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In the aftermath of Donald Trump’s victorious reelection bid, Democrats are searching for an explanation of Kamala Harris’s loss in order to begin rebuilding for the future. So it goes every election cycle—a loss, a scramble for causality, and competing narratives begin to set.

Just one week out from Election Day, there are multiple dissenting and overlapping arguments being made to try to make sense of the results. In 2016, many Democrats believed that Trump’s attack on trade policies was core to his victory. As a result, the Biden-Harris administration pursued Trump-like policies on trade, none of which seem to have made a significant difference in increasing the union vote share, reducing Trump’s likelihood of victory, or stemming the flow of working-class voters out of the Democratic Party.

Now, again, various parts of the Democratic coalition are seeking to define the party’s loss. But what do we actually know about why the Democrats were defeated? There are still theories forming, but on today’s episode of Good on Paper, I talk with the former Republican strategist and current host of The Bulwark Podcast, Tim Miller about the postelection narratives jockeying for power.

“But for those of us who do have a belief that there’s something kind of special about the American system and that have revered America, that understand that America is flawed and has made mistakes, that still is a unique experiment in the world. That “America is an idea” type of thing. The idea is pretty dim at this point,” Miller argued.

The following is a transcript of the episode:

[Music]

Jerusalem Demsas: In the aftermath of a bruising electoral loss, the losing party begins participating in a well-worn democratic tradition: slinging takes about what happened.

This is democracy! When the voters send a dissatisfied response, the messy work of recalibration requires parsing the signal from the noise.

Were voters mad because of a global inflationary environment that no Democrat could dig their way out of? Did they want to see specific breaks between Harris and Biden on policy? Were they frustrated by a candidate they saw as too left on cultural issues?

There are data points in favor of many different theses. Here’s where I’d put my stake in the ground, with the caveat that we still don’t have a complete analysis on subgroup dynamics, or even a final vote count on all the races:

First, incumbents worldwide were facing tough election odds. Electorates were frustrated by the COVID inflationary years and were clearly seeking change. In Australia, Sweden, the Netherlands, France, and beyond, ruling coalitions lost power across the political spectrum.

Second, I don’t think Kamala Harris was ever going to be a great candidate. After Biden’s disastrous debate effort in late June and it seemed he might be pressured to drop out, I wrote an article calling on Democrats not to coronate their vice president, and pointing to key vulnerabilities she displayed and the value of an open democratic process.

Figuring out how much of this is in the campaign’s control—would it really have mattered that much if she’d gone on Joe Rogan’s podcast?—or figuring out what this means for America’s two political parties will take months, if not years. As you’ve heard on this podcast, I’m still arguing about what 2016 really meant on trade and immigration.

My name’s Jerusalem Demsas, I’m a staff writer at The Atlantic, and this is Good on Paper, a policy show that questions what we really know about popular narratives. As a disclaimer, I worked for the Harris primary campaign in 2019 before becoming a journalist, and my guest today, Tim Miller, is a political strategist who was Jeb Bush’s 2016 communications director on his presidential campaign. He’s been an anti-Trump conservative since then and is the host of The Bulwark Podcast.

Today we’re going to talk through some of these inchoate narratives and debate which ones we think are likely to hold water.

[Music]

Demsas: Tim, welcome to the show.

Tim Miller: Hey Jerusalem. What’s happening?

Demsas: Well, we’re recording this six days after Election Day. And—as you have seen on Twitter, and I’m sure in your various interviews—the takes are already coming in very, very hot. And this is a show where we often look at narratives that have already baked, and kind of look at the research and data behind how these narratives formed and what truth is there and what sorts of things have gotten ahead of themselves.

But we’re in an interesting moment right now where we’re seeing very important narrative formation happen in real time. In the aftermath of an election, everyone’s scrambling to define what happened in order to maybe wrest control of the future of the party from an ideological perspective or just a pure power perspective. And so we’re seeing a bunch of people arguing about why Trump won and why Harris lost in a time where there’s a bunch of unknowns. So we’re going to go through a few of these different narratives that are coming up.

But Tim, right off the bat, I wanted to ask you: What’s your perception of why Trump won and Harris lost?

Miller: I’m going to preempt my answer by saying that I think that uncertainty is important in this moment, and that false certainty can lead to some very mistaken and disastrous results. I say this from experience, having worked on the Republican autopsy in 2013, when the conventional wisdom congealed very quickly that Republicans, in order to win again, needed to moderate on immigration and cultural issues to appeal more to Hispanics and women. And not only was that wrong, but the person that became the nominee and then the president used that autopsy for toilet paper and went exactly the opposite direction.

It also always didn’t also work out in Trump’s favor. In 2022, the conventional wisdom was that Trumpism was badly hurt and that Ron DeSantis was ascendant. Right? So anyway, in the week after the election, bad takes abound.

Demsas: [Laughs.]

Miller: That said, my answer is, I’m open to a variety of different things that the Democrats might have to do, among them being maybe nothing and watch Trump self-implode. Might be as simple as that. That said, the one thing that I think is certain that the Democrats need to reflect on when it comes to this question of why Trump won and why Harris lost—it’s that the Democratic message is not landing outside of a particular demographic of middle- to upper-income, college-educated, not particularly religious, urban- and suburban-dwelling white Americans, in addition to Black women, right? Those are the demos that the Democrats are doing well with, that Kamala Harris grew her share with from last time, at least in the case of college-educated women. And I think that the Democrats are doing a very poor job of communicating to people in all of those other demographics.

On what they need to do, I’m very open to various possibilities about whether it’s about affect or vibe or policy or whatever. But I’m certain that there is—fair or unfair, there’s a perception that the Democrats don’t care about these other demographics, particularly working-class demographics, particularly working-class men. And that they did not offer them something that was more appealing than the nostalgia and promises of gold bullion that they got from Donald Trump. And so we can hash through all the different theories about why that was. But I think the fact that what happened—you can’t argue with.

Demsas: Yeah. I think that that’s very descriptively true. But I guess what I would want to know from you is do you feel like there are specific things that Democrats have done that tipped the scales against them? I think that what you’re outlining here is very sound. There’s a difference between why Harris may have lost and what the Democrats need to do going forward to be a more electorally relevant party at the presidential level. And so from your perspective, though, is there something about the Democratic argument around the economy or other issues that you think was particularly relevant this time around?

Miller: I think that, for starters, people were unhappy with the economy. And I don’t think that the Democrats presented a message to them about how they plan to change that for the better. But, again, I’m also not even really ready to concede that, with the exception of inflation being annoying and that broadly hurting people, the Democrats were hurt based on their economic argument. It might simply be cultural. It might be the way that they spoke, and having people feel like they weren’t being heard.

I think the Democrats in particular—I always want to immediately go to, What is the policy prescription that would have appealed? And I’m like, It’s possible that there wasn’t one.

Demsas: Yeah. An important backdrop that I think you’re alluding to here, as well, is that the inflationary environment was really, really bad for incumbents across the world, right? You’re kind of going into an election where the fundamentals are sort of rigged against incumbents because the inflationary episode was just really, really hard for people. I think one narrative that I’m seeing come up a lot is about campaign strategy. And this seems like something that’s going to be hashed out significantly. But I guess the question I have here is whether you think Harris could have won with a campaign run differently, even given the shortened timeline.

Miller: I’m giving another “I don’t know” answer to that question: I don’t know. I think that she, by all accounts, ran a strong campaign that was based on her strengths. And I think she had an undeniably dominating debate performance. They ran a nice convention. Her speeches were good. The messaging pivot, the launch was good. There wasn’t a lot of drama inside the campaign, right? There are other things that she isn’t particularly strong at. I don’t think that she is that great in unscripted moments. Sometimes she’s better than others.

And so then that’s the other thing that people come to, which is like, Oh, she should have done Rogan and all this. And I agree. I think she should have done more of those interviews, but they also weren’t really her strong suit. And I think that this was something that might’ve borne out had there been a longer primary, and maybe somebody else would have emerged. But that said, I don’t think so. I think Kamala Harris was going to emerge from a primary, no matter when Joe Biden dropped out.

And so I’m not saying, Oh, this was inevitable. Just give up. Life is pain. [Laughs.] That’s not really what I’m saying. Any specific thing that people are like, Oh, if this tactic had been different, that would have helped—I don’t really buy that. I mean, I think that broadly speaking, her having the ability to separate herself from the administration would have been helpful, and I think that was very challenging to do given the situation Joe Biden left her in and the time period that was left. And I think that it’s very likely that she might have separated herself from the administration more and still lost, and we would have been here on this podcast with people saying, Why did she distance? [Laughs.] You know what I mean? Why did she break up the Democratic coalition?

Demsas: Yeah. I mean, it’s funny. I think that, on the tactics, I’m sort of with you here. I was looking at some of the data analyses that are coming out now, and it looks like, at this point, given the data we have, while the national average from 2020 to 2024 shifts roughly six points, in battlegrounds, that number is going to end up closer to three points. And that speaks to campaign effects. That speaks to the fact that in battleground states where, again, the majority of the money is going, people are putting ads in battleground states, the campaign is putting rallies there, she’s visiting, they’re really working the press in those places to get her story and message out in a way that you’re not really going to do in a safe, Dem county in Illinois or something.

And so as a result, what they see is that the campaign effects were good on a tactical level. Their ads were persuasive. There’s evidence from Dan Rosenhack at The Economist that it looks like the campaign effects were more effective than Trump’s on things like—indicating things like ads and rallies were better for Harris.

I think on this kind of broader meta question that you kind of raised, right, about Harris as the nominee, I don’t think this is inevitable. I mean, I wrote an article on July 9th arguing that she was unlikely to be a good nominee and the party shouldn’t coronate her, and Nancy Pelosi to The New York Times—I don’t know if you saw this quote, after Harris’s loss—she says that she had expected that if the president were to step aside that there would be an open primary. And that maybe Kamala would have been stronger going forward if she’d gone through a primary and that the president endorsed Kamala Harris immediately, which made it impossible to have a primary at the time. But it sounds like you’re saying that you think that, regardless, this would not have really changed the game that much.

Miller: Yeah, I mean, I think that had Joe Biden followed the—you can argue whether it was a promise or whether it was an indication that he was going to be a one-term [president] and pass the torch. And had there been a two-year process, maybe Kamala Harris does not emerge. But, look, there are three things that I think of when I hear this counterfactual about what would have happened had it been a more open process. The first thing is, the Democrat—one of the things that the Democrats have a lot of baggage around is identity politics. I think it would have been very challenging for a Black woman to be passed over.

Demsas: But the Democratic primary voters did this in 2019, right? There was this argument being made, but they said, no, we care most about electability and they chose Joe Biden.

Miller: Right, that’s true. But Joe Biden had been the vice president in that case. Kamala Harris was the vice president. You already saw this on social media. I saw this on social media, and I was basically for Kamala but also, at the same time, was like, maybe I think it’d be healthy to have an open process. And I guess if you could wave a magic wand, I probably would want Shapiro, Whitmer. Because hopefully that would win two of the three states you need to win the presidency. And that just seems like a safer bet to me. That was my position: It was like pro-Kamala and/but. And I had hundreds of people calling me a racist over that.

So, I think that it would have caused a lot of turmoil within the party.

Now, again, in a longer, two-year process, is that a lot of heat that then just dies out after a while, and you settle on something that’s a little bit more electable and everybody gets behind it except for a few people who have hurt feelings? Maybe.

No. 2, an open process opens up Gaza [as a] wound and rips that apart even wider, and I think creates potentially even greater turmoil than she already was dealing with on that issue. And that’s cost her, frankly. And then No. 3 is then if the theory of the case is a more electable person with someone that could get more distance from the Biden-Harris administration, that assumes that the Democratic voters were looking for somebody to do that.

And that is really where the tension is here, Jerusalem, because if you look at the data, a majority of the Biden-Harris Democrats were basically happy with the administration, right? There were surely big parts of the Democratic coalition, particularly younger voters, particularly working-class Black and Hispanic voters, the types of people that they lost ground with, that were unhappy with the Biden administration. But I think that there was a plurality within the party that was not going to be for somebody—look at the response to Dean Phillips, not exactly the most talented candidate, but total rejection and mockery for somebody who ran trying to get distance from the Biden-Harris administration.

