If you were seeking online therapy from 2017 to 2021—and a lot of people were—chances are good that you found your way to BetterHelp, which today describes itself as the world’s largest online-therapy purveyor, with more than 2 million users. Once you were there, after a few clicks, you would have completed a form—an intake questionnaire, not unlike the paper one you’d fill out at any therapist’s office: Are you new to therapy? Are you taking any medications? Having problems with intimacy? Experiencing overwhelming sadness? Thinking of hurting yourself? BetterHelp would have asked you if you were religious, if you were LGBTQ, if you were a teenager. These questions were just meant to match you with the best counselor for your needs, small text would have assured you. Your information would remain private.

Except BetterHelp isn’t exactly a therapist’s office, and your information may not have been completely private. In fact, according to a complaint brought by federal regulators, for years, BetterHelp was sharing user data—including email addresses, IP addresses, and questionnaire answers—with third parties, including Facebook and Snapchat, for the purposes of targeting ads for its services. It was also, according to the Federal Trade Commission, poorly regulating what those third parties did with users’ data once they got them. In July, the company finalized a settlement with the FTC and agreed to refund $7.8 million to consumers whose privacy regulators claimed had been compromised. (In a statement, BetterHelp admitted no wrongdoing and described the alleged sharing of user information as an “industry-standard practice.”)

We leave digital traces about our health everywhere we go: by completing forms like BetterHelp’s. By requesting a prescription refill online. By clicking on a link. By asking a search engine about dosages or directions to a clinic or pain in chest dying???? By shopping, online or off. By participating in consumer genetic testing. By stepping on a smart scale or using a smart thermometer. By joining a Facebook group or a Discord server for people with a certain medical condition. By using internet-connected exercise equipment. By using an app or a service to count your steps or track your menstrual cycle or log your workouts. Even demographic and financial data unrelated to health can be aggregated and analyzed to reveal or infer sensitive information about people’s physical or mental-health conditions.  

All of this information is valuable to advertisers and to the tech companies that sell ad space and targeting to them. It’s valuable precisely because it’s intimate: More than perhaps anything else, our health guides our behavior. And the more these companies know, the easier they can influence us. Over the past year or so, reporting has found evidence of a Meta tracking tool collecting patient information from hospital websites, and apps from Drugs.com and WebMD sharing search terms such as herpes and depression, plus identifying information about users, with advertisers. (Meta has denied receiving and using data from the tool, and Drugs.com has said that it was not sharing data that qualified as “sensitive personal information.”) In 2021, the FTC settled with the period and ovulation app Flo, which has reported having more than 100 million users, after alleging that it had disclosed information about users’ reproductive health with third-party marketing and analytics services, even though its privacy policies explicitly said that it wouldn’t do so. (Flo, like BetterHelp, said that its agreement with the FTC wasn’t an admission of wrongdoing and that it didn’t share users’ names, addresses, or birthdays.)

Of course, not all of our health information ends up in the hands of those looking to exploit it. But when it does, the stakes are high. If an advertiser or a social-media algorithm infers that people have specific medical conditions or disabilities and subsequently excludes them from receiving information on housing, employment, or other important resources, this limits people’s life opportunities. If our intimate information gets into the wrong hands, we are at increased risk of fraud or identity theft: People might use our data to open lines of credit, or to impersonate us to get medical services and obtain drugs illegally, which can lead not just to a damaged credit rating, but also to canceled insurance policies and denial of care. Our sensitive personal information could even be made public, leading to harassment and discrimination.

Many people believe that their health information is private under the federal Health Insurance Portability and Accountability Act, which protects medical records and other personal health information. That’s not quite true. HIPAA only protects information collected by “covered entities” and their “business associates”: Health-insurance companies, doctors, hospitals, and some companies that do business with them are limited in how they collect, use, and share information. A whole host of companies that handle our health information—including social-media companies, advertisers, and the majority of health tools marketed directly to consumers—aren’t covered at all.

“When somebody downloads an app on their phone and starts inputting health data in it, or data that might be health indicative, there are definitely no protections for that data other than what the app has promised,” Deven McGraw, a former deputy director of health-information privacy in the Office for Civil Rights at the Department of Health and Human Services, told me. (McGraw currently works as the lead for data stewardship and data sharing at the genetic-testing company Invitae.) And even then, consumers have no way of knowing if an app is following its stated policies. (In the case of BetterHelp, the FTC complaint points out that from September 2013 to December 2020, the company displayed seals saying HIPAA on its website—despite the fact that “no government agency or other third party reviewed [its] information practices for compliance with HIPAA, let alone determined that the practices met the requirements of HIPAA.”)

