

Dart's thinking is that drones would be cheaper to use and cost less taxpayer money than using helicopters for aerial operations, Bilecki said. A small, unmanned aircraft used for search and rescue can cost on average between $38,000 and $50,000, much less than in years past, said James Hill, president of AirCover Integrated Solutions, a California-based drone manufacturer.

To gain traction at the Capitol, Biss potentially might have to overcome resistance from law enforcement leaders. To that end, Biss said he's talking with police chiefs, the Illinois State Police and other police agencies to iron out any wrinkles.

The American Civil Liberties Union thinks the time is ripe to look at drone regulations.

"Technology is changing," said Ed Yohnka, spokesman for the ACLU's Illinois chapter. "And the idea is we need to get ahead of the technology to be better prepared."

raguerrero2@tribune.com

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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses

Eric Kayne for The New York Times

SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.

HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.

Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.

“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.

She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.

“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”

Cutting Risks, and Costs

The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.

But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.

In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.

“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”

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ComEd chief hopes to spark positive change

Every organization has its low point. For Commonwealth Edison, it was in summer 2011 when a storm left more than 850,000 people without power, some for days.

Customers flocked to the phones for information and were shocked to find that they were not only in the dark, but in the dark ages. They waited on hold for hours, only to hear the same message every 45 minutes. They couldn't find out when their power would be restored, what had caused the outage or how many other people were affected.

Residents raged about ComEd on Facebook and Twitter and to mayors, state representatives, and fire and police departments. Dealing with wires that blocked roadways, nursing homes without power and angry residents with spoiled groceries, these public officials turned back to ComEd — only to receive misinformation or no information at all.

For soon-to-be-instated CEO Anne Pramaggiore, it was a blaring wake-up call: Customers hated the utility.

"We heard our customers loud and clear that summer," Pramaggiore said. "Everything else in the world is instantaneous, and they don't understand why they have to sit and wait without power or information."

Fast-forward to today, and customers can text, call, look online, use an iPhone or Android app or communicate with a ComEd representative on Twitter or Facebook. In less than a year, the company's smartphone app has generated more than 1 million transactions and 59,000 downloads.

"We're on a mission to improve service to our customers," said Pramaggiore, 54.

The good news is that the company has nowhere to go but up. Since 1999, ComEd has consistently ranked among the worst utilities in the Midwest for customer satisfaction in surveys conducted by The American Customer Satisfaction Index and J.D. Power and Associates.

Two months ago, the company had zero pending complaints for the first time in its history after working its way out of backlog in "the thousands," according to Miguel Ortega, director of customer technology and support for ComEd.

"Anne gets it," he said. "I've been around for quite a while. I've been through a lot of CEOs. She has made it a priority to put the customer in every aspect of our business, which is a huge cultural change."

The shift comes at a time when ComEd's parent company, Exelon Corp., is squeezing its three regulated utilities for revenue. The money Exelon receives for producing its mostly nuclear-powered electricity is not what it once was because of increased competition from natural gas and wind.

As a regulated utility that is paid by customers to deliver electricity regardless of which supplier they choose, ComEd is in a position to provide a steady, predictable stream of income to its parent if it can garner support from the General Assembly to pass legislation that will benefit its bottom line. But to get there, Pramaggiore must convince legislators — the same ones who have spent years fielding complaints from constituents about ComEd's abysmal service — that the company can change.

Legislation related to funding the so-called smart grid, passed into law in 2011 as part of the Energy Infrastructure Modernization Act, is making its way through Springfield and is worth about $1 billion to ComEd.

Within four years, Pramaggiore wants the utility that customers love to hate to be the utility that customers actually like, a plan she has spent countless hours communicating to every employee in the company.

"Whether you'll love your utility, I don't know. It's not the kind of business you ultimately love," said David Kolata, executive director of the Citizens Utility Board consumer advocacy group, a frequent opponent of ComEd. "We are encouraged and do think generally that her heart is in the right place. She does want to transform the company. Will that play out? It's too early to tell."