So I think it would have been very challenging to run as a candidate and get distance. So to me, it’s like if we lived in an imaginary world where identity politics wasn’t an issue, Gaza wasn’t an issue, and there was no backlash to distancing yourself from Biden, then certainly the Democrats could have come up with a stronger option.

We don’t live in an imaginary world. And I think that within the world that we live in, within all those constraints, I think it’s very challenging to see a situation where you end up with somebody stronger than Harris.

Demsas: Yeah, I mean, all those points I think are very well taken. And I think I’m seeing a lot of people make that argument of both Harris’s inevitability as the vice president, and also this sort of sense of It would have been a worse candidate. I do think that kind of my general belief is sort of, when you think you’re behind, you run a high-variance play. If you’re gonna lose anyway, you just kind of throw everything you can at the kitchen sink.

And on this kind of inevitability point, right, I think there is this burgeoning sense that Democrats were just repudiated across the board here. You kind of brought this up, this idea that Democrats do not have a good answer on economic issues or on the issues that Americans care about.

But I don’t know, how do you reconcile that with the clear ticket-splitting you see going on here? [Nebraska’s Dan] Osborne ran seven points ahead of the Harris ticket. [Montana Senator Jon] Tester ran seven points ahead of the ticket. Amy Klobuchar ran six points ahead. That’s just in the Senate. And in the House, we see over-performances from everyone from AOC to Jared Golden in Maine, who’s a much more moderate member of the Democratic coalition. Doesn’t that indicate at some level that candidate quality was important here and that there were other candidates that were much more electable?

Miller: For starters, running the presidential race is so far different from running a Senate or House race that it’s almost not even the same sport.

It’s literally like T-ball versus the major leagues. What people expect from their—I mean, nobody’s like, Oh man, does Amy Klobuchar have to go on Joe Rogan? Nobody watches Amy Klobuchar’s debates. Obviously it’s a little different in Montana, where you’re running a competitive race. But again, just the interest in Senate races is different. I think that the Democrats have a coalition that is perfectly durable and able to win nonpresidential elections. I think that this trade in the voters that has happened where the Democrats are picking up more high-trust, more middle- to high-income, more college-educated voters, and the Republicans are picking up more low-trust, more middle- to low-income, and less educated voters. As a trade, that accrues to Democrats benefits in off-year elections and midterms and special elections, just because it’s the type of person that shows up for those types of things, and it accrues to the Republicans benefit in presidential elections. So that’s not good when the Republicans are nominating Donald Trump, and the Republicans’ presidential nominee is an existential threat to the fabric of our republic. And so that’s a problem.

And so I agree that you can’t look at the data and say, oh, the Democratic brand is irreparably harmed. Like, no, the Democrats won. And a lot of these Senate races are going to end up very narrow minorities, in the House and the Senate, that they will probably be able to win back in the midterms, depending on what happens.

But I think that there are two things, which is, No. 1, the Democrats are not well suited to running presidential elections right now, in this media environment, and then No. 2 is that the Democrats have abandoned huge parts of the country where they are not viable. And that’s particularly problematic, given the Senate and Electoral College and the way that’s set up.

So okay, back to No. 1. Democrats are really good at running campaigns that are set pieces. They have professionals that are running these campaigns: the ads, the conventions, the speeches, the going to the editorial-board meetings, the 2004-type campaigns. And that’s how Senate and House campaigns are basically still run in most of the country, and even governor’s races, right? People just don’t care about those races at that deep of a level. But the presidential race is—the media environment around it is so different. I mean, people are consuming information about the presidential race on their TikTok, listening to sports talk, listening to their random podcasts that aren’t about sports at all that are cultural, on women’s blogs, at a school function, people are talking about it casually, you know what I mean?

I’m a parent, and obviously this is a little bit of selection bias since I’m in politics and people know that, but people don’t come up to me and ask me what I think about the House race in my district. Nobody’s mentioned Troy Carter to me at any events,, at any school functions or any of my kids’ sporting events.

Demsas: He’s got to get his name out there. [Laughs.]

Miller: And so the information environment is just a total category difference. And Trump and even J. D. Vance in certain ways were able to take advantage of that by running campaigns that are a little bit more unwieldy, that are better for viral clips, that are also better for sitting down for two hours and broing out with the Theo Von and talking about how you can’t even do coke in this country anymore because the fentanyl is in it, right?

She wasn’t doing any of that. And doing one of those interviews isn’t really the answer, right? It’s like, can you communicate in a way that feels authentic? It might be fake authenticity, but in a way that feels authentic to people in their Instagram Stories, in their TikTok, in their podcasts, whatever.

And Democrats are not producing a lot of candidates who I feel are good at that.

Demsas: But I think there’s also this broad concern that the media ecosystem itself is not producing convincing, progressive-sounding or left-leaning media personalities. There’s a 2017 AER study that I remember being very, very shocking to people when it first came out, right after Trump’s election in 2016. And there are a couple economists, they look at the effect of Fox News, and they find that watching Fox News for an additional 2.5 minutes per week increases the vote share by 0.3 percentage points. But watching MSNBC has essentially no effect, and they see that Fox News is actually able to shift viewers’ attitudes rightward. And they look at 2004 and 2008 and find that Republican presidential candidates’ share of the two-party vote would have been more than three points lower in 2004, and six points lower in 2008 without Fox News.

And so that’s something where I’m just like—there is something to the fact that the media ecosystem does not have that sort of targeted apparatus. But my usual belief about these sorts of things is that we’re discounting the fact that so much of the media is so liberal that Fox News can have this large effect because it I think stands out among a pack of more liberal institutions, but I am kind of surprised at MSNBC.

Miller: Yeah, I mean, as a person on MSNBC, did that study go on before I was a political contributor? I think it did. So we might need to update the study and have them focus on my hits and see if that changes anything.

I guess I want to noodle on that for a little bit. That does surprise me a little bit as well, but I would say this: I think that I’m less concerned. I think there’s a category of person out there, and maybe this is right, that is focused on Republicans have better propaganda outlets than the Democrats do.

Demsas: Yeah.

Miller: And maybe that’s true. I don’t know. So to me, then the question is, okay, what can be done? What is realistic in this media environment? And it goes back to this question of, can the Democrats speak more through using existing outlets or finding a candidate who has a compelling story in their own right, or compelling communication skills to figure out how to speak to people that don’t watch mainstream news?

And that’s just really what it comes down to. The Democrats are very good at talking to people that are high-information, high-engagement, high-education, middle-to-high-income, and offering persuasive arguments. I think that they’re not good at talking to anybody else. And Obama was good at that, and Clinton was good at that. And we’re in a totally different media environment now than we were back then. But I think that there’s still things that can be learned from that.

[Music]

Demsas: After the break, why the abortion-ballot-measure strategy didn’t pan out for the Harris campaign.

[Break]

Demsas: I want to pull us out of this media conversation here, because I think that there’s also this, let’s say things go a little bit differently—and again, the margins here are not very big—and Harris has won.

I think one of the big things we’d be hearing right now is that she won because of abortion, right? And looking at Election Night, you see a lot of wins for abortion. There are 10 states that have referendums on abortion policies, and seven of them win: New York, Maryland, Arizona, Nevada, Colorado, Montana, Missouri. And in Florida, where it loses, the threshold is 60 percent and it earns 57 percent, so it lost, but there’s clearly a majority in favor.

And, going in, I mean, especially after the midterms, there was a real feeling, kind of the big narrative that came out of those midterms was that abortion is the place where Democrats can clearly distinguish and can clearly win over Republican candidates, even in deeply Republican states, and especially in deeply purple states.

And I’m trying to think through this. What explains in your mind the sort of difference between how many voters were saying, Yes, I do have more liberal views on abortion; I’m willing to express those in these ballot measures; but no, I’m not going to then reward Democratic presidential candidate Kamala Harris for it?

Miller: Well, a couple of things. No. 1, this tension has always existed as old as time, and it’s particularly existed as old as time in places like Florida. I did one of these, you know, time is a flat circle—

Demsas: [Laughs.]

Miller: I forget which election it was at this point, but it was like, how did the minimum-wage-increase ballot initiative in Florida pass at the same time that Ron DeSantis won by 18 points or whatever, whichever election that was.

And it’s like, voters are complicated. Voters have complex views. And so you see this as kind of just a common thing in voter habits. In this case, I think that there are a couple of complicating factors in addition. No. 1 was, Donald Trump muddied the waters on his views.

Demsas: Yeah.

Miller: And I think that Donald Trump’s whole brand and vibe—I know we’re getting outside of the data space that you like to be in, Jerusalem, but there’s a certain group of people that are like, Yeah, that guy’s not gonna ban abortion. You know what I mean? And there’s just some percentage of voters out there that that’s just it. He doesn’t come off like Ted Cruz on abortion. He comes off as different, because they assume that he paid for an abortion or whatever, that he doesn’t care about it, and that he’s not gonna—this isn’t gonna be what he’s focused on. There are going to be people that are pro-choice that prioritize their economic views or their nativist views, right?

So that is going to be some of it. I think less so in Florida, but more in Arizona. To me, I think that there is actually a strategic backfiring of having these ballot initiatives on the ballot almost gave some people an out to do both, right? People that did not like Kamala Harris or that were more center-right and said, Oh, okay, great, I can protect abortion in Arizona and also vote for Donald Trump. I can have my cake and eat it, too.

Demsas: Yeah, I mean, I think my read of it is more that when you think about the specific argument being made about abortion, it was largely, he’s to blame for all these horrible things that are happening to women in states that have made abortion inaccessible. And by he, I mean Trump is to blame for that. And also, you know, he appointed these Supreme Court nominees who overturned Roe v. Wade. But as a prescription for the future, I feel like there was not a real clear argument made to voters of how Kamala Harris is going to actually protect abortion.

But again, it all comes back to the overarching question, did voters view this as an abortion election? And it seems clear that they viewed it as an inflation election. That was the core thing that they were focused on. And I think that one thing that I’ve heard a lot is what this means for understanding America, right?

So after 2016, people were just, I think, in shock, and were saying, I can’t believe this is the country I live in. And again here I’m hearing the sort of question of, you know, this is a black mark on the conscience of America, that people would vote for someone who threatened to overturn the results of the 2020 election, who talks with such liberal disdain for women and immigrants.

Something someone said to me in 2016 was really interesting: If your entire perception of America would have shifted if a few hundred thousand people voted differently, maybe don’t completely change everything you believe about everyone. And to me, I think that this framing about Trump’s reelection means something really dark about all the people that voted for him doesn’t really sit well with me because it seems like people are voting based on cost of living. At the same time, too, I think they’re taking their signal from Democrats who, if they’d taken their own warnings about the threat of fascism or the threat to our institutions, I think would have behaved very differently over the past couple of years in trying to win.

Miller: Yeah. It doesn’t change my view of the American people, really, that there are good people and bad people everywhere, that we all have good and bad inside of us. I’ll say that what it does impact for me—and maybe this is wrong and maybe I’m raw and it’s six days out—but for those of us who do have a belief that there’s something kind of special about the American system and that have revered America, that understand that America is flawed and has made mistakes but still is a unique experiment in the world. You know, the “America is an idea” type of thing.

The idea is pretty dim at this point. And, to me, that is the change, having him win again, that I’m having trouble getting over. Mentally, it’s not that it makes me look poorly at my neighbors, but that we just might be at the end of the experiment and the sense that America is something different than Hungary or Switzerland or whatever, any country—you name the country.

It was the old fight with Republicans and Democrats during the Obama years, which is, Obama doesn’t think of America as any different than Belgium. Obama believes in Belgian exceptionalism. And that to me is kind of where I am. I think that we’re about to move into an era where America’s flaws, in addition to all of our existing flaws like gun violence and our history of racism, et cetera—the American system’s flaws look a lot more like what flaws look like in other countries.