Companies that sell ads are often quick to point out that information is aggregated: Tech companies use our data to target swaths of people based on demographics and behavior, rather than individuals. But those categories can be quite narrow: Ashkenazi Jewish women of childbearing age, say, or men living in a specific zip code, or people whose online activity may have signaled interest in a specific disease, according to recent reporting. Those groups can then be served hyper-targeted pharmaceutical ads at best, and unscientific “cures” and medical disinformation at worst. They can also be discriminated against: Last year, the Department of Justice settled with Meta over allegations that the latter had violated the Fair Housing Act in part by allowing advertisers to not show housing ads to users who Facebook’s data-collection machine had inferred were interested in topics including “service animal” and “accessibility.”

Recent settlements have demonstrated an increased interest on the part of the FTC in regulating health privacy. But that and most of its other actions are carried out via a consent order, or a settlement approved by the commissioners, whereby the two parties resolve a dispute without an admission of wrongdoing (as happened with both Flo and BetterHelp). If a company appears to have violated the terms of a consent decree, a federal court can then investigate. But the agency has limited enforcement resources. In 2022, a coalition of privacy and consumer advocates wrote a letter to the chairs and ranking members of the House and Senate appropriations committees, urging them to increase funding for the FTC. The commission requested $490 million for fiscal year 2023, up from the $376.5 million it received in 2022, pointing to stark increases in consumer complaints and reported consumer fraud. It ultimately received $430 million.

For its part, the FTC has created an interactive tool to help app creators be in compliance with the law as they build and market their products. And HHS’s Office for Civil Rights has provided guidance on the uses of online tracking technologies by HIPAA-covered entities and business associates. This may head off privacy issues before apps cause harm.

The nonprofit Center for Democracy & Technology has also put together its own proposed consumer-privacy framework in response to the fact that “extraordinary amounts of information reflecting mental and physical well-being are created and held by entities that are not bound by HIPAA obligations.” The framework emphasizes appropriate limits on the collection, disclosure, and use of health data as well as information that can be used to make inferences about a person’s physical or mental health. It moves the burden off consumers, patients, and users—who, it notes, may already be burdened with their health condition—and places it on the entities collecting, sharing, and using the information. It also limits data use to purposes that people anticipate and want, not ones they don’t know about or aren’t comfortable with.

But that framework is, for the time being, just a suggestion. In the absence of comprehensive federal data-privacy legislation that accounts for all the new technologies that now have access to our health information, our most intimate data are governed by a ragged patchwork of laws and regulations that are no match for the enormous companies that benefit from having access to those data—or for the very real needs that drive patients to use these tools in the first place. Patients enter their symptoms into search engines or fill out online questionnaires or download apps not because they don’t care, or aren’t thinking, about their privacy. They do these things because they want help, and the internet is the easiest or fastest or cheapest or most natural place to go for it. Tech-enabled health products provide an undeniable service, especially in a country plagued by health disparities. They’re unlikely to get less popular. It’s time the laws designed to protect our health information caught up.

President Joe Biden’s administration moved boldly yesterday to solve his most immediate immigration problem at the risk of creating a new target for Republicans who accuse him of surrendering control of the border.

Yesterday, the Department of Homeland Security extended legal protections under a federal program called Temporary Protected Status (TPS) that will allow as many as 472,000 migrants from Venezuela to live and work legally in the United States for at least the next 18 months.

With that decision, the administration aligned with the consensus among almost all the key players in the Democratic coalition about the most important thing Biden could do to help big Democratic-leaning cities facing an unprecedented flow of undocumented migrants, many of whom are from Venezuela.

[Jerusalem Demsas: How deterrence policies create border chaos]

In a series of public statements over the past few months, Democratic mayors in New York, Chicago, Los Angeles, Philadelphia, and other major cities; Democrats in the House and Senate; organized labor leaders; and immigrant advocacy and civil-rights groups all urged Biden to take the step that the administration announced yesterday.

Extending TPS protections to more migrants from Venezuela “is the strongest tool in the toolbox for the administration, and the most effective way of meeting the needs of both recently arrived immigrants and the concerns of state and local officials,” Angela Kelley, a former senior adviser to Homeland Security Secretary Alejandro Mayorkas, told me immediately after the decision was announced.

