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Sleep Apnea Testing at Home: Interview with Laurent Martinot, CEO of Sunrise

Obstructive sleep apnea is very common and is associated with a variety of serious health issues, such as cardiovascular disease and diabetes. Getting a proper diagnosis is hampered by the need for patients to visit a sleep clinic and undergo a polysomnog

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Obstructive sleep apnea is very common and is associated with a variety of serious health issues, such as cardiovascular disease and diabetes. Getting a proper diagnosis is hampered by the need for patients to visit a sleep clinic and undergo a polysomnography.

This gold-standard test is complicated and requires specialized staff to interpret the results. To address these issues, a company called Sunrise has developed an at-home sleep apnea test that relies on a small wearable device. The device consists of a small sensor that a user can attach to their chin when they are about to go to sleep.

The sensor records movements of the jaw, which it correlates with sleep events using artificial intelligence. Sunrise has recently launched the device in the UK, and it is relatively inexpensive, starting at £49 ($66). Medgadget had the opportunity to talk to Laurent Martinot, CEO & Co-founder of Sunrise, about the technology.        

Conn Hastings, Medgadget: Please give us an overview of the health issues associated with sleep apnea.

Laurent Martinot, Sunrise: Due to its prevalence and its link with obesity and chronic cardio-metabolic diseases, Obstructive Sleep Apnoea (OSA) is a real public health problem. OSA is primarily responsible for symptoms such as daytime sleepiness (caused by sleep fragmentation), fatigue, irritability and snoring, possibly accompanied by a feeling of suffocation or suffocation during sleep.

Non-restful sleep is accompanied by difficulty concentrating, nocturia (waking up to urinate more than once per night), libido disturbances and disturbances in vigilance. OSA can also be responsible for disrupting the quality of life of spouses/bed neighbors of the sufferer. OSA is thus at the origin of a significant deterioration in the quality of life which can also be the origin of accidents at work and on the road. OSA is also associated with long-term consequences: cardiovascular morbidity and mortality (arterial hypertension, heart failure, atrial fibrillation, etc.), and metabolic (diabetes, obesity) and cognitive effects. It is described as an independent predictor of mortality.

Aside from consequences for quality of life (related to low emotional and professional performance, lack of energy), sleep apnoea includes a large set of comorbidities, displayed in the below chart :

Besides the health issue for the individual, sufferers of OSA also bring an additional cost to the healthcare system. OSA patients are heavy consumers of healthcare services, and due to the varied symptoms this is usually before the diagnosis of OSA is made. The cost of healthcare utilization has been shown to be significantly associated with the severity of OSA.    

Medgadget: How is sleep apnea, and other sleep disorders, currently diagnosed?

Laurent Martinot: Undergoing a polysomnography in a sleep laboratory is considered the gold standard for the diagnosis of OSA. This diagnostic test is very complex to perform and requires specialized personnel to interpret the data (with potential inter-center variability in the quality of the diagnosis). In France, the estimated wait time for a polysomnography varies from a few weeks to several months, leading to a delay and unequal access to care for a pathology which also has very effective treatment for the patient. However, the HAS recommends “promptly registering patients suspected of OSA, presenting severe daytime sleepiness and / or severe cardiovascular or respiratory comorbidities and / or occupational activity at risk of accident”.

The conditions for performing a polysomnography are long and tedious as when a polysomnography is initiated, the placement of the various sensors must be performed in either a sleep laboratory or in a doctor’s office. The patient must then either be hospitalized overnight or return home equipped with the sensors. The complex and highly specialized diagnostic process is not adapted to the prevalence of the disease and its consequences. This is why there is now a strong consensus among experts on the need to develop simplified diagnostic approaches that integrate new technologies including artificial intelligence to provide robust alternatives, on an outpatient basis, for the evaluation of sleep structure, and respiratory abnormalities.

