This blog post, like the ones that preceded it, has the “receipts” about every bad thing the GOP and Trump tried to do to American’s health care. (It also includes the good things that Democrats – and occasionally some Republicans – did to protect our healthcare.)
If you would like the full story, you may want to start with the blogs I’ve written about this topic so far. They include:
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part One
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Two
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four
2020 marks the fourth year of the Donald Trump Presidency. His administration, and the Republicans in Congress, are still trying to destroy Obamacare. They are also going after reproductive health care, Medicaid, Medicare, Social Security Disability, the ability for LGBTQ people to receive health care, and the ability for undocumented children to be covered by Medicaid.
The Guardian reported that President Trump was impeached on December 19, 2019, when the House of Representatives voted 230-197 to approve a first article of impeachment.
April
April 1, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Responds to Indiana Governor Eric Holcomb Exploiting COVID-19 Crisis to Push Anti-Choice Agenda”. From the press release:
Indiana Governor Eric Holcomb announced yesterday that he intends to block access to abortion care in the midst of the COVID-19 pandemic, prioritizing an extreme ideological agenda over medical expertise and science. He joins at least five other Republican anti-choice governors who have exploited the public health crisis to advance their agenda to gut reproductive freedom. Ilyse Hogue, president of NARAL Pro-Choice America, said:
“The radical right has been working for decades to end the legal right to abortion—no matter the cost—and now they are using COVID-19 to achieve that goal.
“As we face this national emergency, we must centralize sound science and medical experts in guiding decision making and not allow the individuals driven by ideology to craft policy to meet their beliefs over public welfare.
“The medical community is clear and unified: Abortion care is time-sensitive and essential healthcare. They should be allowed to continue their work based on medicine and not arbitrary policy. The health and well-being of all Americans are at risk. Allowing ideology to trump science in this moment imperils everyone and sets a terrifying precedent as we face this national crisis.”
The American Medical Association has criticized officials for “exploiting this moment to ban or dramatically limit women’s reproductive health care,” noting that during “this critical moment and every moment, physicians – not politicians – should be the ones deciding which procedures are urgent-emergent and need to be performed, and which ones can wait, in partnership with our patients.”
Indiana already has some of the most extreme restrictions on abortion in the United States, including interrogating women about why they’re ending a pregnancy, forcing delays before a woman can receive abortion care, and subjecting women to mandatory biased counseling. At least 70% of Indiana women live in counties with no abortion clinic.
Vice President Mike Pence, who is leading the federal COVID-19 response effort, has a history of prioritizing his own extreme personal beliefs over the health, safety, and well-being of Americans. As Governor of Indiana, Pence notoriously botched his handling of the state’s HIV crisis by failing to proactively implement public health measures at the urging of medical experts.
April 2, 2020: Senator Cory Booker (Democrat -New Jersey) posted a press release titled: “Booker Blasts Trump Decision to Reject Healthcare Special Enrollment Period, Urges Congress to Pass His Legislation to Reopen HealthCare.gov”. From the press release:
U.S. Senator Cory Booker (D-NJ) today blasted President Trump for his decision against reopening HealthCare.gov so that individuals currently without health insurance could sign up for coverage. Booker was the first lawmaker to propose leglislation that would create such an enrollment period so that millions of individuals impacted by COVID-19 could access coverage.
“This decision is the height of callousness and irresponsibility,” Booker said. “We’re in the midst of a global pandemic and people need health care coverage, yet the President is denying people access to it. The Affordable Care Act was created for this very purpose – so individuals without health insurance could get affordable, quality coverage. At a time when our health care system is already under enormous strain, it makes no sense to willingly allow even one more individual to go without coverage.”
“The President should reverse course immediately and allow for a special enrollment period. Failing that, Congress should quickly pass my Carefor COVID-19 Act, which would immediately create a special enrollment period so that uninsured individuals can get covered.”
Booker introduced the Care for COVID-19 Act in early March. In addition to creating a special enrollment period for individuals impacted by Coronavirus, the bill would also require health insurance plans to cover services related to the virus, like testing and prevention, with no cost-sharing to patients. This measure, which Booker was also the first to propose, was incorporated in the two Coronavirus relief packages recently passed by the Senate. Millions of Americans will no longer face a cost barrier for Coronavirus testing or preventative services.
April 2, 2020: Human Rights Campaign posted news titled: “HRC Responds to Trump Refusing to Reopen Obamacare Exchanges”. From the news:
Over 20 million Americans and almost one-in-five LGBTQ people lack health coverage.
Today, HRC responded to the Trump administration’s decision against reopening the Affordable Care Act’s Healthcare.gov marketplaces to new customers despite millions of Americans living without health insurance during a global pandemic.
“Our country is in crisis. Americans are finding themselves jobless, lying awake at night trying to find ways to make ends meet and put food on their tables. The last thing people should worry about in a pandemic is access to health care,” said HRC President Alphonso David. “Over 20 million Americans and almost one-in-five LGBTQ people lack health coverage. By not reopening the ACA exchange, Trump is making the LGBTQ community, and every marginalized community across this nation, more vulnerable to the virus. Yet again, Trump has failed us when we needed presidential leadership most. Americans need the exchange reopened, President Trump must act now.”…
April 3, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorneys General Becerra and Stein Send Letter Urging Trump Administration to Instate Special Enrollment Period on Healthcare.gov to Help Millions of Consumers with COVID-19”. From the press release:
California Attorney General Xavier Becerra and North Carolina Attorney General Josh Stein today led a coalition of 22 attorneys general in sending a letter to the U.S. Department of Health and Human Services (HHS) and its Centers for Medicare & Medicaid Services (CMS), urging them to reconsider their shortsighted decision to deny a special enrollment period on HealthCare.Gov during the current worldwide pandemic. In the letter, the attorneys general argue that the federal government should take action to make it possible for Americans across the country – who are facing uncertainty as a result of COVID-19 – to obtain the healthcare coverage they need during this critical time.
“As Americans work together to ‘flatten the curve’ of this global health crisis, our leaders must do all they can to support our communities through this period of physical and economic uncertainty,” said Attorney General Becerra. “At a time when millions have lost their jobs as a result of the pandemic, denying people the opportunity to gain healthcare coverage through HealthCare.Gov is not only irresponsible, it’s immoral. We’re calling on the Trump Administration to do their part so that people across our nation can access affordable, life-saving healthcare treatment. No one should have to choose between taking care of their health and going bankrupt.”
In the letter, the attorneys general point out that as a result of the COVID-19 pandemic, millions of individuals have lost their jobs—and with their jobs, their ability to pay for healthcare. Many people may be prevented from obtaining treatment because they lack healthcare coverage, or face financial ruin if they seek care. People working on the front lines in grocery stores, food service, transportation, and sanitation are suffering the brunt of the pandemic as they often lack health insurance and work jobs that do not provide sick leave. Because they are uninsured, they are less likely to have a regular place to obtain healthcare and are more likely to delay obtaining care due to fears of the cost. The Trump Administration has long touted choice and “informed healthcare decisions” as the bedrock of its healthcare policies, but now refuses to give Americans the option of obtaining comprehensive healthcare coverage to combat this unprecedented healthcare care crisis.
The attorneys general also highlight that a national solution to this problem requires federal action. While some states run their own health insurance exchanges and may independently extend enrollment – like Covered California did on March 20, 2020 – 38 states, including North Carolina, rely on HealthCare.Gov to run their exchanges. The federal government has the legal ability to call for a special enrollment period, and must take decisive action so that people in those 38 states can obtain the healthcare they need during this critical time.
Joining Attorneys General Becerra and Stein in sending the letter are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.
A copy of the letter is available here.
April 3, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “ACOG Leads Coalition of Nearly 1 Million Medical Professionals to Oppose Texas Restrictions on Abortion During the COVID-19 Pandemic”. From the press release:
The American College of Obstetricians and Gynecologists (ACOG) led a coalition of major medical organizations representing nearly 1,000,000 health care professionals in filing an amicus brief telling the United States Court of Appeals for the Fifth Circuit that the COVID-19 pandemic should not be used as a pretext to effectively ban abortion in Texas.
The right to terminate a pregnancy is a constitutionally protected legal right. However, a March 22, 2020, Order from Texas Governor Greg Abbott concerning procedures to be delayed or cancelled during the COVID-19 pandemic and its interpretation by the Texas Attorney General would impose criminal and other penalties on medical professionals for providing such care. “For the first time since 1973, abortion is effectively illegal in Texas,” the brief states. The brief explains that abortion is an essential, time-sensitive, and safe component of health care and that the there is no medical justification for this move.
The 20 major medical organizations, which include the American Medical Association and organizations of front-line medical professionals such as the American Academy of Family Physicians, the American College of Physicians, the American College of Nurse-Midwives, the American Academy of Pediatrics, the American Psychiatric Association, the American Osteopathic Association, and the American Academy of Nursing, explain that abortion is a time-sensitive procedure that should not be delayed or restricted. The brief explains that permitting abortion care – which is essential, time-sensitive health care – will not substantially increase the burdens hospitals face as a result of the COVID-19 pandemic. Instead, forcing women to carry pregnancies to term or to resort to illegal methods of abortion will increase reliance on the already strained health care system. Texas’s approach is contrary to the shared position of ACOG, the American Board of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, and other physician organizations, which categorizes abortion as a time-sensitive, essential procedure. The AMA holds a similar position, as do other professional societies.
The brief adds: “The Governor’s decision to effectively ban abortion in Texas and to criminalize physicians and medical professionals for providing necessary abortion care during the COVID-19 pandemic lacks a valid medical justification. If allowed to remain in effect, the Governor’s order will render abortion inaccessible in the state and severely harm women.”
The brief explains that there is no evidence that delaying abortion during the pandemic would mitigate personal protective equipment (PPE) shortages or promote public health and safety. Indeed, forcing women to carry pregnancies to term or to resort to illegal abortion is likely to increase use of PPE.
ACOG President Ted L. Anderson, MD, PhD, FACOG, FACS, stated, “In the face of this pandemic, physicians and clinicians across specialties on the frontlines are putting themselves at risk in order to meet our professional, ethical, and moral obligation to care for our patients. Imposing criminal penalties on health care professionals during this time will leave them unable to provide patients with needed care. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and well-being.”
Skye Perryman, JD, Chief Legal Officer for ACOG, added, “We are disappointed to see that Texas is ignoring the voice of the medical community and placing politics above the advice of physicians. Using the COVID-19 pandemic to push political agendas is unconscionable and is harmful the health of women.”
Read the full brief.
April 3, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Fight to Stop Texas from Blocking Abortions During Coronavirus Pandemic.” From the press release:
New York Attorney General Letitia James today continued her leadership of the nation’s fight to ensure women’s reproductive health care is not stifled or infringed upon in any way during the coronavirus 2019 (COVID-19) public health crisis. Attorney General Games is leading a coalition of 19 attorneys general in filing an amicus brief – supporting the plaintiffs in Planned Parenthood v. Abbott, in the U.S. Court of Appeals for the Fifth Circuit – opposing the State of Texas’s directive banning nearly all abortion services in the state, using the coronavirus as an excuse.
“Neither Texas nor any other state has the right to use the coronavirus as an excuse to restrict a woman’s constitutional right to access an abortion,” said Attorney General James. “This is clearly an effort to circumvent the Supreme Court’s decision nearly 50 years ago guaranteeing women control over their bodies. Instead of trying to strip women of their choices, Texas should be joining us to increase access to medical abortions as we battle COVID-19. Our coalition will not hesitate to take legal action against any assault on women’s choices, women’s freedoms, and women’s bodies.”
On Sunday, March 22, Texas Governor Greg Abbott issued Executive Order GA-09, “postpon[ing] all surgeries and procedures that are not immediately medically necessary” in the State of Texas for at least 30 days. The next day, Texas Attorney General Ken Paxton announced that the executive order banned abortion services unless the life of the mother was in jeopardy. The executive order also states that any health care worker caught defying the order could be fined up to $1,000 and/or imprisoned in jail for up to 180 days.
Last Wednesday, a lawsuit was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, and the Lawyering Project in the U.S. District Court for the Western District of Texas, which called on the courts to immediately issue a temporary restraining order blocking the ban.
Earlier this week, District Court Judge Lee Yeakel issued a temporary restraining order that stopped the abortion ban from taking effect, stating, “Regarding a woman’s right to a pre-fetal-viability abortion, the Supreme Court has spoken clearly. There can be no outright ban on such a procedure.” Judge Yeakel continued, “This court will not speculate on whether the Supreme Court included a silent ‘except-in-a-national-emergency clause’ in its previous writings on the issue. Only the Supreme Court may restrict the breadth of its rulings.”
The very next day — following a request by Texas — the U.S. Court of Appeals for the Fifth Circuit halted the district court’s decision, effectively reinstituting the ban on abortions in Texas. According to news reports, women in Texas have already been turned away when seeking an abortion because of the directive.
Today, Attorney General James is following through on last week’s pledge to lead a coalition of attorneys general in opposing Texas’ ban and filing an amicus brief in support of the plaintiff organizations. In the amicus brief, Attorney General James and the coalition argue that reproductive health care is an “essential medical service” that should be available to women, despite the ongoing public health emergency and that Texas’s “prohibition blocks the exercise of a woman’s constitutional right to access abortion.” Although Texas claims that its abortion ban is needed to conserve limited personal protective equipment (PPE), “most pre-viability abortions do not use PPE or hospital services, and thus restricting such abortions does not appreciably preserve those resources.”
The coalition goes on to argue, at a time when the entire U.S. population is being asked to limit travel, any restriction on abortions could force “women to seek those services in other States, thereby increasing the potential for transmission of COVID-19 and for burdening petitioners’ hospital facilities and PPE supplies.” Further, the coalition contends that residents of New York and other amici states may currently be in Texas without a way to return home, but they still have a right to time-sensitive reproductive care. Additionally, the coalition highlights that as New York nears the peak of projected COVID-19 hospitalizations, health care professionals from other states are being asked to travel to New York to assist, on the understanding that New York health care professionals will eventually travel to other states in an effort to assist when other states’ COVID-19 infection rates rise. These New York physicians should be able to provide residents in Texas with the same health care options they would receive anywhere else.
The coalition concludes by arguing that “a public health crisis should not be used as an excuse to deny women ‘an ability to control their reproductive lives,’” and that any ban on abortion — even for a matter of weeks — can end up restricting a woman’s “constitutional right to choose to terminate a pregnancy prior to fetal viability,” especially in states, like Texas, which already have limited timetables in place for electing to have an abortion.
Instead of limiting women’s access to abortions, Texas should be joining Attorney General James’ call to increase access to telehealth medicine and the medical-abortion pill so that woman who choose to have an abortion don’t have to fear going out and contracting COVID-19 during this public health crisis. Earlier this week, Attorney General James sent a letter to both the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration requesting that the Trump Administration waive or utilize its discretion not to enforce its Risk Evaluation and Mitigation Strategy (REMS) designation, which dictates and subsequently impedes women’s access to the medical-abortion prescription drug known as Mifepristone. Attorney General James called on the Trump Administration to ensure that women across the country can more easily access this critical health care service while the pandemic leaves many women unable to seek in-person care.
The States of Alabama, Iowa, Mississippi, and Ohio have also implemented similar orders banning abortions during the COVID-19 pandemic, limiting their residents’ constitutional rights to access an abortion. Attorney General James plans to lead coalitions opposing these bans as well…
April 3, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Joins Multistate Amicus Brief Challenging Texas’ Restrictions on Abortion During COVID-19″. From the press release”:
California Attorney General Xavier Becerra today joined a multistate coalition of 19 attorneys general in filing an amicus brief in the Fifth Circuit Court supporting Planned Parenthood health centers (Planned Parenthood for Choice, Planned Parenthood of Greater Texas, Planned Parenthood of South Texas), Whole Woman’s Health, and other providers in their case challenging a Texas executive order that declares abortion non-essential medical care during the COVID-19 response. The order would ban all abortion services in the state. In the brief, the attorneys general argue that abortion care is an essential healthcare service and urge the Court to enjoin the executive order, so that women can access needed, time-sensitive healthcare, including safe and legal abortion.
“During the COVID-19 pandemic, we should be making it easier for women to safely access time-sensitive, essential healthcare, not using a crisis as an excuse to pander to antichoice ideology,” said Attorney General Becerra. “We’re standing with attorneys general across the country to defend women’s right to reproductive healthcare, including safe and legal abortion.”
On March 22, 2020, Texas Governor Greg Abbott issued Executive Order GA 09, “relating to hospital capacity during the COVID-19 disaster.” The Executive Order prohibits all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition or to preserve a patient’s life. In response to this Executive Order, on March 23, 2020, Texas Attorney General Ken Paxton issued a press release singling out abortion providers and suggesting that non-emergency abortions would violate the Executive Order and could be subject to criminal penalties, including jail time. This also precludes medication abortion which only involves taking medication and is neither a “surgery” nor a “procedure.” In essence, Attorney General Paxton’s press release operates as a near-complete ban on abortion in Texas during the COVID-19 public health emergency. As a result of the Attorney General’s statements, plaintiff providers have cancelled scheduled appointments and have stopped providing all abortion care. This means that the women of Texas do not have the freedom to make a very personal decision in consultation with their medical providers.
In the amicus brief the attorneys general argue that the executive order:
- Harms patients’ physical, emotional, and financial wellbeing, and the wellbeing of their families;
- Denies Texas women their fundamental right to determine when and whether to have a child or to add to their existing families; and
- Will force some women to travel to other states in search of services, increasing the potential for transmission of COVID-19 and the burden on state hospitals and healthcare workers.
In filing the brief, Attorney General Becerra joins the attorneys general of New York, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Massachusetts, Minnesota, Nevada, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District Of Columbia.
A copy of the brief is available here.
April 3, 2020: Politico posted an article titled: “How Trump surprised his own team by ruling out Obamacare”. It was written by Adam Cancryn, Nancy Cook, and Susannah Luthi. From the article:
As the coronavirus ran rampant and record jobless numbers piled up, the nation’s health insurers last week readied for a major announcement: The Trump administration was reopening Obamacare enrollment to millions of newly uninsured Americans.
It was an announcement that never came.
The White House instead rejected the prospect of allowing new sign-ups across the 38 Affordable Care Act marketplaces it controls — a decision that shocked the health care industry, triggered widespread criticism and prompted a scramble within the administration to find a new way to care for the growing population left exposed to the pandemic.
It’s also one that allowed Trump to sidestep an awkward reckoning with the Affordable Care Act, which he’s long vowed to kill, and the health care program bearing the name of his Democratic predecessor.The president opposed reopening the Obamacare marketplaces when presented with the option, one person familiar with the decision said — prompting the creation of an initiative that federal officials are now rushing to construct…
…On Friday, Trump touted his administration’s plan to cover uninsured patients’ coronavirus treatments by paying hospitals for their costs, on the condition that providers also not stick those people with separate charges…
…That declaration surprised even some officials in the Health and Human Services Department, who believed the concept was still under consideration. And amid a crush of criticism from Democrats led by 2020 presidential frontrunner Joe Biden, it worried officials who viewed the verdict as an unforced error in the middle of a historic pandemic…
…Health and Human Services Secretary Alex Azar on Friday insisted that paying providers directly for coronavirus treatment represented a faster and more targeted solution.
The uninsured will be able to seek treatment immediately, without worrying about first purchasing insurance coverage, Azar said. And hospitals will be reimbursed swiftly for their expenses, on the additional condition that they not stick their patients with surprise bills…
…Yet the announcement comes with fresh questions about how smoothly the administration can run the payment process in the middle of an all-consuming crisis, how much of the $100 billion fund already earmarked for hospitals it will consume and how expansive the coverage for the uninsured will be.
If Trump had chosen instead to reopen the HealthCare.gov website — as 11 largely blue states that control their own markets have already done — people without insurance could buy more comprehensive policies that not only would cover coronavirus treatments but any follow-up treatment, mental-health care, and future check-ups.
Trump, however, has long opposed Obamacare, pledging on the campaign trail to eliminate it and making the law’s repeal and replacement a top priority of his presidency. That aspiration ended in failure in 2017, though the administration has successfully rolled back a central requirement that all Americans purchase health insurance.
The White House has since sought to limit Obamacare’s reach, while backing a lawsuit by GOP-led states to wipe out the law altogether — a position it’s continued to hold as coronavirus cases mount…
…The White House decision also caught the hospital industry off guard, frustrating executives who spent the past week awaiting guidance for how strained front-line facilities could access the new funding…
April 3, 2020: California Governor Gavin Newsom posted a press release titled: “Governor Newsom Issues Executive Order to Expand Telehealth Services”. From the press release:
Governor Gavin Newsom today signed an executive order to expand protections to medical providers as they amplify the use of video chats and similar applications to provide routine and non-emergency medical appointments in an effort to minimize patient exposure to COVID-19.
The order relaxes certain state privacy and security laws for medical providers, so they can provide telehealth services without the risk of being penalized. This action is similar to the federal HHS Office for Civil Rights waiver issued on March 17, 2020 regarding federal privacy and security laws.
“This order provides flexibility to our medical and health providers so that they are able to provide continuity of health services to people across the state, and will allow providers to assess a greater number of patients while limiting the risk of exposure and infection of other persons from in-person consultations,” said Governor Newsom.
Governor Newsom continues to encourage people to practice safe physical distancing and to comply with stay-at-home orders to bend the COVID-19 curve.
A copy of the Governor’s executive order can be found here, and the text of the order can be found here.
April 4, 2020: Center for Reproductive Rights posted a press release titled: “Court Blocks Oklahoma’s COVID-19 Abortion Ban”. From the press release:
Today a federal district judge in Oklahoma granted a temporary restraining order at the request of the Center for Reproductive Rights, Planned Parenthood Federation of America and Dechert LLP, allowing providers to continue time-sensitive, essential abortion care in spite of Oklahoma Gov. Kevin Stitt’s order requiring all elective surgeries and minor medical procedures be postponed. He singled out abortion care in a press release, claiming the order prohibited abortions in the state. Today’s ruling allows medication abortions to resume in the state, along with abortion procedures for patients who would be pushed beyond the gestation limit for care.
In his decision, federal district Judge Charles Goodwin wrote that the state of Oklahoma, “has acted in an ‘unreasonable,’ ‘arbitrary,’ and ‘oppressive’ way—and imposed an ‘undue burden’ on abortion access—in imposing requirements that effectively deny a right of access to abortion.” Orders like these have forced some patients to travel hundreds of miles in a pandemic just to access basic and essential health care.
“The court has stopped Governor Stitt from exploiting this devastating pandemic as a weapon in his battle to ban abortion,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Abortion is time-sensitive, essential healthcare. Women in Oklahoma are again able, for the time being, to access abortion care in their state at a time when travel is even more challenging.”…
…The Center for Reproductive Rights is challenging a host of other abortion restrictions in Oklahoma, including: a ban on the use of telemedicine to provide medication abortion care; a law that forces patients to delay their abortion care for at least 72 hours after receiving certain state-mandated information; a “physician-only” law that bans qualified medical professionals from providing medication abortion care; a ban on the standard method of abortion after approximately 14 weeks of pregnancy; and a law requiring doctors to tell patients that some abortions can be “reversed”—a patently false statement.
This lawsuit was filed by T.J. Tu with the Center for Reproductive Rights, along with Planned Parenthood Federation of America, pro-bono counsel Dechert LLP, and local counsel Blake Patton of Walding & Patton PLLC. Plaintiffs in the case are Trust Women—an abortion provider with clinics in Oklahoma and Kansas—Dr. Larry Burns, and Comprehensive Health of Planned Parenthood Great Plains—which provides abortion services in Oklahoma and Kansas.
The decision is available here.
April 6, 2020: Center for Reproductive Rights posted a press release titled: “Court Blocks Oklahoma’s COVID-19 Abortion Ban”. From the press release:
Today a federal district judge in Oklahoma granted a temporary restraining order at the request of the Center for Reproductive Rights, Planned Parenthood Federation of America and Dechert LLP, allowing providers to continue time-sensitive, essential abortion care in spite of Oklahoma Gov. Kevin Stitt’s order requiring all elective surgeries and minor medical procedures be postponed. He singled out abortion care in a press release, claiming the order prohibited abortions in the state. Today’s ruling allows medication abortions to resume in the state, along with abortion procedures for patients who would be pushed beyond the gestation limit for care.
In his decision, federal district Judge Charles Goodwin wrote that the state of Oklahoma, “has acted in an ‘unreasonable,’ ‘arbitrary,’ and ‘oppressive’ way—and imposed an ‘undue burden’ on abortion access—in imposing requirements that effectively deny a right of access to abortion.” Orders like these have forced some patients to travel hundreds of miles in a pandemic just to access basic and essential health care.
“The court has stopped Governor Stitt from exploiting this devastating pandemic as a weapon in his battle to ban abortion,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Abortion is time-sensitive, essential healthcare. Women in Oklahoma are again able, for the time being, to access abortion care in their state at a time when travel is even more challenging.”
“It’s a huge relief that we can start seeing patients again, at least for now,” said Julie Burkhart, founder and CEO of Trust Women. “We hope the court will keep the ban blocked so our patients aren’t forced to travel to other states to find abortion care at a time when travel is risky and discouraged.”
“Though this is a relief for patients, they should have never had to wait for a judge to rule before accessing the time-sensitive care they needed. Gov. Stitt is wasting valuable time and resources using the COVID-19 pandemic to score political points,” said Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America. “To politicians and anti-abortion groups playing political games amid a pandemic, let this be a lesson to you that we won’t allow you to put our patients and the community at risk.”
“Planned Parenthood is committed to ensuring that every person is able to get the essential health care they need,” McGill Johnson continued. “But the same cannot be said for Gov. Stitt. Planned Parenthood will work day by day, week by week to safeguard the ability of patients and the community to access essential health care, no matter what.”
“Today’s ruling is important because our patients need and deserve access to abortion care,” said Brandon Hill, Ph.D., president and CEO of Comprehensive Health of Planned Parenthood Great Plains. “Abortion is an essential and time-sensitive medical procedure that should not be caught in the crosshairs of poltical agendas—especially during this public health crisis. Access to health care is a basic human right, and every person deserves care that gives them control over their own bodies, lives, and futures. Planned Parenthood Great Plains will always be there for our patients. We will do everything in our power to ensure access for patients who need sexual and reproductive health care, including access to abortion.”Oklahoma is not the first state to attempt to ban abortion during the COVID-19 pandemic. The Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, and other allies have also filed lawsuits in Alabama, Iowa, Ohio, and Texas. Temporary restraining orders were also secured in Ohio, Alabama, and Texas. However, the 5th U.S. Circuit Court of Appeals stayed the temporary restraining order in Texas on March 31.
Leading medical organizations like the American College of Obstetricians and Gynecologists and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. The AMA stated, “At this critical moment and every moment, physicians – not politicians – should be the ones deciding which procedures are urgent-emergent and need to be performed, and which ones can wait, in partnership with our patients.”
The Center for Reproductive Rights is challenging a host of other abortion restrictions in Oklahoma, including: a ban on the use of telemedicine to provide medication abortion care; a law that forces patients to delay their abortion care for at least 72 hours after receiving certain state-mandated information; a “physician-only” law that bans qualified medical professionals from providing medication abortion care; a ban on the standard method of abortion after approximately 14 weeks of pregnancy; and a law requiring doctors to tell patients that some abortions can be “reversed”—a patently false statement.
This lawsuit was filed by T.J. Tu with the Center for Reproductive Rights, along with Planned Parenthood Federation of America, pro-bono counsel Dechert LLP, and local counsel Blake Patton of Walding & Patton PLLC. Plaintiffs in the case are Trust Women—an abortion provider with clinics in Oklahoma and Kansas—Dr. Larry Burns, and Comprehensive Health of Planned Parenthood Great Plains—which provides abortion services in Oklahoma and Kansas.
The decision is available here.
April 6, 2020: Planned Parenthood posted an article titled: “Court Blocks Oklahoma’s COVID-19 Abortion Ban”. From the press release:
Today a federal district judge in Oklahoma granted a temporary restraining order at the request of the Center for Reproductive Rights, Planned Parenthood Federation of America and Dechert LLP, allowing providers to continue time-sensitive, essential abortion care in spite of Oklahoma Gov. Kevin Stitt’sorder requiring all elective surgeries and minor medical procedures be postponed. He singled out abortion care in a press release, claiming the order prohibited abortions in the state. Today’s ruling allows medication abortions to resume in the state, along with abortion procedures for patients who would be pushed beyond the gestation limit for care.
In his decision, federal district Judge Charles Goodwin wrote that the state of Oklahoma, “has acted in an ‘unreasonable,’ ‘arbitrary,’ and ‘oppressive’ way—and imposed an ‘undue burden’ on abortion access—in imposing requirements that effectively deny a right of access to abortion.” Orders like these have forced some patients to travel hundreds of miles in a pandemic just to access basic and essential health care.
Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“Though this is a relief for patients, they should have never had to wait for a judge to rule before accessing the time-sensitive care they needed. Gov. Stitt is wasting valuable time and resources using the COVID-19 pandemic to score political points. To politicians and anti-abortion groups playing political games amid a pandemic, let this be a lesson to you that we won’t allow you to put our patients and the community at risk.
“Planned Parenthood is committed to ensuring that every person is able to get the essential health care they need. But the same cannot be said for Gov. Stitt. Planned Parenthood will work day by day, week by week to safeguard the ability of patients and the community to access essential health care, no matter what.”
Statement from Brandon Hill, Ph.D., president and CEO of Comprehensive Health of Planned Parenthood Great Plains:
“Today’s ruling is important because our patients need and deserve access to abortion care. Abortion is an essential and time-sensitive medical procedure that should not be caught in the crosshairs of political agendas—especially during this public health crisis. Access to health care is a basic human right, and every person deserves care that gives them control over their own bodies, lives, and futures. Planned Parenthood Great Plains will always be there for our patients. We will do everything in our power to ensure access for patients who need sexual and reproductive health care, including access to abortion.”
Statement from Nancy Northup, president and CEO of the Center for Reproductive Rights:
“The court has stopped Governor Stitt from exploiting this devastating pandemic as a weapon in his battle to ban abortion. Abortion is time-sensitive, essential healthcare. Women in Oklahoma are again able, for the time being, to access abortion care in their state at a time when travel is even more challenging.”
Statement from Julie Burkhart, founder and CEO of Trust Women:
“It’s a huge relief that we can start seeing patients again, at least for now. We hope the court will keep the ban blocked so our patients aren’t forced to travel to other states to find abortion care at a time when travel is risky and discouraged.”
Oklahoma is not the first state to attempt to ban abortion during the COVID-19 pandemic. The Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, and other allies have also filed lawsuits in Alabama, Iowa, Ohio, and Texas. Temporary restraining orders were also secured in Ohio, Alabama, and Texas. However, the 5th U.S. Circuit Court of Appeals stayed the temporary restraining order in Texas on March 31.
Leading medical organizations like the American College of Obstetricians and Gynecologists and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. The AMA stated, “At this critical moment and every moment, physicians – not politicians – should be the ones deciding which procedures are urgent-emergent and need to be performed, and which ones can wait, in partnership with our patients.”
The Center for Reproductive Rights is challenging a host of other abortion restrictions in Oklahoma, including: a ban on the use of telemedicine to provide medication abortion care; a law that forces patients to delay their abortion care for at least 72 hours after receiving certain state-mandated information; a “physician-only” law that bans qualified medical professionals from providing medication abortion care; a ban on the standard method of abortion after approximately 14 weeks of pregnancy; and a law requiring doctors to tell patients that some abortions can be “reversed”—a patently false statement.
This lawsuit was filed by T.J. Tu with the Center for Reproductive Rights, along with Planned Parenthood Federation of America, pro-bono counsel Dechert LLP, and local counsel Blake Patton of Walding & Patton PLLC. Plaintiffs in the case are Trust Women—an abortion provider with clinics in Oklahoma and Kansas—Dr. Larry Burns, and Comprehensive Health of Planned Parenthood Great Plains—which provides abortion services in Oklahoma and Kansas.
The decision is available here.
April 6, 2020: Centers for Reproductive Rights posted an article titled: “In the Face of COVID-19 Pandemic, Sexual and Reproductive Health Services Are Essential”. From the press release:
As the COVID-19 pandemic continues to spread across the globe – pushing healthcare systems to their limits and compelling governments and healthcare institutions to make difficult and increasingly urgent decisions about how to deliver care while also curbing virus transmission – it is critical that responses to this crisis recognize that sexual and reproductive health services are essential, respecting people’s rights to make decisions about their bodily autonomy and integrity.
The COVID-19 pandemic poses particular threats to poor and marginalized women who face greater difficultly in protecting themselves from transmission due to lack of information, resources, and access to quality health and social services. Women’s societal roles as caregivers, both within their own households and for others, places them at greater risk of infection and exacerbates the impact of COVID in their lives. The rights and health of these women must be central considerations as governments and other stakeholders formulate their response to this public health crisis.
At the same time, anti-abortion groups and some governments are exploiting this situation to deny women and girls access to abortion services. These cynical attempts to rollback decades of progress in increasing women and girls’ access to safe, legal abortion care must be stopped. They otherwise threaten to increase the strain on already over-burdened health care systems by compelling individuals to seek out unsafe abortion services and increase the need for post-abortion care.
As resources are rapidly being redeployed in response to COVID-19, we are calling on all governments to:
Provide abortion as an essential health service. Abortion access is essential preserve the life and health of pregnant people.The attendant impacts of COVID-19 have the potential to severely undermine access to abortion services, as travel restrictions limit transportation options, the economic slowdown pushes many individuals into more precarious financial situations, and healthcare system capacity becomes increasingly limited. Abortion is always a time-sensitive procedure that should not be postponed. Measures that undermine access to abortion care will force people to seek out unsafe abortion services or services later in pregnancy, putting their lives and health at risk.