There’s going to be oligarchy, kleptocracy, corruption. There’s no special sense that the huddled masses around the world are welcome here any more than they might be welcome anywhere else. They frankly are probably going to be welcome here less than they’re welcome in certain other places.

And so to me, that is what I see differently. I reserve the right to change my mind about that at some point, but that’s where I’m at right now.

Demsas: Yeah. I think in contrast to this large view about the American idea of maybe being different than we believed beforehand is this, I think, really popular take that’s picking up steam, which is about just Democrats need to moderate on cultural issues, whether it’s about immigration, or it’s the issue of trans women and girls in sports. They’re just too left of the median voter, and you don’t actually need to do a bunch else other than accept that people are where they are on those places and not go so far away from it.

The data point that’s kind of in favor of this, particularly on the trans-girls-in-sports one, is Kamala Harris’s leading super PAC, Future Forward, finds that the most effective, or one of the most effective, Trump ads is one of the “Kamala is for they/them, President Trump is for you” ads. They find that it shifted the race 2.7 percentage points in Trump’s favor after people watched it.

How relevant do you think that the Democratic Party’s leftward shift on cultural issues is to Harris’s loss? And I mean, there’s some people who I think are really making the claim that you could just really focus on this and you don’t need to make these kind of larger arguments about strategy or how we’re speaking to America on economic policy.

Miller: I don’t think that this was alone to account for Harris’s loss or even maybe the biggest thing to account for her loss. I think that she didn’t really respond to that ad in particular quite well, and that maybe that was a strategic mistake. I think her campaign—and she didn’t run like an overly “woke,” culturally left campaign. Ao the question is, did the Democratic brand on those issues drag her down? I think possibly.

To me, look, could Kamala Harris have squeaked out a victory this time while holding the same positions on trans issues had inflation been 20 percent better? Maybe. Probably. It was a clear victory for Trump, but it wasn’t, you know, Reagan ’84.

A couple of things changed, and had that one, the cultural stuff stayed static, could she have still won? Clearly. I mean, Biden won in 2020, when all of those issues were more high-salience, I think, than they were this time. Biden, not a Black woman—so maybe there’s something to that as well, that he was able to be a little bit more resilient against attacks on those issues.

So maybe that’s worth thinking about. I would say this, though. If the Democrats want to have 60 senators again ever, then yeah, they got to moderate on cultural issues. You know what I mean? There are two ways to look at this: Can Democrats still win elections by maintaining their views on everything? Yes. Are the Democrats giving away huge swaths of the country by not really even engaging with their concerns about the leftward shift of the party on a wide array of issues? Yeah, they are. I get the land-doesn’t-vote thing, I get it, but look at the map.

Demsas: [Laughs.] We’ve all seen the map.

Miller: The map is still the map, you know what I mean?

And Trump gained in all of those little red counties out there where it’s just land, all right? But he gained. There are a handful of people out there, and he got more of them, in every county. And the Democrats’, I think, choice to just say, Well, we’re just giving up on that and we’re just going to focus on the more dynamic parts of the growing parts of the country and, eventually, demographics are destiny and blah, blah, blah, that looks like a pretty bad bet today.

I’m not out here being like, yeah, you got to throw trans people or migrants under the bus for them to win. But certainly the cultural leftward shift has created a ceiling on Democratic support that I think has a negative effect for the party, but also for progress on a lot of those issues.

Demsas: Yeah. I think it’s obviously very up in the air here, how people are gonna take this mantle of how you should moderate, and I think that there’s bad and good ways that people can take this. And I think that there’s a level to which people—you don’t have to be throwing trans people under the bus. Maybe we need to figure out ways, whether it’s how Democrats responded to this with gay rights, where they talked about federalism a lot and made sure the country moved toward the issue before making it a national issue.

But I think the most important and damning thing that Democrats are clearly responsible for in the choices they have made is about the poor governance in blue cities and states. This is one of my hobbyhorses, but you see massive shifts, as you mentioned, in high-cost-of-living places that are heavily democratic, in New York and in California and in a lot of the Northeast. And I think it’s hard to see that as anything other than just a repudiation of Democratic governance and particularly the cost of living and the cost of housing in these places.

And so, to me, when you talked about the Democratic brand, I mean, when you’re in a cost-of-living election, yes, there are marginal effects on these cultural issues we’re talking about here. Yes, there are things that campaigns can do better. Yes, there are candidate effects. But if people are asking themselves, What does it look like, how does it feel to my pocketbook to live in a Democratically run state versus a Republican one? I feel like they’re being told a very clear story.

Miller: I think that that’s true. I’ve been ruminating on this a lot over the past week. I live in Louisiana, so there is the kind of emotional guttural response I have to this, which is, do you think Louisiana is being governed that well? Because I don’t.

Demsas: Yeah. Well, on cost, though, right? It’s cheaper, obviously, to have a house in Louisiana.

Miller: It’s cheaper to have a house in Louisiana because of the economic destruction of the state over the past couple of decades and the fact that everybody that grows up in parts of the state that’s not this corridor between New Orleans and Baton Rouge leave home. And a lot of people in these places leave home, too, looking for better economic opportunities. And that’s sad for the state.

That is my initial response, which is emotional, which is like, okay, sure. But why does Kamala Harris have to carry the baggage for the place I used to live—Oakland—but Donald Trump doesn’t have to carry the baggage for the hollowing out of big parts of Louisiana? That said, it’s true that it hurt the Democrats, right? And it’s also true that the Democrats have been badly managing these big cities. And if you just look at the numbers, suburban Democrats—and this could be a counterargument. Now, I’m going to really give you a galaxy brain, Jerusalem, to your original data point earlier that the three-point effect in the battleground states versus national speaks to a campaign effect? Maybe.

Maybe it also speaks to the fact that a lot of these battleground states are made up of places that have mixed governance and big suburbs where the Democrats are doing better. Democrats are doing better in suburban America because they know they’re not feeling the acute pain of governing issues that have plagued a lot of the big cities. And surely there are a couple of big cities in those seven swing states, but none of the ones you think of when you think of major disruptions, and that maybe that explains it and that the Republican gains were in a lot more of those places like that, Illinois, New Jersey, California. Anyway, just something to noodle on.

But I think that it is objectively true that Democrats are doing better in places that have not been plagued by some of these bad governing decisions on crime and on housing that we’ve seen for in Democratic cities, and the Democratic mayors and Democratic governors in blue states should fix that.

And it’s the No. 1 thing—the last thing I’ll say on this is—the No. 1 thing that comes to mind when I already hear stupid parlor-game stuff about 2028 and it’s like Gavin Newsom and J. B. Pritzker. And to me, the No. 1 thing Gavin Newsom and J. B. Pritzker need to do if they want to run in 2027 is make Illinois and California run better in the meantime. Otherwise, nothing against either of those two guys, but I think that they’re going to carry this baggage that you’re talking about.

Demsas: Well, I could go on about housing in blue states forever. And there’s an article popping, I think today, listeners, as you’re hearing about this, about why I think this was a big issue for the election.

But Tim, always our last and final question.

Miller: Okay.

Miller: What is something that you once thought was a good idea but ended up only being good on paper?

Miller: Oh, okay. Hold on. I wasn’t prepared for this. I misread the question. I thought it was an idea that was only good on paper that then ended up being not good on paper.

Demsas: Idea could be good.

Miller: No, no, no. I’ll come up with one where I’m wrong. I’m happy to bet where I’m wrong. I was just saying the ideas are endless on those.

Demsas: Oh. Yeah, yeah, yeah. Something that you held, yeah, yeah, yeah.

Miller: An idea that I thought that was good on paper that ended up not being good on paper. Well, I guess I have to give the obvious answer to that question, sadly. I don’t get to rant about daylight savings time as I hoped to—an idea that was certainly good on paper in the 1800s or whenever they came up with it that’s no longer good. Falling back, that is. Permanent daylight saving time: good idea.

Changing times: not good.

Demsas: Four hundred electoral votes for whoever does this.

Miller: Yeah. The idea that I thought that was good on paper that is relevant to this podcast—because I literally put it on paper and wrote it—was the aforementioned 2013 GOP autopsy.

Demsas: Oh, yeah.

Miller: Well, how great! Compassionate conservatism. Republicans can diversify their party by getting softer on cultural issues and reaching out to the suburbs and reaching out to Hispanic voters and Black voters, criminal-justice reform, and that through criminal-justice reform and immigration reform and softening on gays, that Republicans can have a new, diverse electorate, and we can all move into a happy, bipartisan future.

That was a great idea on paper that backfired spectacularly, and now the Republicans have their most diverse electorate that they’ve had ever, I think, voting for Donald Trump after rejecting all of those suggestions that I put on paper. So there you go.

Demsas: As one vote of confidence for younger Tim, there are very many ways that history could have gone. I think that people often forget how contingent things are and how unique of a figure Trump is. And right now we’ve talked through a bunch of different ways that people are reading this moment, but there are a lot of ways that people can go, depending on what candidates do and say and how they catch fire and their charisma and what ends up being relevant in two years and in four years. So a little bit of sympathy for younger Tim.

Miller: I appreciate that. And that is true. Who the hell knows, right?

Demsas: Yeah, exactly.

Miller: Had Donald Trump not run that time and he decided he wanted to do some other scam instead, then maybe Marco Rubio is the nominee and those things do come to pass.

Demsas: [Laughs.] Yeah. If Obama doesn’t make fun of him at the White House Correspondents’ Dinner, we’re not even sitting here on this podcast.

Miller: Great job, Jon Lovett, or whoever wrote that joke.

Demsas: [Laughs.]

Miller: I’m just joking.

Demsas: Yeah. Well, thank you so much, Tim. Thanks for coming on the show.

Miller: Thank you, Jerusalem.

[Music]

Demsas: Good on Paper is produced by Jinae West. It was edited by Claudine Ebeid and engineered by Erica Huang. Our theme music is composed by Rob Smierciak. Claudine Ebeid is the executive producer of Atlantic audio. Andrea Valdez is our managing editor.

And hey, if you like what you’re hearing, please leave us a rating and review on Apple Podcasts.

I’m Jerusalem Demsas, and we’ll see you next week.

The news came four years ago, at the end of a casual phone call. Bill’s family had always thought it was a freak coincidence that his father and grandfather both had ALS. But at the end of a catch-up, Bill’s brother revealed that he had a diagnosis too. The familial trend, it turned out, was linked to a genetic mutation. That meant Bill might also be at risk for the disease.

An ALS specialist ordered Bill a DNA test. While he waited for results, he applied for long-term-care insurance. If he ever developed ALS, Bill told me, he wanted to ensure that the care he would need as his nerve cells died and muscles atrophied wouldn’t strain the family finances. When Bill found out he had the mutation, he shared the news with his insurance agent, who dealt him another blow: “I don’t expect you to be approved,” he remembers her saying.

Bill doesn’t have ALS. He’s a healthy 60-year-old man who spends his weekends building his dream home by hand. A recent study of mutations like his suggests that his genetics increase his chances of developing ALS by about 25 percent, on average. Most ALS cases aren’t genetic at all. And yet, Bill felt like he was being treated as if he was already sick. (Bill asked to be identified by his first name only, because he hasn’t disclosed his situation to his employer and worried about facing blowback at work too.)

What happened to Bill, and to dozens of other people whose experiences have been documented by disease advocates and on social media, is perfectly legal. Gaps in the United States’ genetic-nondiscrimination law mean that life, long-term-care, and disability insurers can obligate their customers to disclose genetic risk factors for disease and deny them coverage (or hike prices) based on the resulting information. It doesn’t matter whether those customers found out about their mutations from a doctor-ordered test or a 23andMe kit.  

For decades, researchers have feared that people might be targeted over their DNA, but they weren’t sure how often it was happening. Now at least a handful of Americans are experiencing what they argue is a form of discrimination. And as more people get their genomes sequenced—and researchers learn to glean even more information from the results—a growing number of people may find themselves similarly targeted.