The advantages of diagnosing OSA on an outpatient basis are well established but prior to the launch of Sunrise there has been no device capable of performing the test as efficiently as the reference examination, polysomnography. Furthermore, polygraphy (a home-based lighter version of the polysomnography), which does not allow the measurement of total sleep time, can lead to an underestimation of the severity of OSA and the differentiation of respiratory events of a central or obstructive nature is limited.

The new integrated digital solution Sunrise allows the diagnosis of OSA via an original mandibular sensor integrating the analysis of mandibular movements. This approach has been scientifically validated for the identification of respiratory events during sleep (apnea, central or obstructive hypopnea). This diagnostic solution also helps identify sleep fragmentation and estimate total sleep time. The interpretation is reinforced by an AI system which homogenizes the quality of the scoring of respiratory events. In a large single-center validation in 376 patients, the diagnostic performance was equivalent to that of polysomnography. The digital solution functions alongside a partnering app to guide patients, and offers the possibility of carrying out the diagnosis on an outpatient basis and the test can very easily be repeated over several nights. Its integration into practices around the world could respond to the problems encountered and considerably modify the diagnostic approach of a patient suspected of OSA, and thus accelerate its treatment.

While offering a major upgrade in terms of ease of use and ergonomics, Sunrise is equivalent in precision to polysomnography. Such clinical precision is quite new for a device that weighs only 3 grams and is as easy to use as a pregnancy test.

Medgadget: What would lead someone to take a test for sleep apnea? Are there any warning signs that people should be aware of?

Laurent Martinot: Studies show that 936 million people1 are affected by sleep apnoea – other papers concluding to a prevalence of almost 1 in 2 men aged 40 and above! -and more than 80% go undiagnosed despite adequate access to health care2.

Being aware of this prevalence, knowing the long-term consequences on health and keeping in mind that sleep apnoea symptoms are quite common (see list below) is the key to prompt people to take the test. This is why we made the test so simple.

Here are some of the common symptoms that can be associated with Sleep Apnoea:

  • Loud snoring
  • Exhaustion/tiredness on waking up
  • Repeated awakenings and/or insomnia
  • Choking at night
  • Palpitations & high heart rate
  • Frequent toilet runs during sleep (nocturia)
  • Anxiety
  • Mood swings

Obstructive sleep apnoea is also a major risk factor for a variety of medical conditions, increasing the risk and severity of cardiometabolic diseases, including hypertension, arrhythmias, stroke, coronary heart disease, type 1 and type 2 diabetes, and metabolic dysfunction, ultimately resulting in increased overall mortality.

Medgadget: Please give us an overview of the Sunrise sensor. How does it work?

Laurent Martinot: The Sunrise sleep test is an AI-powered innovative 3 gram sensor that sits on the user’s chin and helps to diagnose sleep disorders and monitors for sleep disorders from the comfort of your own bedroom.

Science has recently identified the most reliable signal to measure sleep. This signal comes from mandibular movements, the most direct proxy to the brain’s sleep and breathing regulation action.

The real-time analysis of these mandibular movements consists of reading the activity generated by upper airway muscle contractions. This activity reflects the adjustments performed by the brain to preserve quality sleep and provides the data to allow a complete understanding of sleep events.

Since it directly comes from the brain stem, the most profound and primitive part of our brain, this signal is free from the interference of complex cortex activity. To the purpose of sleep analysis, it is therefore considered as purer.

The Sunrise sensor, which rests securely on the user’s chin, records data whilst the user is asleep to generate a thorough report shared the next day that highlights possible sleep apnoea or other sleep conditions through the partnering Sunrise app. Once the report is generated, users are then offered the choice to connect with sleep physicians, and receive treatment when needed.

Medgadget: How is the sensor used, and how soon can it provide results?

Laurent Martinot: The sensor is clinically proven and puts science at the tip of the chin, and the Sunrise sleep test can provide results after a minimum of 4 hrs of sleep. By measuring the movements in the chin, Sunrise allows everyone to perform a clinical test in a natural  sleeping environment with the non-invasive small smart device and receive a thorough breakdown of the recording in just a few hours as the report is sent back at the user at sunrise.