Inspires trust

While Pramaggiore's lawyerlike ability to boil down complex regulatory issues is impressive, her power lies in her charm. Gracious and savvy, she laughs easily and often, winning over opponents with humility and a down-to-earth speaking style that inspires trust.

Gloria Castillo, a personal friend of Pramaggiore and president of Chicago United, said her ability to listen is one of her greatest assets.

"Anne is really one of the highest-ranking women in energy anywhere in the country, but you never get the feeling that she thinks about herself in a way that's different," she said. "She's so striking. She has a unique ability to be so present in a conversation."

Indeed, Pramaggiore, a soccer mom who fits in at a Paul McCartney concert as easily as in a contentious hearing in Springfield, is disarming in her remarkable ability to appear unremarkable. She described her childhood in Dayton, Ohio, as a "quiet, suburban upbringing with good schools," with a father who was a civil engineer and a mom who was president of the local PTO.

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Jail officers accused of ordering an inmate beaten

Two Cook County Jail officers overseeing a psychiatric ward ordered two inmates to beat up another inmate who had angered them and then tried to cover it up by claiming the battered victim attempted suicide, prosecutors said Friday.

"This is what happens to you (expletive) when you step out of line. You disrespect us, we disrespect you," prosecutors said the officers announced to the entire tier after the beating last February.

Delphia Sawyer, 31, and Pamela Bruce, 30, both six-year veterans with the sheriff's office, were charged with official misconduct, obstructing justice, perjury and mob action. Judge Edward Harmening set bail at $50,000 each and ordered them to turn over any firearms.

A photograph taken of the victim, Kyle Pillischafske, on the day after shows he sustained two black eyes and severe swelling on his face. Prosecutors said the damage took place despite the officers yelling for the two inmates to hit Pillischafske with "body shots" so his injuries would be less visible.

The inmate's mother, Morgan Pillischafske, of Mount Prospect, told the Tribune that she was shocked when she learned about the beating and later heard from her son that he thought he was going to die. He had been doing well there, receiving treatment for his bipolar disorder while awaiting trial on an aggravated battery charge, she said.

"Not only did these guards mistreat Kyle, they took advantage of two other inmates as well, all because they were supposedly called a name," she said Friday in a telephone interview. "You have to have thicker skin than that."

Sawyer and Bruce were working the 3 to 11 p.m. shift in the psychiatric tier in maximum-security Division 10 when inmates tried to light a makeshift cigarette in an electrical outlet, sparking a small fire and cutting power to part of the tier, Assistant State's Attorney Nicholas Trutenko said.

The officers, believing Pillischafske was partly to blame, confronted him, prompting a heated exchange, the prosecutor said.

The officers instructed "two of the larger inmates" to go into his cell and beat him, Trutenko said.

Sawyer and Bruce are alleged to have stood watch while the two inmates struck Pillischafske in the face and head. They then joined in, hitting him with their radios and kicking him in the side, the prosecutor said.

To cover up their misconduct, the officers misled a supervisor to believe that Pillischafske hurt himself by banging his head against a shower wall during a suicide attempt, the charges alleged.

The two later lied repeatedly to a grand jury investigating the beating, Trutenko said.

After their arrest Thursday, both officers were stripped of police powers and suspended with pay pending an internal disciplinary hearing next week, said Frank Bilecki, the sheriff's spokesman.

A lawsuit filed by Pillischafske against the officers, the county and Sheriff Tom Dart is pending in federal court.

Bruce, of Chicago, and Sawyer, of Justice, are both married mothers of two and have no criminal records or disciplinary history with the Sheriff's Department, according to their attorneys.

Peter Hickey, Sawyer's attorney, noted she was in charge of a very volatile tier of "psychiatrically disturbed patients."

"These aren't choir boys from St. Patrick's parish," Hickey told the judge.

Pillischafske, now 19, was jailed at the time of the beating on a charge he intentionally caused a car crash in a botched suicide attempt, injuring a woman in the other car. He pleaded guilty a few weeks later to aggravated battery and was sentenced to probation, court records show.

Pillischafske's mother said despite her son's mental health issues, he is a "pretty likable kid" who loves music, plays bass guitar and is hoping to go to college.