Remove Legal and Administrative Barriers to Abortion Services, including to Medical Abortion. Governments and healthcare institutions must also remove all legal and administrative hurdles to access abortion services, including lifting criminal sanctions on abortion, and ensure all possibilities to guarantee safe access while minimizing contact with healthcare personnel at the frontlines of tackling the pandemic, including the adoption of technological advancements such as telemedicine and ensuring women and girls are not unnecessarily compelled to make multiple trips to healthcare facilities.
Medication abortion is a safe, cost-effective means for enabling women and girls to end an unwanted pregnancy. Misoprostol, one of the active drugs for Medication abortion, is included in the WHO’s Model List of Essential Medicines—meaning that governments should register it as an essential medicine. Yet in many countries, Medication abortion remains unavailable. To increase access to safe abortion services while also reducing the strain on healthcare systems, medication abortion should be made widely available, including over the counter at pharmacies. When desired, women and girls should also be able to utilize telemedicine to consult with healthcare providers on medication abortion.
Comply with the Minimum Initial Services Package for Reproductive Health, an international standard of care that should be implemented at the onset of every emergency, including public health emergencies. This priority set of lifesaving and essential services includes obstetric, prenatal, and postnatal care; contraceptive information and services, including emergency contraception; and post abortion care and post-rape care.
Guarantee Access to Quality, Respectful Maternal Health Care. As resources are reallocated to respond to the pandemic, it remains critical that all people have access to quality maternal health care, free from discrimination, violence and coercion. Resource constraints and emergency situations are often precursors to human rights violations in maternal health settings, such as mistreatment and abuse of women during delivery and violations of the right to informed consent. Such violations disproportionately impact marginalized populations, such as racial and ethnic minorities, poor women and rural women. Governments must take steps to guarantee women and girls’ rights in these settings. Furthermore, as information continues to evolve about the risk of COVID-19 to pregnant women and newborn children, it is paramount that governments and health care providers continue ensuring women’s rights to make decisions about labor and childbirth to the extent feasible.
Ensure Timely Access to Contraception, Including Emergency Contraception. Disrupted supply chains and reallocation of health resources during COVID-19 can have dire impacts on access to contraception. In addition to being essential for enabling people to make decisions about their reproductive autonomy, guaranteeing access to contraception can also mitigate near-term demands on the healthcare system that would result from unplanned pregnancy. States must ensure access to contraceptive information and services as an essential measure for enabling people to avoid unintended pregnancy, which can have significant impacts on their lives and health.
April 6, 2020: Human Rights Campaign posted news titled: “An Update on Gender Affirming Care During the COVID-19 Pandemic”. From the news:
The postponement of essential surgeries can take a dangerous mental health toll on patients, many of whom have waited years and gone through a long and painful process in order to finally get them scheduled.
Post submitted by Carl G Streed Jr. MD, MPH (Research Lead), Jennifer Siegel MD (Medical Director), Center for Transgender Medicine & Surgery at Boston Medical Center
By now, we all have seen the impact of COVID-19 on our daily lives. We have been quarantining and physically distancing from our loved ones, witnessed hospitals overwhelmed by the crisis and seen people lose their jobs and livelihoods. Some of us may have already experienced personal loss. We know LGBTQ communities are particularly vulnerable to both the economic and health impacts of the virus–because they are more likely to work in industries highly-impacted by the pandemic, such as service industries–and they may have more health risk factors that exacerbate the disease, like smoking.
As part of their response to the pandemic, hospital systems across the country have postponed non-emergency surgeries and procedures in order to prioritize care for COVID-19 patients. This includes many gender-affirming procedures, which are now unfortunately on hold.
We know that gender-affirming medical and surgical care are essential to the long-term well-being of our transgender and gender diverse patients, families and communities. Just because these procedures have currently been classified as non-urgent does not mean we consider them to be non-essential. We know that gender-affirming care is indeed lifesaving, but we also know that right now the immediate health of the public is paramount. While our transgender and gender-diverse patients understand this, we know that understanding reasons for postponing procedures does not make these postponements any less distressing.
As health care professionals, we recognize that the postponement of these essential surgeries can take a dangerous mental health toll on our patients, many of whom have waited years and gone through a long–and often painful–process in order to finally get them scheduled. We want to be sure that our patients know that we are still here for them during this stressful and painful time. If you or a loved one has had gender-affirming care postponed due to COVID-19, you are not alone.
Our Center for Transgender Medicine & Surgery at Boston Medical Center is still fielding phone calls, conducting telemedicine visits and managing hormone therapy. We do not know of any shortages of hormone therapy at this time, and we ask that patients do not “stock up” or “hoard” medications as that could potentially lead to a temporary shortage. We need to look out for each other and be sure that everyone is getting the care they can at this time — so please reach out to your trans siblings to let them know they are supported and loved…
April 7, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Co-leads Letter Urging Trump Administration to Safeguard Americans’ Healthcare Coverage, Halt Implementation of Their Abortion Separate Payment Rule”. From the press release:
California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of seven attorneys general, sent a letter urging the U.S. Department of Health and Human Services (HHS) to delay the implementation of its rule that unlawfully reinterprets Section 1303 of the Affordable Care Act (ACA). Implementing the rule would limit healthcare coverage, including reproductive care, and endanger Americans’ health as the nation works to combat the COVID-19 pandemic. In the letter, the attorneys general argue that HHS should halt implementation of the rule to aid states’ response to COVID-19 and protect the healthcare coverage that Americans rely on.
“The Trump Administration’s separate payment rule puts Americans’ healthcare coverage at risk, and burdens states and health plans at a time when we should be streamlining our response to the global COVID-19 crisis,” said Attorney General Becerra. “This burdensome rule is intended to limit access to women’s reproductive care, but it will foolishly endanger access to all healthcare when people need it most. The Trump Administration should do the right thing and protect Americans’ healthcare coverage during this unprecedented public health crisis.”
Under California law, all health plans regulated by the state are required to offer abortion coverage as part of their basic healthcare services. On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to separately bill for the portion of health insurance premiums attributable to abortion coverage. This would require consumers to make a separate payment of at least one dollar for these services. Failure to pay the separate bill puts individuals at risk of losing all of their healthcare coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion, putting more than 1.4 million enrollees in California alone at risk of losing coverage if they inadvertently fail to make full premium payments on time. The rule also burdens states with unnecessary administrative costs and harms consumers who may face higher insurance premiums as a result of increased costs to carriers.
In the letter, the attorneys general argue that implementing the rule during this public health and economic crisis is irresponsible and harmful to people across the country. Over the past several weeks, the U.S. has experienced a significant increase in the need for aid, funding, and other support to help various states respond to the pandemic. Pressing ahead with implementation of this rule during the global health crisis would impose additional financial burdens on state agencies; require countless personnel hours, funds, and resources to come into compliance; and jeopardize the health of consumers more in need of health coverage than ever. Furthermore, HHS has recognized that implementing the rule will have significant economic consequences. According to HHS’s own estimates, the one-time costs to bring all affected health plans into compliance would include over 2.9 million hours of work and approximately $385 million for insurers across the nation. These costs would likely result in increased prices for consumers, who are already suffering from the economic impacts of the COVID-19 pandemic. The attorneys general call on HHS to halt implementation of the rule to protect the health and economic security of consumers across the nation.
In sending the letter, Attorney General Becerra joined the attorneys general of New York, Colorado, Maryland, Oregon, Vermont, and the District of Columbia.
A copy of the letter is available here.
April 7, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood’s Clergy Advocacy Board: COVID-19 Response Must Preserve Access to Abortion, Reproductive Health Care”. From the press release:
The Planned Parenthood Federation of America Clergy Advocacy Board today condemned efforts by some state and national leaders to use the COVID-19 response to halt abortions. This call from faith leaders to support access to reproductive health care follows the 5th Circuit Court of Appeals’ use of an extraordinary measure to allow Texas Gov. Greg Abbott to drastically restrict essential, time-sensitive abortion procedures. Planned Parenthood and our partners are fighting in court in Texas, Ohio, Oklahoma, and Alabama to protect access.
Statement from The Rev. Marci Auld Glass, Planned Parenthood Federation of America Clergy Advocacy Board Chair and a Presbyterian minister in Boise, Idaho:
“As a pastor who often accompanies members of my community through personal struggle, I know that individuals should always be assured the right to follow their consciences and make their own decisions about their health care, including abortion. Anxieties about how so many will provide and care for themselves and their families are already so high. In this moment of crisis, people of faith must stand together and demand that politicians stop using this pandemic to gamble with women’s health, lives, and well-being by denying them access to abortion care.”
For more than two decades, the Clergy Advocacy Board has worked with Planned Parenthood at the national and state levels to further reproductive rights and freedom for all people, building on a history of faith leaders’ activism in support of reproductive health care. Its members, who are dedicated clergy and faith leaders from different denominations and communities throughout the U.S., lead a national effort to increase public awareness of the theological and moral basis for reproductive health.
The full statement from the Clergy Advocacy Board is below.
Statement of the Planned Parenthood Federation of America Clergy Advocacy Board:
“The Clergy Advocacy Board calls upon people of faith to speak out in this moment of crisis and affirm that access to abortion care is a religious value. Every person in our country has the right to make decisions about their reproductive lives, informed by their own culture, faith tradition, conscience, and community values. Americans should not fear that politicians will take advantage of a pandemic to impose their own beliefs on others. We condemn all efforts to put the health and well-being of pregnant people at risk by delaying or denying access to abortion care.
“As leaders in our communities, we know how critical it is that our neighbors and friends can receive the essential health care that they, in their hearts, know is right for them. Many of us serve as pastoral counselors and chaplains to families and individuals. People invite us into their lives during the most challenging moments and the hardest medical decisions. Our experience leads us to protect access to reproductive health care, especially during this national medical emergency. We care about community health and want to ensure that basic health care is available in our localities.
“The COVID-19 pandemic exacerbates the vulnerabilities faced by a disturbing percentage of our population. So many are already struggling to make ends meet, to get the care they need, and to plan for their families and their futures. This is especially true for our black and brown neighbors, our refugee and immigrant neighbors, our unhoused neighbors, our LGBTQ+ neighbors, those facing domestic violence, and all who face the burden of inequality. Therefore, we call on national, state, and local leaders to do everything necessary to provide health care coverage to all who need it, regardless of their ability to pay, and that must include essential reproductive health care.”
April 7, 2020: Center for Reproductive Rights posted a press release titled: “5th Circuit Allows Texas to Continue Blocking Abortion Access During COVID-19 Pandemic”. From the press release:
Today, in a 2-1 decision, a three-judge panel of the 5th Circuit Court of Appeals used a rare procedural mechanism to rule that the district court was wrong to grant emergency relief to protect access to essential, time-sensitive abortion care. This allows Gov. Abbott to use his COVID-19 order to block access to abortion. This is the latest twist in a lawsuit brought by Texas abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — to protect access to care. Plaintiffs include Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center. Despite this setback, the providers will continue to fight for patients, who are now scrambling to access care during this pandemic.
Enforcement of the governor’s order has already had a dramatic effect on patients’ lives, with some being forced to travel hundreds of miles in a pandemic to access basic and essential health care.
The American Medical Association, the American College of Obstetricians and Gynecologists, and other national medical groups filed an amicus brief with the 5th Circuit calling out the hypocrisy of this executive order, stating: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“This is not the last word—we will take every legal action necessary to fight this abuse of emergency powers. Texas has been trying to end abortion for decades and they are exploiting this pandemic to achieve that goal. Texas women are not waiting for the courts—those who are able to travel are already leaving the state to get care. Others are tragically being left behind. The need for abortion care doesn’t disappear during a pandemic.”
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“This is unconscionable. Patients are already being forced to put their lives in harm’s way during a pandemic, and now will be forced to continue doing so to get the health care they need. Abortion is essential, it’s time-sensitive, and it cannot wait for a pandemic to pass. Instead of playing politics during a pandemic, Gov. Abbott should be focusing on the health care needs of his constituents. Planned Parenthood won’t let this injustice stand. Our patients deserve better. We’ll use every tool at our disposal to fight this harmful order and protect our patients’ health care.”
As doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers have had to cancel appointments for hundreds of patients in the ensuing confusion.
Abortion providers in mulitple states also filed similar lawsuits last week to protect abortion access during the COVID-19 pandemic. Thus far, judges have provided temporary relief to protect access to care in Alabama, Ohio, and Oklahoma.
The plaintiffs in this case — abortion providers throughout Texas — are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project, and the Law Offices of Patrick J. O’Connell PLLC. A copy of the complaint can be found here.
April 7, 2020: Planned Parenthood posted a press release titled: “5th Circuit Allows Texas to Continue Blocking Abortion Access During COVID-19 Pandemic”. From the press release:
Today, in a 2-1 decision, a three-judge panel of the 5th Circuit Court of Appeals used a rare procedural mechanism to rule that the district court was wrong to grant emergency relief to protect access to essential, time-sensitive abortion care. This allows Gov. Abbott to use his COVID-19 order to block access to abortion. This is the latest twist in a lawsuit brought by Texas abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — to protect access to care. Plaintiffs include Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center. Despite this setback, the providers will continue to fight for patients, who are now scrambling to access care during this pandemic.
Enforcement of the governor’s order has already had a dramatic effect on patients’ lives, with some being forced to travel hundreds of miles in a pandemic to access basic and essential health care.
The American Medical Association, the American College of Obstetricians and Gynecologists, and other national medical groups filed an amicus brief with the 5th Circuit calling out the hypocrisy of this executive order, stating: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“This is unconscionable. Patients are already being forced to put their lives in harm’s way during a pandemic, and now will be forced to continue doing so to get the health care they need. Abortion is essential, it’s time-sensitive, and it cannot wait for a pandemic to pass. Instead of playing politics during a pandemic, Gov. Abbott should be focusing on the health care needs of his constituents. Planned Parenthood won’t let this injustice stand. Our patients deserve better. We’ll use every tool at our disposal to fight this harmful order and protect our patients’ health care.”
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“This is not the last word—we will take every legal action necessary to fight this abuse of emergency powers. Texas has been trying to end abortion for decades and they are exploiting this pandemic to achieve that goal. Texas women are not waiting for the courts—those who are able to travel are already leaving the state to get care. Others are tragically being left behind. The need for abortion care doesn’t disappear during a pandemic.”
As doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers have had to cancel appointments for hundreds of patients in the ensuing confusion.
Abortion providers in multiple states also filed similar lawsuits last week to protect abortion access during the COVID-19 pandemic. Thus far, judges have provided temporary relief to protect access to care in Alabama, Ohio, and Oklahoma.
The plaintiffs in this case — abortion providers throughout Texas — are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project, and the Law Offices of Patrick J. O’Connell PLLC. A copy of the complaint can be found here.
April 7, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Senate Democrats to HHS: Reopen the ACA Marketplace, Allow More Americans to Get Health Insurance During COVID-19 Pandemic”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Tuesday joined Senator Chris Murphy (D-CT) and Tammy Baldwin (D-WI) and 25 Senate Democrats in urging the U.S. Department of Health and Human Services (HHS) to reopen the Affordable Care Act’s online marketplace to allow more un- and under-insured Americans to get health insurance as they face potential health issues related to COVID-19. In a letter to the Secretary Alex Azar, the senators urged HHS to allow Americans to enroll through a unique Special Enrollment Period (SEP) that should last throughout the duration of the pandemic in an effort to ensure comprehensive coverage for families and communities to protect themselves from COVID-related illness.
The senators wrote, “Currently, millions of Americans are uninsured and anxious, not only about what the possibility of contracting COVID-19 could mean for their health and that of their family, but also for their financial stability. Opening up the ACA marketplace would provide an easy pathway to coverage for those who under previous circumstances may have decided to forego health insurance or purchase a substandard, junk insurance plan, but now in a global pandemic are in vital need of comprehensive coverage to protect themselves, their families, and our broader community.”
“We believe opening an ACA SEP is the clearest way to cover the millions of uninsured and underinsured Americans in the 38 states that use the federal platform, and to provide comprehensive protections for COVID-19-related treatment and prevention,” the senators continued.
The senators concluded, “We urge you to put aside the partisan politics of the past, and to expand health coverage to millions of Americans by opening an SEP expeditiously.”
In addition to Senators Harris, Murphy and Baldwin, the letter was also signed by U.S. Senators Richard Blumenthal (D-CT), Joe Manchin (D-WV), Bob Casey (D-PA), Kirsten Gillibrand (D-NY), Martin Heinrich (D-NM), Tina Smith (D-MN), Chris Van Hollen (D-MD), Dick Durbin (D-IL), Angus King (I-ME), Maggie Hassan (D-NH), Amy Klobuchar (D-MN), Mazie Hirono (D-HI), Doug Jones (D-AL), Tim Kaine (D-VA), Tammy Duckworth (D-IL), Jack Reed (D-RI), Gary Peters (D-MI), Dianne Feinstein (D-CA), Jeff Merkley (D-OR), Jon Tester (D-MT), Tom Carper (D-DE), Jeanne Shaheen (D-NH), Elizabeth Warren (D-MA), Sherrod Brown (D-OH) and Tom Udall (D-NM).
A full text of the letter can be found here and below.
Dear Secretary Azar,
We write to urge you to reopen the Affordable Care Act’s (ACA) online marketplace through a unique Special Enrollment Period (SEP) to allow any American to enroll in a comprehensive health insurance plan. Currently, millions of Americans are uninsured and anxious, not only about what the possibility of contracting COVID-19 could mean for their health and that of their family, but also for their financial stability. Opening up the ACA marketplace would provide an easy pathway to coverage for those who under previous circumstances may have decided to forego health insurance or purchase a substandard, junk insurance plan, but now in a global pandemic are in vital need of comprehensive coverage to protect themselves, their families, and our broader community.
The Trump Administration’s reported decision not to open an SEP and leave millions of Americans uninsured and underinsured during this unprecedented public health crisis will inevitably mean fewer individuals seeking testing and treatment—prolonging the spread of the disease—and will put more families in dire financial straits. The COVID-19 pandemic is also causing millions of people to lose their jobs and their employer-provided health insurance. We should be promoting comprehensive health insurance plans to all those impacted, not looking to divert funds appropriated to support hospitals, or promoting junk insurance plans that don’t have to provide coverage for needed services or offer consumer protections.
When the ACA was passed, Congress included the authority to establish SEPs because we understood that everyday Americans may face extenuating circumstances for which they should not be penalized. It is inexcusable for you not to exercise that authority during perhaps the largest extenuating circumstance of our lifetimes, and to choose to lock out millions of Americans from the ACA exchanges because they failed to predict a sweeping global pandemic. Furthermore, the Administration’s continued promotion of junk plans which are not required to comply with consumer protections that limit out-of-pocket costs or coverage of essential health benefits, including those that are needed to pay for the treatment and prevention of COVID-19 such as hospital care, emergency care, laboratory services, or preventive services, leave many Americans vulnerable. Families already struggling to make ends meet in light of the global economic downturn should not be exposed to potential financial ruin because of a lack of comprehensive insurance coverage.
An additional benefit of opening an SEP is that it would publicize to all Americans who have lost their jobs that the exchanges are open again and that they can enroll in high-quality health insurance, providing at least a modicum of reassurance during these deeply troubling times. Given the millions of job losses in recent weeks and the likelihood of millions more in the near future, now is the time to open up the health insurance marketplace to everyone so that people know that losing their job does not mean they must also lose access to health insurance coverage.
We believe opening an ACA SEP is the clearest way to cover the millions of uninsured and underinsured Americans in the 38 states that use the federal platform, and to provide comprehensive protections for COVID-19-related treatment and prevention. In a demonstration of the dramatic demand for such a move, all but one of the 13 state-based marketplaces have opened an SEP, with such high levels of interest that many are now extending the period by several weeks.
We urge you to put aside the partisan politics of the past, and to expand health coverage to millions of Americans by opening an SEP expeditiously.
April 7, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Multistate Coalition Calling on Trump Administration to Halt Anti-Abortion Rule as Coronavirus Pandemic Rages On”. From the press release:
New York Attorney General Letitia James today continued her leadership in the national fight to ensure women’s reproductive health care is not stifled or infringed upon in any way during the coronavirus disease 2019 (COVID-2019) public health crisis. Attorney General James is co-leading a multistate coalition of eight attorneys general in asking the U.S. Department of Health and Human Services (HHS) to delay implementation of a final rule that would unlawfully reinterpret Section 1303 of the ACA by requiring qualified health plans that participate in the state exchanges — like the New York State of Health — to send separate bills and collect separate payments of at least one-dollar for abortion services to all consumers. In a letter to HHS Secretary Alex Azar, Attorney General James and the coalition argue against final implementation of the rule that threatens women’s access to abortion coverage, as well as jeopardizes health coverage of all consumers confused by the billing practice as the nation responds to a public health crisis requiring every resource of the federal government focused on battling COVID-19.
“At a time when states and the federal government must use every resource as efficiently as possible, it is utterly reckless for the Trump Administration to continue to divert means away from responding to this pandemic just so they can further restrict women’s reproductive rights,” said Attorney General James. “This rule not only stands in direct contrast to federal directives issued by the Administration, but specifically threatens to kick individuals off their health plans as we battle a public health crisis, endangering us all. But the origin of this rule is no doubt rooted in the president’s anti-choice ideology that aims to take us backwards almost half a century, which is why our coalition will never stop fighting against this burdensome and controlling regulation that strips women of their constitutional right to an abortion.”
In their letter to Secretary Azar today, Attorney General James and the coalition argue that “implementation of the final rule during this public health and economic crisis is irresponsible and harmful to the residents of the States and the rest of the country, as it will divert attention and resources from fighting the pandemic and saving lives.”
Moreover, any effort by HHS to implement the final rule in the coming months would be inconsistent with Office of Management and Budget Directive M-20-16 — issued just three weeks ago — instructing federal agency heads to “prioritize all resources to slow the transmission of COVID-19” and otherwise focus exclusively on “mission-critical activities.”
The attorneys general go on to argue in their letter, “There is no plausible argument that implementation or enforcement of the Final Rule, which puts at risk consumers’ health coverage, would slow the transmission of COVID-19; nor can implementation of separate billing procedures be considered mission-critical,” continuing, “HHS unnecessarily detracts from the States’ abilities to prioritize responding to the national crisis of COVID-19, and contravenes the White House’s Directive.”
The attorneys general additionally argue that implementing this final rule would impose additional financial burdens on state agencies. “HHS itself recognized that implementation of the Final Rule will have significant economic consequences,” costing approximately $385 million in one-time costs for insurance issuers in the nation to bring all affected issuers across the country “into compliance with the Final Rule and implement the necessary technical changes.”
Under New York law, all private health plans regulated by the state are required to offer abortion coverage as part of their basic health care services. The new Trump Administration rule, however, will require consumers to return premium payments in two separate transactions, otherwise risk jeopardizing their health care coverage because issuers are forced to issue separate bills in order to segregate funds attributed to abortion care. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion for the more than 260,000 New Yorkers that have already enrolled in a qualified health plan this year. Additionally, the rule burdens states with unnecessary administrative costs and harms consumers who may face higher insurance premiums as a result of increased costs to carriers.
Last week, the coalition also filed a motion for summary judgment in this lawsuit, calling for the courts to immediately vacate the rule because it violates federal law and is inconsistent with the Affordable Care Act.
April 8, 2020: Center for Reproductive Rights posted a press release titled: “Texas Abortion Providers Push for Emergency Relief in Federal District Court”. From the press release:
This afternoon, Texas abortion providers went back to a federal district court to renew their request for emergency relief for their patients. This comes one day after the 5th Circuit Court of Appeals used unusual legal procedures to enforce Gov. Abbott’s COVID-19 order targeting abortion. Abortion providers are pursuing every legal avenue available to them, which includes seeking a more limited temporary restraining order from the lower court in response to the concerns expressed by the 5thCircuit. Providers are committed to ensuring Texans have access to the health care they need during this pandemic.
Statement from Molly Duane, Staff Attorney with the Center for Reproductive Rights
“We’re asking the district court to block the state’s order because we believe this is the fastest way to resume full access to abortion in Texas, which is our number one priority. The Fifth Circuit suggested there are outstanding factual questions about the impact of this order. During the last two weeks, abortion has been largely unavailable in Texas, and we have seen that the impact on patients is devastating. That is exactly what we will show the district court.”
Read more about the need for abortion access in Texas and the detrimental effects of Abbott’s order from the country’s leading physician organizations, including the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG):
- Abortion is one of the safest medical procedures performed in the United States, and the vast majority of abortions are performed in out- patient non-hospital settings.
- But the COVID-19 pandemic does not justify restricting abortion care in Texas. Most abortions do not require use of any hospital resources and use only minimal PPE. Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.
- While abortion is a safe and common medical procedure, it is also a time-sensitive one for which a delay may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and wellbeing.
- Advances in medical science have expanded safe options for pregnancy termination. For example, medication abortion is a safe and effective option in the first trimester. Thirty percent of abortions are medication abortions, where patients typically take the medication to complete the procedure at home.
The full amicus brief from the AMA and ACOG can be found here.
April 8, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorneys General Becerra and Healey Lead Multistate Amicus Brief Defending ACA Birth Control Coverage Mandate in Supreme Court.” From the press release:
California Attorney General Xavier Becerra and Massachusetts Attorney General Maura Healey today co-led a coalition of 21 attorneys general in filing an amicus brief in the United States Supreme Court supporting Pennsylvania in its case defending contraceptive coverage and counseling mandated under the Affordable Care Act (ACA). In the brief filed in Donald Trump et al. v. Pennsylvania, the attorneys general explain that states have an interest in safeguarding the ACA’s birth control coverage requirement, which has benefited more than 62 million women across the country. The coalition argues that access to affordable birth control is critical to the health, well-being, and economic security of the states’ residents.
“As our communities grapple with the COVID-19 public health crisis, the importance of delivering critical preventative care to women and families is more clear than ever,” said Attorney General Becerra. “More than 62 million women have benefited from the Affordable Care Act’s birth control coverage over the last decade. This law not only protects equality in healthcare, it supports women’s ability to control their own reproductive health, and promotes access to education, jobs and financial empowerment. We will continue to fight to keep healthcare decisions between women and their doctors, not their employers.”“Decisions about birth control are for women to make, not their bosses, and certainly not the White House,” said Attorney General Healey. “We are urging the Supreme Court to protect the health, well-being and economic security of women in Massachusetts and across the country by upholding their right to access affordable contraception.”
In 2017 and 2018, the Trump Administration issued rules which ignored the ACA’s birth control requirement and allowed employers to deny birth control coverage to their employees based on religious or moral objections. California successfully led a coalition of 14 states and Washington, D.C. in defending the ACA’s birth control coverage requirement. California obtained injunctions against the Trump Administration’s harmful, illegal rules in the Ninth Circuit, while Pennsylvania obtained an injunction in the Third Circuit.
After California and Pennsylvania won injunctions that protect the birth control coverage mandate, the federal government, Little Sisters of the Poor, and March for Life filed petitions for certiorari in the U.S. Supreme Court. The Court granted the petitions in the Pennsylvania litigation. The petitions from the California litigation remain pending.In the amicus brief, the attorneys general argue that the states have a vested interest in providing women seamless contraceptive coverage. The coalition argues that tens of thousands of women will lose their cost-free contraceptive coverage if employers are allowed to exempt themselves from the ACA requirement. This loss of coverage will result in a reliance on state-funded programs that will increase the states’ costs associated with the provision of reproductive healthcare, and will likely lead to an increase in unintended pregnancies.
Joining Attorneys General Becerra and Healey in filing the amicus brief are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.
A copy of the brief is available here.
April 8, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on Amicus Brief in Supreme Court Contraception Case”. From the press release:
Speaker Nancy Pelosi issued this statement after joining a bicameral amicus brief in the United States Supreme Court in the cases of Trump v. Pennsylvania and Little Sisters of the Poor v. Pennsylvania arguing against the Trump Administration’s expansive rule allowing private employers to opt out of providing contraception coverage for their employees, in violation of the Affordable Care Act’s contraceptive-coverage requirement:
“The Trump Administration’s despicable rule allowing private employers and health plans to deny women coverage for contraception is an outrageous attack on women’s health, women’s pocketbooks, and women’s independence.
“While our nation faces an unprecedented health crisis, the Administration continues to fight to take away every woman’s right to the critical, comprehensive care that they and their families need. At the same time, the Trump Administration continues to support the outrageous GOP lawsuit to dismangle the entirity of the Affordable Care Act including lifesaving protections for 130 million Americans with pre-existing conditions. And as coronavirus poses a growing threat to all Americans, the Administration is ignoring the health experts by refusing to reopen ACA enrollment of health coverage to millions of uninsured workers and families.
“House Democrats are committed to upholding the ACA and its critical protections for women and families. We will continue to oppose any actions by the Trump Administration that jeopardizes the safety and well being of the American people as we work tirelessly to combat this deadly virus and ensure that everyone receives the care and support needed to stay healthy.”
The amicus brief is here.
April 8, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Fights Trump Admin. Effort to Strip Women of their Right to Birth Control Coverage Under the ACA”. From the press release:
New York Attorney General Letitia James today continued her leadership in the national fight to ensure women’s reproductive health care is not stifled or infringed upon in any way by the Trump Administration. Attorney General James and a coalition of 20 additional attorneys general from around the nation filed an amicus brief in the U.S. Supreme Court supporting the Commonwealth of Pennsylvania and the State of New Jersey in their lawsuit defending the contraceptive coverage and counseling requirement mandated as part of the Affordable Care Act (ACA). In the brief — filed in Donald Trump et al. v. Pennsylvania — the attorneys general explain that states have an interest in safeguarding the ACA’s birth control coverage requirement, which has benefited more than 62 million women across the country. The coalition argues that access to affordable birth control is critical to the health, well-being, and economic security of the states’ residents.
“Employers should never have a role in making reproductive health care decisions for their employees, yet the Trump Administration’s rules do exactly that,” said Attorney General James. “The president has repeatedly worked to pit Americans against each other by using faith as a wedge between us, but our coalition will not allow religion to be used as a tool that divides us. This is about ensuring women retain control of their bodies, their choices, and their freedoms, which is why we will never stop fighting to protect women’s access to the health care they need, deserve, and choose.”
In 2017 and 2018, the Trump Administration issued rules that ignored the ACA’s birth control coverage requirement by allowing employers to deny birth control coverage to their employees based on religious or moral objections. New York and several coalitions of attorneys general defended the ACA’s birth control coverage requirement and obtained injunctions against the Trump Administration’s harmful, illegal rules in the U.S. Court of Appeals for both the Third Circuit and the Ninth Circuit.
The Trump Administration, Little Sisters of the Poor, and March for Life filed petitions for certiorari in the U.S. Supreme Court. The court granted the petitions for review of the Third Circuit decision, while the petitions for review of the Ninth Circuit decision are still pending.
In the amicus brief filed today, Attorney General James and the coalition of attorneys general argue that states have a vested interest in ensuring that women have access to seamless contraceptive coverage. Tens of thousands of women will lose access to cost-free contraceptive coverage — one of the preventive benefits guaranteed by the ACA — if employers are allowed to use their own religious or moral beliefs as an excuse to exempt themselves from the ACA’s requirement. This loss of coverage would result in a reliance on state-funded programs — increasing states’ costs and likely leading to an increase in unintended pregnancies nationwide.
April 9, 2020: Planned Parenthood posted a press release titled: “Federal Court Blocks Gov. Abbott’s COVID-19 Order Against Abortion Care AGAIN”. From the press release:
Today, a federal district court granted a second temporary restraining order against Gov. Abbott’s COVID-19 order, which the State threatened to enforce as a ban on time-sensitive abortion services. Under this latest order, abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — may provide medication abortion as well as abortion procedures for patients who would be unable to access abortion due to their gestational age on April 22 (the day after Gov. Abbott’s executive order is set to expire).
This comes two days after the 5th Circuit used a rare procedural mechanism to reverse the first emergency restraining order granted to the Texas abortion providers — Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center. As a result of the governor’s order and the 5th Circuit’s rulings, the providers have been forced to turn hundreds of patients away while the legal battle continues.
After just a few weeks, the enforcement of Abbott’s order has already had dramatic effects on patients’ lives, with some being forced to travel hundreds of miles in a pandemic to access basic and essential health care.
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:“This is a temporary sigh of relief for at least some Texas patients. We know that abortion is essential because it is time-sensitive care that cannot wait. Gov. Abbott should stop trying to force Texans into unconscionable choices: to travel long distances and increase their risk of exposure to the new coronavirus or carry a forced pregnancy. We won’t stand for it. Planned Parenthood will continue to fight these cruel attacks on our patients. We know your health cannot wait and we are here with you.”
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“We are relieved that the district court has again stepped in to stop Governor Abbott from blocking women from accessing time-sensitive, essential abortion care. It’s time for Texas to stop its crusade to end abortion, which will inflict irreparable harm on women seeking care at this difficult time.”
Statement Rupali Sharma, Senior Counsel and Director at the Lawyering Project:
“Today’s ruling ensures some Texans will be able to get the care they need, despite the all-out war politicians in the state have declared on abortion access. The Lawyering Project will continue to fight alongside people who need to end their pregnancies safely and with the dignity they deserve.”
Already, courts in Alabama, Ohio and Oklahoma are allowing abortion providers, just like all other doctors, to decide when to provide essential abortion care while conserving needed resources during this pandemic. Texas should be no different. In fact, forcing people to carry their pregnancies to term against their will only creates a heavier burden on a hospital system that’s already stretched thin caring for COVID-19 patients.