This method of results delivery means that there is no need for the user to send the device back to collect the results as the data are uploaded from the sensor to the patient’s smartphone and then to the cloud, making the results directly available for the physician to also review. Additionally, the user can then either dispose of the sensor or send it back to Sunrise through a prepaid envelope that comes with the sensor on delivery. Sunrise will then reuse the electronics and recycle the plastic body.

Medgadget: How does such remote testing technology aid diagnosis and assist in limiting viral spread during the current pandemic?

Laurent Martinot: Thanks to its simplicity and ergonomics, the test can be performed by the user without the need for expert support. Therefore, the user does not have to go to a sleep clinic and get in close contact with a healthcare professional to get equipped with the device. The procedure can be fully contactless and infection risk free. Coupled with the fact that the device is disposable, there is then no risk of cross contamination.

Also after the test, Sunrise gets the user connected with a pool of sleep physicians, all able to perform their consultation via video call. To this extent, Sunrise is helping to limit viral spread in the context of the current pandemic. This is especially important as studies have shown patients with suspected sleep apnoea could be at higher risk if they were to contract COVID-19.

(1) Benjafield et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respiratory Medicine 2019. http://dx.doi.org/10.1016/S2213-2600(19)30198-5
(2) Risk factors for obstructive sleep apnea in adults. Young T, Skatrud J, Peppard PE.JAMA. 2004 Apr 28; 291(16):2013-6.

Link: Sunrise homepage…

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President Biden Delivers The “Darkest, Most Un-American Speech Given By A President”

President Biden Delivers The "Darkest, Most Un-American Speech Given By A President"

Having successfully raged, ranted, lied, and yelled through…

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President Biden Delivers The "Darkest, Most Un-American Speech Given By A President"

Having successfully raged, ranted, lied, and yelled through the State of The Union, President Biden can go back to his crypt now.

Whatever 'they' gave Biden, every American man, woman, and the other should be allowed to take it - though it seems the cocktail brings out 'dark Brandon'?

Tl;dw: Biden's Speech tonight ...

  • Fund Ukraine.

  • Trump is threat to democracy and America itself.

  • Abortion is good.

  • American Economy is stronger than ever.

  • Inflation wasn't Biden's fault.

  • Illegals are Americans too.

  • Republicans are responsible for the border crisis.

  • Trump is bad.

  • Biden stands with trans-children.

  • J6 was the worst insurrection since the Civil War.

(h/t @TCDMS99)

Tucker Carlson's response sums it all up perfectly:

"that was possibly the darkest, most un-American speech given by an American president. It wasn't a speech, it was a rant..."

Carlson continued: "The true measure of a nation's greatness lies within its capacity to control borders, yet Bid refuses to do it."

"In a fair election, Joe Biden cannot win"

And concluded:

“There was not a meaningful word for the entire duration about the things that actually matter to people who live here.”

Victor Davis Hanson added some excellent color, but this was probably the best line on Biden:

"he doesn't care... he lives in an alternative reality."

*  *  *

Watch SOTU Live here...

*   *   *

Mises' Connor O'Keeffe, warns: "Be on the Lookout for These Lies in Biden's State of the Union Address." 

On Thursday evening, President Joe Biden is set to give his third State of the Union address. The political press has been buzzing with speculation over what the president will say. That speculation, however, is focused more on how Biden will perform, and which issues he will prioritize. Much of the speech is expected to be familiar.

The story Biden will tell about what he has done as president and where the country finds itself as a result will be the same dishonest story he's been telling since at least the summer.

He'll cite government statistics to say the economy is growing, unemployment is low, and inflation is down.

Something that has been frustrating Biden, his team, and his allies in the media is that the American people do not feel as economically well off as the official data says they are. Despite what the White House and establishment-friendly journalists say, the problem lies with the data, not the American people's ability to perceive their own well-being.