When scientists were mapping the immense complexity of the human genome around the turn of the 21st century, many thought that most diseases would eventually be traced to individual genes. Consequently, researchers worried that people might, for example, get fired because of their genetics; around the same time, a federal research lab was sued by its employees for conducting genetic tests for sickle-cell disease on prospective hires without their explicit consent. In 2008, the Genetic Information Nondiscrimination Act (GINA) was signed into law, ensuring that employers couldn’t decide to hire or fire you, and health insurers couldn’t decide whether to issue a policy, based on DNA. But lawmakers carved out a host of exceptions. Insurers offering life, long-term-care, or disability insurance could take DNA into account. Too many high-risk people in an insurance pool, they argued, could raise prices for everyone. Those exceptions are why an insurer was able to deny Bill a long-term-care policy.

[Read: The loopholes in the law prohibiting genetic discrimination]

Cases like Bill’s are exactly what critics of the consumer-genetic-testing industry feared when millions of people began spitting into test tubes. These cases have never been tallied up or well documented. But I found plenty of examples by canvassing disease-advocacy organizations and social-media communities for ALS, breast cancer, and Huntington’s disease. Lisa Schlager, the vice president of public policy at the hereditary-cancer advocacy group FORCE, told me she is collecting accounts of discrimination in life, long-term-care, and disability insurance to assess the extent of the problem; so far, she has about 40. A man Schlager connected me with, whose genetic condition, Lynch syndrome, increases the risk for several cancers, had his life-insurance premium increased and coverage decreased; several other providers denied him a policy altogether. Kelly Kashmer, a 42-year-old South Carolina resident, told me she was denied life insurance in 2013 after learning that she had a harmful version of the BRCA2 gene. One woman I found via Reddit told me she had never tested her own DNA, but showed me documents that demonstrate she was still denied policies—because, she said, her mom had a concerning gene. (Some of the people I spoke with, like Bill, requested not to be identified in order to protect their medical privacy.)

Studies have shown that people seek out additional insurance when they have increased genetic odds of becoming ill or dying. “Life insurers carefully evaluate each applicant’s health, determining premiums and coverage based on life expectancy,” Jan Graeber, a senior health actuary for the American Council of Life Insurers, said in a statement. “This process ensures fairness for both current and future policyholders while supporting the company’s long-term financial stability.” But it also means people might avoid seeking out potentially lifesaving health information. Research has consistently found that concerns about discrimination are one of the most cited reasons that people avoid taking DNA tests.

For some genetically linked diseases, such as ALS and Huntington’s disease, knowing you have a harmful mutation does not enable you to prevent the potential onset of disease. Sometimes, though, knowing about a mutation can decrease odds of severe illness or death. BRCA mutations, for example, give someone as much as an 85 percent chance of developing breast cancer, but evidence shows that testing women for the mutations has helped reduce the rate of cancer deaths by encouraging screenings and prophylactic surgeries that could catch or prevent disease. Kashmer told me that her first screening after she discovered her BRCA2 mutation revealed that she already had breast cancer; had she not sought a genetic test, she may have gotten a policy, but would have been a much worse bet for the insurer. She’s now been cancer-free for 11 years, but she said she hasn’t bothered to apply for a policy again.

[Read: Remember that DNA you gave 23andMe?]

Even employers, which must adhere to GINA, might soon be able to hire or fire based on certain genetic risk factors. Laura Hercher, a genetic counselor and director of research at the Sarah Lawrence College Human Genetics Program, told me that some researchers are now arguing that having two copies of the APOE4 mutation, which gives people about a 60 percent chance of developing Alzheimer’s, is equivalent to a Stage Zero of the disease. If having a gene is considered equivalent to a diagnosis, do GINA’s protections still apply? The Affordable Care Act prevents health insurers from discriminating based on preexisting conditions, but not employers and other types of insurers. (The ACA may change dramatically under the coming Trump presidency anyway.) And the Americans With Disabilities Act might not apply to the gray area between what might be viewed as an early manifestation of a disease and the stage when it’s considered a disability. FORCE and other advocacy groups—including the ALS Association and the Michael J. Fox Foundation—as well as members of the National Society of Genetic Counselors, are working in a few states to pass laws that close gaps left by GINA, as Florida did in 2020, but so far they have been mostly unsuccessful.

Genetic testing has only just become common enough in the U.S. that insurers might bother asking about it, Hercher said. Recently, groups like Schlager’s have been hearing more and more anecdotes. “People are so worried about genetic discrimination that they are failing to sign up for research studies or declining medically recommended care because of the concerns of what could happen to their insurance,” Anya Prince, a professor at the University of Iowa College of Law, told me. Carolyn Applegate, a genetic counselor in Maryland, told me that when patients come to her worried about a hereditary disease, she typically advises them to line up all the extra coverage they might need first—then hand over their DNA to a lab.

So far, these unintended consequences of genetic testing seem to be manifesting for people with risk for rare diseases linked to single genes, which, combined, affect about 6 percent of the global population, according to one estimate. But the leading killers—heart disease, diabetes, and the like—are influenced by a yet unknown number of genes, along with lifestyle and environmental factors, such as diet, stress, and air quality. Researchers have tried to make sense of this complex interplay of genes through polygenic risk scores, which use statistical modeling to predict that someone has, say, a slightly elevated chance of developing Alzeheimer’s. Many experts think these scores have limited predictive power, but “in the future, genetic tests will be even more predictive and even more helpful and even more out there,” Prince said. Already, if you look deep enough, almost everyone’s genome registers some risk.

[Read: What happens when you’re convinced you have bad genes]

In aggregate, such information can be valuable to companies, Nicholas Papageorge, a professor of economics at Johns Hopkins University, told me. Insurers want to sell policies at as high a price as possible while also reducing their exposure; knowing even a little bit more about someone’s odds of one day developing a debilitating or deadly disease might help one company win out over the competition. As long as the predictions embedded in polygenic risk scores come true at least a small percentage of the time, they could help insurers make more targeted decisions about who to cover and what to charge them. As we learn more about what genes mean for everyone’s health, insurance companies could use that information to dictate coverage for ever more people.

Bill still doesn’t know whether he will ever develop ALS. The average age of onset is 40 to 60, but many people don’t show symptoms until well into their 70s. Without long-term-care insurance, Bill might not be able to afford full-time nursing care if he someday needs it. People who do develop ALS become unable to walk or talk or chew as the disease progresses. “Moving people to the bathroom, changing the sheets, changing the bedpans,” Bill said—“I dread the thought of burdening my wife with all of those things.”

Cases like Bill’s could soon become more common. Because scientists’ understanding of the human genome is still evolving, no one can predict all of the potential consequences of decoding it. As more information is mined from the genome, interest in its secrets is sure to grow beyond risk-averse insurers. If consumer-facing DNA-testing companies such as 23andMe change their long-standing privacy policies, go bankrupt, or are sold to unscrupulous buyers, more companies could have access to individuals’ genetic risk profiles too. (23andMe told me that it does not share customer data with insurance companies and its CEO has said she is not currently open to third-party acquisition offers.) Papageorge told me he could imagine, say, scammers targeting people at risk for Alzheimer’s, just as they often target older people who may fall for a ploy out of confusion. All of us have glitches somewhere in our genome—the question is who will take advantage of that information.

The reelection of Donald Trump might seem like doomsday for America’s public-health agencies. The president-elect has vowed to dismantle the federal bureaucracy.Robert F. Kennedy Jr., potentially his next health czar, wants to go even further. As part of his effort to “Make America healthy again,” Kennedy has recently promised to tear up the FDA and its regulations, including those governing vaccines and raw milk. But that effort is going to run into a major roadblock: the “deep state.”

The phrase deep state might trigger images of tinfoil hats. After all, Trump has spent much of the past eight years falsely claiming that Democratic bureaucrats are unfairly persecuting him. But operating within the federal health agencies is an actual deep state, albeit a much more benign and rational one than what Trump has talked about. And he might not be able to easily tear it down.

Whether you know it or not, you’ve likely seen this deep state in action. It was the reason Trump’s preferred treatment for COVID during the early phases of the pandemic, hydroxychloroquine, was not flooding pharmacies. And it was why COVID vaccines were not rushed out before the 2020 presidential election. Both of those efforts were stopped by civil servants, despite overt pressure from Trump and officials in his administration.

Public-health officials didn’t buck Trump to sabotage him. They did so because both measures were scientifically unsolid. Vaccines weren’t authorized before the election because FDA officials knew that they had to wait at least two months after the clinical trials were completed to make sure the vaccines didn’t cause dangerous side effects. And the FDA blocked use of hydroxychloroquine for treating COVID because of the drug’s unproven efficacy and spotty safety record.

If they really wanted to, health officials could have caved to Trump’s requests. But in general, they don’t easily renounce their empirically grounded views on science—regardless of who is president. The FDA’s top vaccine regulator vowed to resign in 2020 if the agency relented to Trump’s pressure to approve vaccines early. Two other vaccine regulators resigned in the first year of the Biden administration after the FDA announced the rollout of COVID boosters. Following their resignations, the ex-officials publicly argued that “the data simply does not show that every healthy adult should get a booster,” and that public-health efforts should have been entirely focused on “vaccinating the unvaccinated, wherever they live.”

Many scientists, lawyers, and doctors are involved in each and every decision that federal-health agencies make, because the decisions must be evidence-based. Arbitrary decisions based on conspiracy theories or political whims can, and will, be challenged in court. “A new administration absolutely can come in and set new policies,” Lowell Schiller, who led the FDA’s office of policy during part of Trump’s first term, told me. But, he added, “there is a lot of law that they need to follow, and things have to be done through proper process.”

Some changes that may seem relatively insignificant require reams of paperwork. When the FDA wanted to revoke the standardized federal definition of frozen cherry pie (yes, one existed until earlier this year), it had to go through a formal procedure that forced the agency to defend its legal authority to make the move as well as the costs and benefits of a more laissez-faire cherry-pie policy. The process took more than three years. Few things are harder than approving or revoking approval for a drug: In 2020, the FDA tried to pull an unproven drug meant to prevent preterm births. Despite lots of evidence that the drug was ineffective, the process took nearly three years. Now imagine how things would go if RFK Jr. pressured the FDA to pull a vaccine off the market because he is convinced, incorrectly, that it causes autism.

A Trump administration could do a few things more easily. It could, for example, direct the FDA to stop enforcing the agency’s restrictions on some of the products that Kennedy touts, such as raw milk and certain vitamins. The FDA often declines to go after various products in the name of “enforcement discretion.” A downturn in enforcement actions might anger some within the agency, but Trump could bring that about with little red tape.

Kennedy has promised mass firings at the FDA, presumably to install loyalists who would enact the agenda. That threat should be taken seriously. The president has sweeping power to hinder officials who muck up his agenda. The Trump administration allegedly demoted one top federal official who pushed back against authorizing hydroxychloroquine.

But there are major checks, too, on what a president can do to turn the screws on civil servants. Unlike many workers, federal employees can be fired only for cause or misconduct, and civil servants are entitled to appeals in both cases. “It’s a tangled process that makes it hard to be able to get rid of people,” Donald Kettl, an emeritus public-policy professor at the University of Maryland, told me. Trump was famous for firing people during his first term, but the people who got the axe were political appointees who did not have the same protections as civil servants. In short, few federal employees last just one Scaramucci.

However, one major threat still looms over federal workers. In his first term, Trump pursued an effort to reclassify federal workers in a way that would strip many of them of their protections, and he has said that in his second term he will “immediately” pursue that action. Trump would have to go through an arduous process to make good on that threat, and it would likely be challenged in court. But if implemented, the policy could give Trump massive leverage to fire workers.

Still, Trump takes those actions at the peril of his own agenda. The reality is that the same members of the so-called deep state that Trump and Kennedy are threatening to fire are also essential to making anything the administration wants to do happen. Seminal parts of the “Make America healthy again” agenda would have to run through this deep state. If Kennedy, a champion of psychedelics, wants the FDA to approve a new psilocybin-based treatment, the medicine must be reviewed by the scientists and doctors who review other drugs for safety and efficacy. If he wants a national ban on fluoride in water, that must go through the EPA. There is no way around this: Even if Trump appointed Kennedy as the unilateral king of every single federal health agency, Kennedy cannot make these decisions on his own.