Medical experts including the American Medical Association and the American College of Obstetricians and Gynecologists said: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
Texans already have to navigate a long list of restrictions that force abortion patients to have medically unnecessary face-to-face contact with providers, and for some, push abortion out of reach altogether. These harmful restrictions include state-mandated in-person counseling and a mandatory 24-hour waiting period. For many people, traveling out of state or waiting weeks for their medical care will mean they won’t be able to access an abortion at all.
The plaintiffs in this case — abortion providers throughout Texas — are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project, and the Law Offices of Patrick J. O’Connell PLLC. A copy of the ruling can be found here.
April 9, 2020: Speaker Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement Calling for Immediate Investigation into Abuse and Mistreatment of Pregnant Women in DHS Custody”. From the press release:
Speaker Nancy Pelosi issued this statement calling on the Department of Homeland Security’s Inspector General to conduct an investigation into recent reports of severe mistreatment of pregnant women legally seeking asylum in the United States:
“The reports of abuse and neglect inflicted by U.S. immigration agents on a pregnant Guatamalan women in labor during asylum processing insist that we investigate this unacceptable behavior.
“Very sadly, the appalling and inhuman situation that this woman faced is not an isolated case. There is a pattern of U.S. officials denying and delaying medical treatment to pregnant women and subjecting them to prolonged detention and inappropriate treatment in inadequate facilities. This mistreatment is more disturbing and dangerous, as the coronavirus threatens the health and lives of the most vulnerable among us.
“As Speaker of the House, I join Senator Blumenthal and other Senators in calling on the Department of Homeland Security’s Inspector General to immediately conduct an investigation into reports of abuse and mistreatment of pregnant people in custody.
“As we observe Holy Week, Passover and Ramadan, we pray for all who are suffering during this heartbreaking time. We also pray that those in power will remember their moral responsibility to ensure that all people are treated with compassion and dignity.”
April 10, 2020: Planned Parenthood posted a press release titled: “Legal Whiplash: Abortion Providers Forced to Cancel Appointments Yet Again After Appeals Court Reinstates Gov. Abbott’s COVID-19 Order Blocking Abortion Access”. From the press release:
Today, for the second time this week, the 5th Circuit Court of Appeals ruled against abortion providers, this time granting a stay reversing in part the federal district court’s latest temporary restraining order. This means abortion is once again largely inaccessible in the state of Texas. The ruling is one of many that has created legal whiplash, causing confusion and uncertainty for hundreds of patients in need of essential, time-sensitive abortion care.
Abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — were in the midst of calling patients back to health centers when the 5th Circuit’s ruling came down today. Once again, providers — Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — will have to turn patients away unless they will pass the gestational limit for abortions in Texas before April 22 (the day after Gov. Abbott’s order is set to expire).
Plaintiffs will evaluate this latest ruling from the 5th Circuit and continue exploring every option, including emergency relief from the Supreme Court, in order to ensure patients can access essential, time-sensitive abortion services.
Medical experts including the American Medical Association and the American College of Obstetricians and Gynecologists warned the 5th Circuit Court of Appeals: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“We are in a time of crisis — and the state of Texas is sowing fear, confusion, and chaos about whether people can access health care. The same people who are caring for their families, working essential jobs, and trying to make ends meet during this pandemic are now having to experience the trauma of medical uncertainty. This is a nightmare inside of a nightmare. One day patients are called back for their procedures, the next day they are canceled — all at the whim of Gov. Abbott. Abortion is essential because it is time-sensitive. It cannot wait for lengthy legal battles or a pandemic to pass. This political game will have a lasting consequence on Texans for generations to come.”
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“Once again, Texas women cannot access abortion–with the important exception of those close to the legal limit, who the Fifth Circuit will allow to go forward. The court is unjustifiably forcing women to wait until the eleventh hour to get the time-sensitive, essential healthcare that they are constitutionally guaranteed. We will pursue all legal options to ensure no women are left behind.”
Statement Rupali Sharma, Senior Counsel and Director at the Lawyering Project:
“Texas politicians are intent on restricting abortion access even as a global pandemic threatens the health and welfare of its residents. With today’s ruling, Texans are once again thrown into a state of uncertainty, as many wonder if they’ll be forced to carry pregnancies to term or risk their well-being to travel out of state to obtain an abortion in a public health crisis. We will continue to explore all legal options to help ensure Texans — no matter how vulnerable — get the health care they need and deserve.”
Already, courts in Alabama, Ohio and Oklahoma have stepped in to allow abortion providers, just like all other doctors, to decide when to provide essential care. Texas has not shown why its residents deserve less. In fact, according to medical experts, forcing people to carry their pregnancies to term only creates a heavier burden on a hospital system that’s already stretched thin caring for COVID-19 patients.
Texans already have to navigate a long list of state restrictions that force abortion patients to have medically unnecessary face-to-face contact with providers, and for some, push abortion out of reach altogether. These harmful restrictions include state-mandated in-person counseling and a mandatory 24-hour waiting period. For many people, traveling out of state or waiting weeks for their medical care will mean they won’t be able to access an abortion at all.
The plaintiffs in this case — abortion providers throughout Texas — are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project, and the Law Offices of Patrick J. O’Connell PLLC. A copy of the ruling can be found here.
April 10, 2020: Center for Reproductive Rights posted a press release titled: “Legal Whiplash: Abortion Providers Forced to Cancel Appointments Yet Again After Appeals Court Reinstates Gov. Abbott’s COVID-19 Order Blocking Abortion Access”. From the press release:
Today, for the second time this week, the 5th Circuit Court of Appeals ruled against abortion providers, this time granting a stay reversing in part the federal district court’s latest temporary restraining order. This means abortion is once again largely inaccessible in the state of Texas. The ruling is one of many that has created legal whiplash, causing confusion and uncertainty for hundreds of patients in need of essential, time-sensitive abortion care.
Abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — were in the midst of calling patients back to health centers when the 5th Circuit’s ruling came down today. Once again, providers — Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — will have to turn patients away unless they will pass the gestational limit for abortions in Texas before April 22 (the day after Gov. Abbott’s order is set to expire).
Plaintiffs will evaluate this latest ruling from the 5th Circuit and continue exploring every option, including emergency relief from the Supreme Court, in order to ensure patients can access essential, time-sensitive abortion services.
Medical experts including the American Medical Association and the American College of Obstetricians and Gynecologists warned the 5th Circuit Court of Appeals: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”…
April 10, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Fighting Oklahoma’s Unconstitutional Ban on Abortion During COVID-19 Pandemic”. From the press release:
New York Attorney General Letitia James today led a multistate coalition of 19 attorneys general in seeking to stop the State of Oklahoma from banning almost all abortions in the state, using the coronavirus disease 2019 (COVID-2019) public health crisis as an excuse. Continuing her leadership of the nation’s fight to ensure women’s reproductive health care is not infringed upon, Attorney General James led the coalition in filing an amicus brief in the U.S. Court of Appeals for the Tenth Circuit supporting the plaintiffs in Southwind Women’s Center LLC v. Stitt, as they fight to preserve access to reproductive health care for the women across Oklahoma.
“Oklahoma’s executive order is just the latest in a series of unconstitutional attacks taken by ideologues across the nation who are using the coronavirus as an excuse to trample on women’s reproductive rights,” said Attorney General James. “A global pandemic should never be used as a backdoor channel for any state to chip away at the protections guaranteed in the U.S. Constitution, yet we are still being forced to fight to defend women’s bodies, choices, and freedoms nearly 50 years after Roe v. Wade. Our coalition will not hesitate to challenge Oklahoma, Texas, or any other state using this crisis as an unlawful justification to attack women’s reproductive rights.”
On March 24, Oklahoma Governor Kevin Stitt issued Executive Order 2020-07 (4th amended), postponing all elective surgeries and minor medical procedures in the State of Oklahoma. Three days later, Governor Stitt’s office confirmed that “any type of abortion services…which are not a medical emergency…or otherwise necessary to prevent serious health risks” to the woman would be included in the executive order. The governor’s office even went so far as to compare an abortion to a “routine” dental procedure. This order came just days after the Oklahoma governor posted on social media about eating out with his family in a “packed” Oklahoma establishment, and after his office encouraged Oklahomans to do the same.
Soon after, on March 30, several reproductive health care providers — including the South Wind Women’s Center, the Comprehensive Health Care of Planned Parenthood Great Plains, and Dr. Larry Burns — filed a lawsuit challenging the executive order in the U.S. District Court for the Western District of Oklahoma. Earlier this week, U.S. District Judge Charles Goodwin issued a temporary restraining order halting portions of the Oklahoma abortion ban on the grounds that banning such care was “oppressive” and “unreasonable,” and would cause “irreparable harm” to women unable to obtain abortions in the state.
The State of Oklahoma asked the U.S. Court of Appeals for the Tenth Circuit to set aside the lower court’s decision and reinstate the ban.
Today, Attorney General James and the coalition of attorneys general filed an amicus brief opposing Oklahoma’s request for a stay of the temporary restraining order, stressing that a ban on medication abortions (an abortion brought on by taking two prescription drugs) or on other abortions for patients who would otherwise permanently lose their right to lawfully obtain an abortion in Oklahoma infringes on a woman’s constitutional rights. The coalition explains that the “characterization of the ban as prohibiting only ‘elective’ procedures fails to recognize how the time-sensitive nature of abortion care distinguishes that care from services that can be deferred without patient harm during the current public health crisis.”
The coalition goes on to highlight that if the ban were to be reinstated, women in Oklahoma would be forced to make “risky and expensive” travel plans to cross state lines and obtain an abortion, a point not disputed by the State of Oklahoma. This is especially troublesome at a time when the entire U.S. population is being asked to limit travel to stop the spread of COVID-19.
Additionally, the coalition explains why a ban on abortion would not help the state preserve personal protective equipment (PPE), free up hospital beds, or prevent the spread of COVID-19 transmissions. The exact opposite is actually true, as medical abortions do not typically require any PPE and neither a medical abortion nor a procedural abortion require regular hospitalization.
Further, the coalition notes that residents of New York and other amici states may currently be in Oklahoma without a way to return home, but they still have a right to time-sensitive reproductive care.
The attorneys general conclude by stating that abortion “clinics in amici States have increased the use of telehealth” in an effort to provide women with the proper health care they want and need. Instead of limiting women’s access to abortions, Oklahoma should be joining Attorney General James’ call to increase access to telehealth medicine and the medical abortion pill so that woman who choose to have an abortion don’t have to fear going out and contracting COVID-19 during this public health crisis. Last week, Attorney General James sent a letter to both the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration requesting that the Trump Administration waive or utilize its discretion not to enforce its Risk Evaluation and Mitigation Strategy (REMS) designation, which dictates and subsequently impedes women’s access to the medication abortion prescription drug known as Mifepristone. Attorney General James called on the Trump Administration to ensure that women across the country can more easily access this critical health care service while the pandemic leaves many women unable to seek in-person care…
April 11, 2020: Planned Parenthood posted a press release titled: “BREAKING: Texas Abortion Providers Ask Supreme Court to Urgently Restore Medication Abortion During Pandemic; Abortion Services Remain Virtually Inaccessible Under Gov. Abbott’s COVID-19 Order”. From the press release:
Today, Texas abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — asked the U.S. Supreme Court to take emergency action to restore essential, time-sensitive medication abortion services while the case proceeds. This comes after Gov. Greg Abbott tried to block virtually all abortion services through his COVID-19 order. The emergency request comes after the 5th Circuit Court of Appeals granted most of the state’s request to stay a federal district court’s second temporary restraining order. Under the 5th Circuit’s latest ruling, only patients who will be over the state’s gestational age cutoff by April 22 (the day after Gov. Abbott’s executive order lifts) can access an abortion procedure.
For almost three weeks, providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — have had to cancel appointments for hundreds of patients while Gov. Abbott continues to exploit a pandemic in order to score political points.
Meanwhile, leading medical experts, including the American Medical Association, the American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology told the 5th Circuit Court of Appeals that abortion should not be delayed during the COVID-19 pandemic. Doing so, they said, only creates a greater strain on the hospital system during this global public health crisis.
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“The past few weeks have been untenable for Texans in need of time-sensitive abortion procedures. We’ve heard patients grow increasingly more desperate for care. Gov. Abbott has blocked abortion access for mothers who have lost their jobs because of COVID-19, people quarantined with abusive partners, and patients with fatal fetal diagnoses. Now is the time to be making abortion more accessible, not less. Medical professionals everywhere are being trusted to make necessary but difficult decisions about if and when to treat patients. Doctors who provide abortions are asking to do the same — because they, not politicians, know what’s best for their patients. This is a matter of health care, not political opinion.”Statement from Rupali Sharma, senior counsel and director, Lawyering Project:
“Texans who seek abortion care deserve dignity and compassion — particularly during a public health crisis. Instead, they’ve been thrown into a tailspin of uncertainty, unsure if and when they’ll be able to obtain essential, constitutionally protected healthcare. These extraordinary circumstances require urgent intervention. That’s why we’re asking the Supreme Court to step in and stop Texas from blocking abortion access as its residents contend with unprecedented challenges.”Statement from Nancy Northup, president and CEO, Center for Reproductive Rights:
“It is vital that the Supreme Court step in and protect the health, lives and futures of Texas women. This is an extraordinarily difficult time, but this is an easy case. Texas is blatantly abusing its emergency power to obliterate Roe v. Wade. This tactic of using bogus health and safety justifications to close clinics is nothing new. In fact, we have another case before the Supreme Court right now challenging a different sham law designed to shut down clinics. These thinly veiled attempts to end abortion must stop.”Already, courts in Alabama, Ohio and Oklahoma are allowing abortion providers, just like all other doctors, to decide when to provide essential abortion care while conserving needed resources during this pandemic. Texas should be no different. In fact, forcing people to carry their pregnancies to term against their will only creates a heavier burden on a hospital system that’s already stretched thin caring for COVID-19 patients.
Texans already have to navigate a long list of restrictions that force patients to have medically unnecessary face-to-face contact with providers, and for some, push abortion out of reach altogether. These harmful restrictions include state-mandated in-person counseling and a mandatory 24-hour waiting period. For many people, traveling out of state or waiting weeks for their procedure will mean they won’t be able to access an abortion at all.
The Texas plaintiff abortion providers are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project and the Law Offices of Patrick J. O’Connell PLLC. A copy of the complaint can be found here.
April 11, 2020: Human Rights Campaign posted news titled: “Virginia Values Act Signed Into Law – Extending Long Delayed, Critical Protections to LGBTQ Virginians”. From the news:
…Today, HRC celebrated the signing into law of the Virginia Values Act by Governor Ralph Northam. The law will extend existing state non-discrimination protections in public employment, housing and credit to Virginians on the basis of sexual orientation, gender identity and several other characteristics. Similar legislation passed through the Virginia Senate several times in recent years but was blocked by anti-equality lawmakers in the House of Delegates. In the 2019 election, voters in the commonwealth elected pro-equality majorities to both houses of the General Assembly, making this victory possible.
In addition to sexual orientation and gender identity, the law also creates all-new protections for Virginians in private employment and places of public accommodation on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, and status as a veteran. Virginia is the first state in the South to have non-discrimination protections for LGBTQ people, the first state in over a decade to add both sexual orientation and gender identity to existing non-discrimination law, and the first state since 1993 to add a prohibition on discrimination in public accommodations (protecting all Virginians) where none existed before.
“When this law goes into effect on July 1, LGBTQ people in Virginia — and people of color, people of faith, immigrants, women and more — are at last protected from discrimination at work and in their communities,” said Alphonso David, president of the Human Rights Campaign. “No one should be discriminated against simply because of who they are or whom they love. Right now, as the country and the world deals with an unprecedented pandemic, it is more important than ever to ensure that leaders are looking out for all of us. In this period of uncertainty, it is vital that we are all protected from bias as we earn a living, access housing and healthcare, and seek goods and services. We have arrived at this moment today because of years and years of tireless work from advocates across the commonwealth, and the Virginia voters that filled the halls of the General Assembly with pro-equality champions who fulfilled their promises to their constituents. HRC worked to elect pro-equality lawmakers across Virginia in 2019, and we are proud to see that effort culminate with the signing of this vital law. We want to thank all who helped make this day possible.”
“Equality Virginia has been working with lawmakers on both sides of the aisle for years to create a safer and more welcoming commonwealth for LGBTQ people,” said Vee Lamneck, executive director of Equality Virginia. “This law will have a transformative and positive impact on the lives of LGBTQ Virginians and bring Virginia into alignment with its voters.”
Virginia is home to 257,400 LGBTQ adults. Under prior Virginia law, LGBTQ people were not explicitly protected from discrimination, meaning they were at risk of being fired, evicted or denied service in restaurants or stores. Virginia was one of only five states without protections in public accommodations for any protected class. The new law brings Virginia into the 21st century, and into alignment with Virginia voters, by modernizing and expanding existing human rights law…
April 13, 2020: Planned Parenthood posted a press release titled: “Appeals Court Allows Care to Continue in Oklahoma During COVID-19 Pandemic”. From the press release:
Today, the 10th Circuit Court of Appeals let stand a lower court’s decision temporarily blocking Gov. Kevin Stitt’s ban on abortion care in Oklahoma during the COVID-19 pandemic. This means abortion providers in the state can continue providing essential, time-sensitive abortion care. The appeals court denied the state’s request to block a temporary restraining order issued by a lower court on April 6. Abortion providers will now seek a preliminary injunction from the district court which will continue to block the ban from taking effect until the case concludes.
“Today Oklahomans can breathe a temporary sigh of relief. But the fight is not over. Instead of responding to the COVID-19 pandemic, Gov. Stitt is wasting valuable time and resources to attack essential, time-sensitive abortion services that cannot wait for a pandemic to pass,” said Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America. “Gov. Stitt’s relentless attacks on health care access during a public health crisis is making a dire situation even worse. We won’t stand for it. Planned Parenthood will continue to fight these cruel attacks on the abortion services our patients need in Oklahoma and across the country — no matter what.”
“We are relieved that the court upheld access to abortion, since we know our patients who need essential, time-sensitive medical procedures like abortion cannot wait,” said Brandon Hill, PhD, president and CEO of Comprehensive Health of Planned Parenthood Great Plains. “The last thing public officials should do in the midst of a public health crisis is attack health care of any kind. We will do everything in our power to ensure our doors remain open for the patients who need sexual and reproductive health care, including access to abortion.”…
…This lawsuit was filed on March 30 by the Center for Reproductive Rights and Planned Parenthood Federation of America after Gov. Stitt issued an order requiring all elective surgeries and minor medical procedures be postponed. Gov. Stitt subsequently declared that the order prohibits all abortions in the state, forcing all health centers to halt abortion services. Executive orders like these have forced some patients to travel hundreds of miles to find abortion services during the pandemic.
Oklahoma is not the first state to attempt to ban abortion during the COVID-19 pandemic. The Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, and other organizations have filed lawsuits in multiple states. Temporary restraining orders allowing abortion services to continue have been secured in Alabama and Ohio. Over the weekend, abortion providers in Texas filed an emergency request with the U.S. Supreme Court, asking that medication abortions be allowed to continue in the state.
Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. Both groups filed an amicus brief in this case, stating: “[B]anning abortion will not help address the pandemic. Most abortions do not require any hospital resources and use only minimal PPE. And banning abortion will actually increase use of those resources and contribute to spread of the virus.”
The Center for Reproductive Rights is challenging a host of other abortion restrictions in Oklahoma, including: a ban on the use of telemedicine to provide medication abortion; a law that forces patients to delay their abortion for at least 72 hours after receiving certain state-mandated information; a “physician-only” law that bans qualified medical professionals from providing medication abortion; a ban on the standard method of abortion after approximately 14 weeks of pregnancy; and a law requiring doctors to tell patients that some abortions can be “reversed” — a patently false statement…
April 13, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, 22 Senators Reintroduce Resolution Designating April 11-17 as Black Maternal Health Week”. From the press release:
On Monday, U.S. Senator Kamala D. Harris (D-CA) led 22 of her colleagues in reintroducing a resolution to designate April 11-17, 2020 as Black Maternal Health Week to raise awareness about the Black maternal health crisis. The resolution was led in the House of Representatives by Congresswoman Alma Adams (D-NC).
According to the Centers for Disease Control, Black mothers in the United States are three to four times more likely than white mothers to die from pregnancy-related complications and are two times more likely than white mothers to suffer from pregnancy-related illnesses, known as maternal morbidities.
“The potential ramifications that could come with giving birth during the coronavirus pandemic — specifically a pandemic that is disproportionately impacting African Americans — is of particular concern to Black women who were already facing a maternal health crisis in our country,” said Senator Harris. “Now more than ever, we need to address this issue. During Black Maternal Health Week, we must continue in the fight to ensure Black women are taken seriously when they speak about their health concerns, and remove disparities and implicit bias from our health care system.”
Joining Harris on the resolution are Senators Merkley (D-OR), Durbin (D-IL), Blumenthal (D-CT), Van Hollen (D-MD), Booker (D-NJ), Klobuchar (D-MN), Hirono (D-HI), Markey (D-MA), Jones (D-AL), Duckworth (D-IL), Menendez (D-NJ), Wyden (D-OR), Sanders (I-VT), Feinstein (D-CA), Murray (D-WA), Bennet (D-CO), Baldwin (D-WI), Peters (D-MI), Smith (D-MN), Brown (D-OH), Cortez Masto (D-NV), Stabenow (D-MI), and Gillibrand (D-NY).
The resolution is sponsored by Black Mamas Matter Alliance, Center for Reproductive Rights, American College of Obstetricians and Gynecologists, Black Women’s Health Imperative, Center for Health and Gender Equity (CHANGE), Commonsense Childbirth, Every Mother Counts, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, March for Moms, National Birth Equity Collaborative, National Black Midwives Alliance, National Medical Association, National Partnership for Women & Families, National Perinatal Task Force, National Women’s Law Center, Planned Parenthood Federation of America, Southern Birth Justice Network, and WomenHeart: The National Coalition for Women with Heart Disease.
“This resolution says, unequivocally, that Black Moms matter,” said Representative Adams, co-founder and co-chair of the Black Maternal Health Caucus. “I’m proud to stand with my colleagues to raise awareness of Black Maternal Health Week, and urge our Congressional leaders to take action on one of the greatest public health crises of our time.”
“The Black Mamas Matter Alliance (BMMA) thanks Senator Harris and Congresswoman Adams for their continued support and amplification of Black Maternal Health Week (#BMHW20). As the founders of #BMHW20, BMMA believes that the experiences, voices, and maternity care work of Black women must be centered in order to address the U.S. maternal health crisis – hence the importance of recognizing April 11th – 17th as Black Maternal Health Week!” said Angela D. Aina, Interim Executive Director of BMMA.
“The Center for Reproductive Rights applauds Senator Kamala Harris and Congresswoman Alma Adams on the introduction of this year’s Black Maternal Health Week Resolution. Now more than ever we need recognition of this crisis and federal solutions to save the lives of Black mothers,” said Jennifer Jacoby, Federal Policy Counsel. Breana Lipscomb, Senior Manager, U.S. Maternal Health and Rights Initiative, and BMMA Board Member added, “The COVID-19 pandemic has proven that chronic underinvestment in the public health infrastructure is deadly and Black people pay the price. This year’s resolution is a call to action, reminding us that in this time of crisis we cannot sacrifice the human rights of birthing people.”
“Black Maternal Health Week is an important opportunity to bring national attention to the maternal mortality crisis facing Black women. This is a year like no other, as we grapple with the COVID-19 pandemic, an emergency that is endangering the health and economic well-being of millions and having a particularly harmful–and deadly–impact on the Black community. Sadly, we know the maternal mortality crisis and COVID-19 disparities share a common underlying force: racism and structural inequality. Now is the time to address those evils in this country once and for all, and do all that we can to ensure health equity along racial lines,” said Dr. Jamila Taylor, Director of Health Care Reform and Senior Fellow for the Century Foundation
The United States is one of only 13 countries in the world where rates of illness and death during pregnancy are on the rise. From 2000 to 2014, the U.S. experienced a substantial increase of 26.6 percent in maternal mortality rates.
A full copy of the resolution can be found here.
April 13, 2020: Planned Parenthood posted an article titled: “Black Maternal Health Week: Planned Parenthood calls on Congress to Endorse The Black Maternal Health Momnibus Act of 2020”. From the press release:
This Black Maternal Health Week — an initiative spearheaded by the Black Mamas Matter Alliance (BMMA) — Planned Parenthood Federation of America (PPFA) joins patients, advocates, and providers to call for reform to improve maternal health care for Black women. Along with 90 other partners and organizations, PPFA endorses the The Black Maternal Health Momnibus Act of 2020, which was introduced last month by U.S. Representatives Lauren Underwood (D-IL) and Alma Adams (D-NC), U.S. Senator Kamala Harris (D-CA), and members of the Black Maternal Health Caucus. The bill addresses the racial disparities in pregnancy outcomes among Black women in America, including higher rates of death and severe morbidity.
According to the latest data from the Centers of Disease Control and Prevention (CDC), Black women are 3 times more likely to die from pregnancy-related causes compared to white women. These outcomes are the result of bias of medical providers, structural racism, and economic inequality — leading to limited access to health care and a heightened risk of health complications. And recent data shows that Black Americans are disproportionately affected by COVID-19 due to medical racism and structural barriers to testing and receiving care.
Congress must act now and pass the Momnibus Act so that research, policies, resources, and funds are allocated to combat the inequities in maternal health…
While there is currently limited data and research on the effects of COVID-19 on pregnant women and infants, there are clear racial disparities in testing, treatment, and mortality rates among Black people who have been infected by the new coronavirus. The COVID-19 crisis makes the problems associated with maternal health even more acute, with social distancing guidance that keeps loved ones and doulas from the delivery room, reducing their ability to advocate for those in labor — and environmental factors that make pre- and postnatal care less feasible. Health equity will not be achieved without addressing racial equity, and addressing implicit bias in health care delivery is a top priority for Planned Parenthood. Planned Parenthood health center providers and staff undergo training to understand and eliminate provider bias, racial microaggressions, and stereotypes.
Many Planned Parenthood health centers serve pregnant patients with screenings for diabetes, depression, substance abuse, and environmental and teratogenic exposures, as well as offering obesity management, smoking cessation support, vaccinations (including flu), and preconception genetic screening. Some Planned Parenthood health centers offer care for patients experiencing miscarriage and primary care and behavioral health.
Planned Parenthood advocates for Black mothers and maternal health, and the improved health outcomes for Black women and communities. We endorse legislation that improves maternal health care, including the The Healthy MOMMIES Act and The Rural MOMS Act. The Momnibus bill would help ensure pregnancy and birth experiences are not contingent on race and that Black women have the freedom to be pregnant without added fear. It allocates the resources, investment, and support that would allow Black mothers to thrive….
April 13, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Urging Supreme Court to Halt Public Charge Rule as Coronavirus Rages On”. From the press release:
New York Attorney General Letitia James today led a coalition of three states and New York City in urging the U.S. Supreme Court to revisit the question of whether to halt implementation of the Trump Administration’s Public Charge Rule as New York and the nation undergo a public health crisis created by the spread of the coronavirus disease 2019 (COVID-19). The Public Charge Rule drives immigrants and their families away from accessing health benefits to which they are entitled by threatening applicants’ eligibility for green cards and visa renewals. The Supreme Court issued an order in January that had been denied by the lower courts, allowing the rule to take effect while legal challenges to the rule are pending in the U.S. Court of Appeals for the Second Circuit and through a possible petition to the Supreme Court. Attorney General James and the coalition are today asking the court to revisit the question of interim relief in light of the new and devastating effects that the rule has had on the nation’s public-health and economy as COVID-19 has spread over the last six weeks, and — in an effort to prevent the rule from impeding efforts to slow the continued spread of the virus happening nationwide — to temporarily halt the Public Charge Rule until the national pandemic is over.
“Every person who doesn’t get the health coverage they need today risks infecting another person with the coronavirus tomorrow,” said Attorney General James. “Immigrants provide us with health care, care for our elderly, prepare and deliver our food, clean our hospitals and public spaces, and take on so many other essential roles in our society, which is why we should all be working to make testing and health coverage available to every single person in this country, regardless of immigration status. Our country cannot afford to wait, yet the sustained application of the Public Charge Rule continues to harm this nation’s public health and our economy to its core. We’re asking the Supreme Court to temporarily halt this rule until this national crisis is over because any rule that threatens an immigrant’s well-being, threatens all of us.”
Last August, the U.S. Department of Homeland Security issued a Public Charge Rule that changed the established meaning of public charge, which had long been that immigrants who use basic, non-cash benefits are not considered public charges because they are not primarily dependent on the government for survival.
Federal law allows lawful immigrants to apply for certain supplemental public benefits if they have been in the country for at least five years. But the new Public Charge Rule creates a “bait-and-switch” ― if immigrants use these supplemental benefits to which they are legally entitled, they may jeopardize their chances of later becoming a legal permanent resident or renewing their visa…
…In the more than two months since the Supreme Court issued its ruling, COVID-19 has fundamentally changed the national landscape. The United States went from not a single reported COVID-19 case to well more than 575,000 confirmed infections and more than 23,000 confirmed deaths, and is now the country with the most virus-related deaths in the world. More than 195,000 of those infections and more than 10,000 deaths have been reported in New York State alone…
…Since that time, New York City Mayor Bill de Blasio has issued a state of emergency, as have cities across the United States. New York Governor Andrew M. Cuomo has issued a state of emergency, as has every other state in the nation. President Donald J. Trump has declared a national state of emergency and has approved federal disaster declarations for all 50 states, as well as Washington, D.C., the U.S. Virgin Islands, the Northern Mariana Islands, Guam, and Puerto Rico.
The motion filed with the Supreme Court today by Attorney General James and the coalition asks the court to take into consideration the extraordinary events of the last six weeks and the new harms that the rule is causing to the public health and the economy during the COVID-19 crisis. The motion asks the court to temporarily lift or modify its stay to halt implementation of the Public Charge Rule until the national emergency concerning COVID-19 is over. Of note is the fact that immigrants make up a large number of essential workers helping move our nation along at this time, and if they don’t have access to the proper health care today, they are more likely to spread the virus to all Americans, inadvertently, tomorrow — not only contributing to the exponential growth of infection rates, but of fatalities as well.
“By deterring immigrants from accessing publicly funded health care, including programs that would enable immigrants to obtain testing and treatment for COVID-19, the Rule makes it more likely that immigrants will suffer serious illness if infected and spread the virus inadvertently to others — risks that are heightened because immigrants make up a large proportion of the essential workers who continue to interact with the public,” the motion argues. “The Rule’s deterrent effect on immigrants’ access to health care and other public benefits for which they are indisputably eligible is impeding efforts to stop the spread of the coronavirus, preserve scarce hospital capacity and medical supplies, and protect the lives of everyone in our communities — citizens and noncitizens alike.”
Further, the coalition argues that the nation’s economy cannot undergo further damage from the spread of COVID-19. In the three-week period between March 19 and April 9, more than 16 million residents across the nation lost their jobs and filed for unemployment. And according to estimates by the U.S. Bureau of Labor Statistics, between February and March 2020, the number of immigrant adults who are unemployed rose by 26 percent. As today’s motion argues, “many workers who lose their jobs and their employer-sponsored health insurance because of the pandemic are likely to need Medicaid coverage until they can find another job.”
Attorney General James and the coalition conclude by arguing that none of these harms were before the Supreme Court when it decided to stay the district court’s orders in January, justifying a temporarily halt of the stay order. “The nature and magnitude of the harms currently being imposed by the Rule warrant temporary relief from the stay, particularly when these harms were not known to the parties or the Court when the Court considered defendants’ stay application. Although this case has always concerned issues of public health and welfare, the COVID-19 outbreak and its ramifications on public health and the economy present sudden and stark new circumstances not previously considered by the Court and have vastly changed and amplified the irreparable harms caused by the Rule. And the likelihood of these harms occurring is no longer a prediction. The Rule’s devastating effects are happening now. Given these new circumstances, the Court should modify or lift its stay temporarily to meet the exigencies and equities of the current public-health and economic crisis.”
Joining Attorney General James in filing today’s motion with the Supreme Court are the attorneys general of Connecticut and Vermont, as well as corporation counsel for New York City.
April 13, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Responds to Emergency Appeal to Supreme Court After Texas Exploits Pandemic to Block Abortion Access”. From the press release:
Today, doctors in Texas who provide abortion care— represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — filed an emergency appeal with the U.S. Supreme Court, asking the Court to take immediate action to restore access to medication abortion in the state as the case unfolds.
Texas Governor Greg Abbott, along with anti-choice officials in 11 other states, recently seized upon the COVID-19 pandemic to try to ban abortion, falsely claiming abortion care is “elective” rather than time-sensitive and essential healthcare for women. In response, NARAL President Ilyse Hogue released the following statement:
“The fate of countless women and pregnant people in my home state of Texas now rests with the Supreme Court. Nine Justices face a choice between following an anti-choice GOP down a path to ignore science and prioritize ideology that undercuts fundamental freedoms and hurts women and families, or they can uphold the rule of law and scientific and medical advice. We’re here. We’re watching. And we’ll never stop fighting.”
Anti-choice politicians in Texas have consistently worked to ban abortion and roll back reproductive freedom, even going so far as to introduce a bill last legislative session which would have punished women seeking abortion care with the death penalty.
April 14, 2020: Politico posted an article titled: “SCOTUS won’t face abortion case after lower court eases Texas’ pandemic ban”. It was written by Alice Miranda Ollstein. From the article:
Abortion rights groups on Tuesday withdrew their request for the Supreme Court to lift Texas’ coronavirus emergency ban on the procedure after a lower court allowed some abortions to resume in the state.