As I wrote back in January, the reason for the discrepancy is the lack of distinction made between private economic activity and government spending in the most frequently cited economic indicators. There is an important difference between the two:

  • Government, unlike any other entity in the economy, can simply take money and resources from others to spend on things and hire people. Whether or not the spending brings people value is irrelevant

  • It's the private sector that's responsible for producing goods and services that actually meet people's needs and wants. So, the private components of the economy have the most significant effect on people's economic well-being.

Recently, government spending and hiring has accounted for a larger than normal share of both economic activity and employment. This means the government is propping up these traditional measures, making the economy appear better than it actually is. Also, many of the jobs Biden and his allies take credit for creating will quickly go away once it becomes clear that consumers don't actually want whatever the government encouraged these companies to produce.

On top of all that, the administration is dealing with the consequences of their chosen inflation rhetoric.

Since its peak in the summer of 2022, the president's team has talked about inflation "coming back down," which can easily give the impression that it's prices that will eventually come back down.

But that's not what that phrase means. It would be more honest to say that price increases are slowing down.

Americans are finally waking up to the fact that the cost of living will not return to prepandemic levels, and they're not happy about it.

The president has made some clumsy attempts at damage control, such as a Super Bowl Sunday video attacking food companies for "shrinkflation"—selling smaller portions at the same price instead of simply raising prices.

In his speech Thursday, Biden is expected to play up his desire to crack down on the "corporate greed" he's blaming for high prices.

In the name of "bringing down costs for Americans," the administration wants to implement targeted price ceilings - something anyone who has taken even a single economics class could tell you does more harm than good. Biden would never place the blame for the dramatic price increases we've experienced during his term where it actually belongs—on all the government spending that he and President Donald Trump oversaw during the pandemic, funded by the creation of $6 trillion out of thin air - because that kind of spending is precisely what he hopes to kick back up in a second term.

If reelected, the president wants to "revive" parts of his so-called Build Back Better agenda, which he tried and failed to pass in his first year. That would bring a significant expansion of domestic spending. And Biden remains committed to the idea that Americans must be forced to continue funding the war in Ukraine. That's another topic Biden is expected to highlight in the State of the Union, likely accompanied by the lie that Ukraine spending is good for the American economy. It isn't.

It's not possible to predict all the ways President Biden will exaggerate, mislead, and outright lie in his speech on Thursday. But we can be sure of two things. The "state of the Union" is not as strong as Biden will say it is. And his policy ambitions risk making it much worse.

*  *  *

The American people will be tuning in on their smartphones, laptops, and televisions on Thursday evening to see if 'sloppy joe' 81-year-old President Joe Biden can coherently put together more than two sentences (even with a teleprompter) as he gives his third State of the Union in front of a divided Congress. 

President Biden will speak on various topics to convince voters why he shouldn't be sent to a retirement home.

According to CNN sources, here are some of the topics Biden will discuss tonight:

  • Economic issues: Biden and his team have been drafting a speech heavy on economic populism, aides said, with calls for higher taxes on corporations and the wealthy – an attempt to draw a sharp contrast with Republicans and their likely presidential nominee, Donald Trump.

  • Health care expenses: Biden will also push for lowering health care costs and discuss his efforts to go after drug manufacturers to lower the cost of prescription medications — all issues his advisers believe can help buoy what have been sagging economic approval ratings.

  • Israel's war with Hamas: Also looming large over Biden's primetime address is the ongoing Israel-Hamas war, which has consumed much of the president's time and attention over the past few months. The president's top national security advisers have been working around the clock to try to finalize a ceasefire-hostages release deal by Ramadan, the Muslim holy month that begins next week.

  • An argument for reelection: Aides view Thursday's speech as a critical opportunity for the president to tout his accomplishments in office and lay out his plans for another four years in the nation's top job. Even though viewership has declined over the years, the yearly speech reliably draws tens of millions of households.

Sources provided more color on Biden's SOTU address: 

The speech is expected to be heavy on economic populism. The president will talk about raising taxes on corporations and the wealthy. He'll highlight efforts to cut costs for the American people, including pushing Congress to help make prescription drugs more affordable.