"Kyle needs to move on from this," she said. "The whole thing was very unfortunate."

jmeisner@tribune.com

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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16 airport investors show interest in Midway

An international array of airport investors and operators have shown interest in developing bids to privatize Midway Airport, the city announced Friday evening.

Sixteen parties responded to the city's "request for qualifications" by a 4 p.m. deadline, indicating they had interest in leasing, operating and improving the Southwest Side airport, the nation's 26th busiest, with about 9 million passengers passing through annually.

"The response generated from the  ... process is encouraging and provides the city with a sense of the strong level of interest in a potential lease," said Lois Scott, the city's chief financial officer. "We must evaluate fully if this could be a win for Chicagoans."

The city and its advisers will review the responses to identify qualified potential bidders.

Of the 16, seven had both the operational and financial capabilities sought in the RFQ. The city identified them as:

-- ACO Investment Group, an investor and operator with global airport experience.

-- AMP Capital Investors Limited, a manager and investor in airports, including Melbourne Airport in Australia and Newcastle Airport, in Britain.

--  Corporacion America Group, an Argentina-based airport operator with 49 airports in seven countries.

-- Global Infrastructure Partners (GIP), which is the controlling investor and active manager of London City Airport, London Gatwick Airport and Edinburgh Airport.

--Great Lakes Airport Alliance, which is a partnership of Macquarie Infrastructure and Real Assets and Ferrovial. Its airport operations include London's Heathrow, Brussels Airport and Copenhagen Airport.

-- Incheon International Airport and Hastings Funds Management, which is the sole owner and operator of Incheon International Airport in South Korea and an investor with 16 airport-related investments.

--  Industry Funds Management and Manchester Airport Group, an investor with interests in 13 airports, including Melbourne Airport and Brisbane Airport, both in Australia, and operator of Manchester Airport and East Midlands Airport, in Britain.

If the city moves forward and seeks proposals, a privatization plan could be submitted to the City Council this summer.

This is the second time Chicago has looked at privatizing Midway. A 99-year lease that would have brought in $2.5 billion died in 2009 when the financial markets froze. That deal had drawn six serious bidders.

Mayor Rahm Emanuel has said any second attempt would have to provide city taxpayers with a better deal than the widely criticized 75-year agreement to privatize parking meter operations, carried out during former Mayor Richard Daley's administration. Proceeds from the earlier deal were used to plug operating deficits, and meter rates rose sharply.

This time, proposed leases must be less than 40 years, which locks in the city for a shorter period.

Rather than making only an upfront payment, the private operator also must share revenue with the city on an ongoing basis. Initial proceeds would be used to pay down debt issued since 1996 to rebuild the airport, the mayor's office said. There is about $1.4 billion in outstanding debt.

Longer term, cash flow would be directed to city infrastructure needs. The mayor has pledged proceeds would not be used to pay for city operations.

kbergen@tribune.com

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Governors Fall Away in G.O.P. Fight Against More Medicaid

Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans.

The Supreme Court ruled last year that expanding Medicaid to include many more low-income people was an option under the new federal health care law, not a requirement, tossing the decision to the states and touching off battles in many capitols.

The federal government will pay the entire cost of covering newly eligible beneficiaries from 2014 to 2016, and 90 percent or more later. But many Republican governors and lawmakers immediately questioned whether that commitment would last, and whether increased spending on Medicaid makes sense, given the size of the federal budget deficit. Some flatly declared they would not consider it.

In Florida, where Gov. Rick Scott reversed his position and on Wednesday announced his support for expanding Medicaid, proponents say that doing so will not only save lives, but also create jobs and stimulate the economy. Similar arguments have swayed the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who in recent months have announced their intention to expand Medicaid.

The shift has delighted supporters of the law.

“I think this means the dominoes are falling,” said Ronald F. Pollack, the executive director of Families USA, a consumer group. “The message is, ‘Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn’t opt into taking these very substantial federal dollars to help people who truly need it.’ ”

 Nationwide, Medicaid covers 60 million people, most of them low-income or disabled. The Congressional Budget Office has estimated that 17 million more people could be enrolled if all states took the expansion option. So far, 22 states have said they will expand the program, 17 have opted against it, and 11 have not yet decided, according to Avalere Health, a consulting firm.