The move allows the high court, at least for now, to avoid considering whether anti-aborion states can block access to the constitutionally protected procedure in the name of a public health crisis. However, bans from red states have popped up across the country in recent weeks, so the court could soon be confronted again with a similar question.
Abortion rights groups called off their challenge to the Texas ban after the 5th Circuit Court of Appeals in a Monday night ruling said medication abortions could continue under the state’s pandemic emergency order.
Texas and several other conservative states who have long sought to curb abortion have deemed the procedure nonessential amid the public health crisis, arguing it would cut into short supply of protective gear for health workers and create unnecessary risk of coronavirus infection. Abortion rights advocates say the bans ultimately hurt public health and accuse Republican governors of using a health emergency to advance an anti-abortion agenda…
…Surgical abortions remain banned in the state for now for most patitents, except for those who would be unable to get an abortion under the state’s 22-week ban if further delayed…
…Texas’ emergency order is set to expire next week, but the state could decide to extend it.
April 14, 2020: Planned Parenthood posted a press release titled: “5th Circuit Court of Appeals Backs Down, Restores Medication Abortion in Texas for Now”. From the press release:
Late Monday night, the 5th Circuit Court of Appeals backed down from its stay of a lower court’s temporary restraining order that had protected access to medication abortions under Texas Gov. Greg Abbott’s COVID-19 order banning “non-essential procedures.” This means medication abortions — a two-pill process — will once again be available in Texas, for now.
Last week, for a second time, the 5th Circuit blocked a temporary restraining order and made abortion largely inaccessible across the state. The appeals court ruled without even allowing providers time to respond. Instead, it waited to ask any questions until two days after abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — asked the U.S. Supreme Court to take emergency action to restore access to medication abortion. Only then did the 5th Circuit ask the parties to further explain whether medication abortion is a “procedure.” This, despite the providers’ submission of numerous briefs in both the trial and appellate courts over the past few weeks making clear medication abortion is not a “procedure.”
Consistent with all of its briefing in the case, including several to the 5th Circuit, abortion providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — once again explained that medication abortion consists of two pills administered without any personal protective equipment (PPE).
Even with the 5th Circuit’s decision to allow medication abortions under Gov. Abbott’s COVID-19 order, the only other abortion procedures that remain available are for Texas patients with a gestational age that would exceed the state’s legal limit by April 22 (one day after Gov. Abbott’s COVID-19 order expires).
Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“It has become a day by day, week to week fight for people whose health care cannot wait. Planned Parenthood and its partners have never wavered in the facts: abortion is safe, necessary, and time-sensitive. While this is a very temporary relief for some Texans, many others still cannot access time-sensitive abortion procedures. As people try and navigate their new realities under a pandemic — job loss, quarantining with abusive partners, or still having to work essential jobs — we need more abortion access, not less. This fight is far from over.”…
…The 5th Circuit has yet to consider Texas Attorney General’s second petition for writ of mandamus, a rare procedural motion that could quickly end abortion access once again in the state.
Leading medical experts, including the American Medical Association, the American College of Obstetricians and Gynecologists, and the American Board of Obstetrics & Gynecology agree: forcing people to carry their pregnancies to term against their will only creates a heavier burden on a hospital system that’s already stretched thin caring for COVID-19 patients.
Already, courts in Alabama, Ohio and Oklahoma are allowing abortion providers — just like all other doctors — to decide when to provide essential abortion care while conserving needed resources during this pandemic. Texas should be no different…
April 14, 2020: Center for Reproductive Rights posted a press release titled: “Louisiana’s COVID-19 Ban on Abortion Challenged in Court”. From the press release:
Today, the Center for Reproductive Rights filed a lawsuit challenging Louisiana’s latest attempt to close abortion clinics in the state. Louisiana Attorney General Jeff Landry has targeted abortion clinics for closure, citing the COVID-19 pandemic as justification. The Center is asking a federal court to immediately block the state’s attempts to shutter Hope Medical Group for Women and other abortion clinics.
“This is a shameful abuse of power,” said Nancy Northup, President & CEO of the Center for Reproductive Rights. “Louisiana has been trying for decades to end abortion. We are already fighting a separate Louisiana law at the Supreme Court that would shut down nearly every clinic in the state. If the state’s latest actions are not blocked, that will become a reality before the Supreme Court even rules.”
“Hope Medical Group for Women is in full compliance of the Notice, but the Attorney General’s recent actions have thrown our patients into a state of fear and panic. There are women in Louisiana who need an abortion today—they cannot wait. But our hands are now being tied by the state,” said Kathaleen Pittman, clinic administrator for Hope Medical Group for Women in Shreveport, Louisiana. “If women can’t access abortion here in Louisiana, they will no doubt attempt to access care in other states, which will only hurt efforts to contain the spread of the coronavirus. Most of our patients are already mothers, so they are dealing with all this on top of caring for kids while schools are closed, and many are struggling financially.”
Louisiana is one of several states that have attempted to restrict abortion access during the COVID-19 pandemic. The Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, and other allies have filed challenges in multiple states. Temporary restraining orders allowing abortion care have been secured in Alabama, Ohio, and Oklahoma. Just last night, the Fifth Circuit Court of Appeals amended its previous ruling to allow medication abortion care to continue in Texas while they consider the rest of the state’s appeal.
Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. Both groups filed an amicus brief in the case challenging Texas’s COVID-19 abortion ban, stating that interpreting Health Department Notices like Louisiana has “is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
The Center’s lawsuit argues that although Hope has been in full compliance with the Health Department’s Notice, Louisiana’s recent actions and application of the Notice, would deny Louisianans’ access to essential, time-sensitive healthcare and violate their constitutional right to choose abortion prior to viability and nearly 50 years of Supreme Court precedent protecting a woman’s right to bodily integrity and autonomy under the Fourteenth Amendment. The lawsuit also argues that—contrary to the state’s claims—forcing women to carry a pregnancy to birth or travel out of state for abortion care in the middle of this current crisis is not only cruel and unconstitutional but will also undermine public health, by increasing the risk of spreading COVID-19 and expending more medical resources.
The Center is currently litigating three other cases in Louisiana, including June Medical Services v. Russo—a case awaiting a decision from the Supreme Court that could leave just one abortion provider in the state. The Center also filed a lawsuit challenging seven abortion restrictions passed in 2016; and a lawsuit challenging the state’s targeted regulation of abortion providers (TRAP) laws.
Louisiana has more abortion restrictions than any other state, andmore than 92% of Louisiana parishes have no abortion clinic. Since 2001, the number of abortion clinics in Louisiana has fallen from 11 to three as the state has imposed a slew of onerous requirements for abortion providers. There are nearly one million women of reproductive age in the state.
This case was filed by Center for Reproductive Rights attorneys Jenny Ma, Caroline Sacerdote, and Arielle Humphries on behalf of Hope Medical Group for Women. The full complaint is available here.
April 14, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Sexual Health Care Via Telehealth To Be Available in All 50 States”. From the press release:
Today, Planned Parenthood announced a national expansion of telehealth services to provide health care by phone or video to patients in all 50 states by the end of April. Planned Parenthood knows that even during a pandemic, sexual and reproductive health services can’t wait — they are time-sensitive and essential. Through telehealth, patients can access timely care and information from Planned Parenthood’s trusted providers with fewer visits or without the need to visit a health center at all.
While many things are different right now, you can still have a safe, healthy sex life. Planned Parenthood also has new digital resources available with information on the new coronavirus, or COVID-19, and how it can affect sexual and reproductive health.
- Planned Parenthood’s new webpages provide medically accurate answers to questions like “Can I still have sex?” and “What do I do if my birth control method is about to expire?” and “Can I still get an abortion during the COVID-19 pandemic?”
- Planned Parenthood has added new information to Roo, our sexual health chatbot, and to our popular Chat/Text program to help people understand how COVID-19 affects their sexual health and how to access health care during the pandemic.
Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
Sexual health needs don’t go away, even when our country is in crisis. Planned Parenthood is proud to redouble our efforts to make sure people can still access the care and information they need. We know this pandemic has increased barriers to health care for many of the communities we serve — at exactly the time when people need that care the most. Through telehealth, Planned Parenthood is providing the high-quality care and information people need to stay safe and healthy, even as our everyday reality is rapidly changing. Challenging times require us to innovate, and expand the tools that connect our expert, compassionate providers with patients who need care. No matter how you meet Planned Parenthood — in our health centers, online, or on your phone — we’re here with you.
Telehealth appointments, where a patient connects with a provider in a different location using technology, are a secure and private way for people to access health care services without the need to travel. While telehealth services vary health center to health center, patients can access direct-to-patient services including birth control, sexually-transmitted infection (STI) testing and/or treatment, gender-affirming hormone therapy, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), UTI screening and treatment, and emergency contraception (also known as the morning-after pill). Some Planned Parenthood health centers also offer counseling and follow-up for abortions through telehealth.
April 14, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Co-Leads Push with Michigan and North Carolina AGs for Increased Federal Government Outreach to Inform Americans of Healthcare Coverage Eligibility During COVID-19”. From the press release:
California Attorney General Xavier Becerra today co-led a multistate letter to the U.S. Department of Health and Human Services (HHS) and its Centers for Medicare and Medicaid Services (CMS) urging them to immediately develop and implement an outreach plan to inform the millions of Americans who have lost – or may lose – their employer-sponsored health insurance coverage about the Special Enrollment Period available to them through Healthcare.gov, the federal Exchange. In the letter, the attorneys general highlight the importance of providing families with the information and tools they need to navigate their healthcare options and access coverage during the unprecedented international healthcare crisis posed by COVID-19.
“Healthcare is not a luxury. Neither, sadly, is it a right in America. Not yet. COVID-19 has made that crystal clear, especially for millions of American families suddenly struggling against health and economic uncertainty,” said Attorney General Becerra. “The federal government has the tools to help under the Affordable Care Act. HHS and CMS can actively and immediately reach out to and inform Americans, especially those who have lost their jobs and insurance, that they can now apply for affordable healthcare coverage through the federal healthcare Exchange. We call on the federal government to act, this is no time for spectating.”
In the letter, the attorneys general highlight that the Affordable Care Act (ACA) provides the flexibility necessary to help people wrestling with the loss of their livelihood and their family’s healthcare coverage during this critical time. The ACA requires the HHS Secretary to provide yearly open enrollment periods on the Exchanges to permit individuals to enroll in new or different healthcare coverage. Outside of this period, individuals may enroll in coverage through the Exchange only if they qualify for a Special Enrollment Period due to certain life events such as loss of employment offering healthcare coverage. Informing individuals of the potential for replacing the coverage they have lost through Healthcare.gov is vital, as most Americans obtain their healthcare coverage through their employer. In 2018, over half of individuals under age 65 had insurance through an employer.
The importance of this outreach will only increase as the economic upheaval of this crisis continues to expand. A new study by the Health Management Associates estimates that the number of people receiving coverage from an employer could decline by up to 35 million due to layoffs caused by the COVID-19 pandemic. This same study estimates that the economic impact to the labor market could disproportionately impact the roughly 58 million non-elderly individuals who have employer-sponsored coverage and earn less than $50,000 per year. This heavily hit population could greatly benefit from navigating their options on the Exchanges where they may qualify for subsidies to help pay for healthcare coverage.
The coalition expresses concern that, without immediate and widespread outreach, Americans who have recently been laid off will remain unaware of the Special Enrollment Period and thus not access needed healthcare coverage. Evidence shows that marketplace advertising and consumer assistance increases enrollment numbers and stabilizes markets. For this reason, states that run their own Exchanges, like California, continue to invest heavily in marketing and outreach to support their state-based marketplaces. Yet, over the last few years, the Trump Administration has actively cut marketplace advertising and consumer assistance. HHS, as the operator of Healthcare.gov, must step in to get the word out to consumers in the 38 states that rely on the federal Exchange. HHS should also ensure that outreach materials are translated into the same range of languages as other HHS vital documents in order to ensure meaningful access to information about the Special Enrollment Period.
The attorneys general urge HHS to empower individuals and working families across the country to pursue the best coverage option for them, whether it is Exchange coverage, COBRA, Medicare, Medicaid, or the Children’s Health Insurance Program. While the federal government’s promise to reimburse for the testing and treatment of COVID-19 for the uninsured is a step in the right direction, it will not help provide these Americans the comprehensive healthcare they so desperately need and could leave many families with large hospital and insurance bills in the long-run.
Joining Attorney General Becerra in sending the letter are the attorneys general of Michigan, North Carolina, and Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington and the District of Columbia.
April 14, 2020: Center for Reproductive Rights posted a press release titled: “Emergency Lawsuit Filed in Tennessee to Keep Abortion Accessible During Pandemic”. From the press release:
Today, a Tennessee order effectively banning abortion procedures in the state was challenged by the Center for Reproductive Rights, Planned Parenthood Federation of America, the American Civil Liberties Union and the American Civil Liberties Union of Tennessee. The April 8 order, issued by Tennessee Governor Bill Lee in response to the coronavirus (COVID-19) pandemic, limits “non-emergency” health care procedures and bars people from getting a procedural abortion. Patients who are less than 11 weeks pregnant are still permitted to obtain medication abortions in the state.
Tennessee is not the first state to restrict abortion care during the COVID-19 pandemic. The Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, and other allies have filed lawsuits in multiple states. In Texas, most abortions are currently prohibited, and providers have asked the Supreme Court to intervene on an emergency basis. Court decisions allowing abortion care to continue have occurred in Alabama, Ohio and Oklahoma.
Statement from Nancy Northup, President & CEO of the Center for Reproductive Rights:
“We have filed this case to protect the constitutional rights of women in Tennessee who need access to essential, time-sensitive abortion care. All signs indicate that this crisis will not be over soon, and patients cannot wait until it is. Leading medical experts have been clear that COVID-19 responses should not ban abortion care.”..…The lawsuit filed today argues that Tennessee’s order effectively bans abortion in the state for many women, violating Roe v. Wade and nearly 50 years of Supreme Court precedent protecting a woman’s right to liberty and autonomy under the Fourteenth Amendment. The lawsuit also argues that forcing women to travel out of state for abortion care, or to carry an unwanted pregnancy to term and give birth, will increase the risk of spreading COVID-19 and undermine the state’s asserted goal of preserving medical resources and limiting person-to-person encounters.
Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. Both groups filed an amicus brief in the case challenging Texas’s COVID-19 abortion ban, stating: “Indeed, the Governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.”
Tennessee also bans the use of telehealth for medication abortion — a tool that could greatly expand access and reduce in-person contact. Other abortion restrictions in Tennessee include: a mandatory 48-hour waiting period (which includes a requirement that patients make an additional, medically unnecessary trip to the clinic to receive state-mandated information); limits on when state and public insurance can cover abortion services; and a requirement that minors obtain parental consent.
This lawsuit was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, the ACLU of Tennessee and pro-bono counsel Kramer Levin. Plaintiffs in the case are CHOICES Memphis Center for Reproductive Health, Knoxville Center for Reproductive Health, Planned Parenthood of Tennessee and North Mississippi, Adams & Boyle P.C, and Dr. Kimberly Looney.
The full complaint is available here.
April 15, 2020: Planned Parenthood posted a press release titled: Trump Administration’s Decision to Suspend Funding to the World Health Organization is Devastating for Global Health”. From the press release:
Yesterday evening, the Trump administration announced it would suspend funding to the World Health Organization (WHO), a move that would be devastating for global health especially amidst the COVID-19 pandemic. An effective response must be evidence-based and grounded in data; it requires global cooperation and coordination from all countries around the world, especially the United States, which now has the largest number of COVID-19 fatalities.
As the foremost institution for global health research and response, the WHO has a mandate to promote the highest standard of health for all and provide leadership and expertise in the delivery of essential health care, including sexual and reproductive health. Since its founding over 70 years ago, the WHO has led the global response to health emergencies such as tuberculosis, HIV, malaria, Zika, avian influenza, and SARS.
Statement from Monica Kerrigan, Executive Director, Planned Parenthood Global:
“As the world faces the COVID-19 pandemic, we need global cooperation and the leadership of the World Health Organization more than ever. Cutting funding to the WHO undermines global health and endangers the lives of all people, including those living in the U.S. This is not the time for political maneuvering—it is the time for bold leadership and urgent action both globally and locally. Abandoning the foremost institution for global health – a powerhouse of research with decades of experience responding to global pandemics – is shortsighted and devastating. We cannot forget that the fates of the U.S. and the rest of the world are intertwined.”
This isn’t the first time the Trump administration has withdrawn from UN agencies. For the past three years, the administration has withheld funding from UNFPA, the principal UN agency providing reproductive health care around the world. And in 2018, the Trump administration withdrew from the Human Rights Council, the UN body charged with protection of global human rights.
April 15, 2020: Center for Reproductive Rights posted a press release titled: “Statement from the Center for Reproductive Rights on the Trump Administration’s suspension of funding of the World Heath Organization”. From the press release:
The following is the statement of Nancy Northup, president and CEO of the Center for Reproductive Rights regarding the Trump Administration’s suspension of funding of the World Health Organization (WHO).
“It is irresponsible and unjust for President Trump to direct the United States to halt funding to the WHO during this extraordinary crisis. Countries, health professionals and humanitarian relief organizations across the globe rely on WHO guidance and support to effectively respond to the pandemic. Suspension of funding will limit this ability, including the ability to effectively provide time-sensitive, essential health care, grounded in evidence, equity and human rights.
Delay or denial of time-sensitive, essential health care, exacerbates the dire situation we are facing around the globe, but especially for marginalized populations, including women and girls, threatening their rights to life, health and gender equality in fundamental ways.
The WHO has provided important guidance for reproductive healthcare, which is central to women’s health and can itself be life-saving. WHO guidance during this pandemic has included information on caring for pregnant women, infants and mothers with COVID-19 as well as information on intrapartum care (IPC) and breastfeeding, and on contraception and family planning during the Covid-19 response.
“We call on President Trump to continue United States funding to the WHO and support its urgent global, evidence-based, public health response.
April 15, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on President Trump Halting WHO Funding”. From the press release:
Speaker Nancy Pelosi issued this statement after President Trump announced that he would halt funding to the World Health Organization in the middle of the coronavirus crisis:
“The President’s halting of funding to the WHO as it leads the global fight against the coronavirus pandemic is senseless.
“We can only be successful in defeating this global pandemic through a coordinated international response with respect for science and data. But sadly, as he has since Day One, the President is ignoring global health experts, disregarding science and undermining the heroes fighting on the frontline, at great risk of the lives and livelihoods of Americans and people around the world. This is another case, as I have said, of the President’s ineffective response, that ‘a weak person, a poor leader, takes no responsibility. A weak person blames others.’
“This decision is dangerous, illegal and will be swiftly challenged.”
April 17, 2020: Center for Reproductive Rights posted a press release titled: “Court Blocks Tennessee’s COVID-19 Ban on Most Abortions”. From the press release:
Today — at the request of the Center for Reproductive Rights, Planned Parenthood Federation of America, the American Civil Liberties Union and the American Civil Liberties Union of Tennessee — a federal district court in Tennessee granted an emergency motion, allowing clinics to resume procedural abortions during the COVID-19 pandemic. The decision comes after Gov. Bill Lee issued a state order limiting “non-emergency” health care procedures. That order banned all abortions other than medication abortions (which involve taking pills and are only available until 11 weeks of pregnancy), despite leading national medical groups agreeing that abortion procedures are essential and time-sensitive.
In his decision, Judge Bernard Friedman wrote, “Moreover, abortion is a time-sensitive procedure. Delaying a woman’s access to abortion even by a matter of days can result in her having to undergo a lengthier and more complex procedure that involves progressively greater health risks, or can result in her losing the right to obtain an abortion altogether. Therefore, plaintiffs have demonstrated that enforcement of EO-25 causes them irreparable harm.”
“Women in Tennessee can breathe a sigh of relief for now, knowing abortion procedures are available again in their home state,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Today’s ruling in Tennessee joins those from courts across the country that have blocked these abuses of emergency powers. Women cannot wait until the pandemic is over to access abortion care, and we will continue fighting to make sure they can.” …
…Since the beginning of the COVID-19 outbreak, many states have attempted to ban or limit abortion. In addition to Tennessee, lawsuits are ongoing in Alabama, Arkansas, Louisiana, Ohio, Oklahoma, and Texas. Court decisions allowing abortion care to continue have been issued in Alabama, Arkansas, Ohio, Oklahoma, Tennessee, and Texas.
Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. Both groups filed an amicus brief in the case challenging Oklahoma’s COVID-19 ban, stating: “[B]anning abortion will not help address the pandemic. Most abortions do not require any hospital resources and use only minimal PPE. And banning abortion will actually increase use of those resources and contribute to spread of the virus.”
Tennessee also bans the use of telehealth for medication abortion — a method that could greatly expand access and reduce in-person contact. Other abortion restrictions in Tennessee include: a mandatory 48-hour waiting period (which includes a requirement that patients make an additional, medically unnecessary trip to the clinic to receive state-mandated information); limits on when state and public insurance can cover abortion services; and a requirement that minors obtain parental consent.
This lawsuit was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, the ACLU of Tennessee and pro-bono counsel Kramer Levin. Plaintiffs in the case are CHOICES Memphis Center for Reproductive Health, Knoxville Center for Reproductive Health, Planned Parenthood of Tennessee and North Mississippi, Bristol Regional Women’s Center, and Dr. Kimberly Looney.
The decision is available here.
April 19, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Demands Insurance Providers Obey the Law, Protect Women’s Access to Birth Control”. From the press release:
New York Attorney General Letitia James today demanded that three health insurance companies immediately provide coverage for 12-month supplies of contraceptives in accordance with New York State law. Under the Comprehensive Contraception Coverage Act (CCCA), health insurance providers are required to cover 12-month supplies of contraception at one time, yet the Attorney General’s Office found that Aetna, MetroPlus Health, and Oscar Health have refused to provide coverage for 12-month supplies to patients. In letters to these three companies, Attorney General James stressed the importance of adhering to this law especially in the midst of the coronavirus disease 2019 (COVID-19) pandemic, as many New Yorkers lose their jobs, health insurance coverage, and need to limit unnecessary trips to pharmacies.
“There’s nothing more important than protecting New Yorkers’ health care, including reproductive care,” said Attorney General James. “With more than one million New Yorkers losing their jobs, and with it their health insurance, it’s critically important that women are able to fill their birth control prescriptions for the full duration allowed under the law. Insurance companies must comply with the law and permit women to get up to a year’s supply of birth control. During this crisis and beyond, I will continue to fight to protect New Yorkers’ health care and their rights.”
The Attorney General’s Office received multiple complaints from New Yorkers that these companies refused to provide patients with 12-month supplies when requested and that representatives did not know this was required. The Attorney General’s Office is also reminding other insurers in New York State of their obligations under the CCCA.
In addition to ensuring access to 12-month supplies, the CCCA, which took effect on January 1, 2020, requires that health plans cover all forms of contraception without deductible, coinsurance, copayment, or any other cost-sharing requirements, ensures access to emergency contraception, and prohibits any restrictions or delays on coverage, such as pre-authorizations.
Attorney General James encourages anyone who has been denied this coverage by their health insurance plan or pharmacy or who believes they are being wrongfully denied other care to please report it to the Attorney General’s Office Health Care Bureau Helpline by filing a complaint or calling 1-800-428-9071. New Yorkers seeking information about available health plans in New York State should visit the state’s health plan marketplace….
April 20, 2020: Planned Parenthood posted a press release titled: “Court Blocks Tennessee’s COVID-19 Ban on Most Abortions”. From the press release:
Today, at the request of the Center for Reproductive Rights, Planned Parenthood Federation of America, the American Civil Liberties Union and the American Civil Liberties Union of Tennessee – a federal district court in Tennessee granted an emergency motion, allowing clinics to resume procedural abortions during the COVID-19 pandemic. The decision comes after Gov. Bill Lee issued a state order limiting “non-emergency” health care procedures. That order banned all abortions other than medication abortions (which involve taking pills and are only available until 11 weeks of pregnancy), despite leading national medical groups agreeing that abortion procedures are essential and time-sensitive.
In his decision, Judge Bernard Friedman wrote, “Moreover, abortion is a time-sensitive procedure. Delaying a woman’s access to abortion even by a matter of days can result in her having to undergo a lengthier and more complex procedure that involves progressively greater health risks, or can result in her losing the right to obtain an abortion altogether. Therefore, plaintiffs have demonstrated that enforcement of EO-25 causes them irreparable harm.”
“Let’s be clear: Abortion is essential, it’s time-sensitive, and it cannot wait. Though this is good news for our patients today, we should never have had to go to court to defend their health care access. A pandemic is a time to expand health care, not an excuse to take it away,” said Alexis McGill Johnson, acting president and CEO of the Planned Parenthood Federation of America. “Planned Parenthood is here for the patients and communities we serve in Tennessee, and we won’t back down when it comes to protecting our patients.”
“Abortion is essential health care and today is a win for our patients who need and deserve access to that care,” said Ashley Coffield, president & CEO of Planned Parenthood of Tennessee and North Mississippi. “The priority of Planned Parenthood health centers has always been the health and safety of our patients, staff, and community. Since the onset of the pandemic, we have done our part to promote best practices that reduce the transmission of the coronavirus and conserve needed resources. I am grateful that the guidance in the executive order has been clarified so we may continue to do so while still meeting the needs of our patients.”
“Women in Tennessee can breathe a sigh of relief for now, knowing abortion procedures are available again in their home state,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Today’s ruling in Tennessee joins those from courts across the country that have blocked these abuses of emergency powers. Women cannot wait until the pandemic is over to access abortion care, and we will continue fighting to make sure they can.” …
…Since the beginning of the COVID-19 outbreak, many states have attempted to ban or limit abortion. In addition to Tennessee, lawsuits are ongoing in Alabama, Arkansas, Louisiana, Ohio, Oklahoma, and Texas. Court decisions allowing abortion care to continue have been issued in Alabama, Arkansas, Ohio, Oklahoma, Tennessee, and Texas.
Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed these attempts to restrict abortion during the pandemic. Both groups filed an amicus brief in the case challenging Oklahoma’s COVID-19 ban, stating: “[B]anning abortion will not help address the pandemic. Most abortions do not require any hospital resources and use only minimal PPE. And banning abortion will actually increase use of those resources and contribute to spread of the virus.”
Tennessee also bans the use of telehealth for medication abortion — a method that could greatly expand access and reduce in-person contact. Other abortion restrictions in Tennessee include: a mandatory 48-hour waiting period (which includes a requirement that patients make an additional, medically unnecessary trip to the clinic to receive state-mandated information); limits on when state and public insurance can cover abortion services; and a requirement that minors obtain parental consent.
This lawsuit was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, the ACLU, the ACLU of Tennessee and pro-bono counsel Kramer Levin. Plaintiffs in the case are CHOICES Memphis Center for Reproductive Health, Knoxville Center for Reproductive Health, Planned Parenthood of Tennessee and North Mississippi, Bristol Regional Women’s Center, and Dr. Kimberly Looney.
The decision is available here.
April 20, 2020: Center for Reproductive Rights posted a press release titled: “Medication Abortion Blocked Again in Texas COVID-19 Court Battle”.
Today, the Fifth Circuit Court of Appeals ruled against abortion providers, prohibiting medication abortion yet again for women in Texas. At Texas’ request, the court vacated a lower court’s ruling that allowed medication abortion to continue. Today’s decision means that most abortions are again prohibited in Texas. Only patients who will pass the state’s gestational limit by April 22 (when the emergency order expires) will be allowed to have an abortion. The ruling is one of many that has created legal whiplash, causing confusion and uncertainty for hundreds of patients in need of essential, time-sensitive abortion care.
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“The appellate court is creating chaos and uncertainty for women seeking abortions in Texas. Patients who had appointments scheduled will now be thrown into a state of panic yet again. It’s clear this abortion ban has nothing to do with the pandemic. Texas has been trying to restrict abortion for decades and this is part of that larger strategy. We will continue to fight for the rights of the women of Texas.”
April 20, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Fighting Arkansas’ Unconstitutional Abortion Ban During COVID-19 Pandemic”. From the press release:
New York Attorney General Letitia James has led a multistate coalition of 19 attorneys general in seeking to stop the State of Arkansas from banning almost all procedural abortions in the state, as the state uses the coronavirus disease 2019 (COVID-2019) public health crisis as an excuse. Continuing her leadership of the nation’s fight to protect women’s reproductive health, Attorney General James led the coalition in filing an amicus brief in the U.S. Court of Appeals for the Eighth Circuit, supporting the plaintiffs in Little Rock Family Planning Services v. In re Leslie Rutledge, as they fight to preserve access to reproductive health care for the women across Arkansas.
“While multiple states are using the coronavirus as an excuse to push their anti-choice political agenda, we will continue fighting every day so that women retain control of their reproductive rights across this country,” said Attorney General James. “A pandemic does not give any state the right to undo all the progress made in the nearly 50 years since Roe, which is why I will continue to lead the fights against Arkansas, Oklahoma, Texas, or any other state that attempts to use this public health crisis as unjustified grounds to control women’s bodies, their choices, and their freedoms.”
Women seeking an abortion in Arkansas typically have the choice between one of two options: a medication abortion (induced by taking two different prescription drugs) or a procedural abortion (a procedure performed by aspiration or by dilation and evacuation, neither of which involves general anesthesia or incision). Medication abortions can take place through the 10th week of pregnancy in Arkansas, while a procedural abortion can currently take place through approximately 22 weeks of pregnancy, despite new state laws, passed last year, attempting to scale back that period to just 18 weeks. Only one abortion clinic in the entire State of Arkansas is currently licensed to perform procedural abortions — the Little Rock Family Planning Services (LRFPS) health clinic.
On March 11, 2020, Arkansas Governor Asa Hutchinson issued Executive Order 20-03, declaring a state of emergency. Ten days later, on March 21, 2020, the Arkansas Department of Health (ADH) issued a public statement recommending that health care facilities and clinicians “prioritize urgent and emergency visits and procedures now and for the coming several weeks.” The statement detailed that its goals were to “preserve staff, personal protective equipment (PPE), and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic.” The ADH stated that “[p]rocedures … that can be safely postponed shall be rescheduled to an appropriate future date.” The ADH issued another directive on April 3 with the same language as the March 21 directive, but which further specified that “urgent” and “care designated as an exception…will continue,” including care for circumstances in which “there is a risk of…progression of staging of a…condition if surgery is not performed.”
On April 1, representatives from the ADH called LRFPS twice to inquire about what the clinic was doing to reduce non-essential services, preserve PPE, and protect against the spread of COVID-19. On both occasions, LRFPS summarized practices it was following. On April 7, ADH inspectors performed an unannounced, in-person inspection at LRFPS. At no point during either of the phone calls or the in-person inspection (which occurred on a day during which both procedural and medication abortions were being provided) did the ADH representatives suggest that LRFPS was not complying with the state’s April 3 directive.
However, on the morning of April 10, ADH inspectors hand delivered a cease-and-desist order to LRFPS, asserting that the clinic was “in violation of the April 3, 2020 Arkansas Department of Health Directive on Elective Surgeries,” despite acknowledging that the April 7 inspection “did not reveal any deficiencies with respect to the rules for abortion facilities in Arkansas.” The cease-and-desist order stated that the April 3 “prohibition applies to surgical abortions that are not immediately necessary to protect the life or health of the patient” and that “[a]ny further violations of the April 3 Directive will result in an immediate suspension of [LRFPS’s] license.”
Although the ADH is using the April 3 directive as the basis for ordering LRFPS to stop performing procedural abortions — except when the life or health of the woman is at immediate risk — the ADH has, to date, continued to allow a range of other non-urgent medical services, including orthodontist visits to adjust orthodontic wires and dentist visits to treat cracked teeth. Further, at an April 9 press conference with Governor Hutchinson and Arkansas State Health Director Dr. Nathaniel Smith, Dr. Smith was asked if “elective surgery” was still permitted in the state, and he responded that judgments at surgical centers would be left primarily to the providers.
A lawsuit LRFPS filed last year against government officials in the State of Arkansas in the U.S. District Court for the Eastern District of Arkansas was amended on April 13 to add a challenge to the ADH April 3 directive and, specifically, the cease-and-desist order issued on April 10. The next day, the district court issued a temporary restraining order blocking the state from shutting down LRFPS’s procedural abortion services, in which the court noted that the state’s ban would, among other things, “bar access to abortion because medication abortion is contraindicated” for some women; “likely push [some women] to a more complex and more time-intensive” abortion procedure; and “likely push [other women] beyond the point at which abortion is available in the State.”
The district court also noted that the continuation of procedural abortions would not preserve PPE or hospital resources because procedural abortions make minimal use of both, and that continuing to allow procedural abortions would not increase the risk of transmission of COVID-19 any more than other activities that Governor Hutchinson has allowed to continue in Arkansas. Instead, the court observed, the state’s decision to bar procedural abortions in Arkansas will cause some women to undertake lengthy interstate travel that will actually increase the risk of transmission of the disease. The different defendants then asked the U.S. Court of Appeals for the Eighth Circuit to halt the lower court’s order, which would effectively reinstitute the ban on procedural abortions in the State of Arkansas.
In the amicus brief filed on Friday, Attorney General James and the coalition lay out why they oppose the request to halt the lower court’s temporary restraining order, stressing that the ban on procedural abortions in Arkansas infringes on a woman’s constitutional rights. The coalition explains that the “characterization of the ban as prohibiting only ‘elective’ procedures fails to recognize how the time-sensitive nature of abortion care distinguishes that care from services that can be postponed without patient harm during the current public health crisis” because “abortions cannot be deferred indefinitely or for long stretches without increasing risks for some women and denying access to others.” The coalition explains that Arkansas’ “ban on [procedural] abortions will irreparably injure any woman who reaches the legal limit for an abortion during the ban,” resulting in some women “permanently los[ing] their right to lawfully obtain an abortion in Arkansas.”