Biden will talk about the need to preserve democracy and freedom, a cornerstone of his re-election bid. That includes protecting and bolstering reproductive rights, an issue Democrats believe will energize voters in November. Biden is also expected to promote his unity agenda, a key feature of each of his addresses to Congress while in office.

Biden is also expected to give remarks on border security while the invasion of illegals has become one of the most heated topics among American voters. A majority of voters are frustrated with radical progressives in the White House facilitating the illegal migrant invasion. 

It is probable that the president will attribute the failure of the Senate border bill to the Republicans, a claim many voters view as unfounded. This is because the White House has the option to issue an executive order to restore border security, yet opts not to do so

Maybe this is why? 

While Biden addresses the nation, the Biden administration will be armed with a social media team to pump propaganda to at least 100 million Americans. 

"The White House hosted about 70 creators, digital publishers, and influencers across three separate events" on Wednesday and Thursday, a White House official told CNN. 

Not a very capable social media team... 

The administration's move to ramp up social media operations comes as users on X are mostly free from government censorship with Elon Musk at the helm. This infuriates Democrats, who can no longer censor their political enemies on X. 

Meanwhile, Democratic lawmakers tell Axios that the president's SOTU performance will be critical as he tries to dispel voter concerns about his elderly age. The address reached as many as 27 million people in 2023. 

"We are all nervous," said one House Democrat, citing concerns about the president's "ability to speak without blowing things."

The SOTU address comes as Biden's polling data is in the dumps

BetOnline has created several money-making opportunities for gamblers tonight, such as betting on what word Biden mentions the most. 

As well as...

We will update you when Tucker Carlson's live feed of SOTU is published. 

Tyler Durden Fri, 03/08/2024 - 07:44

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What is intersectionality and why does it make feminism more effective?

The social categories that we belong to shape our understanding of the world in different ways.

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Mary Long/Shutterstock

The way we talk about society and the people and structures in it is constantly changing. One term you may come across this International Women’s Day is “intersectionality”. And specifically, the concept of “intersectional feminism”.

Intersectionality refers to the fact that everyone is part of multiple social categories. These include gender, social class, sexuality, (dis)ability and racialisation (when people are divided into “racial” groups often based on skin colour or features).

These categories are not independent of each other, they intersect. This looks different for every person. For example, a black woman without a disability will have a different experience of society than a white woman without a disability – or a black woman with a disability.

An intersectional approach makes social policy more inclusive and just. Its value was evident in research during the pandemic, when it became clear that women from various groups, those who worked in caring jobs and who lived in crowded circumstances were much more likely to die from COVID.

A long-fought battle

American civil rights leader and scholar Kimberlé Crenshaw first introduced the term intersectionality in a 1989 paper. She argued that focusing on a single form of oppression (such as gender or race) perpetuated discrimination against black women, who are simultaneously subjected to both racism and sexism.

Crenshaw gave a name to ways of thinking and theorising that black and Latina feminists, as well as working-class and lesbian feminists, had argued for decades. The Combahee River Collective of black lesbians was groundbreaking in this work.

They called for strategic alliances with black men to oppose racism, white women to oppose sexism and lesbians to oppose homophobia. This was an example of how an intersectional understanding of identity and social power relations can create more opportunities for action.

These ideas have, through political struggle, come to be accepted in feminist thinking and women’s studies scholarship. An increasing number of feminists now use the term “intersectional feminism”.

The term has moved from academia to feminist activist and social justice circles and beyond in recent years. Its popularity and widespread use means it is subjected to much scrutiny and debate about how and when it should be employed. For example, some argue that it should always include attention to racism and racialisation.

Recognising more issues makes feminism more effective

In writing about intersectionality, Crenshaw argued that singular approaches to social categories made black women’s oppression invisible. Many black feminists have pointed out that white feminists frequently overlook how racial categories shape different women’s experiences.

One example is hair discrimination. It is only in the 2020s that many organisations in South Africa, the UK and US have recognised that it is discriminatory to regulate black women’s hairstyles in ways that render their natural hair unacceptable.