A central tenet of the “Make America healthy again” agenda is removing potentially dangerous chemicals from food. Although the FDA has been slow to ban certain chemical additives, the agency seems to have recently seen the light. Earlier this year it set up a new initiative for reassessing the safety of these substances. But if Kennedy guts the FDA, no one might be there to do that review.

The Trump administration could hypothetically hold a massive job fair to get cronies into all of those roles—especially if the president-elect makes good on his promise to make hiring and firing bureaucrats easier—but few people can successfully perform these highly technical jobs, not to mention that hiring in the federal government typically takes forever. (The average hiring time in 2023 was 101 days.)

Still, Trump’s second term will be one of the biggest challenges facing our federal health system. No president in modern history has been so intent on bending health agencies to his will, and he seems even more emboldened to do so now than in his first go-around. Trump will likely have some successes—some people may be fired, and some important policies may be scrapped. America is about to find out just how resilient the deep state really is.

For nearly two years, the world’s biggest tech companies have said that AI will transform the web, your life, and the world. But first, they are remaking the humble search engine.

Chatbots and search, in theory, are a perfect match. A standard Google search interprets a query and pulls up relevant results; tech companies have spent tens or hundreds of millions of dollars engineering chatbots that interpret human inputs, synthesize information, and provide fluent, useful responses. No more keyword refining or scouring Wikipedia—ChatGPT will do it all. Search is an appealing target, too: Shaping how people navigate the internet is tantamount to shaping the internet itself.

Months of prophesying about generative AI have now culminated, almost all at once, in what may be the clearest glimpse yet into the internet’s future. After a series of limited releases and product demos, mired with various setbacks and embarrassing errors, tech companies are debuting AI-powered search engines as fully realized, all-inclusive products. Last Monday, Google announced that it would launch its AI Overviews in more than 100 new countries; that feature will now reach more than 1 billion users a month. Days later, OpenAI announced a new search function in ChatGPT, available to paid users for now and soon opening to the public. The same afternoon, the AI-search start-up Perplexity shared instructions for making its “answer engine” the default search tool in your web browser.

[Read: The AI search war has begun]

For the past week, I have been using these products in a variety of ways: to research articles, follow the election, and run everyday search queries. In turn I have scried, as best I can, into the future of how billions of people will access, relate to, and synthesize information. What I’ve learned is that these products are at once unexpectedly convenient, frustrating, and weird. These tools’ current iterations surprised and, at times, impressed me, yet even when they work perfectly, I’m not convinced that AI search is a wise endeavor.

For decades, the search bar has been a known entity. People around the world are accustomed to it; several generations implicitly regard Google as the first and best way to learn about basically anything. Enter a query, sift through a list of links, type a follow-up query, get more links, and so on until your question is answered or inquiry satisfied. That indirectness and wide aperture—all that clicking and scrolling—are in some ways the defining qualities of a traditional Google search, allowing (even forcing) you to traverse the depth and breadth of connections that justify the term world-wide web. The hyperlink, in this sense, is the building block of the modern internet.

That sprawl is lovely when you are going down a rabbit hole about Lucrezia de Medici, as I did when traveling in Florence last year, or when diving deep into a scientific dilemma. It is perfect for stumbling across delightful video clips and magazine features and social-media posts. And it is infuriating when you just need a simple biographical answer, or a brunch recommendation without the backstory of three different chefs, or a quick gloss of a complex research area without having to wade through obscure papers.

In recent years, more and more Google Search users have noted that the frustrations outweigh the delight—describing a growing number of paid advertisements, speciously relevant links engineered to top the search algorithm, and erroneous results. Generative AI promises to address those moments of frustration by providing a very different experience. Asking ChatGPT to search the web for the reasons Kamala Harris lost the presidential election yielded a short list with four factors: “economic concerns,” “demographic shifts,” “swing state dynamics,” and “campaign strategies.” It was an easy and digestible response, but not a particularly insightful one; in response to a follow-up question about voter demographics, ChatGPT provided a stream of statistics without context or analysis. A similar Google search, meanwhile, pulls up a wide range of news analyses that you have to read through. If you do follow Google’s links, you will develop a much deeper understanding of the American economy and politics.

Another example: Recently, I’ve been reading about a controversial proposed infrastructure project in Maryland. Google searches sent me through a labyrinth of public documents, corporate pitches, and hours-long recordings of city-council meetings, which took ages to review but sparked curiosity and left me deeply informed. ChatGPT, when asked, whipped up an accurate summary and timeline of events, and cited its sources—which was an extremely useful way to organize the reading I’d already done, but on its own might have been the end of my explorations.

I have long been a critic of AI-powered search. The technology has repeatedly fabricated information and struggled to accurately attribute its sources. Its creators have been accused of plagiarizing and violating the intellectual-property rights of major news organizations. None of these concerns has been fully allayed: The new ChatGPT search function, in my own use and other reports, has made some errors, mixing up dates, misreporting sports scores, and telling me that Brooklyn’s Prospect Park is bigger than Manhattan’s (much larger) Central Park. The links offered by traditional search engines are filled with errors too—but searchbots implicitly ask for your trust without verification. The citations don’t particularly invite you to click on them. And while OpenAI and Perplexity have entered into partnerships with any number of media organizations, including The Atlantic—perhaps competing for the high-quality, human-made content that their searchbots depend on—exactly how websites that once relied on ad revenue and subscriptions will fare on an AI-filtered web eludes me. (The editorial division of The Atlantic operates independently from the business division, which announced its corporate partnership with OpenAI in May.)

[Read: AI search is turning into the problem everyone worried about]

Although ChatGPT and Perplexity and Google AI Overviews cite their sources with (small) footnotes or bars to click on, not clicking on those links is the entire point. OpenAI, in its announcement of its new search feature, wrote that “getting useful answers on the web can take a lot of effort. It often requires multiple searches and digging through links to find quality sources and the right information for you. Now, chat can get you to a better answer.” Google’s pitch is that its AI “will do the Googling for you.” Perplexity’s chief business officer told me this summer that “people don’t come to Perplexity to consume journalism,” and that the AI tool will provide less traffic than traditional search. For curious users, Perplexity suggests follow-up questions so that, instead of opening a footnote, you keep reading in Perplexity.

The change will be the equivalent of going from navigating a library with the Dewey decimal system, and thus encountering related books on adjacent shelves, to requesting books for pickup through a digital catalog. It could completely reorient our relationship to knowledge, prioritizing rapid, detailed, abridged answers over a deep understanding and the consideration of varied sources and viewpoints. Much of what’s beautiful about searching the internet is jumping into ridiculous Reddit debates and developing unforeseen obsessions on the way to mastering a topic you’d first heard of six hours ago, via a different search; falling into clutter and treasure, all the time, without ever intending to. AI search may close off these avenues to not only discovery but its impetus, curiosity.

The issues with factuality and attribution may well be resolved—but even if they aren’t, tech companies show no signs of relenting. Controlling search means controlling how most people access every other digital thing—it’s an incredible platform to gain trust and visibility, advertise, or influence public opinion.

The internet is changing, and nobody outside these corporations has any say in it. And the biggest, most useful, and most frightening change may come from AI search engines working flawlessly. With AI, the goal is to keep you in one tech company’s ecosystem—to keep you using the AI interface, and getting the information that the AI deems relevant and necessary. The best searches are goal-oriented; the best responses are brief. Which perhaps shouldn’t be surprising coming from Silicon Valley behemoths that care, above all, about optimizing their businesses, products, and users’ lives.

A little, or even a lot, of inefficiency in search has long been the norm; AI will snuff it out. Our lives will be more convenient and streamlined, but perhaps a bit less wonderful and wonder-filled, a bit less illuminated. A process once geared toward exploration will shift to extraction. Less meandering, more hunting. No more unknown unknowns. If these companies really have their way, no more hyperlinks—and thus, no actual web.

The morning after the election, a second result emerged beside the blindingly obvious one that Donald Trump will once again be president of the United States: In some places, abortion rights remained a winning issue.

Ballot measures to expand abortion access passed in seven states, including Missouri, Arizona, and Montana, three places that Trump won. Previous polling and election outcomes had shown that most Americans support abortion rights. Less clear was how they’d behave with Trump on the ballot. The issue of abortion may have shed its partisan salience—just not in a way that helped Kamala Harris and other Democrats. Abortion access “is becoming less partisan, ironically, in the sense that Republicans and independents are more likely to support abortion rights,” Mary Ziegler, a law professor at UC Davis and an Atlantic contributor, told me, “while not translating that into support for Democratic candidates.”

For Democrats and abortion-rights activists, last night’s referendums were glittering pinpricks of light in an otherwise long, dark night of defeats. The White House—gone; control of the Senate—gone; the House of Representatives—clearly leaning Republican. Missouri, which went for Trump by 18 percent and had one of the strictest abortion bans in America, voted 52 to 48 percent to establish a constitutional guarantee to the “fundamental right to reproductive freedom.” Similar measures passed in Arizona and Montana, by 23 and 15 points so far, respectively. Four other states—Nevada, Maryland, New York, and Colorado—passed their own abortion measures, though these were less politically revealing, given the existing abortion-rights protections there.

Not all the news was rosy for abortion-rights activists. Ballot measures failed in Nebraska by 2.6 points and in South Dakota by 17. Different reasons might account for those losses, Ziegler said. Nebraska had two abortion referendums on the ballot, each proposing contrary changes to state law, which could easily have confused voters. In Florida, a large majority of voters did support an effort to overturn the state’s six-week abortion ban—but it fell a few points short of the 60 percent needed to pass.

Those three state results were the biggest wins the anti-abortion movement has achieved since the Supreme Court’s Dobbs decision overturned Roe v. Wade in 2022. Expect to hear this example touted more widely, Ziegler said. “Activists will take that to Republicans and say, ‘Hey, you don’t need to be afraid of being pro-life. You can take aggressive positions,’” she told me. “This should be a huge encouragement to the pro-life movement,” the conservative political commentator Matt Walsh wrote on X yesterday afternoon. “We have a lot of work to do. But the people are on our side.”

That would be an overstatement, based on last night’s results. Harris had worked to make abortion rights a strong campaign issue—though not enough, evidently, to carry her party to victory. But abortion-rights groups achieved victories in spite of the Democrats’ failed presidential efforts. Several factors are involved: Abortion access is popular. And Trump, through his chaotic and confusing abortion tightrope walk, may have successfully neutralized the issue for now, for his voters: assuring enough pro-choice voters that he would protect their reproductive rights, while hanging on to pro-life base voters who want him to further restrict abortion access. “Trump created this possibility of being all things to all people,” Ziegler told me.

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But when you’re president, you have to pick. A near future in which Trump continues to downplay any talk of restricting abortion and focuses instead on issues that do not divide his voter coalition, such as immigration, is easy to imagine. “And then there’s a scenario where he doesn’t, and the partisan divide springs back as ever,” Ziegler said. If that happens, then what the anti-abortion movement will be demanding from a second Trump administration is immediate executive action to restrict abortion. That could mean appointments of committed anti-abortion officials to important Cabinet positions—former Texas solicitor general Jonathan Mitchell for attorney general, say, or Heritage Foundation adviser Roger Severino as the head of the Department of Health and Human Services. It could also involve a reinterpretation of the Comstock Act, which could see abortion banned across the country de facto, without any congressional legislative action at all.

The anti-abortion movement may not be successful in these maneuvers. Little suggests, right now, that Trump is interested in cementing his legacy as the most pro-life president in history. But the one thing Americans can almost certainly count on is a slew of new anti-abortion judges appointed to the federal courts. Conservative groups are already floating favored names—such as the Fifth Circuit’s James Ho and Kristen Waggoner, the chief executive of the pro-life group Alliance Defending Freedom—for the Supreme Court. With a Republican Senate, these could be easy appointments. “That may be how Trump has his cake and eats it too,” Ziegler said. “Put conservatives on the courts, and their decisions may not happen until years after he’s no longer in office.”