Despite the panoramic pressure from across the Democratic coalition, the administration had been hesitant to pursue this approach. Inside the administration, as Greg Sargent of The Washington Post first reported, some feared that providing legal protection to more Venezuelans already here would simply encourage others from the country to come. With polls showing widespread disapproval of Biden’s handling of border security, and Republicans rallying behind an array of hard-line immigration policies, the president has also appeared deeply uncomfortable focusing any attention on these issues.

But immigrant advocates watching the internal debate believe that the argument tipped because of changing conditions on the ground. The tide of migrants into Democratic-run cities has produced wrenching scenes of new arrivals sleeping in streets, homeless shelters, or police stations, and loud complaints about the impact on local budgets, especially from New York City Mayor Eric Adams. And that has created a situation where not acting to relieve the strain on these cities has become an even a greater political risk to Biden than acting.

“No matter what, Republicans will accuse the administration of being for open borders,” Maria Cardona, a Democratic strategist working with immigrant-advocacy groups, told me. “That is going to happen anyway. So why not get the political benefit of a good policy that so many of our leaders are clamoring for and need for their cities?”

Still, it was revealing that the administration paired the announcement about protecting more Venezuelan migrants through TPS with a variety of new proposals to toughen enforcement against undocumented migrants. That reflects the administration’s sensitivity to the relentless Republican accusation—which polls show has resonated with many voters—that Biden has lost control of the southern border.

As Biden’s administration tries to set immigration policy, it has been forced to pick through a minefield of demands from its allies, attacks from Republicans, and lawsuits from all sides.

Compounding all of these domestic challenges is a mass migration of millions of people fleeing crime, poverty, and political and social disorder in troubled countries throughout the Americas. In Venezuela alone, political and social chaos has driven more than 7 million residents to seek new homes elsewhere in the Americas, according to a United Nations estimate. “Venezuela is a displacement crisis approximately the size of Syria and Ukraine, but it gets, like, one one-thousandth of the attention,” Todd Schulte, the president and executive director of FWD.us, an immigration-advocacy group, told me. “It’s a huge situation.”

Most of these displaced people from nations across Central and South America have sought to settle in neighboring countries, but enough have come to the U.S. to overwhelm the nation’s already strained asylum system. The system is so backlogged that experts say it typically takes four to six years for asylum seekers to have their cases adjudicated. If the time required to resolve an asylum case “slips into years, it does become a magnet,” encouraging migrants to come to the border because the law allows them to stay and work in the U.S. while their claims are adjudicated, says Muzaffar Chishti, a senior fellow at the Migration Policy Institute, a center-left think tank.

Former President Donald Trump dealt with this pressure by severely restricting access to asylum. He adopted policies that required asylum seekers to remain in Mexico while their cases were decided; that barred anyone from claiming asylum if they did not first seek it from countries between their homeland and the U.S. border; and, in the case of the pandemic-era Title 42 rule, that turned away virtually all undocumented migrants as threats to public health.

Fitfully, Biden has undone most of Trump’s approach. (The Migration Policy Institute calculates that the Biden administration has taken 109 separate administrative actions to reverse Trump policies.) And Biden and Mayorkas, with little fanfare, have implemented a robust suite of policies to expand routes for legal immigration, while announcing stiff penalties for those who try to enter the country illegally. “Our overall approach is to build lawful pathways for people to come to the United States, and to impose tougher consequences on those who choose not to use those pathways,” Mayorkas said when he announced the end of Trump’s Title 42 policy.

Immigration advocates generally express confidence that over time this carrot-and-stick approach will stabilize the southern border, at least somewhat. But it hasn’t yet stanched the flow of new arrivals claiming asylum. Some of those asylum seekers have made their way on their own to cities beyond the border. At least 20,000 more have been bused to such places by Texas Governor Greg Abbott, hoping to produce exactly the sort of tensions in Democratic circles that have erupted in recent weeks.

[Ronald Brownstein: The GOP’s lurch toward extremism comes for the border]

However they have arrived, this surge of asylum seekers has created enormous logistical and fiscal challenges in several of these cities. Adams has been the most insistent in demanding more help from the federal government. But he’s far from the only Democratic mayor who has been frustrated by the growing numbers and impatient for the Biden administration to provide more help.

The top demand from mayors and other Democratic interests has been for Biden to use executive authority to allow more of the new arrivals to work. “There is one solution to this problem: It’s not green cards; it’s not citizenship. It’s work permits,” Philadelphia Mayor Jim Kenney told me earlier this week. “All these people need work. They wouldn’t be in [a] hotel, they wouldn’t be lying on streets, if they can go to work.”