Additionally, Attorney General James and the coalition go on to highlight that if the ban were to be reinstated, some women in Arkansas would be forced to make “risky and expensive” travel plans to cross state lines in order to obtain an abortion. This is especially troublesome at a time when the entire U.S. population is being asked to limit travel to stop the spread of COVID-19. Further, the coalition notes that residents of New York and other amici states may currently be in Arkansas without a way to return home, but they still have a right to time-sensitive reproductive care.
Finally, the coalition explains why a ban on abortion would not help the state preserve PPE, free up hospital beds, or prevent the spread of COVID-19 transmissions. As the district court noted in its temporary restraining order, the exact opposite is actually true. The attorneys general note that procedural abortions require limited PPE and actually require “far less PPE and medical resources than continuing a pregnancy” does. Additionally, procedural abortions rarely require admission to a hospital.
The amended complaint by LRFPS was filed in a suit brought last year when the governor, in March 2019, signed into law several bills intended to restrict a woman’s access to abortion services throughout the state. The laws would criminalize abortions performed after 18 weeks and impose additional undue burdens on a woman’s constitutional right to an abortion. In July 2019, the U.S. District Court for the Eastern District of Arkansas granted a preliminary injunction and temporarily blocked the laws restricting abortion care from taking effect. The State of Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter. Earlier this year, in January, Attorney General James filed a multistate amicus brief in support of LRFPS’s lawsuit that seeks to protect a woman’s right to safe and legal abortion care without the burdensome restrictions imposed by Arkansas’ laws…
April 20, 2020: American Academy of Pediatrics (AAP) posted a press release titled: “AAP does not recommend home births, but offers guidance”. From the press release:
The AAP has released updated guidance to protect the health of infants born at home, even as the Academy does not recommend this option.
Hospitals and accredited birth centers remain the safest settings for birth in the U.S.
Planned home birth in the U.S. has been associated with a two- to three-fold increase in infant mortality and an increased incidence of low Apgar scores and neonatal seizures, according to the policy statement Providing Care for Infants Born at Home from the AAP Committee on Fetus and Newborn.
But because some women will continue to choose a home birth, the AAP has issued the guidance – similar to a 2013 policy – to help pediatricians discuss the issue with those seeking information or counsel…
…The AAP and the American College of Obstetricians and Gynecologists support provision of care by midwives who are certified by the American Midwifery Certification Board or its predecessor organizations or whose education and licensure meet International Confederation of Midwives Global Standards for Midwifery Education.
Two care providers should be present at each delivery. At least one should have primary responsibility for the newborn and appropriate training, skills, and equipment to perform full resuscitation of the infant according to the Neonatal Resuscitation Program.
This guidance also is supported by the American Heart Association.
April 21, 2020: Centers for Reproductive Rights posted a press release titled: “Court Says Oklahoma Abortion Providers Can Stay Open as COVID-19 Lawsuit Continues”. From the press release:
Last night, a federal district judge in Oklahoma granted a preliminary injunction allowing most abortion care to continue in the state, and allowing abortion access to resume fully on Friday, April 24, despite Gov. Kevin Stitt’s order banning abortion during the COVID-19 pandemic. The judge previously granted a temporary restraining order allowing most abortion care to continue through April 20, but yesterday’s decision extends that relief until the case concludes, and allows all abortion care to resume on Friday. The request for emergency relief came from the Center for Reproductive Rights and Planned Parenthood Federation of America on behalf of Oklahoma abortion providers.
Statement from Nancy Northup, President & CEO of the Center for Reproductive Rights:
“This ruling should send a clear message: enough is enough. Oklahoma now has struck out three times–twice at the district court and once at the appellate court. It’s time for Oklahoma and other states to stop exploiting the pandemic to close abortion clinics and deny women essential, time-sensitive healthcare.”
The decision is available here.
April 21, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Fighting Tennesse’s Unconstitutional Abortion Ban During COVID-19 Pandemic”. From the press release:
New York Attorney General Letitia James today led a multistate coalition of 19 attorneys general in seeking to stop the State of Tennessee from banning almost all procedural abortions in the state, using the coronavirus disease 2019 (COVID-2019) public health crisis as an excuse. Continuing her leadership of the nation’s fight to protect women’s reproductive health, Attorney General James led the coalition in filing an amicus brief in the U.S. Court of Appeals for the Sixth Circuit, supporting the plaintiffs in Adams & Boyle, P.C., v. Slatery, as they fight to preserve access to reproductive health care for women across Tennessee.
“Tennessee is the latest state to use the coronavirus as an excuse to outlaw abortion and strip women of their constitutional rights,” said Attorney General James. “This is just another power grab by a state willing to sacrifice women’s abortion rights to push a suppressive political agenda. We are standing up against this ban because the efforts by Tennessee and multiple other states to deny women their constitutionally-guaranteed rights will not go unchallenged. This is about protecting women’s bodies and their freedoms.”
Women seeking an abortion in Tennessee typically can obtain a medication abortion (induced by taking two different prescription drugs) or a procedural abortion (performed by aspiration or by dilation and evacuation, neither of which involves general anesthesia or incision). Medication abortions can take place through the 11th week of pregnancy in Tennessee, while a procedural abortion can currently take place through the 20th week of pregnancy, despite indications by the governor and many members of the legislature to scale back those timeframes.
On March 23, 2020, Tennessee Governor Bill Lee issued Executive Order No. 18, in which he declared: “All hospitals and surgical outpatient facilities…shall not perform non-essential procedures, which includes any medical procedure that is not necessary to address a medical emergency or to preserve the health and safety of a patient, as determined by a licensed medical provider.” Although the governor — through his aides — made clear his “hope and expectation” that “elective” abortions wouldn’t take place during the pandemic, he allowed for certain exemptions in his order, including one for “pregnancy-related visits and procedures.”
As has been reported in multiple news outlets, opponents of abortion — including legislatures, lobbyists, and activists — then put pressure on the governor’s office to clarify the first executive order and ban all abortions in the state. Emails released in the media show one lawmaker even asking the governor’s office if they had explored how other states addressed the “apparent way around” the order Tennessee abortion providers were using to continue providing abortion services. On April 8, before his earlier emergency order expired, Governor Lee issued Executive Order No. 25 with stricter guidelines that declared: “All health care professionals and health care facilities in the State of Tennessee shall postpone surgical and invasive procedures that are elective and non-urgent,” in which the life or health of the patient is not in jeopardy. Following that order, Tennessee Health Commissioner Lisa Piercey warned health care providers about the potential to be charged with a Class A misdemeanor and face penalties and discipline by medical boards if they did not comply with the governor’s executive order.
The next week, on April 13, the CHOICES Memphis Center for Reproductive Health, the Knoxville Center for Reproductive Health, Planned Parenthood of Tennessee and North Mississippi, Adams & Boyle P.C, and Dr. Kimberly Looney (an obstetrician-gynecologist) sought to file an amended complaint in a lawsuit in the U.S. District Court for the Middle District of Tennessee, along with a motion for a preliminary injunction to immediately halt the ban of all procedural abortions. In that suit, the providers had previously challenged Tennessee’s 48-hour waiting period for any woman seeking an abortion.
Last Friday, on April 17, the district court accepted the plaintiffs’ amended complaint and granted a preliminary injunction that immediately halted the ban of procedural abortions. The court found that “[d]elaying a woman’s access to abortion even by a matter of days can result in her having to undergo a lengthier and more complex procedure that involves progressively greater health risks, or can result in her losing the right to obtain an abortion altogether.”
That same day, Tennessee appealed the order for a preliminary injunction to the U.S. Court of Appeals for the Sixth Circuit.
In the amicus brief filed today in the Sixth Circuit, Attorney General James and the coalition lay out why they oppose the request to halt the lower court’s preliminary injunction, stressing that the ban on procedural abortions in Tennessee infringes on a woman’s constitutional rights. The coalition explains that the Tennessee defendants’ “characterization of the ban as a few weeks’ postponement of an ‘elective and non-urgent’ procedure fails to recognize how the time-sensitive nature of abortion care distinguishes that care from services that can be deferred without patient harm during the current public health crisis” because procedural “abortions cannot be deferred indefinitely or for long stretches without increasing risks for some women and denying access to others.”
The coalition notes that a ban on procedural abortions — “which appellants do not dispute will likely be extended even further — will irreparably injure any woman who reaches the legal limit for an abortion during the ban,” resulting in some women losing their constitutional right to a legal abortion.
Attorney General James and the coalition also explain that a prohibition on procedural abortions, even for a short period of time, would harm some women by requiring them “to undergo a more invasive and complex procedural abortion.”
Additionally, the coalition goes on to highlight that the procedural abortion ban would force some women in Tennessee to make “risky and expensive” travel plans to cross state lines in order to obtain a procedural abortion. This is especially troublesome at a time when the entire U.S. population is being asked to limit travel to stop the spread of COVID-19. Further, residents of New York and other amici states may currently be in Tennessee without a way to return home, but they still have a right to time-sensitive reproductive care.
The attorneys general add that: “To decrease transmission risks, reproductive health care clinics in amici States have increased the use of telehealth to conduct assessments, which reduces travel and in-person interactions. Some amici have modified state rules to allow increased use of telehealth during the pandemic. While Tennessee has taken similar steps to increase telehealth, it has refused to do so for abortion care.”
Instead of limiting women’s access to abortions, Tennessee should be joining Attorney General James’ call to increase access to telehealth medicine for abortion care and timely medication abortions so that women seeking abortions don’t have to fear going out and contracting COVID-19 during this public health crisis. Last month, Attorney General James sent a letter to both the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration requesting that the Trump Administration waive or utilize its discretion not to enforce its Risk Evaluation and Mitigation Strategy (REMS) designation, which dictates and subsequently impedes women’s access to the medication abortion prescription drug known as Mifepristone. Attorney General James called on the Trump Administration to ensure that women across the country can more easily access this critical health care service while the pandemic leaves many women unable to seek in-person care.
Finally, the coalition explains why a ban on procedural abortion would not help the state preserve PPE or prevent the spread of COVID-19 transmissions. As the district court found in the preliminary injunction it ordered, the exact opposite is actually true. The court found that “[procedural] abortions require significantly less PPE and provider-patient interaction than continuing a pregnancy” does. The coalition’s brief also notes that procedural abortion procedures rarely require admission to a hospital. In fact, only one out of 10,000 emergency room visits in the United States each year are abortion-related, whereas “a significant number of hospitalizations resulting from complications and miscarriages” occur early on in a pregnancy. The coalition adds, “[b]ecause some of these events are inevitably avoided by providing access to timely abortion procedures, denying access to timely abortions may not appreciably conserve PPE and reduce transmission risk even in the short term,” but could actually use more resources…
April 22. 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Urges FDA to Move Toward Risk Based, Gender Neutral Screening for Blood Donations to Eliminate Bias Against Gay and Bisexual Men”. From the press release:
California Attorney General Xavier Becerra led a multistate coalition in submitting comments to the U.S. Department of Health and Human Services’ Food and Drug Administration (FDA) supporting efforts to maintain an adequate national blood supply to aid the nation’s medical response during the COVID-19 pandemic. In the letter, Attorney General Becerra argues that while the FDA’s guidance easing restrictions on blood donations from the LGBTQ population, specifically gay and bisexual men, is a step in the right direction, the guidance does not go far enough to meet the nation’s needs. The letter advocates moving toward a risk-based, gender neutral screening model and further revising guidance to make it easier for the LGBTQ population to donate blood and plasma in response to the nation’s needs during the COVID-19 public health emergency.
“As Americans stay home to stop the spread of coronavirus, the nation is facing a shortage of blood donations, which provide critical medical support to hospitals and their patients,” said Attorney General Becerra. “During this pandemic, it is important to continue to evaluate and modernize blood donation guidance to be inclusive of LGBTQ Americans. A risk-based model not only protects the health and safety of our communities – it’s the right thing to do.”
In the midst of the COVID-19 health crisis, blood drives and donations have dropped significantly. Every day, the United States needs approximately 36,000 units of red blood cells, nearly 7,000 units of platelets, and 10,000 units of plasma to provide blood transfusions for major surgeries, treat patients and victims of trauma, and more. The American Red Cross, which provides about 40 percent of our nation’s blood and blood components, recently reported less than a five-day blood supply on hand. As of mid-March, over 4,000 blood drives have been canceled across the country due to coronavirus concerns and closures of schools and workplaces where these drives are usually held, resulting in over 100,000 fewer blood donations.
Recently, the FDA issued revised guidance related to blood donation policies for the LGBTQ community. This guidance reduced the wait period after sexual activity for gay and bisexual men from 12 months to three months. While this reform takes a step toward increasing blood donations made by healthy bisexual and gay men in a time when the nation’s supply of blood and blood products is at risk of collapse due to the COVID-19 pandemic, it does not go far enough. Data from the University of California, Los Angeles School of Law Williams Institute indicates that lifting restrictions completely, as compared to a 12-month waiting period, would produce more than 2 million additional eligible blood donors, including nearly 175,000 likely blood donors, and would potentially produce nearly 300,000 pints of additional donated blood annually.
Attorney General Becerra also argues that moving toward a risk-based model, rather than one based on gender, is not only more appropriate to address the population’s needs, but is also more in line with laws that protect against discrimination. A population-based policy singling out bisexual and gay men threatens the constitutional Equal Protection principles under the Fourteenth Amendment and Fifth Amendment. Over the long term, the FDA should instead look at risk behavior rather than sex for determining who should donate blood.
A copy of the letter is available here.
A copy of the letter is available here.
April 22, 2020: California Governor Gavin Newsom posted a press release titled: “Governor Newsom Announces Plan to Resume Delayed Health Care that was Deferred as Hospitals Prepared for COVID-19 Surge”. From the press release:
Today, California Governor Gavin Newsom announced plans to allow hospitals and health systems to resume delayed medical care for Californians – such as heart valve replacements, angioplasty and tumor removals, and key preventive care services, such as colonoscopies – which were deferred as the state’s health care delivery systems prepared for a surge of COVID-19 patients. The decision was based on progress toward preparing California hospitals and health systems for a surge in COVID-19 patients – one of the six critical indicators the governor unveiled last week as part of the state’s framework for gradually modifying California’s stay-at-home order.
As part of the Western State’s Pact, California will work with Washington and Oregon to share best practices on how our states can allow hospitals and medical providers to resume delayed medical care in areas that have sufficient hospital capacity, while ensuring the safety and health of our health care workers and patients. The Western states had previously announced a shared, science-based vision for gradually reopening their economies and controlling COVID-19 into the future.
“From the beginning, I have said California’s decisions will be guided by science, not politics, and that Californians’ health comes first,” said Governor Newsom. “Thanks to the work our health care delivery system has done expanding hospital capacity and reducing the rate of spread of COVID-19, hospitals and health systems can consider resuming medical care that residents have delayed during this crisis, such as heart valve replacements, angioplasty and tumor removals, when such care can be delivered safety and with appropriate protections for health care workers. It’s in the best interest of the overall health of our state to allow these procedures to resume when they can be done safely.”
Last week, Governor Newsom announced six indicators that would drive California’s decision to gradually modify portions of the state’s stay-at-home order. They include:
- Expanding testing and contact tracing to be able to identify and isolate those with the virus;
- Preventing infection in people who are most at risk;
- Being able to handle surges in hospitals and the health care delivery system;
- Developing therapeutics to meet demand;
- Ensuring businesses, schools and child care facilities can support physical distancing; and
- Determining when to reinstate certain measures like the stay-at-home order if need be.
Also today, Governor Newsom announced that President Trump has personally committed to sending the state 100,000 testing swabs next week and 250,000 swabs the following week.
Health officials also outlined progress toward the first indicator: expanding testing and contact tracing to be able to identify and isolate those with the virus.
To that end, the state announced the expansion of community testing in underserved areas. The state is contracting with Verily, an Alphabet company, in partnership with Community Organized Relief Effort (CORE) and with support from Rockefeller Foundation and an anonymous donor, to establish six new community testing sites focused on underserved communities such as farmworkers and communities of color. Additionally, the state is contracting with OptumServe, to establish an additional 80 community testing sites, which too will be focused on underserved communities.
“We know that communities of color are disproportionately affected by COVID-19,” said Governor Newsom. “We must ensure that we are deploying testing equitably in an effort to reduce the higher death rates we are seeing in African American and Latino communities.”
In addition, the state is:
- Accelerating equitable COVID-19 testing by aiming to deploy 25,000 tests per day by April 30; establishing an additional 80-100 testing sites; and identifying five new high-throughput testing hubs.
- Establishing a contact tracing workforce by surveying counties on their capacity; developing a statewide training academy; and training 10,000 public health connectors to conduct contact tracing.
- Developing isolation protocols and supports by identifying regional alternate isolation sites and building private-public partnerships to support those who are isolated.
- Deploying data management system and tools by publishing a symptom-check app; deploying a data management platform; and establishing a data dashboard for the public.
Now that testing has become more widely available across the state, California updated its testing guidance earlier this week to become the first state to recommend testing of some asymptomatic individuals such as health care workers, first responders and correctional workers. This action will better protect Californians and prevent COVID-19 spread in high-risk settings such as congregate living facilities and correctional facilities.
April 23, 2020: California Governor Gavin Newsom posted a press release titled: “Governor Newsom Provides Flexibility to Medi-Cal Providers and the Department of Health Care Services for Continuity of Service Amidst COVID-19”. From the press release:
Governor Gavin Newsom today issued an executive order that will give flexibility to the California Department of Health Care Services (DHCS) and Medi-Cal providers on a variety of deadlines and requirements to ensure continuity of service to patients and customers is not impacted by the effects of the COVID-19 pandemic.
The executive order will allow fair hearings to continue for California Children’s Services on grievances and appeals to take place by phone or video conference. Additionally, the order will ensure flexibility for DHCS and the Department of Social Services to continue providing mental health care services and programs.
Finally, the executive order will temporarily suspend requirements for in-person signatures for people to obtain certain prescription drugs covered by Medi-Cal, and will allow a 90-day extension for providers on cost reporting, change of scope of service and administrative hearings.
The text of the Governor’s executive order can be found here and a copy can be found here.
April 24, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on Federal Relief Funds for Obstetrician-Gynecologists”. From the statement:
Maureen Phipps, MD, MPH, FACOG, CEO of the American College of Obstetricians and Gynecologists (ACOG), released the following statement regarding the Department of Health & Human Services (HHS) methodology for dispersing emergency relief funds:
“Obstetrician-gynecologists across the country are on the front lines of responding to the COVID-19 pandemic and providing essential care to women in the midst of a public health crisis. At the same time, the health care system is in upheaval and many obstetrician-gynecologists are facing a financial crisis that threatens to shutter many women’s health practices. In order to ensure that women can continue to receive needed care today and in the months to come, it is vital that the Administration prioritize providing direct financial support to obstetrician-gynecologists and their practices.
“The Administration has acknowledged that despite great need, congressionally designated relief funds distributed to date have largely excluded obstetrician-gynecologists, who are among the physicians who provide essential care to underserved patients and make up our nation’s safety net. Although ACOG has proactively and thoroughly outlined specific recommendations for how HHS could quickly disperse funds to obstetrician-gynecologists, the Administration has indicated that women’s health practices may have to wait at least two more weeks until they receive relief funds. For many practices, this two-week delay could be too much to absorb, forcing them to close.
“Widespread closures will undoubtedly have a negative impact on the health and wellbeing of women and their families, particularly as our country continues to face a maternal mortality crisis. It is imperative that obstetrician-gynecologists and other women’s health practitioners continue to provide women with the lifelong care they need.
“ACOG looks forward to partnering with HHS to ensure that women’s health physicians are prioritized as relief funds are distributed. Access to obstetric and gynecologic care is essential – today and in the future.”
April 24, 2020: New York Attorney General Letitla James posted a press release titled: “Supreme Court Rules That Attorney General James Can Take Public Charge Back to Lower Court”. From the press release:
New York Attorney General Letitia James tonight confirmed that she will lead a coalition of three states and New York City in asking the U.S. District Court for the Southern District of New York to halt implementation of the Trump Administration’s Public Charge Rule, after the U.S. Supreme Court earlier this evening chose not to act in the matter itself but ruled that the plaintiffs had this option. Last week, Attorney General James and the coalition filed a motion with the Supreme Court, asking the court to revisit the question of interim relief on Public Charge in light of the new and devastating effects that the rule has had on the nation’s public health and economy as the coronavirus disease 2019 (COVID-19) continues to spread across New York and the rest of the nation.
“The Supreme Court’s order tonight allows us to continue the fight to halt the Public Charge Rule during the current public health crisis, and gives us the opportunity to make our case in a federal court in New York,” said Attorney General James. “We will soon file an emergency motion in the Southern District of New York because our country cannot afford to wait. The Public Charge Rule threatens the public’s health, our economy, and all New Yorkers — citizens and non-citizens alike. Every person who doesn’t get the health coverage they need today risks infecting another person with the coronavirus tomorrow.”
The Public Charge Rule drives immigrants and their families away from accessing health and nutritional benefits to which they are entitled by threatening applicants’ eligibility for green cards and visa renewals. The Supreme Court issued an order in January that had been denied by the lower courts, allowing the rule to take effect while legal challenges to the rule are pending in the U.S. Court of Appeals for the Second Circuit and through a possible petition to the Supreme Court.
Last week, Attorney General James led a coalition in asking the Supreme Court to take emergency measures to temporarily halt its earlier order on the Public Charge Rule until the national pandemic is over, in light of the new and devastating effects that the rule has had on the nation’s public health and economy as COVID-19 has spread over the last six weeks and in an effort to prevent the rule from impeding efforts to slow the continued spread of the virus happening nationwide.
While the Supreme Court did not halt its own order tonight, the court gave Attorney General James and the coalition permission to take the request back to the district court. In October 2019, after Attorney General James and the coalition filed a motion for a preliminary injunction in the U.S. District Court for the Southern District of New York, the district court issued an order that stopped the rule from going into effect during the litigation. The Trump Administration then filed a motion to stay the order, but the U.S. Court of Appeals for the Second Circuit denied the request. The Administration finally filed a motion in the U.S. Supreme Court, which issued a stay of the district court’s preliminary injunction, pending the Second Circuit’s decision in the case and any subsequent petition to the Supreme Court to hear the case.
Last August, days after the Trump Administration initially issued the Public Charge Rule, Attorney General James and a coalition of states and New York City filed a lawsuit challenging Trump Administration rule, noting that the rule specifically targets immigrants of color, immigrants with disabilities, and low-income immigrants, while putting these communities at risk, and would have short- and long-term impacts on public health and the economy.
The attorneys general of Connecticut and Vermont, as well as corporation counsel for New York City, will join Attorney General James in filing this new motion in U.S. District Court for the Southern District of New York.
April 24, 2020: Politico posted an article titled: “Trump team moves to scrap protections for LGBTQ patients”. It was written by Dan Diamond. From the article:
The Trump administration is moving to scrap an Obama-era policy that protected LGBTQ patients from discrimination, alarming health experts who warn that the regulatory rollback could harm vulnerable people during a pandemic.
The health department is close to finalizing its long-developing rewrite of Obamacare’s Section 1557 provision, which barred health care discrimination based on sex and gender identity. The administration’s final rule on Thursday was circulated at DOJ, a step toward publicly releasing the regulation in the coming days, said two people with knowledge of the pending rule. The White House on Friday morning also updated a regulatory dashboard to indicate that the rule was under review. Advocates fear that it would allow hospitals and health workers to more easily discriminate against patients based on their gender or sexual orientation.
The Obama administration moved to create its non-discrimination protections in response to advocates and health care experts who said that LGBTQ patients were being turned away from necessary care or intimidated from seeking it out. The broad rule also offered specific protections for transgender patients for the first time and extended protections for women who had abortions.But a federal judge in 2016 blocked those protections following a lawsuit from religious groups, and the Trump administration has steadily worked to weaken the rule before it could take full effect.
In last year’s proposal, the health department also proposed changes that went further than simply rolling back the new Obama protections, moving to eliminate similar nondiscrimination protections for LGBTQ patients that were contained in other regulations…
…Any rule issued by the Trump administration on LGBTQ protections could be short-lived. The Supreme Court is set to rule on whether the Civil Rights Act protects LGBTQ workers, which could create a new regulatory framework and force health officials to swiftly return to the drawing board.
Meanwhile, advocates say they’re worried that LGBTQ patients could be deterred from seeking care during a public health crisis. The liberal-leaning Center for American Progress published findings that 8 percent of lesbian, gay, and bisexual adults and 29 percent of transgender adults said they had been turned away by a health care provider based on their sexual orientation or gender identity.
April 25, 2020: Center for Reproductive Rights posted a press release titled: “Appellate Court Allows Abortion Services to Continue in Tennessee During Pandemic”. From the press release:
Last night, the 6th Circuit Court of Appeals affirmed a preliminary injunction granted by a lower court, allowing abortion clinics in Tennessee to continue providing time-sensitive abortion procedures during the coronavirus (COVID-19) pandemic. The decision comes after Gov. Bill Lee issued a state order on April 8 banning all abortion services other than medication abortions (which involve taking pills and are only available until 11 weeks of pregnancy), despite leading national medical groups agreeing that abortion procedures are essential and time-sensitive. Tennessee is one of eight states where officials have exploited the COVID-19 pandemic to limit abortion access.
In its decision, the court wrote, “The State has never, at any point in this litigation, attempted to support its policy choice with expert or medical evidence. This is unsurprising because, as far as we can tell, every serious medical or public health organization to have considered the issue has said the opposite.”
“This decision sends a clear message to Tennessee: You cannot use a public health crisis to cut off abortion access,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “In the last month, courts across the country have ruled that states cannot use emergency powers to deny women the right to end a pregnancy. It’s time for states to stop exploiting this pandemic.”
“We are so relieved that we can continue seeing patients and providing the essential abortion care they need,” said Rebecca Terrell, executive director of CHOICES Memphis Center for Reproductive Health. “It’s common sense that abortion is time-sensitive and cannot be delayed.”
“Once again, it’s taken a court fight to stop another governor from exploiting this pandemic to score political points. Abortion is time-sensitive, essential health care that cannot wait for a pandemic to pass. Today’s ruling is a sigh of relief for patients,” said Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America. “We cannot forget that the essential workers on the front lines of this pandemic are the same people who are disproportionately harmed when access to health care is attacked. We’ll continue to fight these cruel attacks on abortion in Tennessee and across the country.”
“This is a critical victory for Tennesseans who, on top of all the turmoil of this moment, are facing an unintended pregnancy and urgently need care,” said Julia Kaye, staff attorney at the ACLU Reproductive Freedom Project. “We hope the state will now focus on protecting its citizens during the pandemic rather than exploiting the crisis to push an anti-abortion agenda.”
Since the beginning of the COVID-19 outbreak, many state officials have attempted to ban or limit abortion. In addition to Tennessee, lawsuits are ongoing in Alabama, Arkansas, Louisiana, Ohio, and Oklahoma. Leading medical organizations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) have opposed Tennessee’s order, stating: “Permitting abortion care — which is essential, time-sensitive health care — will not substantially increase the burdens hospitals face as a result of the COVID-19 pandemic. The vast majority of procedural abortions are performed in non-hospital settings, and they typically require only minimal PPE.”
Tennessee also bans the use of telehealth for medication abortion — a method that could greatly expand access and reduce in-person contact. Other abortion restrictions in Tennessee include: a mandatory 48-hour waiting period (which includes a requirement that patients make an additional, medically unnecessary trip to the clinic to receive state-mandated information); limits on when state and public insurance can cover abortion services; and a requirement that minors obtain parental consent.
This lawsuit was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, the American Civil Liberties Union, the ACLU of Tennessee, pro-bono counsel Kramer Levin, and local counsel Barrett Johnston Martin & Garrison, LLC. Plaintiffs in the case are CHOICES Memphis Center for Reproductive Health, Knoxville Center for Reproductive Health, Planned Parenthood of Tennessee and North Mississippi, Bristol Regional Women’s Center, and Dr. Kimberly Looney.
The decision is available here.
April 27, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Applauds Kentucky Governor Andy Beshear for Safeguarding Reproductive Freedom by Vetoing Extreme Anti-Choice Bill”. From the press release:
Kentucky Governor Andy Beshear today vetoed an extreme anti-choice bill (SB 9) designed to expand Republican Attorney General Daniel Cameron’s power to roll back abortion access and promote political interference in deeply personal family decisions.
Last week, in the midst of a major public health crisis, the Kentucky General Assembly dedicated the final hours of the state’s legislative session to passing SB 9 in a transparent attempt to circumvent the authority of pro-choice Democratic Gov. Beshear, who in 2019 defeated extreme anti-choice incumbent Matt Bevin in the governor’s race.
In response to Governor Beshear vetoing this harmful bill, NARAL President Ilyse Hogue said:
“Anti-choice Republicans in Kentucky cravenly pounced on the opportunity presented by the COVID-19 pandemic to advance their agenda of ending abortion access. Governor Beshear has been an advocate for women and families for many years and reaffirmed his commitment today by vetoing SB 9. Now more than ever, sound science and medical expertise should guide public policy, not political games and an extreme agenda. Governor Beshear joins the ranks of other governors, both Republican and Democratic, who have rejected measures designed to meddle in personal decision-making. We applaud him for doing the right thing.”
Kentucky NARAL members also voiced their appreciation for Governor Beshear’s commitment to reproductive freedom and ensuring doctors are able to designate what healthcare is essential, not politicians looking to score points…
April 28, 2020: Center for Reproductive Rights posted a press release titled: “Appellate Court Says Oklahoma Abortion Clinics Can Stay Open During Pandemic”. From the press release:
Last night, the Tenth Circuit Court of Appeals ruled in favor of abortion providers, denying Oklahoma’s request to stay a lower court’s ruling from last week that blocked the state’s ban on abortion care during the COVID-19 pandemic. The decision means that abortion clinics can continue providing care as the case continues.
Statement from Nancy Northup, president & CEO of the Center for Reproductive Rights:
“For the past month, Governor Stitt has exploited this pandemic to try to ban abortion, but the courts have repeatedly ruled against him. In the wake of this latest ruling, it’s past time for Oklahoma to respect the essential needs of women seeking abortion care. This attempt to ban abortion is an abuse of emergency powers. It has nothing to do with legitimate public health efforts to address the pandemic and everything to do with politics. There is no question that abortion care is time-sensitive and cannot be delayed.”
April 28, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James and Pharmacy Executives Applaud New York’s Expansion of COVID-19 Testing to Pharmacies”. From the press release:
New York Attorney General Letitia James and representatives from major nationwide pharmacies today responded to the State of New York’s expansion of COVID-19 tests to local pharmacies.
“I am grateful that New York will begin to take advantage of its vast system of pharmacies to provide COVID-19 tests to more New Yorkers than ever before,” said Attorney General James. “It is critically important for us to increase the availably for testing in order to accurately capture the scope of the virus in our communities. I encourage all of those eligible to utilize these new testing opportunities.”
“New York State has made a significant step in curbing the COVID-19 crisis by working with pharmacists to provide the increased testing needed at this critical time. Pharmacists play a key role in the health and wellbeing of this country, and they have routinely shown that they are able to step in when we need them most. We will continue to work closely with Attorney General James and other officials across the state to ensure that pharmacists have all the resources needed to support New Yorkers through amplified testing efforts,” said Steve Moore, president, Pharmacists Society of the State of New York (PSSNY). “PSSNY is the largest organization in NY state representing the profession of pharmacy to promote and optimize public health and wellness through patient centric pharmacist care in the diverse communities pharmacy serves.”
“Approval for pharmacists to conduct COVID-19 tests is a recognition of the critical role that pharmacists play in our communities,” said Emmanuel Kolady, senior vice president, CVS Health. “This action will help us as we expand our testing capabilities in New York. Working together, we can help slow the spread of the virus.”
“From the beginning of this crisis, we made it our mission to support our communities and associates and to move as quickly as we can to provide solutions,” said Heyward Donigan, president and chief executive officer, Rite Aid. “I’m incredibly proud of our pharmacy teams – it’s their hard work that has allowed Rite Aid to ramp up testing so quickly and enables us to expand testing criteria to include all adults exhibiting symptoms.”
April 29, 2020: New York Attorney Letitia James posted a press release titled: “Attorney General James Continues Fight to Stop Public Charge Rule”. From the press release:
New York Attorney General Letitia James last night led a coalition of three states and New York City in filing a motion asking the courts to temporarily halt implementation of the Trump Administration’s Public Charge Rule in light of the coronavirus disease 2019 (COVID-19) public health crisis. A motion seeking a new preliminary injunction with the U.S. District Court for the Southern District of New York was filed after the U.S. Supreme Court, on Friday evening, chose not to act in the matter, but ruled that the plaintiffs had the option to take their argument back to the lower court for a decision.
“Unlike the Public Charge Rule, this disease does not discriminate — infecting both citizens and non-citizens alike,” said Attorney General James. “As our state and nation continue to suffer the devastating effects of COVID-19, it has become more and more clear that the Trump Administration’s Public Charge Rule will only further exacerbate the problem and punish New York and other immigrant-rich states by denying many the ability to obtain health care. We’re asking the district court to again take immediate action and suspend this rule and the threat it places on all of us. It’s time to end this national nightmare because every person who doesn’t get the health coverage they need today risks infecting another person with the coronavirus tomorrow.”