This is an intersectional approach. White women and most black men do not face the same discrimination and pressures to straighten their hair.

View from behind of a young, black woman speaking to female colleagues in an office
Intersectionality can lead to more inclusive organisations, activism and social movements. Rawpixel.com/Shutterstock

“Abortion on demand” in the 1970s and 1980s in the UK and USA took no account of the fact that black women in these and many other countries needed to campaign against being given abortions against their will. The fight for reproductive justice does not look the same for all women.

Similarly, the experiences of working-class women have frequently been rendered invisible in white, middle class feminist campaigns and writings. Intersectionality means that these issues are recognised and fought for in an inclusive and more powerful way.

In the 35 years since Crenshaw coined the term, feminist scholars have analysed how women are positioned in society, for example, as black, working-class, lesbian or colonial subjects. Intersectionality reminds us that fruitful discussions about discrimination and justice must acknowledge how these different categories affect each other and their associated power relations.

This does not mean that research and policy cannot focus predominantly on one social category, such as race, gender or social class. But it does mean that we cannot, and should not, understand those categories in isolation of each other.

Ann Phoenix does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Biden defends immigration policy during State of the Union, blaming Republicans in Congress for refusing to act

A rising number of Americans say that immigration is the country’s biggest problem. Biden called for Congress to pass a bipartisan border and immigration…

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President Joe Biden delivers his State of the Union address on March 7, 2024. Alex Brandon-Pool/Getty Images

President Joe Biden delivered the annual State of the Union address on March 7, 2024, casting a wide net on a range of major themes – the economy, abortion rights, threats to democracy, the wars in Gaza and Ukraine – that are preoccupying many Americans heading into the November presidential election.

The president also addressed massive increases in immigration at the southern border and the political battle in Congress over how to manage it. “We can fight about the border, or we can fix it. I’m ready to fix it,” Biden said.

But while Biden stressed that he wants to overcome political division and take action on immigration and the border, he cautioned that he will not “demonize immigrants,” as he said his predecessor, former President Donald Trump, does.

“I will not separate families. I will not ban people from America because of their faith,” Biden said.

Biden’s speech comes as a rising number of American voters say that immigration is the country’s biggest problem.

Immigration law scholar Jean Lantz Reisz answers four questions about why immigration has become a top issue for Americans, and the limits of presidential power when it comes to immigration and border security.

President Joe Biden stands surrounded by people in formal clothing and smiles. One man holds a cell phone camera close up to his face.
President Joe Biden arrives to deliver the State of the Union address at the US Capitol on March 7, 2024. Chip Somodevilla/Getty Images

1. What is driving all of the attention and concern immigration is receiving?

The unprecedented number of undocumented migrants crossing the U.S.-Mexico border right now has drawn national concern to the U.S. immigration system and the president’s enforcement policies at the border.

Border security has always been part of the immigration debate about how to stop unlawful immigration.

But in this election, the immigration debate is also fueled by images of large groups of migrants crossing a river and crawling through barbed wire fences. There is also news of standoffs between Texas law enforcement and U.S. Border Patrol agents and cities like New York and Chicago struggling to handle the influx of arriving migrants.

Republicans blame Biden for not taking action on what they say is an “invasion” at the U.S. border. Democrats blame Republicans for refusing to pass laws that would give the president the power to stop the flow of migration at the border.

2. Are Biden’s immigration policies effective?

Confusion about immigration laws may be the reason people believe that Biden is not implementing effective policies at the border.

The U.S. passed a law in 1952 that gives any person arriving at the border or inside the U.S. the right to apply for asylum and the right to legally stay in the country, even if that person crossed the border illegally. That law has not changed.

Courts struck down many of former President Donald Trump’s policies that tried to limit immigration. Trump was able to lawfully deport migrants at the border without processing their asylum claims during the COVID-19 pandemic under a public health law called Title 42. Biden continued that policy until the legal justification for Title 42 – meaning the public health emergency – ended in 2023.

