Gun policy. The year offered more of the same: senseless carnage followed by government inaction to prevent new bloodshed. This, despite the October 1 mass shooting in Las Vegas that killed 59 people, including the shooter, and injured more than 500 others. A bipartisan bill to ban the manufacturing and sale of "bump stocks"-devices that allow a semiautomatic rifle to fire nearly as fast as a machine gun-has stalled. Another bill, introduced in late October, would require the Bureau of Alcohol, Tobacco, Firearms and Explosives to regulate-but not ban-bump stocks. Before any action could be taken by Congress, another mass shooting at the First Baptist Church in Sutherland Springs, Texas, on November 5 left 26 people-many of them children-dead and another 20 people wounded. President Trump reacted by blaming the shooter's "mental health problem," asserting that the massacre wasn't "a guns situation." As AJN went to press, the toll of gun violence in the United States was more than 13,991 deaths and 28,012 injuries in 2017. A Pew Research Center study found that 44% of Americans personally know victims of gun violence, shot either accidentally or intentionally.
Immigration. The number of refugees admitted into the United States in fiscal year 2017 has dropped precipitously from over 25,000 in the first quarter to over 13,000 in the second quarter and over 10,000 in the third. The first quarter total was unusually high-an 86% increase over 2016. But the second and third quarter numbers represent significant declines from 2016. According to the United Nations Refugee Agency, 65.6 million people worldwide are forcibly displaced from their homes, with 22.5 million of these considered refugees.
Lesbian, gay, bisexual, and transgender (LGBT) rights. More than 100 anti-LGBT bills were introduced in 29 states during 2017, according to the advocacy group Human Rights Campaign (HRC). Among them were HB 1894 in Arkansas, which would have prevented changing the biological sex on a birth certificate, and SB 6 in Texas, which would have prohibited transgender people from using bathrooms corresponding to their gender identity. Both bills failed to pass, as have many others. In addition, a federal judge temporarily blocked part of the transgender military ban proposed by the Trump administration. Meanwhile, 68 municipalities received a perfect score from the HRC's Municipal Equality Index-the highest number since the organization began tracking statutory and regulatory nondiscrimination protections for LGBT citizens in 2012.
Women's reproductive rights. A rule issued in October by the Trump administration expanded the rights of employers and insurers to invoke religious or moral beliefs to exclude birth control pills and other contraceptives from insurance coverage. The rule replaces a 2012 regulation under the Affordable Care Act that required employers who provide employees with health insurance benefits to include coverage of birth control as part of preventive care. President Trump has also vowed to nominate judges who would help overturn Roe v. Wade, the landmark 1973 abortion-rights decision.
Access to health care. A May analysis by the Commonwealth Fund of the impact of coverage expansions under the Affordable Care Act found that they decreased the probability of not receiving medical care by between 20.9% and 25%. A Kaiser Family Foundation analysis, which used a different data set, also found significant improvement in health care access: the proportion of Americans who reported delaying or forgoing needed care because of costs dropped from 13% in 2009 to 9% in 2015.-Dalia Sofer