Federal law allows lawful immigrants to apply for certain supplemental health and nutritional public benefits if they have been in the country for at least five years. But, last August, the U.S. Department of Homeland Security issued a Public Charge Rule that changed the established meaning of public charge, which had long been that immigrants who use basic, non-cash benefits are not considered public charges because they are not primarily dependent on the government for survival. This “bait-and-switch” consequently jeopardized immigrants’ chances of becoming legal permanent residents or renewing their visas if they used these supplemental benefits to which they are legally entitled…
…Despite the Supreme Court’s decision in January, two weeks ago, Attorney General James led a coalition in asking the Supreme Court to take emergency measures to temporarily halt its earlier order on the Public Charge Rule until the national coronavirus pandemic is over. While the Supreme Court did not halt its own order on Friday, the court gave Attorney General James and the coalition permission to take the request back to the district court, which issued the initial preliminary injunction and originally stopped the rule from going into effect.
Since the initial preliminary injunction motion was argued in the district court, COVID-19 has fundamentally changed the national landscape. The United States went from not a single reported COVID-19 case to more than one million confirmed infections and more than 58,000 confirmed deaths, and is now the country with the most virus-related deaths in the world. More than 292,000 of those infections and more than 17,000 deaths have been reported in New York State alone.
In the months since the outbreak began, New York City, and cities across the United States have issued states of emergency. New York State and every other state in the nation have issued states of emergency. President Donald Trump has declared a national state of emergency and has approved federal disaster declarations for all 50 states and almost all territories.
In last night’s motion asking for a new preliminary injunction from the district court, Attorney General James leads the coalition in asking the court to now take into consideration the extraordinary events of the last two months and the new and devastating effects that the Public Charge Rule has had on the nation’s public-health and economy as COVID-19 has spread across the country, as well as how the rule continues to impede efforts to slow the continued spread of the virus happening nationwide. The motion asks the court to temporarily halt further implementation of the rule until the national emergency concerning COVID-19 is over.
Of note in the motion is the fact that immigrants make up a large number of essential workers helping move our nation along during this crisis, and if they don’t have access to the proper health care today, they are more likely to spread the virus to all Americans, inadvertently, tomorrow — not only contributing to the exponential growth of infection rates, but of fatalities as well. In short, “the Rule is undermining efforts to slow the spread of the virus.”
Further, the coalition argues that the nation’s economy cannot undergo further damage from the spread of COVID-19. In the five-week period ending April 23, more than 26 million residents across the nation lost their jobs and filed for unemployment, more than 1.4 million of which were New Yorkers. And according to estimates by the U.S. Bureau of Labor Statistics, between February and March 2020, the number of immigrant adults who are unemployed rose by 26 percent. As last night’s motion argues, “many workers who lose their jobs and employer-sponsored health insurance because of the pandemic are likely to need Medicaid coverage until they can find another job.”
Attorney General James and the coalition end by arguing that while the district court had earlier halted the Public Charge Rule from taking effect, the harms of the rule at the time of COVID-19 have only intensified and exacerbated the reasons why the rule need to be halted.
Joining Attorney General James in filing this new motion in the U.S. District Court for the Southern District of New York are the attorneys general of Connecticut and Vermont, as well as corporation counsel for New York City.
This matter is being handled by Deputy Bureau Chief of the Civil Rights Bureau Elena Goldstein, Civil Enforcement Section Chief of the Labor Bureau Ming-Qi Chu, and Assistant Attorneys General Abigail Rosner and Amanda Meyer, all under the supervision of Chief Counsel for Federal Initiatives Matthew Colangelo. Additional support was provided by Senior Assistant Solicitor General Judith N. Vale and Deputy Solicitor General Steven C. Wu. The Division for Federal Initiatives is overseen by First Deputy Attorney General Jennifer Levy.
April 30, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorneys General Becerra and Healey Urge HHS Not to Finalize Rule That Would Permit Healthcare Discrimination During Global COVID-19 Pandemic”. From the press release:
California Attorney General Xavier Becerra and Massachusetts Attorney General Maura Healey today co-led a multistate coalition in sending a letter to the U.S. Department of Health and Human Services (HHS) urging it not to finalize its proposed regulation, “Nondiscrimination in Health and Health Education Programs or Activities” (Section 1557 Rule). Section 1557 is an anti-discrimination provision that prohibits discrimination in healthcare based on gender, race, ethnicity, sex, age or disability. If finalized, the proposed changes to this provision would seriously undermine the Affordable Care Act’s (ACA) critical anti-discrimination protections at a time when they are most needed to help address the COVID-19 pandemic.
“Authorizing discrimination in healthcare is not only illegal, it is incredibly dangerous, and doing so in the midst of this global pandemic is nothing short of deadly,” said Attorney General Becerra. “We urge HHS not to move forward with this foolish rule that would threaten communities that already struggle disproportionately to access needed care – communities of color, women, immigrants, LGBTQ individuals, and disabled Americans. We should devote all our resources to the COVID-19 response and recovery efforts, not make it harder on our healthcare professionals and Americans seeking life-saving healthcare.”
The proposed rule would roll back anti-discrimination protections for communities of color, women, LGBTQ individuals, those with limited English proficiency, and people with disabilities by undermining critical legal protections that guarantee healthcare as a right. Data shows that the COVID-19 pandemic is already exacerbating racial and ethnic disparities in healthcare that the ACA attempted to address, particularly in states that have not expanded Medicaid. Communities of color have been disproportionately impacted, and recently more than 100 national and local organizations signed on to an open letter to the healthcare community about how COVID-19 may pose an increased risk to the LGBTQ population. HHS itself has long noted that discrimination within the healthcare system contributes to poor coverage and health outcomes, and exacerbates existing health disparities in underserved communities. Individuals who have experienced discrimination in healthcare often postpone or forgo needed healthcare, resulting in adverse health outcomes.
In the letter, the attorneys general argue that moving forward with this rule in the midst of this unprecedented healthcare crisis will create unnecessary confusion and administrative burdens for state agencies, healthcare providers, and patients at a time when the healthcare system is battling to save lives. Data suggests that increased access to healthcare could assist with prompt COVID-19 detection and increase early treatment, which helps diminish spread of the disease. For these reasons, the attorneys general warn the Administration that making this major regulatory change in the midst of the current crisis is not only irresponsible, it is potentially deadly.
Joining California Attorney General Becerra and Massachusetts Attorney General Healey in filing the comment letter are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia.
Today’s letter is Attorney General Becerra’s latest effort in his fight to protect the ACA and ensure Californians have access to high quality affordable care. In August 2019, Attorney General Becerra and Attorney General Healey led a multistate comment letter opposing the 1557 proposed rule. Attorney General Becerra also called on the Trump Administration to open a Special Enrollment Period for the ACA due to the COVID-19 pandemic. He is also currently leading a coalition of 21 attorneys general in defending the ACA and the healthcare of millions of Americans in the Supreme Court.
A copy of the letter can be found here.
April 30, 2020: Arizona Central posted an article titled: “Shady campaign ad for Sen. Martha McSally uses former employee paid $381,000″. It was written by EJ Montini. From the article”
For years Republican Sen. Martha McSally has had a problem trying to defend her many attempts to dismantle the Affordable Care Act, including its protections for those with pre-existing conditions.
During her losing campaign against Democrat Sen. Kyrsten Sinema, McSally was constantly under fire, correctly so, for pushing to have the ACA dismantled. Not only did McSally vote for such a plan, she was quoted as urging her Republican colleagues to pass it with the fiery profane admonition: “Let’s get this f-ing thing done!”
McSally attempts to defend herself by pointing to her vote for American Health Care Act, which prohibited insurance companies from denying people coverage for having pre-existing conditions.
The problem is that the bill would have allowed states to eliminate a ban on high-priced premiums for people with preexisting conditions. A big jump in those premiums would have forced many to lose coverage. And the so-called “high-risk pools” that were to be created, and that the Republicans said would help such people, wouldn’t have had enough funding to do so…
May
May 1, 2020: Center for Reproductive Rights, Human Rights Watch, and International Women’s Health Coalition sent a letter to the U.S. State Department Commission on Unalienable Rights. From the letter:
Dear U.S. State Department Commission on Unalienable Rights:
As human rights organizations, scholars, defenders and activists, we the 167undersigned, write to express our grave concern about the work of the U.S.State Department’s Commission on Unalienable Rights and any potential report or output that undermines the international human rights system and purports to reinterpret its respective treaties and monitoring bodies. In particular, we urge the Commission to reject the prioritization of freedom of religion as a cloak to permit violations of the human rights of women, girls, and lesbian, gay, bisexual and transgender (LGBT) people.
Now more than ever, countries worldwide should prioritize the rights to health and well-being of all their people without discrimination and recognize that reproductive rights are clearly established and articulated under international law. These rights are interrelated and indivisible from all human rights and cannot be subordinated within a hierarchy of rights.
There is clear and unequivocal consensus by UN human rights treaty bodies and independent experts that reproductive rights are human rights, grounded in the Universal Declaration of Human Rights (UDHR) and the core principles underlying the human rights treaties. The human rights treaty bodies have consistently recognized and protected reproductive rights as a component of and essential to the realization of fundamental human rights, including the rights to health, life, equality, information, education, privacy, non-discrimination and protection from torture and other ill-treatment.
One of the great advances with respect to rights in the period since World War II was that, through the adoption of the Charter of the United Nations and of the Universal Declaration of Human Rights, it was recognized that rights are universal: they apply to everyone everywhere. In addition, these documents recognized that a core value undergirding the universal application of rights is dignity. The Charter of the United Nations provides: “We the peoples of the United Nations, determined ….to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women.[…]” In keeping with the Charter, the UDHR begins with the assertion that: “Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world….”
The concept of dignity carries with it a commitment to privacy and autonomy. Human rights advocates in the US and around the world know that rights are grounded in dignity and its embrace of privacy and autonomy. We submit that the values that are inherent in the concepts of dignity, privacy and autonomy do not permit the state to dictate that women must conceive or reproduce. Respect for dignity, privacy, and autonomy—the core values of universal rights—requires that these are matters for each and every person to decide on their own.
For example, the UN Human Rights Committee—tasked with monitoring implementation of the International Covenant on Civil and Political Rights (ICCPR)—has consistently recognized that the right to privacy (article 17) obligates the state to ensure reproductive autonomy. It has also made clear that the right to life (article 6) includes the right to access comprehensive reproductive health care, including that state regulation of abortion should not put the lives of women or girls at risk, subject them to ill-treatment, discriminate against them, arbitrarily interfere with their privacy, or lead them to resort to unsafe abortion.
The UN Committee Against Torture has found that denying or delaying safe abortion or post-abortion care, in particular, may amount to torture or other cruel, inhuman or degrading treatment. Similarly, the UN Committee on Economic, Social and Cultural Rights has concluded that the right to the highest attainable standard of health, set forth in the UDHR and the International Covenant on Economic, Social and Cultural Rights, includes the right to sexual and reproductive health.
These rights, like all human rights protections,attach at birth. The UDHR provides clear language in the first article that is unequivocal: “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”
During the drafting of the declaration, the committee specifically considered, debated, and rejected an amendment that would have removed the specification that rights begin at birth. And while the American Convention on Human Rights (a regional treaty the United States has signed but not ratified) is the only human rights instrument that contemplates that the right to life may attach prenatally, the Inter-American Court of Human Rights has clarified that in regulating abortion, the protection of prenatal life does not prevail over other rights. In the 2012 case of Artavia Murillo et al. (“in vitro fertilization”) v. Costa Rica, the Inter-American Court struck down Costa Rica’s ban on the use of in vitro fertilization, which Costa Rica attempted to justify as a measure to protect the right to life prior to birth. In that case, the Court determined that, under the American Convention, the “right to life should not be understood as an absolute right, the alleged protection of which can justify the total negation of other rights” and that disproportionate restrictions on the exercise of other human rights due to absolute protection of the right to life “would be contrary to the protection of human rights”(paras 259 and 264).
Further, these rights are indivisible from other human rights. It is a tenet of human rights that all rights are universal, equal, interdependent, and interrelated. The preamble of UDHR begins by recognizing that the “equal and inalienable rights” of all members of humanity is the “foundation of freedom, justice, and peace.”The UDHR makes clear that each of the thirty articles in the declaration are equally important and that no state or individual can decide that some rights are more important than others. Indeed,the deprivation of rights in one area tends to create conditions for the deprivation of rights in others.
Of course, it is of great concern if the exercise of one person’s fundamental right impedes upon the realization of another’s. The ICCPR itself recognizes that this tension may arise. Article 18(1) recognizes the right to freedom of thought, conscience and religion, which includes both the “freedom to have or to adopt a religion or belief of [a person’s] choice, and freedom, either individually or in community with others and in public or private, to manifest his religion or belief in worship, observance practice and teaching.”The Human Rights Committee in its General Comment No. 22 has emphasized that Article 18 “does not permit any limitations whatsoever on the freedom of thought and conscience or on the freedom to have or adopt a religion or belief of one’s choice,”but—recognizing that religious exercise may affect others—does permit limitations on the freedom to manifest one’s religion or beliefs.
Further, the text of the treaty itself recognizes this. Under Article 18(3), states may regulate the manifestation of religion or belief if, and only if, such regulations “are prescribed by law and are necessary to protect public safety, order, health, or morals or the fundamental rights and freedoms of others.” The Committee has consistently clarified that the freedom of thought, conscience, and religion does not protect religiously motivated discrimination against women, or racial and religious minorities.
Thus, in order to protect and uphold the basic rights of all people, states may impose some limitations on acts manifesting religion or belief in order to protect the infringement of other people’s rights. These include limitations to ensure that health care providers do not impede access to reproductive health services. Yet, we continue to see in our work “conscientious objection” policies that allow providers to refuse to provide critical services to women and LGBT people, on the basis of conscience. In many instances, this increases discrimination in care and increased health disparities.
Marginalized groups, including women, young people, and LGBT individuals, are particularly at risk. Such was the case for a fourteen-year-old girl in Poland who was denied access to a legal abortion, for a pregnancy resulting from a rape, under claims of “conscience” by providers and health systems. She was compelled to undergo non-fact-based counseling, had her personal information disclosed to the press, and was removed by the state from her mother, who supported her decision to have an abortion. In 2012, the European Court of Human Rights issued its decision in her case in P. and S. v. Poland and determined Poland had violated her right to be free from degrading treatment, as well as her right to privacy. The Court also found that states have the obligation to limit the use of ‘conscientious objections’ in order to guarantee people access to lawful reproductive health services. Despite this clear legal ruling, however, the intersection between religious freedom and reproductive rights has continued to be a flashpoint in Poland. Contraception, particularly emergency contraception, remains difficult to access.
While this Commission has indicated an interest in prioritizing and ranking human rights, with a freedom of religion at the apex, as human rights defenders and activists we have seen firsthand how human rights are interdependent and indivisible. In recent years, we have often seen that authoritarian regimes may start by targeting reproductive rights, citing arguments of religion or “traditional values,” before expanding their attacks on other human rights.
This has been starkly visible in Turkey, where women’s rights movements were quick to sound the alarm about the Turkish presidency and government’s regressive approach to women rights and role in society. Restrictive amendments have limited access to sexual and reproductive health and rights, reports of gender-based violence have more than doubled, and female employment has decreased in a political context that prioritizes “traditional families.” The presidency of Recep Tayyip Erdogan has overseen a purging of academia and the civil service, the jailing of journalists and opposition politicians, and a broad crack down on civil society. Should it prioritize freedom of religion and conscience over other rights, the Commission on Unalienable Rights will further fuel authoritarian regimes’ readiness to “sacrifice” reproductive rights in the name of “traditional values.”
This same pattern has been displayed as well in Brazil. President Jair Bolsonarohas promoted extreme anti-choice religious views at the expense of gender and sexual and reproductive health and rights, stating that he would veto any bill to legalize abortion. Accusing advocates of sexual and reproductive health and rights of encouraging teens to have sex at a young age, Bolsonarois opposed to and has condemned comprehensive sexuality education (CSE). For example, as a member of congress he joined the evangelical caucus in labeling a proposed educational initiative to combat homophobia in schools a “gay kit” intended to “pervert” students. Bolsonaro appointed Damares Alves as Minister of Women, Family and Human Rights, who has promoted abstinence for adolescents and student programs developed by anti-reproductive rights groups. Increasing barriers to access to science-based health information puts at risk Brazil’s steadily decreasing teenage pregnancy rates and young people’s right to access sexual and reproductive health services.
In times of crisis, human rights protections only become more important. Just recently, in response to the current pandemic, Hungary’s national government invoked a state of emergency law that allows the government to rule by decree indefinitely, which in reality means that Prime Minister Viktor Orban has absolute power to decide how long he can set aside and adopt laws without parliamentary or judicial scrutiny. Since consolidating his power in the name of fighting the spread of the illness, Orban has cracked down on the press and proposed a new law blocking access to legal recognition for transgender people. Advocates fear this new unbalanced power dynamic will increase assaults on asylum rights, women’s human rights, LGBT people’s rights, and democracy as a whole.
We urge the United States to uphold and promote the international human rights framework contained in the Universal Declaration of Human Rights and in subsequent human rights treaties. Any attempt to undermine the international human rights system would put in jeopardy the rights and protections of the women, girls and all people for whom we stand alongside and fight for the realization of these universal rights.
The letter includes several pages filled with organizational signers and individual signers.
May 1, 2020: Center for Reproductive Rights posted a press release titled: “U.S. Unalienable Right Commission Shouldn’t Cherry-Pick Rights”. From the press release:
The U.S. State Department’s Commission on Unalienable Rights should uphold international human rights commitments and not use freedom of religion as a cloak to permit violations of the rights of women, girls, and LGBTQ people, 167 leading human rights activists and groups from 28 countries said today in a letter to the Commission.
The Commission on Unalienable Rights is an advisory body created by Secretary of State Mike Pompeo in July 2019 to advise on human rights in U.S. foreign policy. It has sparked concern from experts that the United States seeks to unilaterally rewrite agreed-upon human rights obligations and create a hierarchy of rights.
The Center for Reproductive Rights, Human Rights Watch, the International Women’s Health Coalition, and other organizations and activists from around the world said that the Commission should prioritize everyone’s rights to health and well-being, without discrimination, and recognize that reproductive rights are clearly established under international law. These rights are essential to people’s dignity and well-being and should not be treated as less worthy of protection than other human rights.
“The Trump administration has routinely employed freedom of religion as a tool of discrimination against women, girls, and LGBTQ people,” said Françoise Girard, president of the International Women’s Health Coalition (IWHC). “The Commission on Unalienable Rights is a callous attempt to create a hierarchy of rights and deny the world’s most marginalized their fundamental rights. This politicization of international human rights sets a dangerous precedent and empowers regressive governments worldwide to pick-and-choose human rights obligations based on political ideology—a development with severe consequences for women and girls.”
The Commission serves, in Secretary Pompeo’s own words, to distinguish between “unalienable” rights and so-called ad-hoc rights—a worrying sign of the Commission’s intent. These fears are supported by the appointment of commissioners with extensive records opposing access to sexual and reproductive health services, women’s human rights, and rights for lesbian, gay, bisexual, transgender, and queer people. The Commission’s public hearings have not allayed concerns as commissioners have repeatedly alluded to the primacy of freedom of religion over other rights.
“The Commission was improperly established as yet another shameful attempt by this administration to erase protections in international human rights law for sexual and reproductive rights,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Reproductive rights are human rights. These attempts by the U.S. State Department, through the Commission, to pick and choose which rights the United States will recognize and prioritize threatens to erode protections for women, LGBTQ people, and other marginalized and vulnerable communities around the world.”
Human rights instruments and mechanisms, many ratified by the U.S., clearly lay out fundamental rights that are universal, interrelated, and indivisible. By casting doubt on decades of international human rights law, the Trump administration gives cover to those who seek to roll back essential protections for women, girls, LGBTQ people, and minority groups worldwide, the letter said, urging the United States to uphold all human rights, not only those that fit a narrow political ideology.
Freedom of religion—while a fundamental human right—has increasingly been misused as an excuse to discriminate, with particularly severe consequences for women, girls, and LGBTQ people. For example, health care providers worldwide routinely refuse to provide critical health services—including abortion care, contraception, and gender-affirming services—arguing that it goes against their personal beliefs. To this end, the Trump administration has championed the right to freedom of religion at the United Nations and World Health Organization in an attempt to further restrict sexual and reproductive rights.
“The Trump administration has a record of curtailing women’s human rights at every opportunity, and this Commission attempts to provide cover to insidious discrimination against women and girls around the world who seek to fulfill their human rights and access the health services they need,” said Amanda Klasing, acting women’s rights co-director at Human Rights Watch. “Redefining some rights, and by extension some people, as ‘less equal’ only increases inequality, insecurity, and injustice.”
May 1, 2020: California Attorney General Xavier Becerra posted a press release titled: “California and Nevada Co-Lead Multistate Amicus Brief Supporting Challenge to Harmful Trump-Pence Title X Rule”. From the press release:
California Attorney General Xavier Becerra and Nevada Attorney General Aaron Ford today filed a multistate amicus brief in the U.S. Court of Appeals for the Fourth Circuit, supporting the City of Baltimore in its lawsuit against the Trump-Pence Administration’s Title X rule. The new rule restricts access to critical preventative reproductive healthcare by prohibiting doctors from providing referrals for abortion or offering complete information to patients about their family planning options. In the brief, the state coalition explains that the new rule endangers the health, well-being, and economic security of their residents, leaving patients in entire regions and states nationwide without providers. The coalition urges the court to uphold a lower court ruling halting implementation of the Title X rule.
“With this rule, the Trump-Pence Administration has upended the Title X program, which provides critical reproductive and preventative health services to low-income women and families across the nation,” said California Attorney General Xavier Becerra. “At a time when many Americans are facing uncertainty in both their health and finances due to the coronavirus, programs that provide low-cost healthcare, like Title X, are more critical than ever. Our coalition stands with the millions of women and families across the nation who rely on Title X for healthcare services in urging the court to halt this harmful rule.”
“Politics has no place in the doctor’s office, and I’m proud to lead an effort to fight misguided attempts to prevent families from receiving accurate information and options about their healthcare,” said Nevada Attorney General Aaron D. Ford. “Millions of low-income and under-served families rely on Title X for access to a broad range of health services, and my office will use every means to ensure their rights are protected.”
The Title X family planning program is instrumental in states’ efforts to deliver preventative and reproductive healthcare to low-income women and families. Over the last 50 years, Title X has created a strong network of medical providers committed to delivering high-quality, evidence-based preventive health services. Prior to 2019, the Title X program funded a wide array of critical public health services, including family planning counseling, access to FDA-approved contraceptive methods, pelvic exams, and crucial screenings for high blood pressure, anemia, diabetes, sexually transmitted diseases and infections, and cervical and breast cancer. The Trump-Pence Administration’s new Title X Rule, however, has harmed the Title X program nationwide.
Since the new Title X rule went into effect, the states’ Title X programs have been upended, with many qualified providers leaving the program. In 13 states, more than 50 percent of Title X grantees have withdrawn from the program, and several states no longer have any Title X providers. Further, new providers have not filled the gap caused by the withdrawals. As a result, states have faced increased burdens to meet residents’ needs for essential healthcare. California alone has experienced a significant loss of Title X providers—going from 366 health centers in 38 counties to 229 health centers in only 18 counties. This leaves several rural counties with no Title X providers. As a result of these withdrawals, 38 percent fewer patients were served in 2019 compared to before the Trump-Pence Rule went into effect. And this year, California’s Title X network is projected to serve fewer patients still, a reduction of almost 72 percent since before the rule took effect.
The coalition also notes that in light of the recent pandemic, clinic withdrawals from the Title X program place an additional strain on health systems nationwide. Due to COVID-19, many people have lost insurance coverage or are experiencing financial instability due to unemployment and could benefit from Title X’s low-cost services.
Today’s brief is the latest step in Attorney General Becerra’s efforts to protect the Title X program. On July 30, 2018, he led a coalition of 13 attorneys general in filing a comment letter opposing the Trump-Pence Administration’s proposed rule. On March 4, 2019, he filed a lawsuit challenging the final rule in the Northern District Court of California, claiming the proposed restrictions to Title X disregard the rule of law and harm California’s healthcare providers and over one million women in our state who relied on Title X for healthcare services. That lawsuit is ongoing in the Ninth Circuit.
Joining Attorneys General Becerra and Ford in filing the brief are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.
A copy of the amicus brief is available here.
May 2, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on Trump Administration Assault on the Health of LGBTQ Americans”. From the press release:
Speaker Nancy Pelosi released the following statement on the Trump Administration’s proposed Health and Human Services Department rule that would end anti-discrimination protections for LGBTQ Americans in health care:
“The Trump Administration’s latest shameful rule is a shocking attack on the health and well being of the LGBTQ community at a time when access to quality health care is more important than ever.
“Our nation is in the midst of a health and economic crisis of staggering proportions. Instead of working to ensure that every American, regardless of who they are or who they love, has access to the care they need to stay healthy and safe, the Administration is working on rolling back life-saving protections for some of the most vulnerable communities and enshrining discrimination into vital federal guideline. Religious freedom is no justification for hatred or bigotry, and every American has the right to seek and recieve care without intimidation or fear. The Administration must immediately abandon this outrageous, un-American plan and give LGBTQ individuals the reassurance that they will never be denied the health care they or their families need.
“House Democrats will continue to hold this Administration accountable for their dangerous assault on our fundamental values of equality and justice, and we will never stop fighting to ensure all Americans are treated with the respect and dignity they deserve.”
May 5, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Releases Statement as Supreme Court Hears Oral Arguements in Birth Control Case”. From the press release:
Tomorrow, the U.S. Supreme Court will hear oral arguements in Trump v. Pennsylvania, a challenge to the Trump administration’s rules that would allow virtually any employer or university to declare itself exempt from the Affordable Care Act’s landmark requirement that health insurers cover birth control without co-pays. NARAL Pro-Choice America President Ilyse Hogue released the following statement:
“The Trump administration’s push to undermine this essential part of the Affordable Care Act could rob countless people across this country of their dignity and ability to determine their own futures. These reckless attacks on birth control access are nothing more than another shameless effort by the radical right to advance their agenda of power and control, no matter the cost to women and families. Every body deserves birth control coverage, and your boss or school shouldn’t be allowed to interfere with what kind of coverage you can get.
The Trump administration’s rules put ideology above our health and well-being — and thanks to Brett Kavanaugh’s confirmation to the Supreme Court, even access to birth control is on the chopping block thanks to a fringe political agenda. We will never stop working to hold accountable all politicians who enabled Trump and his dangerous attacks on reproductive freedom—including the senators who greenlit Kavanaugh’s confirmation.”
May 6, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Coalition of 20 States and the District of Columbia Defending the ACA in U.S. Supreme Court”. From the press release:
California Attorney General Xavier Becerra, leading a coalition of 20 states and D.C., today filed a brief in the U.S. Supreme Court defending the Affordable Care Act (ACA) against efforts by the Trump Administration and the state of Texas to repeal the entire ACA, putting the healthcare of tens of millions of Americans at risk. The Court agreed to review a recent Fifth Circuit decision that held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the law could still stand—jeopardizing Medicaid expansion, critical public health programs that help fight COVID-19, and subsidies that help working families access care, among countless others. Critically, this decision threatens healthcare coverage protections for 133 million Americans with pre-existing conditions, and would allow health insurance companies to deny individuals care or charge more based on their health status.
“It’s unconscionable that the Trump Administration continues its attack on healthcare, just when many Americans across the country need it most. A global pandemic is the time to wake up and protect the lives of our loved ones, yet all we see from the President’s team is repeal without replace,” said Attorney General Becerra. “The ACA is the backbone of our healthcare system, making doctor’s visits and care possible for millions of people, while providing critical public health funds for our communities to fight infectious diseases like the coronavirus. Under this hallmark law, more than 133 million people have been guaranteed healthcare protections, who could have been denied coverage entirely pre-ACA. We can’t afford to return to those days, so we’re marching forward at the Supreme Court determined to save the ACA and American lives.”
The lawsuit, originally filed by a Texas-led coalition, and later supported by the Trump Administration, argued that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for forgoing coverage to $0. They further argued that the rest of the ACA should be held invalid as a result of that change. California’s coalition defended the ACA in its entirety, supported by a bipartisan group of amici including scholars, economists, public health experts, hospital and provider associations, patient groups, counties, cities, and more. While the Fifth Circuit held that the individual mandate is unconstitutional, it sidestepped the further question as to the validity of the ACA’s remaining provisions. Attorney General Becerra’s coalition petitioned the Supreme Court for review in order to protect Americans’ healthcare and resolve the uncertainty created by the Fifth Circuit decision.
In today’s filing, California’s coalition makes clear that patients, doctors, hospitals, employers, workers, states, pharmaceutical companies and more will be negatively impacted if the ACA should fall. It also highlights important advancements in healthcare access made under the ACA, including:
- More than 12 million Americans receiving coverage through Medicaid expansion;
- Nearly 9 million individuals nationwide receiving tax credits to help afford health insurance coverage through individual marketplaces;
- Millions of working families relying on high-quality, employer-sponsored insurance plans;
- Important protections prohibiting insurers from denying health insurance to the 133 million Americans with pre-existing conditions (like diabetes, cancer, or pregnancy) or from charging individuals higher premiums because of their health status;
- Improved payment reforms and increased access to Medicare for seniors and people disabilities; and
- Nearly $1.3 trillion in federal funding being dedicated to keeping Americans healthy and covered, including Medicaid expansion and public health dollars.
Joining Attorney General Becerra in defending the ACA are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the Governor of Kentucky.
A copy of the brief is available here.
May 6, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on House Brief to Defend Affordable Care Act at Supreme Court”. From the press release:
Speaker Nancy Pelosi issued this statement after the House filed a brief with the Supreme Court in the California v. Texas health care repeal lawsuit, to defend the Affordable Care Act from the Trump Administration’s assault in the courts:
“The Affordable Care Act is a pillar of health and economic security in America, and its protections are more important than ever, as the coronavirus crisis shatters the lives and livelihoods of millions.
“As our brief makes clear, the President’s insistence on doubling down on his senseless and cruel argument in court to destroy the ACA and every last one of its benefits and protections is unconscionable, particularly in the middle of a pandemic.
“Access to affordable, quality health care is a matter of life and death. On Day One of this Congress, the House voted to throw our full legal weight into the fight to defeat this Republican lawsuit and we will continue to fight to defend the ACA, which is the law of the land, from the President’s attacks. The President must abandon his support for this suit and end his attacks on families’ health now.”
May 6, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Fights to Defend ACA in Supreme Court”. From the press release:
New York Attorney General Letitia James and a coalition of states today fought to defend the Affordable Care Act (ACA) against efforts by the Trump Administration and the State of Texas to repeal the law, putting the health care of tens of millions of Americans at risk. If the ACA is repealed, 133 million Americans with pre-existing conditions could be denied coverage or charged more based on their health status. The ACA is also providing critical public health programs that are helping to fight the spread of the coronavirus disease 2019 (COVID-19), states’ decisions to expand Medicaid, and subsidies that are helping working families access the health coverage they need, among countless other benefits. Attorney General James and the coalition of 19 additional attorneys general and the governor of Kentucky, have now taken their fight to the U.S. Supreme Court, after the court agreed to review a recent decision by the U.S. Court of Appeals for the Fifth Circuit that held that the ACA’s individual mandate was unconstitutional and simultaneously called into question whether the remaining provisions of the law could still stand.
“In the midst of the COVID-19 pandemic, it has never been more clear how important it is for Americans to have access to quality, affordable health coverage,” said Attorney General James. “Yet, President Trump continues to actively work to strip health coverage away from millions of individuals and families, including more than a million who have the coronavirus. We are asking the Supreme Court to stop the president from kicking Americans off their health plans and finally end his efforts to undo all the progress made over the last ten years.”
The lawsuit — originally filed by a Texas-led coalition and later supported by the Trump Administration — argued that a Republican-led Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for forgoing coverage to $0. They further argued that the rest of the ACA should be held invalid as a result of that change. Attorney General James and a coalition of attorneys general defended the ACA in its entirety, supported by a bipartisan group of amici, including scholars, economists, public health experts, hospital and provider associations, patient groups, counties, cities, and more. While the Fifth Circuit held the individual mandate to be unconstitutional, it declined to further rule on the validity of the ACA’s remaining provisions. The court instead sent the case back to the U.S. District Court for the Northern District of Texas to determine whether the problem with the mandate requires striking down the whole law. In January, however, Attorney General James and the coalition petitioned the Supreme Court for expedited review to protect Americans’ health care and resolve the uncertainty created by the Fifth Circuit decision. The Supreme Court granted review of the case in March for the upcoming term.
In today’s filing, Attorney General James and the coalition make clear that patients, doctors, hospitals, employers, workers, states, and more will be negatively impacted if the ACA is repealed. The brief also highlights important advancements in health care access made under the ACA, including:
- More than 12 million Americans now receive coverage through the ACA’s Medicaid expansion;
- Nearly nine million individuals nationwide receive tax credits to help subsidize their health insurance coverage through individual marketplaces;
- Millions of working families rely on high-quality, employer-sponsored insurance plans;
- Important protections prohibit insurers from denying health insurance to the 133 million Americans with pre-existing conditions, like COVID-19, diabetes, cancer, or pregnancy, or from charging individuals higher premiums because of their health status; and
- Nearly $1.3 trillion in federal funding has been dedicated to keeping Americans healthy and covered, which includes spending through Medicaid expansion and public health dollars.