Republicans falsely attribute the surge in undocumented migration to the U.S. over the past three years to something they call Biden’s “open border” policy. There is no such policy.

Multiple factors are driving increased migration to the U.S.

More people are leaving dangerous or difficult situations in their countries, and some people have waited to migrate until after the COVID-19 pandemic ended. People who smuggle migrants are also spreading misinformation to migrants about the ability to enter and stay in the U.S.

Joe Biden wears a black blazer and a black hat as he stands next to a bald white man wearing a green uniform and a white truck that says 'Border Patrol' in green
President Joe Biden walks with Jason Owens, the chief of the U.S. Border Patrol, as he visits the U.S.-Mexico border in Brownsville, Texas, on Feb. 29, 2024. Jim Watson/AFP via Getty Images

3. How much power does the president have over immigration?

The president’s power regarding immigration is limited to enforcing existing immigration laws. But the president has broad authority over how to enforce those laws.

For example, the president can place every single immigrant unlawfully present in the U.S. in deportation proceedings. Because there is not enough money or employees at federal agencies and courts to accomplish that, the president will usually choose to prioritize the deportation of certain immigrants, like those who have committed serious and violent crimes in the U.S.

The federal agency Immigration and Customs Enforcement deported more than 142,000 immigrants from October 2022 through September 2023, double the number of people it deported the previous fiscal year.

But under current law, the president does not have the power to summarily expel migrants who say they are afraid of returning to their country. The law requires the president to process their claims for asylum.

Biden’s ability to enforce immigration law also depends on a budget approved by Congress. Without congressional approval, the president cannot spend money to build a wall, increase immigration detention facilities’ capacity or send more Border Patrol agents to process undocumented migrants entering the country.

A large group of people are seen sitting and standing along a tall brown fence in an empty area of brown dirt.
Migrants arrive at the border between El Paso, Texas, and Ciudad Juarez, Mexico, to surrender to American Border Patrol agents on March 5, 2024. Lokman Vural Elibol/Anadolu via Getty Images

4. How could Biden address the current immigration problems in this country?

In early 2024, Republicans in the Senate refused to pass a bill – developed by a bipartisan team of legislators – that would have made it harder to get asylum and given Biden the power to stop taking asylum applications when migrant crossings reached a certain number.

During his speech, Biden called this bill the “toughest set of border security reforms we’ve ever seen in this country.”

That bill would have also provided more federal money to help immigration agencies and courts quickly review more asylum claims and expedite the asylum process, which remains backlogged with millions of cases, Biden said. Biden said the bipartisan deal would also hire 1,500 more border security agents and officers, as well as 4,300 more asylum officers.

Removing this backlog in immigration courts could mean that some undocumented migrants, who now might wait six to eight years for an asylum hearing, would instead only wait six weeks, Biden said. That means it would be “highly unlikely” migrants would pay a large amount to be smuggled into the country, only to be “kicked out quickly,” Biden said.

“My Republican friends, you owe it to the American people to get this bill done. We need to act,” Biden said.

Biden’s remarks calling for Congress to pass the bill drew jeers from some in the audience. Biden quickly responded, saying that it was a bipartisan effort: “What are you against?” he asked.

Biden is now considering using section 212(f) of the Immigration and Nationality Act to get more control over immigration. This sweeping law allows the president to temporarily suspend or restrict the entry of all foreigners if their arrival is detrimental to the U.S.

This obscure law gained attention when Trump used it in January 2017 to implement a travel ban on foreigners from mainly Muslim countries. The Supreme Court upheld the travel ban in 2018.

Trump again also signed an executive order in April 2020 that blocked foreigners who were seeking lawful permanent residency from entering the country for 60 days, citing this same section of the Immigration and Nationality Act.

Biden did not mention any possible use of section 212(f) during his State of the Union speech. If the president uses this, it would likely be challenged in court. It is not clear that 212(f) would apply to people already in the U.S., and it conflicts with existing asylum law that gives people within the U.S. the right to seek asylum.

Jean Lantz Reisz does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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