That answer seems especially obvious, Kenney continued, because “we have so many industries and so many areas of our commerce that need workers: hotels, restaurants. Let them go to work. [Then] they will get their own apartments, they will take care of their own kids.”

The obstacle to this solution is that under federal law, asylum seekers cannot apply for authorization to work until 150 days after they filed their asylum claim, and the government cannot approve their request for at least another 30 days. In practice, it usually takes several months longer than that to receive approval. The Biden administration is working with cities to encourage asylum seekers to quickly file work applications, but the process cannot be streamlined much, immigration experts say. Work authorization through the asylum process “is just not designed to get people a work permit,” Todd Schulte said. “They are technically eligible, but the process is way too hard.”

The inability to generate work permits for large numbers of people through the asylum process has spurred Democratic interest in using the Temporary Protected Status program as an alternative. It allows the federal government to authorize immigrants from countries facing natural disasters, civil war, or other kinds of political and social disorder to legally remain and work in the U.S. for up to 18 months at a time, and to renew those protections indefinitely. That status isn’t provided to everyone who has arrived from a particular country; it’s available only to people living in the U.S. as of the date the federal government grants the TPS designation. For instance, the TPS protection to legally stay in the U.S. is available to people from El Salvador only if they were here by February 2001, after two major earthquakes there.

The program was not nearly as controversial as other elements of immigration law, at least until Trump took office. As part of his overall offensive against immigration, Trump sought to rescind TPS status for six countries, including Haiti, Honduras, and El Salvador. But Trump was mostly blocked by lawsuits and Biden has reversed all those decisions. Biden has also granted TPS status to migrants from several additional countries, including about 200,000 people who had arrived in the U.S. from Venezuela as of March 2021.

The demand from Democrats has been that Biden extend that protection, in a move called “redesignation,” to migrants who have arrived from Venezuela since then. Many Democrats have urged him to also update the protections for people from Nicaragua and other countries: A coalition of big-city mayors wrote Biden this summer asking him to extend existing TPS protections or create new ones for 11 countries.

Following all of Biden’s actions, more immigrants than ever are covered under TPS. But the administration never appeared likely to agree to anything as sweeping as the mayors requested. Yesterday, the administration agreed to extend TPS status only to migrants from Venezuela who had arrived in the U.S. as of July 31. It did not expand TPS protections for any other countries. Angela Kelley, now the chief policy adviser for the American Immigration Lawyers Association, said that providing more TPS coverage to any country beyond Venezuela would be “a bigger piece to chew than the administration is able to swallow now.”

But advocates considered the decision to cover more Venezuelans under TPS the most important action the administration could take to stabilize the situation in New York and other cities. The reason is that so many of the latest arrivals come from there; one recent survey found that two-thirds of the migrants in New York City shelters arrived from that country. Even including this huge migrant population in TPS won’t allow them to instantly work. The administration will also need to streamline regulations that slow work authorization, experts say. But eventually, Kelley says, allowing more Venezuelans to legally work through TPS would “alleviate a lot of the pressure in New York” and other cities.

Kerri Talbot, the executive director of the Immigration Hub, an advocacy group, points out the TPS program is actually a better fit for Venezuelans, because the regular asylum process requires applicants to demonstrate that they fear persecution because of their race, religion, or political opinion, which is not the fundamental problem in Venezuela. “Most of them do not have good cases for asylum,” she said of the new arrivals from Venezuela. “They need TPS, because that’s what TPS is designed for: Their country is not functional.”

Biden’s authority to expand TPS to more Venezuelans is likely to stand up in court against the nearly inevitable legal challenges from Republicans. But extending legal protection to hundreds of thousands of Venezuelans still presents a tempting political target for the GOP. Conservatives such as Elizabeth Jacobs, the director of regulatory affairs and policy at the Center for Immigration Studies, have argued that providing work authorizations for more undocumented migrants would only exacerbate the long-term problem by encouraging more to follow them, in the hope of obtaining such permission as well.

Immigration advocates note that multiple academic studies show that TPS protections have not in fact inspired a surge of further migrants from the affected countries. Some in the administration remain uncertain about this, but any worries about possibly creating more long-term problems at the border were clearly outweighed by more immediate challenges in New York and other cities.

If Biden did nothing, he faced the prospect of escalating criticism from Adams and maybe other Democratic mayors and governors that would likely make its way next year into Republican ads denouncing the president’s record on immigration. That risk, many of those watching the debate believe, helped persuade the administration to accept the demands from so many of Biden’s allies to extend TPS to more undocumented migrants, at least from Venezuela. But that doesn’t mean he’ll be happy about this or any of the other difficult choices he faces at the border.