And in New York:
- The state uninsured rate reached its lowest point ever recorded in 2018 — 4.7-percent;
- More than 4.7 million New Yorkers now receive health coverage through the ACA, including nearly 3.3 million on Medicaid;
- 58 percent of enrollees were expected to receive $636 million in tax credits to help subsidize the cost of health care in 2019 alone; and
- The average monthly premium tax credit available to eligible Qualified Health Plan enrollees in 2019 was $335.
Joining Attorney General James in filing today’s brief are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky.
May 12, 2020: Military.com posted an article titled: “Tricare Drops Telehealth Copays, Adds Phone Call Coverage in Emergency Measure”. It was written by Patricia Kime. From the article:
Tricare will now cover telephone services for some medical appointments and will eliminate copayments for beneficiaries who use telehealth services in place of an in-person visit to the doctor during the COVID-19 pandemic.
Effective Wednesday, the Defense Department health program will cover audio-only remote services for office visits “when appropriate” and will not require copays for telemedicine, according to a notice in the Federal Register.
The coverage will extend through the end or suspension of the national emergency as declared by President Donald Trump, according to the ruling.
The ruling eliminates cost-sharing, including co-pays and deductibles, for in-network telehealth services for both Tricare Prime and Tricare Select beneficiaries in all geographic locations.
It also lifts Tricare’s prohibition on medical services via telephone, allowing physicians or other providers to evaluate a patient’s symptoms by phone. While the ruling is clear that appointments via telehealth — with audio and video capability — are preferred, phone calls are acceptable for those who may not have access to high-speed internet or a computer with Wi-Fi access.
The service applies to any illness or injury covered by Tricare, including COVID-19, but calls must be considered medically necessary and conducted by a network Tricare provider within the scope of his or her professional license.
To be eligible for reimbursement for a telephone consult, providers should determine that a phone call is “appropriate for accomplishing the clinical goals of the encounter” and must document it, according to the ruling.
Any visit requiring a physical exam would not be appropriate for a phone consultation and would not be covered, Tricare officials added.
The ruling also lifts some restrictions on providers practicing medicine across state lines. Under normal circumstances, Tricare requires that providers must be licensed in the state where they are practicing, and they can treat patients only in that state.
Under the temporary rule, providers will still be required to be licensed but can provide telehealth and audio medicine to patients across state lines. For example, in Washington, D.C., Tricare providers would be allowed to provide telemedicine to their patients who reside in Virginia. Previously, this was prohibited…
May 13, 2020: California Attorney General Becerra and Senator Monning Announce That Legislation to Reduce Healthcare Costs, Increase Access to Affordable Care Passes Senate Health Committee”. From the press release:
California Attorney General Xavier Becerra and Senator Bill Monning today announced Senate Bill 977 (SB 977), legislation that would make healthcare more affordable and accessible by cracking down on anticompetitive behavior and consolidation in the healthcare market, passed out of Senate Health Committee. The bill would require the Attorney General’s Office to review and approve affiliations or acquisitions between healthcare systems, facilities, or provider groups to ensure transactions either improve care coordination or increase healthcare access for underserved populations. The bill also provides new enforcement tools to reduce anticompetitive behavior in the market that leads to higher costs.
“The coronavirus pandemic has shone a light on the crucial importance of our healthcare system and ensuring that everyone has access to affordable, quality healthcare. When giant companies strangle competition in the healthcare market, patients and employers are left paying the price,” said Attorney General Becerra. “I’m grateful to be working with Senator Monning to champion SB 977, a bill that provides our office with new tools to combat anticompetitive behavior in the healthcare market. We must all work together to protect consumers and make healthcare more affordable for all Californians.”
“As our state continues to face the devastating impacts COVID-19 has on our healthcare system, it is important to ensure costs remain affordable for patients,” said Senator Monning. “Physicians are facing severe financial pressures because of the current pandemic and data shows that prices skyrocket when providers consolidate and reduce competition in the marketplace. SB 977 will protect existing services for patients and address the issue of unfair business practices that increase healthcare costs for all Californians.”
Anticompetitive behavior in the healthcare sector is a growing concern because large healthcare systems can flex their market power to raise prices for patients, employers, and insurers while limiting services and decreasing the quality of care offered to Californians. For example, average prices for hospital care are 35 percent higher in Northern California, where healthcare systems are more consolidated, than in Southern California. The impact of consolidation on prices was reinforced by a 2018 study by professor Richard Scheffler and the Petris Institute at the University of California, Berkeley, which found the percentage of physicians in practices owned by hospitals increased from about 25 percent in 2010 to more than 40 percent in 2016. This increased hospital ownership resulted in an estimated 12 percent increase in premiums from 2014 to 2016 and has led these physician groups to be less flexible and adaptable during the pandemic.
SB 977 would work to improve healthcare affordability and limit anticompetitive behavior by requiring healthcare systems to gain approval from the Attorney General’s Office before moving forward with any planned affiliation agreement or acquisition. The Attorney General’s determination to approve or deny a transaction will rely on two factors:
- Whether the transaction would truly increase care coordination and/or increase access and affordability of care to an underserved population; and
- Whether the transaction is substantially likely to result in anticompetitive effects that outweigh any benefits.
In addition, SB 977 would declare that healthcare systems that exercise substantial market power may not engage in behavior that has a significant likelihood of anticompetitive effects. These behaviors include: raising market prices, diminishing the quality of care, reducing choice, increasing the total cost of care, and diminishing access or availability of healthcare services. Under SB 977, the Attorney General’s Office would have the ability to file civil actions to recover damages and obtain civil penalties against those that abuse market power.
May 14, 2020: Senator Kamala Harris (Democrat – California) tweeted: “It’s unconscionable that Trump and Republicans continue to support a lawsuit to dismantle the Affordable Care Act. Yet that’s exactly what they’re doing. In the middle of a pandemic.”
May 14, 2020: California Attorney General Xavier Becerra posted a press release titled: “Bipartisan Coalition of Leaders and Experts Support Supreme Court Fight to Protect ACA”. From the press release:
California Attorney General Xavier Becerra today announced that a diverse group of bipartisan attorneys general, economists, patient groups, hospitals, healthcare providers, insurance companies, cities, counties, tribes, and more filed amicus briefs in the Supreme Court supporting California’s defense of the healthcare system and Affordable Care Act (ACA). The amici coalition also includes new partners in the attorneys general of Maryland, Maine, Montana, New Hampshire, New Mexico, Ohio, Pennsylvania, and Wisconsin.
“As we confront a global pandemic of historic proportions, a bipartisan coalition of leaders, from bipartisan attorneys general to public health experts, stand with us before the Supreme Court in agreement: protecting the Affordable Care Act is critical to protecting the health of our nation and countless loved ones,” said Attorney General Becerra. “While the Trump Administration continues its attempt to destroy the ACA, state attorneys general, legal experts, economists, medical groups, and more know better: our nation’s hallmark healthcare law is lawful and we must do everything we can to protect it, for the sake of saving lives.”
The Supreme Court agreed to review a recent Fifth Circuit decision that held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the law could still stand — jeopardizing Medicaid expansion, critical public health programs that help fight COVID-19, subsidies that help working families access care, and healthcare coverage protections for 133 million Americans with pre-existing conditions. The amici support California’s fight to protect America’s healthcare system and the well-being of Americans across the nation.
These amicus briefs support California’s defense of the ACA and highlight the importance of safeguarding our public health system – especially given the current COVID-19 pandemic. The briefs highlight not only the critical public health gains made under the ACA, but also crucial ways that the ACA aids the nation in its COVID-19 response, including:
- The ACA’s pre-existing condition protections keep the millions of Americans who have or may become infected by COVID-19 from being denied coverage based on COVID-19 exposure, or from having their benefits limited to exclude coverage for the ongoing health consequences caused by COVID-19;
- The ACA’s Prevention and Public Health Fund provides more than 12 percent of the program funding for the Centers for Disease Control and Prevention, the agency at the forefront of the government’s efforts to contain the pandemic;
- The ACA’s multi-billion-dollar Community Health Center Fund, extended by the recent Coronavirus Aid, Relief, and Economic Security (CARES) Act, provides as much as 70 percent of all grant funding for community health centers, which are on the front lines of the COVID-19 response;
- The ACA’s non-discrimination requirements ensure that access to medical resources may not be denied to COVID-19 patients because a patient is disabled;
- The ACA’s investment in health care innovation, including telehealth, has paid great dividends during the pandemic by allowing providers and patients to adapt as communities shelter in place;
- The ACA’s expanded Medicaid program and Special Enrollment Periods provide a backstop for workers who lose their jobs and health insurance coverage; and
- In Medicaid expansion states, the ACA will provide financial assistance to anywhere from 66 to 75 percent of laid-off workers in the industries most vulnerable to pandemic-related unemployment.
Amicus briefs in support of California’s coalition were filed by: the attorneys general of Maryland, Maine, New Hampshire, New Mexico, Pennsylvania, and Wisconsin; AARP et al.; Alliance of Community Health Plans and Association for Community Affiliated Plans; America’s Health Insurance Plans (AHIP); American Cancer Society et al.; American Association of People with Disabilities et al.; American Medical Association et al. (AMA); the American Thoracic Society; the Association for Accessible Medicines; Bipartisan Economic Scholars; Blue Cross Blue Shield Association; the Catholic Health Association of the United States; Constitutional Law Experts; Families USA et al.; First Focus on Children et al.; HCA Healthcare, Inc.; Health Care Policy Scholars; Lambda Legal Defense and Education Fund, Inc.; Legal scholars; the National Association of Community Health Centers; National Health Law Program et al.; National Hospital Associations; National Women’s Law Center et al.; Small Business Majority Foundation; Patient-Centered Outcomes Research Institute; Public Citizen, Inc.; Public Health Experts et al.; Service Employees International Union (SEIU) et al.; Tribes and Tribal Organizations; Washington and Lee University School of Law Black Lung Clinic; 47 members of the United States Senate; 44 counties, cities, and towns and the California State Association of Counties; 36 State Hospital Associations; and more.
May 15, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Sanders, Gillibrand, Booker, Warren, Markey, Merkley Introduce Emergency Health Care Guarantee Act”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Friday joined Senator Bernie Sanders (I-VT) and 5 of their colleagues in introducing the Health Care Emergency Guarantee Act to eliminate all out-of-pocket health costs for every person in America during the COVID-19 crisis. Along with Harris and Sanders, the legislation was cosponsored by Senators Kirsten Gillibrand (D-NY), Edward Markey (D-MA), Elizabeth Warren (D-MA), Cory Booker (D-NJ), and Jeff Merkley (D-OR).
“The COVID-19 pandemic has placed Americans under tremendous stress,” said Harris. “On top of wondering how they will pay rent and put food on the table, paying for medical treatment if they get sick should not be another worry for families. I am proud to join my colleagues to introduce this legislation to protect patients from cost barriers to the medical care they need to stay healthy.”
“During this public health crisis, we must make sure that everyone in America is able to receive all of the medical care they need, regardless of their income, immigration status or insurance coverage. No one in this country should be afraid to go to the doctor because of the cost—especially during a pandemic. The American people deserve an emergency health care response that is simple, straightforward, comprehensive, and cost-effective,” said Sanders. “We should empower Medicare to pay all of the medical bills of the uninsured and the under-insured—including prescription drugs—for the duration of the coronavirus pandemic. When so many people in this country are struggling economically and terrified at the thought of becoming sick, the federal government has a responsibility to take the burden of health care costs off of the backs of the American people. The legislation we are introducing today does just that.”
New polling reveals overwhelming enthusiasm for this proposal. According to Data for Progress, 73 percent of American voters support Medicare covering all out-of-pocket health expenses during this emergency, including 58 percent of Republicans. In comparison, 55 percent backed a separate proposal to cover the cost of insurance premiums through COBRA, a federal program that allows those who have lost their jobs to temporarily retain their former employers’ health insurance coverage. When presented with evidence that the emergency Medicare proposal is significantly less expensive despite covering millions more people, 61 percent preferred this approach versus 14 percent who backed COBRA subsidies.
The legislation would simply leverage the existing Medicare payment infrastructure to affordably and efficiently pay all costs of treatment for the uninsured, and cover all out-of-pocket costs such as copayments and deductibles for those who already have public or private insurance. The bill also halts medical debt collections, prohibits private insurance companies from increasing cost-sharing, and requires ongoing data collection and weekly reporting on health disparities related to COVID-19. The legislation would be effective until a COVID-19 vaccine is widely available to the public.
The bill enjoys the endorsement of 32 national organizations and unions including the Association of Flight Attendants-CWA, International Federation of Professional and Technical Engineers, National Nurses United, Service Employees International Union (SEIU), United Electrical Radio and Machine Workers of America; Center for Popular Democracy, Indivisible, League of United Latin American Citizens (LULAC), MoveOn.Org, National Domestic Workers Alliance, People’s Action, Progressive Change Campaign Committee, Public Citizen, Social Security Works, Sunrise Movement, United We Dream, Working Families Party, Business for Medicare for All, Debs-Jones-Douglass Institute, Democracy for America, Democratic Socialists of America, Economic Opportunity Institute, Economic Policy Institute, Faith Action Network, Healthcare-NOW, Hometown Action, Jane Addams Senior Center, Labor Campaign for Single Payer, Legal Voice, Medicare for All Now, Partners for Dignity & Rights, Presente.org, and Progressive Democrats of America.
To read a summary of the bill, click here.
To read a section-by-section outline of the bill, click here.
To read the text of the bill, click here.
To read a polling memo on the bill, click here.
May 15, 2020: NARAL Pro-Choice America posted a press release titled: “Coalition of Progressive Groups Slam Rúben Díaz Sr. for his Anti-Abortion Anti-LGBTQ Record”. From the press release:
As New York grapples with the COVID-19 pandemic, a broad coalition of progressive groups — including Planned Parenthood Action Fund, LGBTQ Victory Fund, NARAL Pro-Choice America, Latino Victory Fund, and the Congressional Hispanic Caucus BOLD PAC — announced their opposition to Rubén Díaz Sr. as a candidate to represent the 15th Congressional District in New York for his attacks on equal access to basic health care; the LGBTQ community; and the right to safe, legal abortion.
Due to historic inequities in health care access for the Latinx community in the district, the Bronx has been one of the hardest hit areas by the COVID-19 pandemic. In the midst of this public health crisis, New York voters need to elect a leader who will fight for equality and their basic health care needs. And that leader is anybody but Díaz Sr. Every other leading Democratic candidate has demonstrated support for protecting and expanding abortion access and LGBTQ rights, and would be far more qualified to represent New Yorkers in Congress.
It’s not just that Díaz Sr. is out of step with the values of New Yorkers, he doesn’t have the best interests or well being of those in the district at heart. The Bronx, where the 15th District is located, has the highest abortion rate in the state. Latinx voters — who make up the majority of the district — overwhelmingly support the right to access abortion. Latinx millenials are more likely to identify as LGBTQ than any other group and the New York City metropolitan area has the largest LGBTQ population in the country with more than 750,000. As time has passed, Díaz Sr.’s policies have never been more disconnected from the priorities of New Yorkers.
It’s clear voters across the country are ready for candidates who will expand abortion access and LGBTQ rights. In April, Marie Newman beat incumbent Democratic Rep. Dan Lipinski after 15 years of representing the Chicago suburbs in a race where Lipinski’s anti-abortion position was a key issue…
…The full list of coalition groups includes: Planned Parenthood Action Fund, LGBTQ Victory Fund, NARAL Pro-Choice America, Latino Victory Fund, the Congressional Hispanic Caucus BOLD PAC, Bend the Arc Jewish Action, Congressional Progressive Caucus PAC, Human Rights Campaign, Equality PAC, and People for the American Way
Here are just a few of the comments and actions that show how unqualified Rubén Díaz Sr. is to represent New York:
- Comparing abortion to the Holocaust: Díaz Sr. penned a newsletter piece comparing abortion to genocide, saying, “Hitler was pro-choice. He chose to send the Jews to Auschwitz. That was not their choice that was Hitler’s choice…Murderers, assassins and criminals are pro-choice. They choose to put a gun to your head and take your life.” Observer, 05/01/2012
- Standing steadfast against marriage equality: Two years after being the lone Democratic state senator to vote against New York’s Marriage Equality Act, Díaz Sr. addressed an anti-marriage equality rally in Washington, D.C., saying “The majority is not always right. 2,000 years ago the majority chose the rabbi and rejected Jesus. Now, the majority are rejecting the Bible and not choosing Jesus. I know my conviction and I know I will not change my view.” Observer, 04/05/2013
- Pushing homophobic stigma and policies: Díaz Sr. has been peddling misinformation and anti-LGBTQ stigma for decades, saying last year, “When I get to the City Council, I find that the City Council is controlled — most council members out of 51 council members — over there, everybody is controlled by the homosexual community,” New York Times, 02/11/2019
- Ignoring sexual harassment: Díaz Sr. showed his true colors when he claimed he would protect perpetrators of sexual harassment instead of taking complaints seriously. During a mandatory City Council training, he was asked hypothetically what he would do if he overheard a chief of staff sexually harassing another staffer in an elevator. He responded, “I’m not gonna rat my people out! This place is full of rats!” City & State New York, 05/09/2019
- Questioning support for abortion and LGBTQ rights: During his floor speech in opposition to the Marriage Equality Act, Díaz Sr. revealed his unfiltered views on support for reproductive and LGBTQ rights, saying, “All Democrats do is abortion and gay marriage, but the Republican party has always been the party that protects traditional values and family values.” LGBTQ Nation, 06/26/2011
- Supporting Sen. Ted Cruz who proudly attacked “New York values”: After then-presidential candidate Sen. Ted Cruz made his controversial comments about “New York values,” Díaz Sr. invited the Texas senator to his district, saying “Imagine Ted Cruz traveling to the Bronx where there is a grassroots army of Black and Hispanic Evangelical Christians who are just like him — and who have been ignored by every presidential candidate.” City & State New York, 07/17/2018
May 19, 2020: The U.S. Mission to International Organizations in Geneva posted a written statement titled: “U.S. Explanation of Position “COVID-19 Response” Resolution”. From the statement:
The United States thanks the European Union and the other co-sponsors for their leadership in preparing the COVID-19 Response resolution for adoption at the virtual 73rd World Health Assembly (WHA). That we are meeting in virtual session, at a time when more than 300,000 people have lost their lives and the global economy has been deeply affected, is a testament to the need to come together in response to this pandemic. This resolution makes an important contribution to that global response, immediately calling for whole-of-government and whole-of-society approaches to fighting the pandemic with the best available evidence, and by urging the international community to come together around all aspects of the response.
Most importantly, the terms of this resolution take the first critical steps necessary to ensure that, when we face the next pandemic, we will have a World Health Organization (WHO) and an international system capable of responding effectively and decisively to save lives and protect the vulnerable. We applaud the call for an impartial, independent, and comprehensive review of the WHO’s response, to be undertaken in consultation with Member States, and we urge that work to begin now. This will help ensure we have a complete and transparent understanding of the source of the virus, timeline of events, early discussions, and the decision-making process for the WHO’s response to the COVID-19 pandemic. We must reform the WHO and supporting entities to be fully capable of fulfilling their core and crucial mission moving forward. We further appreciate the mandate given by the resolution to the WHO to investigate the origins of the virus, and we are confident that through this knowledge, researchers and medical practitioners around the world will be empowered in the pursuit of vaccines and other countermeasures.
Finally, we wholeheartedly endorse the call in the resolution for all Member States to provide the WHO with timely, accurate, and sufficiently-detailed public health information related to the COVID-19 pandemic, as required by the International Health Regulations (IHR 2005). We stand ready to work with all partners to implement this resolution. If we are to fully realize the promise contained in the IHRs of a safer world for everyone, changes must be made within the WHO to hold Member State accountable to address and reduce risks that threaten public health.
Unfortunately, despite our best efforts at working toward consensus language in all areas of this resolution, we regret that the United States must disassociate itself from a few paragraphs due to the following issues:
The United States dissociates from operative paragraphs 7.5 and 9.4. The United States strongly supports women reaching the highest attainable outcomes for health, life, dignity, and well-being throughout their lives. We champion access to high-quality health care for women and girls across the lifespan. However, we do not accept references to “sexual and reproductive health,” or other language that suggests or explicitly states that access to abortion is included in the provision of population and individual level health services. The United States believes in legal protections for the unborn, and rejects any interpretation of international human rights (such as General Comment 36 on the International Covenant on Civil and Political Rights) to require any State Party to provide access to abortion. As President Trump has stated, “Americans will never tire of defending innocent life.” Each nation has the sovereign right to implement related programs and activities consistent with their laws and policies, free from external pressure. There is no international right to abortion, nor is there any duty on the part of States to finance or facilitate abortion. Further, consistent with the 1994 International Conference on Population and Development Programme of Action and the 1995 Beijing Declaration and Platform for Action, we do not recognize abortion as a method of family planning, nor do we support abortion in our global health assistance.
The United States must also disassociate from operative paragraphs 4, 8.2 and 9.8 because the language in these operative paragraphs does not adequately capture all of the carefully negotiated, and balanced, language in the World Trade Organization (WTO) Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) and the Doha Declaration of 2001 and instead presents an unbalanced and incomplete picture of that language at a time where all actors need to come together to produce vaccines and other critical health products. The United States recognizes the importance of access to affordable, safe, high-quality, and effective health products and the critical role that intellectual property plays in incentivizing the development of new and improved health products. However, as currently drafted, paragraphs 4, 8.2 and 9.8 send the wrong message to innovators who will be essential to the solutions the whole world needs.
We are concerned that a misinterpretation of international trade obligations in non-WTO multilateral fora may negatively affect countries’ abilities to incentivize new drug development and expand access to medicines. We would also like to clarify our understanding of the reference in 8.2 to “existing mechanisms for voluntary pooling … of patents.” The United States interprets this reference as limited to voluntary mechanisms existing before the COVID-19 pandemic, not new or proposed “patent pooling” mechanisms created in response to the pandemic. It is critical that any such voluntary mechanisms as applied to COVID-19 related technologies be narrowly tailored in scope and duration to the medical needs of the current crisis, and that the World Intellectual Property Organization (WIPO), as the UN agency with technical expertise on intellectual property issues, play an appropriate role in their operation and evolution.
The United States is leading global efforts for the development of vaccines, for therapies and treatments for COVID-19, including providing significant funding and leading other initiatives to accelerate innovation in this space, for example the ACTIV Partnership recently unveiled by the United States National Institutes of Health. We applaud other global efforts as well and are committed to supporting a collaborative approach to ensuring that all efforts support one another and that we are truly accelerating progress toward a vaccine.
Going forward, given the need for innovation incentives in the development of new health products, the U.S. Government encourages member states to engage with innovators to find mutually-acceptable solutions that achieve increased access to affordable, safe, effective, and high quality COVID-19 health products. By taking an unbalanced and incomplete approach to the issue of access to medicines and TRIPS, this resolution misses an opportunity to galvanize the world, beyond bureaucracy and UN bodies, toward the critical goal of accelerating research, development, distribution and access to affordable, safe, quality and effective COVID-19 related products. We remain committed to working with all partners toward that goal.
May 20, 2020: Planned Parenthood posted an article titled: “Amidst COVID-19 Talks at the World Health Assembly, the U.S. Government Inserts Anti-Repro Health, Anti-Abortion Agenda”. From the press release:
Yesterday at the World Health Assembly, the administration further isolated the U.S. from other member nations with its refusal to accept references to “sexual and reproductive health” in the World Health Organization (WHO) resolution on the COVID-19 pandemic response. This move follows a letter sent yesterday by the USAID acting administrator to UN Secretary-General António Guterres, demanding the UN delete abortion and sexual and reproductive health as an essential service in guidance for the global COVID-19 response.
The administration announced last month it would suspend funding to the WHO, a threat Trump repeated in a letter to the WHO director-general, shared via Twitter Monday night.
Statement from Monica Kerrigan, Executive Director, Planned Parenthood Global:
“The COVID-19 pandemic has demonstrated how interconnected the world is and how a threat to one is a threat to all. The World Health Organization member states came to the table yesterday to develop a critical response to the biggest global health crisis of our time. Yet, instead of working together with the global community, the U.S. government is once again exploiting the crisis to impose its extreme anti-reproductive health, anti-abortion ideology. Abortion is essential, reproductive health is essential, and Planned Parenthood will continue working to ensure that these services are accessible, no matter where you live.”
This isn’t the first time the Trump administration has pushed its anti-reproductive health agenda on the global stage. Over the past three years, the administration has tried to undercut global consensus on sexual and reproductive health and rights at forums like the Commission on the Status of Women and the UN Security Council and advanced harmful policies like the expanded global gag rule, which weaken global health systems and erode access to critical health services around the world.
The virus has placed a heavy burden on women as frontline workers and caregivers, and has increased rates of gender-based violence for women around the world. A study by the Guttmacher Institute projects that the COVID-19 pandemic will have a devastating impact on global sexual and reproductive health, including as many as 28,000 additional maternal deaths.
May 20, 2020: American Academy of Pediatrics posted news titled: “Stay in the know: COVID-19 updates from the nation’s capital”. From the news:
…Tucked into the $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act package — which became law — are two long-standing AAP advocacy priorities: over-the-counter (OTC) drug reform and reauthorization of the Pediatric Subspecialty Loan Repayment Program.
Understandably, much of the attention paid to this sweeping legislation was on the critical provisions it included to address the pandemic. It also is important to recognize these priorities, which were included with little fanfare but will have a major impact on children’s health.
Meaningful reform of the Food and Drug Administration’s (FDA’s) OTC drug regulatory system has been long overdue. Pediatric labeling on older drugs is outdated, as it is based on evidence that no longer meets current safety and efficacy standards or is based on incorrect assumptions about how adult data should inform the labeling of drugs for children.
The new law will make it easier for the FDA to update labels based on the latest scientific developments, ensuring that OTC drugs are safe and effective for use in children. It also strengthens the agency’s ability to require packaging that keeps children safe from accidental ingestion.
The CARES Act also reauthorized the Pediatric Subspecialty Loan Repayment Program for five years. The program helps address shortages of pediatric subspecialists in underserved areas. The Academy is urging Congress to provide $50 million in funding for the program for fiscal year 2021.
Pediatric subspecialists provide care for children with complex medical conditions or who require long-term, coordinated care for chronic illnesses. Shortages of pediatric subspecialists force families to face long wait times for appointments or travel long distances.
The program would provide up to $35,000 annually for a maximum of three years to pediatric subspecialists who agree to practice in an underserved area, helping to ensure children can receive care no matter where they live.
After years of AAP and pediatrician advocacy on both of these issues, their inclusion in the broader coronavirus legislation represents a long-fought victory for children’s health…
May 20, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Applauds Senate Introduction of HEAL Act”. From the press release:
Today, Sen. Cory Booker (D-NJ) introduced the Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act, which removes politically motivated barriers to health insurance coverage so all immigrants, regardless of status, can fully participate in federal programs, including Medicaid, the Affordable Care Act’s Marketplace, and the Children’s Health Insurance Program (CHIP). Expanding access to health care is always critical but, as the nation struggles to respond to the COVID-19 pandemic, the need is even more urgent. The House version of this bill was introduced last fall. This is the first time the bill has been introduced in the Senate.
Statement from Jacqueline Ayers, Vice President, Government Relations & Public Policy, Planned Parenthood Federation of America:
“Viruses do not discriminate, and everyone deserves access to health care, regardless of their immigration status. Planned Parenthood Federation of America applauds Sen. Booker for his leadership in introducing the HEAL Act in the Senate for the first time. As the Trump administration continues to attack and leave behind immigrant communities in its COVID-19 response, it is critical we work to remove barriers that prevent immigrants and their families from accessing the care they need. Planned Parenthood calls on Congress to pass the HEAL Act and protect everyone’s access to health care — no matter what.”
The HEAL Act removes the five-year waiting period that prevents immigrants from fully participating in federal health care programs, and opens up the Affordable Care Act Marketplace so that all immigrants, including the undocumented and Deferred Action for Child Arrivals (DACA) recipients, can access the affordable health care they need. Additionally, the HEAL Act reinstates Medicaid eligibility for Compact of Free Association (COFA) migrants who lost access to the program in 1996. Facing many systemic barriers to basic health care and information, immigrants endure challenging and life-endangering health care disparities. Many women in immigrant communities are more likely to die from breast and cervical cancers, and some immigrant groups have high rates of HIV and other sexually transmitted infections. All of these diseases could be screened for, and in some cases prevented, with equal access to care.
Planned Parenthood Federation of America joins 215 organizations in supporting the HEAL Act, and is committed to ensuring that all individuals, regardless of citizenship, have access to quality care, including reproductive health care.
May 20, 2020: Planned Parenthood posted a press release titled: “PPFA Denounces Political Attacks on Local Planned Parenthood Health Centers”. From the press release:
Today, Planned Parenthood Federation of America released the following statement on the Trump administration’s latest attacks on Planned Parenthood and its patients by targeting independent Planned Parenthood 501(c)(3) organizations that recieved federal assistance under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
Statement from Jacqueline Ayers, vice president of government relations & public policy, Planned Parenthood Federation of America:
“Like many other local nonprofits and health care providers, some independent Planned Parenthood 501(c)(3) organizations applied for and were awarded loans under the eligibility rules established by the CARES Act and the Small Business Administration (SBA), which they met. Planned Parenthood health centers play a core role in the social safety net, and there is no more critical time for the care they provide than during a public health crisis.
“And just like other nonprofits and health care providers, this pandemic has had a significant impact on Planned Parenthood health centers’ ability to provide care. Paycheck Protection Program loans have ensured health centers can retain staff and continue to provide patients with essential, time-sensitive sexual and reproductive health care during this crisis.
“This is a clear political attack on Planned Parenthood health centers and access to reproductive health care. It has nothing to do with Planned Parenthood health care organizations’ eligibility for COVID-19 relief efforts, and everything to do with the Trump administration using a public health crisis to advance a political agenda and distract from their own failures in protecting the American public from the spread of COVID-19. It is also just the latest salvo in the Trump administration’s long history of targeting Planned Parenthood, and trying to severely limit access to sexual and reproductive health care.
“For many patients, local Planned Parenthood health centers are their only source of health care; the unfortunate reality is the pandemic has made existing barriers to care worse for many of the communities they serve. While local Planned Parenthood health centers are focused on providing critical health care for their communities during this pandemic, the Trump administration is focused on attacking critical safety net providers. This is not the time to play politics, and it is certainly not the time to reduce access to critical health care.”
May 20, 2020: San Francisco Chronicle posted an article titled: “Nearly 124,000 sign up through Covered California; plans include free coronavirus testing”. It was written by Rusty Simmons. From the article:
Nearly 124,000 people have signed up for medical insurance through Covered California since March 20 as the state grapples with the coronavirus pandemic and startling unemployment numbers.
According to the state health care marketplace, 123,810 people have sought insurance during Covered California’s special open-enrollment period. The exchange is generally open from Oct. 15 to Jan. 31, but it extended the period amid the crisis…
…Medi-Cal, which covers 13 million Californians and is offered through Covered California, put a 90-day hold on renewal reviews last month, so people can automatically continue coverage.
Under Covered California, people have access to private health insurance plans with monthly premiums that may be subsidized, and coverage begins the first of the month after a person chooses a plan.
Californians previously could sign up for health insurance through the marketplace outside of the annual open-enrollment period because of a “qualifying life event,” such as losing coverage, moving, getting married or having a baby. The special enrollment period, which extends through the end of June, is available to people who were unaware of available premium subsidies or the new state penalty for not having health insurance…
…All Covered California and Medi-Cal health plans include no-charge telehealth options for COVID-19 screening, which allow people to speak to a medical professional via phone or video chat, so they don’t have to go to a doctor’s office or hospital. The coverage includes free coronavirus testing as well as visits to emergency rooms or urgent care for screening or testing…
May 21, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Colleagues Praise Senate Passage of Resolution Marking National Minority Health Month”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Thursday joined Senators Ben Cardin (D-MD) and Tim Scott (R-SC) and 14 of their colleagues in applauding the passage of the resolution recognizing April as Minority Health Month. As in previous years, the Senators introduce this resolution to raise awareness of the disparities in health care and health outcomes faced by minority populations including American Indians, Alaska Natives, African Americans, Hispanics, Native Hawaiians, Asian Americans and Pacific Islanders. This year, the COVID-19 pandemic places an urgency on this issue, as preliminary data suggests that minority groups have been disproportionately impacted by the disease. Targeted solutions to help communities of color are critical to closing gaps in health outcomes and improving efforts to combat the COVID-19 crisis.
“Communities of color have been plagued by health disparities for far too long,” said Harris. “The COVID-19 pandemic has exacerbated these inequities. We know that people of color are more likely to suffer from conditions such as heart disease, asthma, and lupus — conditions that could also put people at higher risk of complications or death from coronavirus. I’m proud to join my colleagues on this important resolution– it is vital that we take action to eradicate these disparities and improve access to care for minority communities across the nation.”
In addition to Senators Harris, Cardin and Scott, the resolution is cosponsored by U.S. Senators Cory Booker (D-NJ), Marco Rubio (R-FL), Bob Menendez (D-NJ), John Boozman (R-AR), Shelley Moore Capito (R-WV), Mazie Hirono (D-HI), Kevin Cramer (D-ND), Ron Wyden (D-OR), James Lankford (R-OK), Chris Van Hollen (D-MD), Mike Braun (D-IN), Sherrod Brown (D-OH), Ed Markey (D-MA) and Catherine Cortez Masto (D-NV).
May 21, 2020: Reuters posted an article titled: “U.S. Supreme Court rebuffs bid to halt Idaho trangender inmate’s surgery”. It was written by Andrew Chung. From the article:
The U.S. Supreme Court on Thursday allowed a transgender prison inmate in Idaho to go ahead with sex reassignment surgery, rejecting the state’s bid to put it on hold.