After last night, abortion-rights activists can take a measure of comfort in the confirmation that their position is still popular. But cutting against that is the fact that abortion rights are no cure-all for Democrats—especially when the leader of the Republican Party has apparently managed to detoxify the issue.

Photographs by Ross Mantle

Maybe the tell was when the mayor of Philadelphia didn’t say Kamala Harris’s name. Cherelle Parker looked out at her fellow Democrats inside a private club just northeast of Center City last night. Onstage, she beamed with pride about how, despite Donald Trump’s fraudulent claims on social media, Election Day had unfolded freely and fairly across her city. But Parker did not—could not—telegraph victory for her party. “You’ve heard us say from the very beginning that we knew that the path to the White House had to come through our keystone state. And to get through the keystone state, you had to contend with our city of Philadelphia. And I want to thank each and every Philadelphian who participated in democracy in action,” she said. Her remarks were bland, vague, safe. Soon, the mayor slipped out of the venue.

The watch party trudged along. Four ceiling fans blew hot air. Stacks of grease-stained Del Rossi’s pizza boxes filled a rear table. Anxious Philadelphians sipped $5 bottles of Yuengling from the cash bar. But no single word or phrase could encompass the swirl of emotion: anticipation, dread, denial, despair. Across two floors of what might technically be considered “partying,” attendees peered up at projection screens that showed MSNBC’s Steve Kornacki pacing and pointing. His big map was glowing red. The revelers were blue.

Early on, many partygoers were still clinging to fleeting moments of zen. Around 9 p.m., after Rachel Maddow declared Michigan “too early to call,” the venue erupted in earnest applause. The hooting grew even louder when, shortly thereafter, Maddow announced that Pennsylvania, the place that most of these voters called home, was also in toss-up territory. But by 9:30, when Kornacki showed Trump comfortably up in Waukesha County, Wisconsin, enough people could grasp that the “Blue Wall” of Michigan, Wisconsin, and Pennsylvania—which Harris had been counting on to win the White House—was now crumbling, brick by brick, county by county.

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I saw genuine fear in people’s eyes when, just after 9:50, zooming in on the Pennsylvania map, Kornacki mentioned Trump and Lackawanna County. A union leader named Sam Williamson told me about all the door-knocking he’d done. He had been “really confident” Harris would win Pennsylvania. But by 10:30 or so, even the formerly blue Centre County, where Penn State University is located, had flipped red. Was this actually happening? Hardly anyone even murmured when Kornacki spoke of Harris’s success right there in Philadelphia. People were pissed. Demoralized. Many began to filter out. Democrats had spent this twisty, complex presidential campaign with a narrow path to victory, and now that path was narrowing to a close.

People gather for an election night watch party at the Ruba Club in Philadelphia, PA (Ross Mantle for The Atlantic)

Each voter I spoke with processed the night a little differently. A 38-year-old nurse named Abena Bempah conceded, somewhat sheepishly, that she had tuned out this election until late June, when President Joe Biden had his disastrous debate against former (and future) President Donald Trump. After that night, Bempah had an awakening: “It actually reminded me that I need to be an engaged citizen throughout a candidate’s entire term.” So she spent the summer and fall volunteering with the Philadelphia Democrats. She told me that to preserve democracy, people need to do so much more than vote—they need to voice their concerns to elected officials. “I think that Republicans are planning on Democrats to rest on our laurels and not be as active,” she said.

Near a billiards table, I met a father and son, Shamai and Liv Leibowitz, who live in Silver Spring, Maryland, and had driven up to Pennsylvania to volunteer. Liv, who is 21, is taking a year off from school, and had recently been canvassing in nearby Bucks County and Chester County. He wore a baseball hat with Representative Jamie Raskin’s name on the dome. “I was here for the past two weeks,” he told me with a smile. Half of the undecided voters he’d met felt that they didn’t know enough about Harris and her positions. But many, he said, were staying home because of her support of Israel.

Liv’s father, Shamai, told me that he had the gut feeling that Trump would win. Shamai had grown up in Israel, and he moved to the United States in the early 2000s. He believed that Harris was doomed in this election because she wouldn’t substantively deviate from Biden’s Middle East policy. “I’m worried right now because she didn’t come out forcefully for a weapons embargo, or even hint at a weapons embargo. We met people canvassing who told us, ‘We’re voting Green Party’; ‘We’re staying home,’” he said. Shamai knew it would have been politically risky for her to criticize Israel, but, he told me, in the end, not changing course was hurting her more.

Philadelphia, PA (Ross Mantle for The Atlantic)

I also spoke with two people who might be considered interlopers. One was a 27-year-old Swede named Gabriel Gunnarsson, who had flown to Philadelphia from his home in Stockholm just to witness the U.S. election with his own eyes. As he nursed a beer, he told me that everyone he knew in Sweden had been following our election particularly closely this year. “I’m feeling bad,” he told me. “I’m sort of dystopic about the future, I think, and just seeing this, it’s a horrible result for the world.” I asked him if he recalled one of Trump’s more vile comments from his first term in office: He’d said that America was bringing in people only from “shithole countries,” and he’d lamented that we don’t have more immigrants from places like Norway. Gunnarsson laughed and shook his head. “He did this when he was president as well: He just randomly said, ‘Look at what’s happening in Sweden!’” Gunnarsson recalled. “And we were all like, ‘What did happen?’”

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Finally, as the evening was winding down, I met a man named Tim Brogan, who very quietly told me he was an independent, not a Democrat. Would you care to share whom you voted for today? I asked. Brogan looked down at his feet, then off to the corner, then back at me. “I voted for the other party,” he said. “I did in fact vote for Trump, yes.”

He had come out to this particular event because he lives in the neighborhood and wanted to be around some friends. He told me he works in real estate, and as a lifelong Philadelphian, he was distressed to see inflation and more crime in the city. This was, in fact, Brogan’s third consecutive time voting for Trump, even though he had previously voted for Barack Obama. He earnestly believed that Trump was the only person who could set America back on the right path. “There’s just so many things that we missed—and we’re allowing—with the Democratic Party,” he said. “I think my choice was a good direction for my beliefs.”

I asked him how he talks about politics with his friends, family, and neighbors.

“Simple,” he said. “We don’t like to get into it.”

Photographs by OK McCausland

The vibe shifted sometime around 10:30 p.m. eastern.

For several hours beforehand, the scene at the Howard University Yard had been jubilant: all glitter and sequins and billowing American flags. The earrings were big, and the risers were full. Men in fraternity jackets and women in pink tweed suits grooved to a bass-forward playlist of hip-hop and classic rock. The Howard gospel choir in brilliant-blue robes performed a gorgeous rendition of “Oh Happy Day,” and people sang along in a way that made you feel as if the university’s alumna of the hour, Kamala Harris, had already won.

But Harris had not won—a fact that, by 10:30, had become very noticeable. As the evening drew on, the clusters of giddy sorority sisters and VIP alumni stopped dancing, their focus trained on the projector screens, which were delivering a steady flow of at best mediocre and sometimes dire news for Democrats. No encouragement had yet come from those all-important blue-wall states, Pennsylvania, Michigan, and Wisconsin. Somewhere between Georgia turning red and Senator Ted Cruz demolishing Colin Allred in Texas, attendees started trickling out the back.

It was starting to feel pretty obvious, even then, that Donald Trump would be declared the winner of the 2024 presidential election. And soon after 5:30 a.m. eastern this morning, he was, when the Associated Press called Wisconsin for him, giving him an Electoral College majority even with a number of states yet to declare. An across-the-board rightward shift, from Michigan to Manhattan, had gradually crushed the hopes of Democrats in an election that, for weeks, polling had indicated was virtually tied. But a Trump victory was a reality that nearly everyone at Harris’s watch party seemed to have prepared for only theoretically.

Before last night, Democrats felt buoyant on a closing shot of hopium. While Harris stayed on message, Trump had what seemed a disastrous final week: His closing argument was incoherent; his rally at Madison Square Garden was a parade of racism; he stumbled getting into a garbage truck and looked particularly orange in photos. Democratic insiders crowed that early-vote totals were favoring Harris, and that undecided voters in swing states were coming around. Then there was Ann Selzer’s well-respected poll in Iowa, which suggested that the state might go blue for the first time since Barack Obama’s presidency.

(OK McCausland for The Atlantic)

On a breezy and unseasonably warm evening in Washington, D.C., thousands of people had gathered on the grassy campus at Harris’s alma mater to watch, they hoped, history being made. No one mentioned Trump when I asked them how they were feeling—only how excited they were to have voted for someone like Harris. Kerry-Ann Hamilton and Meka Simmons, both members of the Delta Sigma Theta sorority, had come together to witness the country elect the first Black woman president. “She is so well qualified—” Hamilton started to say. “Overqualified!” Simmons interjected.

Leah Johnson, who works at Howard and grew up in Washington, told me that she would probably leave the event early to watch returns with her mother and 12-year-old daughter at home. “It’s an intergenerational celebratory affair,” she said. “I get to say, ‘Look, Mom, we already have Barack Obama; look what we’re doing now!’”

Everyone I spoke with used similar words and phrases: lots of firsts and historics and references to the glass ceiling, which proved so stubbornly uncrackable in 2016. Attendees cheered in unison at the news that Harris had taken Colorado, and booed at Trump winning Mississippi. A group of women in tight dresses danced to “1, 2 Step” by Ciara and Missy Elliott. Howard’s president led alumni in the crowd in a call-and-response that made the whole evening feel a little like a football game—just fun, low stakes.

Several people I talked with refused to entertain the idea that Harris wouldn’t win. “I won’t even let myself think about that,” a woman named Sharonda, who declined to share her last name, told me. She sat with her sorority sisters in their matching pink-and-green sweatshirts. Soon, though, the crowd began to grow restless. “It was nice when they turned off the TV and played Kendrick,” said one attendee who worked at the White House and didn’t want to share her name. “Just being part of this is restoring my soul, even if the outcome isn’t what I want it to be,” Christine Slaughter, a political-science professor at Boston University, told me. She was cautious. She remembered, viscerally she said, the moment when Trump won in 2016; and the memory was easy to conjure again now. “I know that feeling,” she said. She was consoling herself: She’d been crushed before. She could handle it again.

Harris herself was expected to speak at about 11 p.m., but by midnight, she still hadn’t appeared. People bit their cheeks and scrolled on their phones. There was a burst of gleeful whoops when Angela Alsobrooks beat Larry Hogan in Maryland’s U.S. Senate election. But soon the trickle of exiting attendees became a steady flow. Potentially decisive results from Pennsylvania and Wisconsin were not due soon, but Michigan didn’t look good. North Carolina was about to be called for Trump.

I texted some of my usual Democratic sources and received mostly radio silence in response. “How do you feel?” I asked one, who had been at the party earlier. “Left,” she answered. Mike Murphy, a Republican anti-Trump consultant, texted me back at about 12:30 a.m: “Shoot me.”

Donors and VIPs were streaming out the side entrance. The comedian Billy Eichner walked by, looking sad, as the Sugarhill Gang’s “Apache (Jump On It)” played over the loudspeakers. A man pulled me aside: “There will be no speech, I take it?” he said. It was more of a comment than a question.

(OK McCausland for The Atlantic)

“I’m depressed, disappointed,” said Mark Long, a software salesman from D.C., who wore a T-shirt with a picture of Harris as a child. He was especially upset about the shift toward Trump among Black men. “I’m sad. Not just for tonight, but for what this represents.” Elicia Spearman seemed angry as she marched out of the venue. “If it’s Trump, people will reap what they sow,” she said. “It’s karma.”

Just before 1 a.m., the Harris campaign co-chair Cedric Richmond came onstage to announce that the candidate would not be speaking that night. The former Louisiana representative offered muted encouragement to the crowd—an unofficial send-off. “Thank you for being here. Thank you for believing in the promise of America,” he said, before adding, “Go, Kamala Harris!” The remaining members of the crowd cheered weakly. Some of the stadium lights went off.