Some Republican governors remain firmly opposed to the expansion of Medicaid. In her State of the State address, Gov. Nikki R. Haley said, “As long as I am governor, South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.”

Gov. Rick Perry affirmed that “Texas will not expand Medicaid” and said he was proud that Texas did not follow other states “scrambling to grab every tax dollar they can.”

The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals. Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid.

Politics could also be a factor in states where Republican governors have decided to expand Medicaid. Mr. Obama won all of those states except Arizona and North Dakota in last year’s election, a fact that may have influenced several of the governors’ decisions. Some of the seven are also up for re-election next year.

Religious leaders have added a moral dimension to the campaign in some states. The Roman Catholic bishops of Salt Lake City and Little Rock, Ark., for example, have urged state officials to expand Medicaid.

The Obama administration has tried to win over skeptical state officials by offering new flexibility to manage Medicaid as they like. On the same day that he agreed to expand Medicaid in Florida, Mr. Scott got federal permission to move more Medicaid beneficiaries into private managed care plans.

Mr. Scott’s support for expanding Medicaid is particularly significant — Florida is the fourth most populous state — and surprising. A onetime hospital executive, he has been among the most strident critics of the health care law, and his opposition to it was a cornerstone of his 2010 campaign for governor.

The battle is not over, however. In Florida, as in many other states, expansion is subject to approval by the Legislature, whose Republican leaders have expressed misgivings. The legislative session begins next month, and advocates say they plan to press ahead with a lobbying campaign.

Leah Barber-Heinz, a spokeswoman for Florida Chain, a health advocacy group, said it was trying to inform lawmakers and the public about who would benefit from an expansion of Medicaid. More than one-fifth of Florida residents, roughly 4 million of 19 million people, lack health insurance.

“There are so many misperceptions about the uninsured,” Ms. Barber-Heinz said. “So we’re trying to show faces of who would be impacted: people who have been hit by the recession, people who have been laid off, educated people, people who own homes.”

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United takes Dreamliner off schedule until June

The All Nippon Airways Dreamliner 787 arrives at Mineta San Jose International Airport. (Gary Reyes/San Jose Mercury News/MCT / January 22, 2013)

Staff and wire report

1:35 p.m. CST, February 21, 2013

The parent company of United Airlines says it is taking the Boeing 787 off its schedule through June 5 for all but one of its routes.

United Continental Holdings Inc. said it still plans to use the 787 on its flights between Denver and Tokyo's Narita airport starting May 12. It had aimed to start that route on March 31.

United, currently world's largest airline and the only U.S. customer for the 787, said the timing of that reinstatement will depend on resolution of the Dreamliner's current issues.

The 50 Dreamliners in commercial service were grounded worldwide last month after a series of battery-related incidents including a fire on board a parked plane in the United States and an in-flight problem on another jet in Japan. United had only been flying the plance since November.

Sources told Reuters earlier this week that Boeing Co. has found a way to fix the battery problems that involves increasing the space between the lithium ion battery cells.

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Tribune exclusive: 'We were just regular parents who were slapped in the face'

The parents of slain teen Hadiya Pendleton talk about her life and death and the issues raised after she died. (Chris Walker/Chicago Tribune)

11:57 p.m. CST, February 20, 2013

Hadiya Pendleton’s parents haven’t had much time to reminisce about their daughter’s life and death before Wednesday, when they sat down for an exclusive interview with the Tribune.

Cleopatra Cowley-Pendleton recalled getting the phone call on Jan. 29 that her 15-year-old daughter had been shot, and rushing to the hospital only to find out it was too late, her daughter was dead.

A whirlwind of activity followed as Hadiya became a national symbol of gun violence and her parents traveled to Washington for President Barack Obama’s State of the Union speech.

“I’m not going to be extremely political, but if I can help someone else not go through what we’ve gone through, then I have to do what I can,” Cowley-Pendleton said. “These are the cards we have been dealt. If these are the shoes I need to walk in, I don’t mind walking in them.”

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