Rupert Murdoch famously insisted that he would never retire.

In 1998, when he was already 67 years old, he told an interviewer that if he retired, he would “die pretty quickly.”

Nearly two decades later, in 2015, when Rupert was grooming his son Lachlan to succeed him at Fox, Lachlan said he was well aware that “Rupert’s never retiring.”

So today’s announcement of Murdoch’s new title, chairman emeritus, is the closest step toward retirement that he will likely ever take. The once-feared media mogul, now 92, is stepping down, or up, as it were, to an honorary title, leaving Lachlan as the sole chairman of both Fox Corp and News Corp.

The Murdoch media empire’s conservative bent will not change as a result of the transition. If anything, Lachlan is more conservative than his father, and far more in tune with Trumpism. (The longer-term direction of the network is somewhat murkier, because after Rupert passes from the scene, Lachlan’s three siblings will have their own say in the decisions of the Murdoch Family Trust.)

[Read: Do you speak Fox?]

But this is an epochal moment in media nonetheless. Murdoch’s own newspapers and TV networks certainly think so: Fox News began its 9 a.m. newscast by reading his announcement, and the headline “Rupert Murdoch to Step Down as Chair of Fox, News Corp” dominated The Wall Street Journal’s homepage all morning.

Rupert’s allies depicted his shift as a semiretirement of sorts, and he told employees that he would still be watching and reading and opining at all hours. “When I visit your countries and companies,” he wrote, flexing his multinational muscles, “you can expect to see me in the office late on a Friday afternoon.”

This week, Murdoch was seen on the Fox Corp studio lot in Los Angeles, a short drive from his Bordeaux-style vineyard estate in Bel Air. His movements and political machinations will continue to be tracked by friends and foes alike. But today’s announcement confirms something that his aides will never quite admit out loud: Murdoch is a diminished figure.

The man who, after recovering from prostate cancer a quarter century ago, said, “I’m now convinced of my own immortality,” and insisted on Thursday that he remains in “robust health,” no longer inspires either the reverence or the revulsion he once did.

For my forthcoming book, Network of Lies, I spent months combing through the emails and texts unearthed by Dominion Voting Systems in the Dominion v. Fox lawsuit. I was struck by how passive Murdoch seemed, in his missives to Fox News Media CEO Suzanne Scott and then–New York Post editor Col Allan. When Fox took on water for telling the truth about Donald Trump’s election loss, then tried to patch the holes in the hull by lying and smearing Dominion, Murdoch acted more like an economy-class passenger than the captain of the ship.

“There was a time when Rupert would say jump and people would say how high,” a longtime Murdoch lieutenant told me. “But not anymore.”

That’s why today’s announcement did not surprise me, despite Murdoch’s earlier protestations about never retiring.

The nonagenarian seldom speaks in public, and virtually never gives interviews, so the Dominion legal proceeding was a rare window into his world. When he was deposed for two days in January by the Dominion attorney Justin Nelson, he sounded—well, checked out.

“I’m a journalist at heart,” he said, or more specifically, a newspaperman, still obsessed with print. “I read my newspapers a lot more than I watch television,” he said. “I don’t watch Fox News enough, or as much as I should,” he added. During the deposition, Murdoch mixed up the names of hosts; said, “I don’t talk to Sean [Hannity] very often”; and refrained from talking about Fox’s shows except to brag about their high ratings. He portrayed himself, intentionally or not, as a mere bystander at his own company.

The pretrial discovery process surfaced ample evidence of Murdoch’s influence: he banned Steve Bannon from appearing on air; he mobilized Fox assets to help Republicans win Senate races; he fretted about Rudy Giuliani’s relationship with Trump.

But the process also showed that Murdoch did not intervene when several Fox shows introduced insidious lies about the 2020 election results. He seemed shockingly unaware of what went on at his own company.

[Adam Serwer: Why Fox News lied to its viewers]

Nelson asked Rupert at one point, “Do you think it’s healthy for democracy when millions of people believe a falsehood about whether an election was rigged?” Rupert responded, “It is not good for any country if masses of people believe in falsehoods.”

It would be hard to write a more brutal epitaph for Murdoch’s decades at the helm of Fox.

His speech, delivered in French and English, touched on climate change and Russia's invasion of Ukraine.

General CQ Brown has been confirmed as chairman of the Joints Chiefs of Staff, despite a months-long Senate blockade.