Lupus, doctors like to say, affects no two patients the same. The disease causes the immune system to go rogue in a way that can strike virtually any organ in the body, but when and where is maddeningly elusive. One patient might have lesions on the face, likened to wolf bites by the 13th-century physician who gave lupus its name. Another patient might have kidney failure. Another, fluid around the lungs. What doctors can say to every patient, though, is that they will have lupus for the rest of their life. The origins of autoimmune diseases like it are often mysterious, and an immune system that sees the body it inhabits as an enemy will never completely relax. Lupus cannot be cured. No autoimmune disease can be cured.

Two years ago, however, a study came out of Germany that rocked all of these assumptions. Five patients with uncontrolled lupus went into complete remission after undergoing a repurposed cancer treatment called CAR-T-cell therapy, which largely wiped out their rogue immune cells. The first treated patient has had no symptoms for almost four years now. “We never dared to think about the cure for our disease,” says Anca Askanase, a rheumatologist at Columbia University’s medical center who specializes in lupus. But these stunning results—remission in every patient—have fueled a new wave of optimism. More than 40 people with lupus worldwide have now undergone CAR-T-cell therapy, and most have gone into drug-free remission. It is too early to declare any of these patients cured for life, but that now seems within the realm of possibility.

Beyond lupus, doctors hope CAR-T portends a bigger breakthrough against autoimmune diseases, whose prevalence has been on a troubling rise. CAR-T has already been used experimentally to treat patients with other autoimmune diseases, including multiple sclerosis, myositis, and myasthenia gravis. And the success of CAR-T has inspired researchers to borrow other—cheaper and simpler—strategies from cancer therapy to kill immune cells gone awry. Not all of these ideas will pan out, but if any do, the next few years could bring an inflection point in treating some of the most frustrating and intractable diseases of our modern era.

CAR-T-cell therapy was originally developed as a way to kill malignant cells in blood cancer. It could, scientists later reasoned, also be used to kill specific white blood cells, called B cells, that go haywire with certain autoimmune diseases. One group tried a CAR-T-like therapy against an autoimmune disease called pemphigus vulgaris, and another CAR-T against lupus. It worked—but these experiments were only in mice.

This was the sum total of available scientific evidence when a 20-year-old woman came to her doctors in Erlangen, Germany, asking to try anything for her severe and uncontrolled lupus. None of the long-term medications typically used to manage lupus were working. Her kidneys, heart, and lungs were all failing, and she could walk only 30 feet by herself. CAR-T was risky, her doctor agreed, but lupus was killing her.

CAR-T-cell therapy could essentially turn her immune system against itself. First, doctors extracted from her blood a class of immune cells, called T cells, which they then engineered into chimeric antigen receptor T (CAR-T) cells that could recognize and destroy the B cells driving her lupus. CAR-T cells can cause dangerous and overwhelming inflammatory responses in cancer patients, and her doctors did worry that CAR-T could do the same for someone with autoimmune disease, whose immune system is already in overdrive. “We take the T cells out, activate them like crazy, and then shoot those massively overactivated T cells in an activated autoimmune disease. So if you think about it, that's kind of crazy to do that, right?” says Fabian Müller, a hematologist-oncologist at the University Hospital of Erlangen and one of the doctors on the German team that pioneered the treatment. But fortunately, the woman with lupus did not have any serious side effects, nor did any of the other patients the German group has since dosed. They are all living their everyday lives, free of lupus symptoms and medications. The woman who could walk a mere 30 feet now runs five times a week, Müller told me. She’s gone back to school and is considering studying for a master’s in immunology.

Müller and his colleagues believe that CAR-T-cell therapy works by wiping out enough B cells to trigger a “deep reset” of the immune system. CAR-T cells are dogged little assassins; they are able to find and destroy even the B cells hiding deep in the body’s tissues. A patient’s B-cell count eventually recovers, but the new ones no longer erroneously attack the body itself. Cancer patients are sometimes considered “cured” after five years of remission, and the first lupus patient to receive CAR-T is not so far off from that milestone. But the therapy cannot erase the genetic predisposition many patients have for the disease, says Donald Thomas, a rheumatologist in Maryland. Whether remission is actually durable enough to be a “cure” will take time to find out.

Still, these extraordinary results have set off a gold rush among biotech companies eager to solve autoimmune diseases. CAR-T start-ups founded to treat cancer are pivoting to target autoimmune diseases. And large pharmaceutical companies such as Bristol Myers Squibb, AstraZeneca, and Novartis are developing their own therapies. Columbia’s Askanase is now an investigator on five separate trials, all using CAR-T or a similar cellular therapy, and she hears from more companies all the time. There’s so much interest, she told me, “I don’t even know there are enough patients” to test new treatments. About 1.5 million Americans have lupus, but only a minority of them—those sick enough to justify experimental treatment but not so sick that they’ve suffered too much irreversible organ damage—are eligible for trials.

For now, CAR-T for lupus and other autoimmune diseases is pretty much only accessible in the U.S. through clinical trials—which, in effect, means it’s inaccessible to almost all lupus patients. Jonathan Greer, a rheumatologist in Florida, works in a seven-doctor practice that treats hundreds of people with lupus; not a single one has received CAR-T. He doesn’t know of a single center in Florida that is up and running to do these studies, so interested patients would have to travel out of state.

Even if it becomes FDA approved for autoimmune diseases, CAR-T is a long and expensive process. Because each patient’s own cells are reengineered, it cannot be easily scaled up. The cost of CAR-T for cancer runs about $500,000. Patients also need chemotherapy to kill existing T cells to make room for CAR-T, which adds risk, and in lupus, they usually need to taper off any medications keeping their disease in check, which can cause flare-ups. All these complications make the current iteration of CAR-T suitable only for lupus patients with severe disease, who have run out of other options.

The practical limitations of CAR-T have dogged the cancer field for a long time now, and researchers have already come up with ideas to get around it. A number of simpler strategies for killing B cells are now making their way from blood cancer to autoimmune disease. They include using donor T cells, a different type of immune cell called natural killer cells, or a molecule that binds a T cell to the B cell it’s meant to destroy. Those molecules, called bispecific T-cell engagers, or BiTEs, are “cheap, fast, uncomplicated,” Müller said, but they may not penetrate as deeply into the tissues where B cells reside. Nevertheless, in September, The New England Journal of Medicine published two successful case reports describing successful treatment in a handful of autoimmune diseases, including lupus, with a BiTE called teclistamab. Similar BiTES on the market could be repurposed for autoimmune disease too.

These simpler therapies may ultimately be “good enough,” Askanase said. And their ease of use could ultimately beat out custom CAR-T therapy, which is unlikely to reach all of the millions of people with lupus worldwide. It’s simply too expensive and too cumbersome, a problem that has held back other cutting-edge therapies that were approved to much initial fanfare. Even if CAR-T itself is never widely adopted for autoimmune diseases, it has opened the door to new ideas that could one day revolutionize their treatment.

In the fall of 2022, pro-democracy protesters in cities across mainland China developed a clever tactic for speaking out against government forces that wished to silence them. They began holding up blank sheets of paper, as well as tacking up blank paper in public spaces, to register their disapproval of restrictive lockdown rules as well as their disapprobation of the government’s repressive censorship laws.

Observers from all over the world noted with admiration the courage and creativity of the protesters, who’d found a bold way to speak out while saying nothing at all. Chinese authorities cracked down on the dissenters, censoring online reporting about them and arresting or otherwise threatening those who have tried to remind people of the movement since then.

In America, a country consecrated to freedom, the dystopian scenes out of China seemed distant. Americans understand on a bone-deep level that, to paraphrase James Madison, absolute sovereignty belongs to the people, not the government. Americans are free to say what we believe, and free to share our ideas with our fellow citizens. We are free to criticize the government, which is accountable to the people, not the other way around. The First Amendment does not grant us these freedoms—they are an inviolable right. The First Amendment does, however, dictate that the government dare not interfere with these freedoms, that officials have no right to cut down the American people’s speech, including the people’s right to free press.

To be comfortable in these freedoms, to assume that we would never need to resort to holding up blank sheets of paper to criticize the powerful, is a luxury that Americans cannot presently afford.

The United States is on the eve of an election that could see the return to power of Donald Trump, an autocrat who vociferously and repeatedly threatens the basic freedoms of the American people—with a particular preoccupation with curbing freedom of speech and freedom of the press. Worse still, he has persuaded his followers to cheer on the demise of their own freedoms. When Trump tells people that journalists are “the enemy of the American people,” or “evil,” when he says that Americans who describe the criminal charges he faces should be investigated for treason, he is not merely denigrating a professional class; he is directly attacking the rights of all Americans. He is attacking those who happen to work as journalists, but he is likewise attacking their neighbors—every American who has the right to free speech and free press themselves.

“I think the bigger problem is the enemy from within,” Trump said in an interview with Fox Business’s Maria Bartiromo in October. “We have some very bad people; we have some sick people, radical-left lunatics,” he said, using the term he often directs at American citizens who work in journalism, as well as his political foes generally. He went on: “And it should be very easily handled by, if necessary, by the National Guard, or if really necessary by the military.”

Donald Trump does not seem to believe in free speech or the freedom of the press at all. He believes that when his fellow citizens say things he doesn’t like, he should have the power to shut them up. And he has repeatedly suggested investigating and imprisoning Americans, as well as turning the U.S. military on the American people in order to do so. No wonder Trump is so starry-eyed over China’s dictator, Xi Jinping, whom Trump often praises in effusive terms. No wonder Trump has similarly embraced the dictator and former president of the Philippines, Rodrigo Duterte, who bragged about leading his country to the extrajudicial killing of thousands of Filipino citizens, including those working as journalists. (“Just because you’re a journalist, you are not exempted from assassination if you’re a son of a bitch,” Duterte once said.) And no wonder Trump openly admires the autocrats Vladimir Putin (“genius”) and Viktor Orbán (“a great man”), both of whom he describes as being “at the top of their game, whether you like it or not.”

In Trump’s recent interview with the podcaster Joe Rogan, Trump complained about the Americans who have noticed his pattern of adulation for the brutal leaders of antidemocratic regimes, whose citizens do not have the right to free speech. “They hate when I say—you know, when the press—when I call President Xi, they said, ‘He called President Xi brilliant.’ Well, he’s a brilliant guy. He controls 1.4 billion people with an iron fist.” He went on: “Actually, we have evil people in our country.”

Trump is making it abundantly clear that dictators aren’t the problem—rather, Americans exercising their right to free speech and free press are the problem, and they are a problem that should be solved by dictatorial rule.

One person who seems to share Trump’s confusion over basic American freedoms is Elon Musk, who strangely claims to be a free-speech absolutist, all while remaking Twitter into a propaganda arm of the Trump campaign. Musk, like Trump, is fixated on tearing down American citizens and their right to free press. Musk likes to post spirited calls to action on his social platform such as “We are the mainstream media now,” seeming to believe that he is the one who grants Americans their right to expression. (Never mind that a social platform that is truly absolutist in letting anyone say whatever they want would probably look more like 4Chan than anything else—that is, it would neither delete its users’ comments nor deploy algorithms to amplify its owners’ political views.)

Musk has long aspired to be taken seriously by the news industry, and his aggrievement seems to stem, in part, from the fact that he is not. Before his $44 billion purchase of Twitter, he floated the idea of starting various news sites—including one in which users would upvote or downvote stories as part of a “credibility-ranking site for people to rate journalists and news organizations,” not realizing or perhaps not caring that truth, and therefore credibility, is not something that can be established or eliminated through the clicking of buttons on the internet at scale. (Such a system would, however, be very useful for efforts at political warfare.)

Today, Musk claims that Twitter is “the top source of news on Earth!” when in reality it is among the closest analogues that America has ever seen to a state-run media outlet. And although several operators of huge social platforms have floated the idea of accreditation or licensing for journalists the way lawyers take the bar and doctors take board exams, there is no special class of licensed journalists, and that is by design. Every American citizen has the right to free press. You do not need to work full-time as a journalist, or pass a test, or join a professional association to exercise this right.

One of the knock-on effects of living in a country whose citizens have the right to say and publish whatever they want is that people sometimes say abhorrent things. (And also: People can consume the information they wish. But for that to happen, your fellow citizens have to be free to offer it to you in the first place, whether what you’re seeking is Newsmax, Joe Rogan, or The New York Times.) In practice, the rights of free speech and free press are interwoven this way. And any American who consumes media, or publishes their own research, reporting, or opinions on any platform—whether on a flyer stuck to a telephone poll, in an Instagram post, or in a local newspaper—is benefiting from the protection of these rights, and would suffer greatly if they were curtailed.

Social media is miraculous in its flattening ability—people can self-publish their ideas with very little friction and no financial cost; they have the potential to reach a massive audience in an instant. These qualities are positive on their face, and sometimes mean that people mistake Twitter for an engine of free speech, when in fact it is a private company run by an illiberal man who is throwing everything he has behind an anti-free-speech politician who wants to attack his fellow Americans with their own military.

Trump’s and Musk’s most ardent supporters are fond of posting a meme that goes like this: “You don’t hate journalists enough. You think you do, but you don’t.” Musk, of course, has every right to run his social platform how he chooses. If he wants to make it a forum for railing against the American right to free speech and free press, while believing he can convince people that doing so demonstrates his commitment to free speech, that’s his prerogative. If he wants to stoke hatred and partisanship, and advocate for interruptions to the peaceful transfer of power in the United States, he can.

But Musk cannot grant the American people their right to free speech any more than Trump can. The American right to free speech and free press is God-given. And the Constitution is intended to protect Americans from government tyrants who would attempt to quash our freedom in just the way that Trump is threatening to do, with Musk’s full-throated endorsement.

Trump’s threats are already effectively silencing Americans. Consider, for example, Jeff Bezos’s profound cowardice in banning The Washington Post from publishing its endorsement of Trump’s rival. (Ditto Patrick Soon-Shiong over at the Los Angeles Times.) Bezos, like Musk, is free to run his business how he chooses. But that shouldn’t shield him from criticism over his actions. In explaining his decision, Bezos blamed the American citizens who work as journalists for being hated, denigrated, and threatened by Trump. “Our profession is now the least trusted of all,” he wrote in an essay explaining himself, with no apparent trace of irony given the breach of trust that his actions represented. “Something we are doing is clearly not working.”

Something that is apparently working: Trump’s Musk-assisted campaign to tell Americans they should rail against their own right to free press and free speech. The illiberal techno-authoritarian crowd cheered Bezos on for his kowtowing, and for his chastising of the journalism industry, and Trump began using the newspaper’s non-endorsement as a campaign talking point. (It may seem odd that Trump would boast about a newspaper’s decision not to endorse his rival, given his hatred of the press, but he dismisses newspapers as “fake news” only when they criticize him.)

This is how tyranny works: Amplify praise for the dear leader, silence dissent, crack down on individual freedoms, repeat. A free society’s fall into authoritarianism does not start with citizens being forced to protest using blank sheets of paper. But it can get to that point with dizzying speed. This is the warning that people in once-free nations always repeat: You’re free until you are not. And destroying a people’s right to speak and publish freely is always one of the first moves in the autocrat’s playbook.

Centuries ago, the American colonists forging a new way of life on this continent found themselves subject to laws and restrictions on free speech that dated back to medieval England. You could not criticize the government without facing violent punishment. Public whippings were routine. One Maryland man, who called his local legislature a “turdy shitten assembly” in 1666, was sentenced to be tied to an apple tree and lashed 30 times, according to Stephen D. Solomon’s account in Revolutionary Dissent: How the Founding Generation Created the Freedom of Speech. A Virginia man who criticized the government had his arms broken and was beaten by a group of men who flogged him with their rifles. Courts sentenced others to have their ears cut off, as in the case of a Massachusetts man who denounced the Church and the government in 1631. Americans were lashed and beaten and bloodied for their right to speak freely. Eventually many of them fought and died to protect themselves, and they did so to create a free society that would protect future American citizens from such barbarism and tyrannical government overreach.

Trump would like to convince the American people that his hatred is laser-focused. He would like Americans to believe that his threats of retribution are reserved only for his political foes, for the former advisers he now deems disloyal, for the tens of thousands of American citizens who work as journalists. What Americans need to understand is that anyone who would threaten to quash the most fundamental rights of some of their fellow citizens is threatening to impinge the rights of all Americans. The United States is still a nation consecrated to freedom. And the American people should not hand it over to anyone who would dare try to convince you otherwise.

Everything about the staging of Kamala Harris’s “closing argument” rally Wednesday night on the White House Ellipse seemed designed to frame the upcoming election as a referendum on democracy. Flanked by American flags and surrounded by banners that screamed FREEDOM, the Democratic nominee delivered her speech against the same backdrop that Donald Trump used on January 6 when he addressed the crowd that went on to storm the Capitol.

“So look,” Harris said about halfway through her speech. “In less than 90 days, either Donald Trump or I will be in the Oval Office …”

Scattered shouts of You will! You will! echoed from the audience near the stage. In my conversations with Harris supporters afterward, their confidence seemed authentic. To a person, everyone I talked with believed they were on the verge of victory—that Harris would defeat the “wannabe dictator” once and for all, pull America back from the brink, and save the world’s oldest democracy from descending into facism.

Then I would ask a question they found dispiriting: What if she doesn’t?

It’s a question that’s been on my mind for months. We are in a strange and precarious political moment as a country: With four days left in one of the closest presidential races in history, supporters of both campaigns seem convinced that they are going to win—and that if they don’t, the consequences for America will be existential.

Trump and his allies have already clearly signaled what they will do if he loses: Claim victory anyway, declare the election rigged, and engage in another conspiracy to overturn the result, whether by litigation, extra-Constitutional arm-twisting, or even violence. The pressure campaign is unlikely to work; as Paul Rosenzweig noted in The Atlantic, none of the officials overseeing vote tabulation in battleground states is a partisan election denier. Still, this full-frontal assault on the validity of the election represents an ongoing threat.

If Harris loses, the response from her coalition would almost certainly be less dramatic and damaging; unlike Trump, she has committed to accepting the result. But as the election nears and panic over Trump’s authoritarian impulses reaches a fever pitch in certain quarters, I’ve begun to worry that prophecies of democratic breakdown following a Trump reelection could become self-fulfilling. What happens to America if Harris voters have fully internalized the idea that democracy is on the ballot, and then “democracy” loses?

In 2016, Trump’s surprise victory was met with a groundswell of small-d democratic energy. There were marches in the streets, and record-breaking donations to the ACLU, and waves of grassroots organizing. Subscriptions surged at newspapers committed to holding the new administration to account; books about combating tyranny became best sellers. The energy wasn’t contained to the liberal “resistance” movement. Conservative expats launched their own political groups and publications. As my colleague Franklin Foer recently wrote, the warnings of impending autocracy in America at the time “helped propel a spirit of loud, uncompromising opposition to Trump.”

That energy contributed to record-high turnout in the 2020 election, when Trump was defeated. To many people outside the MAGA coalition, Joe Biden’s victory represented a triumphant climax in the narrative of the Trump era. And had the one-term, twice-impeached president simply receded into a Mar-a-Lago exile, the story might have ended with a tidy civic moral: An aspiring authoritarian was vanquished in the most American way possible—at the ballot box. Democracy wins again.

But of course the story didn’t end there. And the fact that, four years later, Trump is within a coin flip of returning to the Oval Office has created some dissonance in liberal America. Trump has, in his third campaign, been more explicit than ever about his illiberal designs. He has talked about weaponizing the Justice Department against his political enemies, replacing thousands of civil servants with loyalists, and revoking broadcast licenses for TV networks whose news coverage he doesn’t like.

Democrats have sought to warn voters about the threat that these actions would pose to democracy—sometimes dialing up the rhetoric in an effort to wake Americans to the peril. But the messaging seems to have had an unfortunate dual effect, deeply stressing out voters already inclined to believe it while largely failing to resonate with the undecided and politically disengaged. Last week, The New York Times reported on a memo circulated by the leading pro-Harris super PAC warning Democrats that persuadable voters weren’t being moved by messages that focused on the former president’s authoritarianism. “Attacking Trump’s fascism is not that persuasive,” the email read. Compared with 2020, fewer Americans are telling pollsters that they are highly motivated to vote, or that this is the most important election of their lifetime.

Within a certain segment of Harris’s base, though, the struggle against autocracy remains very much top of mind. And if you spend too much time online monitoring the discourse, as I do, you might come away with the impression that, for many, Election Day will be the decisive moment in the battle for American democracy. Some liberals are even making plans to leave the country if Trump wins. Biden’s son Hunter recently told Politico he was worried that Trump’s reelection would mean “losing our democracy to a fascist minority” and warned that a second Trump term “is potentially the end of America as we’ve known it.”

I’ve heard similar sentiments from my most anxious Harris-voting friends and family members. And I’ve wondered whether another Trump victory would spur in them the same spirit of post-2016 activism or send them spiraling into fatalism and disengagement.

On Wednesday night, Harris was careful in her speech not to wallow too much in the doom and gloom of an imperiled democracy. But she did take aim at her opponent’s illiberalism. She said that Trump was “out for unchecked power” and warned that if elected, he would enter the Oval Office with an “enemies list.” She alluded to the country’s birth in revolt against a “petty tyrant,” and described Americans who have fought over centuries to defend and promote democracy around the world. “They did not struggle, sacrifice, and lay down their lives only to see us cede our fundamental freedoms, only to see us submit to the will of another petty tyrant,” Harris declared to cheers.

In my conversations after the speech, many supporters, teary-eyed and high on adrenaline as Beyoncé’s “Freedom” still blared from the speakers, were understandably loath to talk about what they’ll do next week if their candidate loses. But they politely indulged me.

Alyssa VanLeeuwen, a mom from Maryland who brought her eighth-grade daughter to the rally, emitted a guttural agghh when I posed the question to her. “Democracy is absolutely on the line,” she told me. A Trump victory, she said, would mean a bleak and uncertain future for her daughter. “I’m scared. I’m terrified if that happens.”

When I asked her if she thought that fear would translate to disillusionment or activism, she paused to give it thought. “I think,” she said, “everybody’s going to go to battle again to try to fight for their neighbors.”

I spoke with another Harris supporter who asked me not to use her name (“My family could be targeted”). She, too, called the prospect of Trump’s reelection “terrifying.” She said that Trump would herald “the return of McCarthyism” as he used federal power to root out and punish his political enemies, and went on to lay out in vivid detail the various worst-case scenarios of a second Trump term. But when I asked her whether she thought American democracy itself might be destroyed, she said no. “We have 300 million people in this country,” she told me, “and I don’t think we would allow that.”

This attitude was shared by almost everyone I spoke with that night on the Ellipse. Some of them told me about friends, glued to cable news and doomscrolling on their phones, who might tend toward fatalism if Trump wins again. But the people I met—the kind who travel long distances and wait outside in the cold for hours to attend political rallies—were not thinking of Election Day as a singular make-or-break moment. They seemed to know that, no matter who wins, America will still be a democracy next week, and the week after that. Its preservation depends, in part, on not pegging its fate to the outcome of any one election.

Before leaving the Ellipse, I met Salome Agbaroji, a 19-year-old Harvard student who had traveled from Cambridge to see Harris speak. As a poet, she spends a lot of time thinking about the language that shapes our politics, and she told me she resents what she considers hyperbolic rhetoric in the media about the end of democracy. A professor had recently taught her the root of the Greek word for democracy—demos, meaning “people,” and kratia, meaning “rule.” The power of the people doesn’t disappear overnight just because the White House is occupied by an illiberal leader.

“I don’t think democracy lives in an institution,” Agbaroji told me. “Democracy lives in the people.” As long as people hold on to “that spirit, it will be hard to kill.”