The decision by the justices means that the surgery for the inmate, Adree Edmo, which is scheduled for July, will remain on the calendar while they consider whether to hear the state of Idaho’s appeal in the case.
The brief court order noted that two of the nine justices, conservatives Clarence Thomas and Samuel Alito, would have granted the state’s request that the surgery be put on hold.
Edmo, 32, is serving a sentence for a 2011 sexual assault of a 15-year-old boy. Edmo is scheduled to be released from prison next year.
The San Francisco-based 9th U.S. Circuit Court of Appeals had found that prison officials denied Edmo access to the surgery “despite full knowledge of Edmo’s ongoing and extreme suffering and medical needs” in violation of the U.S. Constitution’s Eighth Amendment prohibition against cruel and unusual punishment.
Idaho told the Supreme Court that the 9th Circuit failed to consider the professional opinions of a prison psychiatrist and other officials that Edmo was best served by a more conservative treatment regimen, rather than sex reassignment surgery.
Edmo had been diagnosed with gender dysphoria, which the American Psychiatric Association defines as “clinically significant distress” due to a conflict between a person’s gender identity and their sex assigned at birth.
Prison officials provided Edmo with hormone therapy. But Edmo continued to experience dysphoria primarily because of her male genitalia, according to court papers. Twice, in 2015 and 2016, Edmo attempted to self-castrate in order to eliminate testosterone from her body, court papers said.
A federal judge in 2018 ordered the state to provide the surgery to Edmo, a ruling the 9th Circuit upheld.
May 26, 2020: Missouri Governor Michael L. Parson (Republican) posted a press release on his official website titled: “Governor Parson Signs Proclamation Placing Medicaid Expansion on August Primary Ballot”. From the press release:
During today’s COVID-19 briefing, Governor Mike Parson announced that Medicaid expansion will be placed on a ballot at the August 4, 2020, primary election.
Citizens of Missouri filed an initiative petition with the Secretary of State to place Medicaid expansion on the ballot. Following the Secretary of State’s certification of the petition, Governor Parson today signed a proclamation to place the initiative on the August ballot.
“I want to be clear that this is about policy, not politics,” Governor Parson said. “At a time when our state is undergoing a major health, economic, and budget crisis, we need to know exactly where we stand on what would be a massive spending initiative for Missouri.”
According to research from Pew Charitable Trusts, Missouri is a top five state for general revenue spending on Medicaid. The state estimates it will need an additional $88 million in general revenue through Fiscal Year 2021 due to COVID-19.
“Pass or fail, it is important that we understand the implications of Medicaid expansion as soon as possible,” Governor Parson said. “Placing the initiative on the August ballot will give us more time to prepare and account for the outcome in our state budget.”…
May 27, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “ACOG Suit Petitions Court to Remove FDA’s Burdensome Barriers to Reproductive Care During COVID-19”. From the press release:
The American College of Obstetricians and Gynecologists (ACOG) took another step toward achieving equitable access to care for patients during the COVID-19 pandemic by asking a federal court to require the U.S. Food and Drug Administration (FDA) to suspend a harmful FDA restriction on mifepristone. Joining ACOG as plaintiffs in today’s lawsuit are the Council of University Chairs of Obstetrics and Gynecology, the New York Academy of Family Physicians, and SisterSong Women of Color Reproductive Justice Collective.
Mifepristone is an evidence-based treatment prescribed for management of early pregnancy loss as well as induced abortion. Although mifepristone has long been proven to be safe and effective when prescribed through telemedicine and can be safely taken in the comfort of a patient’s home, outdated FDA restrictions require mifepristone to be dispensed in a hospital, clinic, or medical office.
“Of the more than 20,000 drugs regulated by the FDA, mifepristone is the only one that patients must receive in person at a hospital, clinic, or medical office, yet may self-administer, unsupervised, at a location of their choosing,” says the complaint, which was filed today by the American Civil Liberties Union and the international law firm Arnold & Porter.
For years, the medical community has opposed these restrictions, which have no medical basis, provide no patient benefit, and unnecessarily restrict access to care.
In the current COVID-19 pandemic, these burdensome requirements are especially harmful and must be lifted. The requirements disproportionately affect patients from underserved communities who are burdened by the need to travel, arrange childcare, and present to their chosen clinician in person for the dispensing of the medication. Forcing physicians to dispense this drug in person puts patients at increased risk of COVID-19 as a condition of obtaining abortion or miscarriage care and needlessly raises exposure risks for clinicians and other health care staff.
“Our request in this case is simple: the federal government should permit patients seeking safe and effective reproductive health care, which includes care for miscarriage and termination of pregnancy, the same ability to access care and protect themselves from exposure as patients in other contexts are afforded,” said Eva Chalas, MD, FACOG, FACS, president of ACOG.
People of color have been disproportionately impacted by infections, hospitalizations, and deaths from COVID-19, as well as by the nation’s maternal mortality crisis. The FDA’s restrictions on mifepristone only serve to increase the risk faced by the communities that are already inequitably facing harm from the pandemic.
“During the COVID-19 pandemic, the health care community—from individual physicians to
government agencies—has come together to identify safe, effective ways to provide patients with the care that they need, including through telemedicine. The FDA’s decision to maintain medically unnecessary restrictions on mifepristone is a glaring exception, which results in discrimination in access and threatens to harm patients and their clinicians during a time of national crisis. Lifting the barriers to mifepristone will allow women, including those from underserved communities that are disproportionately affected by both COVID-19 and the ongoing maternal health crisis, the ability to obtain necessary and essential evidence-based care without having to risk potential life-threatening exposure,” Dr. Chalas added.David Chelmow, MD, FACOG, president of the Council of University Chairs of Obstetrics and Gynecology, added, “The medical community must be able to use all the tools at our disposal, including telehealth care where appropriate, to meet patients’ essential medical needs while protecting them from coronavirus. The next generation of health care practitioners must be taught the most safe, effective, and patient-centered care, even during a public health emergency. The FDA’s unique restriction on mifepristone prevents clinicians from exercising their medical judgment during this pandemic, limits the ability to provide the optimal medication for miscarriage and abortion care, and needlessly jeopardizes the safety of patients.”
Read the full complaint
Read the motion for preliminary injunction
May 29, 2020: Planned Parenthood posted a press release titled: “BREAKING NEWS: – Victory for Missourians: Abortion Services Protected in Missouri”. From the press release:
After a year-long battle with Missouri Gov. Mike Parson’s Department of Health and Senior Services (DHSS), an administrative commission just ruled that the state wrongfully withheld Reproductive Health Services of Planned Parenthood of the St. Louis Region’s (RHS) license. Today, the Missouri Administrative Hearing Commission (AHC) renewed the abortion license for RHS, the last remaining healh center in Missouri with a license to provide abortion. RHS can continue providing abortion services at its St. Louis health center.
The commissioner wrote in his decision:
“Planned Parenthood has demonstrated that it provides safe and legal abortion care.” The physicians who perform abortions at Planned Parenthood through Washington University and [Barnes Jewish Hospital] are all exceptionally competent and well trained.”
For far too many people, abortion is already inaccessible in Missouri. Data revealed nearly all Missourians already flee the state for abortion services. Many patients have told RHS the same thing: The long list of medically unnecessary abortion restrictions make it too difficult and burdensome to access the care they need in their home state.
Statement of Alexis McGill Johnson, acting president & CEO, Planned Parenthood Federation of America:
“Today’s decision is a hard-fought victory for Planned Parenthood patients — and for people across Missouri. This is how we fight for our patients: case by case, day by day, to ensure abortion remains safe and legal across the country. The data shows that many have already paid the price, with the vast majority of Missouri patients forced to cross state lines to get the care they need. This is what it looks like when abortion is a right in name only. There is much more work to be done to ensure patients can access safe, legal abortion inside their home state.
“During a worldwide pandemic, every public health care provider including Planned Parenthood should have all the resources they need to care for the complex needs of their communities, including abortion. Planned Parenthood remains committed to helping every patient access the care they need, even if that means having to leave their home state. We know care is much more than the services we provide; it’s how we show up for each other and in the world. In these uncertain times, we’re in this together.”
Statement from Yamelsie Rodríguez, president and CEO, Reproductive Health Services of Planned Parenthood of the St. Louis Region:
“For more than a year, Missouri’s health department has targeted Planned Parenthood. Missouri’s health department director, Randall Williams made false allegations about the high-quality care we provide and the dedicated, expert medical staff who provide it — all the while failing to tackle the real public health crises ravaging the state, including the COVID-19 crisis, rising infant and maternal mortality rates and skyrocketing rates of sexually transmitted infections like syphilis. Today’s ruling is vindication for Planned Parenthood and our patients who rely on us. But the reality is, abortion has essentially become a right in name only in Missouri. Missouri’s medically unnecessary requirements, two in-person trips to the health center at least 72 hours apart, a ban on using telehealth for an abortion and a needless invasive pelvic exam for medication abortion still make it extraordinarily difficult for people to access care in Missouri.
“An abortion license, while critical to our ability to provide care, still cannot undo the harm that medically unnecessary policies in our state inflict on patients. It does not have to be this way. Gov. Parson could eliminate these medically unnecessary restrictions using the authority granted in his emergency order. We continue to keep our doors open, and can continue to care for all patients who choose to access reproductive health care, including safe and legal abortion, in Missouri and across the region.”…
June
June 1, 2020: California Attorney General Xavier Becerra posted a press release titled: “California Department of Justice Issues Final CURES Regulations to Protect Patient Privacy, Combat the Abuse of Controlled Substances”. From the press release:
The California Department of Justice today unveiled final regulations pertaining to the Controlled Substance Utilization Review and Evaluation System (CURES). CURES is California’s prescription drug monitoring program, a tool that assists healthcare practitioners in their efforts to ensure appropriate prescribing and dispensing of controlled substances and aids law enforcement and regulatory agencies in their efforts to control the diversion and resultant abuse of controlled substances.
“At the California Department of Justice, it’s our job to safeguard the rights and interests of nearly forty million Californians,” said Attorney General Becerra. “These regulations make commonsense protections for patient privacy a top priority, while balancing the need for critical enforcement tools to protect public health and safety by combatting the abuse of controlled substances and aiding in public health interventions. We’re grateful to all the stakeholders and members of the public who contributed to the regulation process.”
Under Assembly Bill 1751 enacted in January 1, 2019, the Department of Justice is required to adopt regulations by July 1, 2020, regarding certain processes, purposes, and conditions involving access and use of information within CURES. After consulting with stakeholders, the Department released proposed regulations on October 4, 2019. The Department received comments from the public on the proposed regulations, including at two public hearings in November 2019. The Department then released revisions on January 16, 2020 and sought additional comments. Today’s final regulations will become effective on July 1, 2020.
The regulations address:
- The process for approving, denying, and disapproving individuals or entities seeking access to information in CURES;
- The purposes for which a healthcare practitioner may access information in CURES;
- The conditions under which a warrant, subpoena, or court order is required for a law enforcement agency to obtain information from CURES as part of a criminal investigation; and
- The process by which information in CURES may be provided for educational, peer review, statistical, or research purposes.
A copy of the final regulations is available here. Please view https://oag.ca.gov/bciis/regs for additional information.
June 3, 2020: American Academy of Pediatrics posted news titled: “AAP urges insurers to extend telehealth payments during COVID-19 pandemic”. From the news:
The AAP is urging insurance companies and Medicaid programs to continue paying for telehealth services during the COVID-19 pandemic.
With expanded coverage and increased payment, telehealth has become a vital way for pediatricians to care for patients, but some carriers plan to stop coverage later this month.
“Telemedicine has played a critical role in expanding access to care for many patients, including those who live in rural areas or in areas without access to reliable public transportation during the pandemic,” said AAP President Sara “Sally” H. Goza, M.D., FAAP. “Those needs will not end in June. Nor will the needs of children with complex medical conditions, for whom the ability to interact with pediatric subspecialists and pediatric surgeons to guide their follow-up care is critical for their long-term health.”
A recent Kaiser Family Foundation study found that nearly 50% of families have skipped or put off health care during the pandemic. As the need for health care services builds, there likely will be a surge of patients seeking care. Telehealth will serve as a critical expansion of the pediatrician’s office to support this influx.
“Even though states are starting to open up, families are still frightened to come out,” said Sandy L. Chung, M.D., FAAP, a pediatrician in Fairfax, Va., and president of the AAP Virginia Chapter. “In our area, the coverage for telehealth visits will expire for several of the insurance companies we work with, and we’re afraid this will lead to many families delaying health care even longer.”
The AAP is calling for private insurance and Medicaid payments to continue for at least 90 days after the public health emergency declaration expires.
“It is urgent that insurance companies recognize this need and continue the expansion of telemedicine policies that were established during this crisis, so all children can have access to the health care they need now,” Dr. Goza said.
June 4, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Files Amicus Brief Challenging FDA’s Unnecessary Barriers to Abortion Medication in Light of COVID-19 Pandemic”. From the press release:
California Attorney General Xavier Becerra joined a multistate amicus brief supporting the American College of Obstetricians and Gynecologists challenge to restrictions imposed by the U.S. Department of Health and Human Services’ (HHS) Food and Drug Administration (FDA) on Mifepristone, the medication abortion prescription drug. Currently, due to FDA restrictions, Mifepristone can only be dispensed by certified providers at a hospital, clinic, or medical office — and not via pharmacy or mail — requiring women to go in person for a prescription. In the brief, the attorneys general argue that these restrictions interfere unjustifiably with the states’ efforts to minimize transmission of the COVID-19 virus while providing essential healthcare.
“As communities across the country — and HHS itself — work to promote telehealth to prevent the spread of coronavirus, women’s healthcare must not be excluded,” said Attorney General Becerra. “The FDA’s restrictive policy on Mifepristone targets women — and only women — forcing them to go in person to a doctor’s office to retrieve their prescription. During this unprecedented pandemic and stay-at-home orders, the FDA unnecessarily and irresponsibly puts women’s lives at risk. This is 2020, not 1920.”
In the brief, the coalition argues that the FDA’s Risk Evaluation and Mitigation Strategy (REMS) designation impedes women’s access to the medication abortion prescription drug despite the fact that it has been proven safe and effective. Mifepristone has been approved by the FDA since 2000, and it remains the only drug approved in the United States for pregnancy termination. Since its approval, about three million women in the United States have used the medication to terminate a pregnancy. Indeed, according to the FDA, this medication “has been increasingly used as its efficacy and safety have become well-established by both research and experience.” However, under REMS, the FDA requires that:
- Healthcare providers must be registered with the drug manufacturer;
- Patients must sign a “Patient Agreement” form confirming that they received counseling on the risks associated with the medication; and
- Patients must be handed the medication at a clinic, medical office, or hospital under the supervision of a healthcare provider if the medication is prescribed for the purpose of terminating a pregnancy – yet the drug can be dispensed by mail in higher doses if prescribed for other purposes, such as ulcer relief.
During this unprecedented crisis, it is essential that women across the country have access to critical healthcare services. Many states have already taken steps to increase telehealth care, at the federal government’s request. Yet, the current FDA REMS creates unnecessary barriers for women to access abortion care. In the brief, the coalition argues that these onerous and medically unnecessary requirements limit healthcare providers’ ability to assist their female patients, particularly during this global healthcare crisis. Furthermore, these requirements impose significant burdens on women in rural and medically underserved communities who would be required to travel long distances — sometimes up to 200 miles — for time-sensitive, in-person care. Forcing women to travel at a time when many states and the federal government are urging people to stay home to curb the spread of COVID-19 puts women across the country in harm’s way.
In March, Attorney General Becerra led a multistate coalition in sending a letter to the FDA, asking them to remove REMS restrictions or waive enforcement of these requirements in light of the COVID-19 pandemic and nationwide stay-at-home orders.
In filing the amicus brief, Attorney General Becerra joins the attorneys general of New York, Maryland, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.
A copy of the brief is available here.
June 4, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Responds to Iowa Legislature Advancing Anti-Choice Constitutional Amendment”. From the press release:
As thousands of Iowans march to demand the state take action to confront structural racism and entrenched white supremacy, Republican state legislators remain laser-focused on attacking reproductive freedom.
Amid ongoing protests in support of the Movement for Black Lives and while more than 20,000 Iowans have been diagnosed with COVID-19, anti-choice politicians consumed by an extreme ideological agenda are trying to rush a vote on an extreme constitutional amendment to roll back access to abortion in the state. If implemented, the amendment would nullify a 2018 Iowa Supreme Court decision upholding the fundamental right to access abortion in Iowa.
NARAL Pro-Choice America National Communications Director Kristin Ford released the following statement:
“It’s appalling to see anti-choice Republicans in the state legislature exploiting this moment of national grieving and crisis to advance their extreme ideological agenda. Hundreds of Iowans have lost their lives to COVID-19 and thousands more are peacefully filling the streets to protest the violence, trauma, and racism Black people in the U.S. face every day. Right now our leaders should be doing everything in their power to overhaul systems that perpetuate racial disparities and to provide relief to communities still reeling from an unprecedented pandemic. Instead, these legislators are using women as political props as they attempt to eliminate the state’s constitutional right to abortion. Their actions are shameful. Now more than ever, NARAL Iowa members are committed to holding politicians accountable for failing to protect our fundamental freedoms — enough is enough.”
June 5, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Fighting for Abortion Access During Coronavirus Pandemic”. From the press release:
New York Attorney General Letitia James has led a multistate coalition of 23 attorneys general in taking legal action against the Food and Drug Administration (FDA) and the U.S. Department of Health and Human Services (HHS) for increasing the risk that women nationwide will contract the coronavirus disease 2019 (COVID-19) as they seek abortions in their state. In an amicus brief filed in support of the plaintiffs in American College of Obstetricians and Gynecologists et al. v. FDA et al. in the U.S. District Court for the District of Maryland,Attorney General James led the coalition in supporting the plaintiffs’ request for a preliminary injunction to halt an FDA requirement that forces women to appear in person in a clinical setting to receive a drug known as Mifepristone for an early abortion or for miscarriage care. The coalition argues that the drug should be readily accessible via telehealth, so as to not potentially expose women to COVID-19 by requiring unnecessary travel.
“For years, the Trump Administration has done everything in its power to control women’s bodies,” said Attorney General James. “As much of the country continues to see the spread of the coronavirus and many residents are asked to stay at home or reduce travel, the federal government should be doing everything in its power to ensure women can maintain control of their reproductive choices without endangering their health and safety. Control over one’s reproductive freedom should not be limited to those who are able to leave their homes as we battle the coronavirus. We are fighting the Trump Administration’s continued assault on women’s reproductive freedoms and will fight to ensure Mifepristone is accessible via telehealth so that no woman is forced to risk her health while exercising her constitutional right to access an abortion.”
Since the widespread onset of COVID-19 across the United States in March, nearly 1.9 million Americans have contracted the disease, resulting in more than 108,000 deaths, including more than 375,000 infections in New York and more than 24,000 deaths in the state. In response, legislators, officials, and agencies across the nation have been instituting various emergency measures to slow the spread of the virus by limiting face-to-face contact and reducing in-person social gatherings, such as by closing schools and requiring all nonessential employees to work from home, as limiting interpersonal contact is central to the ability to control the spread of the virus.
But the FDA’s current policy requiring patients to appear in person in a clinical setting to receive Mifepristone heightens the risk of contracting and transmitting COVID-19 for everyone involved — including patients and health care providers. Forcing women to travel at a time when many states and the federal government are urging people to stay home to curb the spread of COVID-19 is shortsighted — not only putting women and their close contacts across the country in harm’s way, but also the public health more generally. Further, this policy undermines different states’ ability to effectively manage the pandemic.
In the brief, Attorney General James and the coalition specifically argue that “many women will need to travel long distances in order to reach a clinic that dispenses” Mifepristone — sometimes up to 200 miles — “especially if they reside in rural and medically underserved locations.” Additionally, those women in more compact, urban cities may not have the option to practice social distancing outside the home, therefore increasing the likelihood of coming into contact with an individual who has contracted COVID-19. But “[b]y using measures like telehealth to reduce unnecessary person-to-person contacts, [states] can decrease their infection rate, as required to safely commence reopening even as the pandemic continues.” In fact, the coalition continues, “telehealth should be used wherever possible — even as phased reopening of the States occur[s] — because it ‘maximize[s] the number of capable health care workers’ providing necessary medical treatment, while protecting health care staff,” and “the counseling required prior to a medication abortion is routinely provided through telehealth in order to reduce in-clinic interactions.”
Even another division of HHS and one of the FDA’s sister agencies — the Centers for Disease Control and Prevention — has advocated for telehealth, stating, “[l]everaging telemedicine whenever possible is the best way to protect patients and staff from COVID-19.”
The coalition goes on to highlight that their states have already taken numerous steps to expand the use of telehealth during the current public health crisis, including the suspension “of existing statutes and regulations that limit the use of telehealth in order to allow the delivery of regulated services through telehealth to additional patient populations, including especially vulnerable ones. These suspension orders expand the types of practitioners who can use telehealth, the settings in which it can be provided, the modalities that can be used to deliver telehealth services, and the circumstances under which telehealth can be initiated.” Further, many states have also suspended existing rules that prohibit telehealth in the absence of an existing patient-provider relationship so that patients can receive care from new providers.
The American College of Obstetricians and Gynecologists has likewise championed telehealth as an effective substitute for in-clinic dispensing of Mifepristone that can improve patient safety and outcomes during the COVID-19 public health crisis. And even before the pandemic, in 2018, the American Medical Association passed a resolution urging the FDA to lift the requirement because it “impedes the provision of” Mifepristone and has no “demonstrated or even reasonably likely advantage.” …
June 5, 2020: American college of Obstetricians and Gynecologists (ACOG) posted a press release titled: “ACOG Discourages the Administration from Severing ties with the World Health Organization”. From the press release:
ACOG is committed to improving and protecting the health of women around the world. We are concerned about the recent announcement that the President plans to terminate the United States’s relationship with the World Health Organization (WHO). We encourage the Administration to position the United States as a steadfast leader in global health, especially as we confront the ongoing global health crisis of COVID-19.
It is clear that a unified response from around the world is required for the containment and eradication of COVID-19, thus saving millions of lives. To that end, severing our relationship with the WHO at this time is reckless and would represent a large step backward in the fight to contain COVID-19 worldwide. Our efforts to support vaccine development; protect maternal and child health gains; and to work with other countries to improve containment, testing, and treatment of COVID-19 should be done in solidarity with the global health community.
There are no borders to this virus, and the United States has a moral imperative to help support and contribute to the efforts to reduce the harm from COVID-19 around the world and, in so doing, to protect the lives of those here in America. We strongly urge the Administration to participate constructively in the WHO and in the effort to find worldwide solutions to the grave global pandemic.
June 5, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “Fifteen Medical Organizations, 22 States, and the District of Columbia File Briefs in Support of ACOG’s Challenge to FDA Restrictions During the COVID-19 Pandemic”. From the press release:
On Wednesday, two coalitions filed briefs in support of a suit filed by ACOG petitioning a federal court to lift requirements for in-person dispensing of mifepristone during the COVID-19 pandemic. Although mifepristone, which is used in miscarriage management and first trimester pregnancy termination, has been proven to be safe and effective when prescribed through telemedicine for patients to receive by mail and take at home, it is subject to an FDA requirement to be dispensed in-person at a hospital, clinic, or medical office. This requirement hinders access to this medical treatment during the COVID-19 pandemic and places both patients and medical staff at risk of unnecessary exposure during the pandemic.
In a brief filed by a coalition of fifteen medical organizations (including, among others, the American Medical Association, American Academy of Family Physicians, and the American Academy of Pediatrics), the groups argued that FDA’s requirements for in-person dispensing are not only medically unnecessary, but do not allow clinicians to exercise their independent medical judgement. This lack of physician and clinician discretion harms patients and clinicians during the current public health emergency. As the brief states:
“AMA policy provides that physicians individually and collectively share the obligation to ensure that the care patients receive is “safe, effective, patient centered, timely, efficient, and equitable.” Yet the REMS on mifepristone in the context of abortion and miscarriage care prevent physicians from carryingout this obligation. Rather than evaluating the concerns of each patient individually, clinicians are forced to schedule an in-person visit even when the clinician has determined that such a visit would be detrimental to the patient’s health and well-being. Because of SARS-CoV- 2, medically unnecessary in-person visits are particularly likely to negatively impact patients’ health and well-being.”
Of particular concern, these negative impacts fall hardest on patients of color who as a result of systemic inequities already at higher risk of infection, hospitalization, and death from COVID-19, as well as by the nation’s maternal mortality crisis. The brief highlights for the court how the logistical burdens and risks inherent in the required travel to pick up these prescriptions fall inequitably on communities already facing disproportionate harm from the pandemic. “Due to lack of transportation, insufficient funds, and lack of childcare, low-income patients and patients of color are particularly likely to be exposed to unnecessary risks from the in-person dispensing requirement during the pandemic. Clinicians’ inability to exercise their judgment when providing miscarriage and abortion care thus particularly harms these populations.”
In a brief filed by Attorneys General representing twenty-two states and the District of Columbia, the states argued that FDA’s restrictions erode states’ efforts to minimize transmission of COVID-19 through social distancing, while allowing access to essential reproductive health care. The brief states that using telehealth whenever medically appropriate helps limit social interaction which is “critical to maintaining health and safety and preventing a surge in infection rates… it is important for residents to avoid unnecessary travel and in-person contacts.”
June 10, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “ACOG Urges Payers to Make Expanded COVID-19 Telehealth Policies Permanent”. From the press release:
Eva Chalas, MD, FACOG, FACS, president of the American College of Obstetricians and Gynecologists (ACOG), released the following statement urging all health insurance carriers to continue broad coverage and payment parity of telehealth services through the COVID-19 pandemic and beyond:
“As health care organizations across the country have quickly implemented changes to help meet the needs of patients during the COVID-19 pandemic, increasing the availability of covered telehealth services is one positive change that should be made permanent.
“ACOG applauds the U.S. Department of Health and Human Services for its quick response to the need for telehealth during the COVID-19 pandemic and for its recommendations that states lift restrictive policies, as these actions have improved patients’ access to telehealth and other remote management services. We also applaud national health plans that voluntarily made changes to policies, including coverage and payment parity of audio-only visits and remote patient monitoring.
“ACOG now calls on all payers to maintain expanded telehealth coverage policies through 2020 and in all the plan years to come. We urge all payers to build upon recent successes by ensuring that patients can regularly access covered telehealth services.
“The coverage and payment policies put in place during the COVID-19 pandemic have expanded access to evidence-based telehealth services and improved the ability of obstetrician–gynecologists to provide quality, patient-centered care. While states are in various stages of reopening, contracting COVID-19 remains a very real threat. Therefore, it is critical that insurance coverage policies allow patients to seek care in the safest possible way, including through telehealth and other remote services, and that payers inform enrollees about their telehealth coverage options.
“ACOG requests that payers ensure coverage and payment parity for audio-only and audio-video visits so that patients across all communities can benefit from telehealth. Payers must also refrain from adding additional barriers that would limit patients’ ability to receive telehealth services from their typical in-network physician.
“Additionally, the ability to receive durable medical equipment benefits by prescription should be expanded so that all patients can have the at-home equipment they need for remote prenatal and postpartum visits.
“Research has shown the benefits of telehealth in obstetric and gynecologic care. In many cases, these visits are deemed to be as effective as, or without statistically significant differences in outcomes from, in-person visits. For certain conditions, telehealth helps address barriers to access, reduces the number of unscheduled office visits, decreases ER visits and readmissions to the hospital, and improves rates of adherence to treatment guidelines. Patients often prefer telehealth visits in place of some in-person visits.
“Telehealth visits with in-network health care practitioners should be considered a standard benefit for all patients in perpetuity. We must maintain the progress we have made during this public health crisis and make telehealth more widely available, not just in times of national emergency.”
June 11, 2020: WBEZ posted an article titled: “Undocumented, Low-Income Seniors in Illinois Can Soon Get Publicly Funded Health Coverage”. It was written by Odette Yousef. From the article:
…As COVID-19 disproportionately harms communities of color in Illinois, the state has taken steps to increase access to testing and health care. On Wednesday, Gov. JB Pritzker put the ink on the latest of those, by signing the Fiscal Year 2021 budget that extends Medicaid-like health insurance coverage to low-income senior residents, regardless of immigration status. This makes Illinois the first state in the country to expand publicly funded health care coverage to undocumented seniors and seniors who have held green cards for less than five years, according to the National Conference of State Legislatures. Advocates of the measure say they expect it will impact up to 1,000 Illinois residents.
“We’re thankful to the [Pritzker] administration for that and are looking forward to aggressively working to figure out how we can quickly cover everyone else,” said Graciela Guzman, director at the Healthy Illinois Campaign, a coalition that seeks to extend health insurance access to all residents of the state. Guzman said her organization believes it will cost the state between $1.5 and $2.6 million to cover seniors in Fiscal Year 2021, which begins July 1.
Guzman said her group and ally organizations initially pushed to extend access to state-funded health insurance to all adult Illinois residents below the federal poverty level, regardless of immigration status. She estimated this would capture 93,000 people, but said the state’s fiscal constraints forced proponents to winnow down the focus this year to a sliver of that group: just those aged 65 and older.
“To even get our foot in the door on this was such a major win for us,” said Andrea Kovach, an attorney specializing in health care at the Shriver Center on Poverty Law. “And we have every intention of taking that foothold in the door and kicking it wide open for everyone.”
According to the National Conference of State Legislatures, other states have considered expanding state-funded Medicaid-like coverage to seniors, though Illinois is the first to move forward. In 2019, California extended its public health eligibility to undocumented adults between 19 and 26 years of age and plans to expand it further to undocumented seniors in 2022…
June 12, 2020: Planned Parenthood posted a press release titled: “Trump Administration Releases Final Rule Encouraging Health Care Discrimination Against LGBTQ+ People, Immigrants, Women, and More”. From the press release:
Today, amid a global pandemic, and on the fourth anniversary of the mass shooting at Pulse nightclub, the Trump administration released a final rule intended to interpret the Affordable Care Act’s (ACA) non-discrimination provision (Section 1557) in a way that scales back protections for transgender people, immigrants, and people who have had abortions — only compounding discrimination for those living at the intersections of these identities.
Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“Regardless of your sexual orientation or gender identity, where you’re from, the language you speak, or whether you’ve had an abortion — every person deserves to access health care free from judgment and discrimination. But it seems that neither a global pandemic, nor national uprisings over racist violence, nor Pride month will stop the Trump administration from doing everything in its power to discriminate, divide, and reduce access to health care. This cruel and discriminatory rule will only make it harder for transgender people, immigrants, and people seeking sexual and reproductive services to get care, and could even prevent people from getting the care they need entirely. One in three transgender people have already faced discrimination with a health care provider, a rate even higher for people of color. We must confront and reduce the continued discrimination and systemic racism, transphobia, and homophobia that are so deeply rooted in our health care system. As we face the dual public health crises of the COVID-19 pandemic and systemic racism and violence, Planned Parenthood will continue fighting to break down the barriers keeping people from getting the health care they need.”
Section 1557, the Health Care Rights Law, was a historic step toward achieving health equity for communities nationwide that have historically faced discrimination in access to health care services and coverage. Today’s rule strips that promise for people who already face discrimination in health care, including women, LGBTQ+ people, people who have had or will have abortions, those whose primary language is not English, and those at the intersections of these identities.
The legal protections and coverage gained from the ACA have played a critical role in responding to the COVID-19 pandemic, as it protects people who get the virus from losing health coverage, facing higher premiums, or paying higher out-of-pocket costs. The ACA has substantially reduced the rate of uninsured in communities of color, important now more than ever as COVID-19 is disproportionately upending the health and economic stability of the Black and Latinx communities.
Despite that, the Trump administration has advanced policy after policy that has damaged the nation’s public health infrastructure and undermined health care rights and access. The administration has:
- Refused to allow people to sign up for ACA coverage during the COVID-19 pandemic;
- Supported a lawsuit that would repeal the ACA entirely, despite the global pandemic;
- Pushed for Medicaid work requirements, proven to kick tens of thousands of people off their health care. Women, particularly women of color, are significantly more likely to lose coverage as a result of these work requirements;
- Issued and continued to defend up to the Supreme Court rules that would allow employers to deny birth control coverage to their employees;
- Tried to block people from getting care at Planned Parenthood health centers;
- Finalized a rule that removes protections for sexual assault survivors on campus;
- Deployed military troops in Washington, D.C., and around the country, and encouraged violence against protesters.
June 12, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Slams Rollback of Section 1557 Protections: Discrimination Has No Place in Our Public Health System”. From the press release:
California Attorney General Xavier Becerra today issued the following statement in response to the U.S. Department of Health and Human Services’ (HHS) decision to finalize its regulation, “Nondiscrimination in Health and Health Education Programs or Activities” (Section 1557 Rule). Section 1557 is an anti-discrimination law that prohibits discrimination in healthcare based on gender, race, ethnicity, sex, age, or disability. HHS’s changes to this rule would seriously undermine the Affordable Care Act’s (ACA) critical anti-discrimination protections, hurt women and LGBTQ individuals, and come at a time when they are most needed to help address the COVID-19 pandemic.
“In the midst of a pandemic, the Trump Administration chooses to make it more difficult for Americans to access lifesaving healthcare by weakening anti-discrimination provisions that protect equal access to care,” said Attorney General Becerra. “While HHS may be content to abandon its mission of protecting public health, California is not. Allowing discrimination against LGBTQ individuals, women and others goes against our public health goals and our values as a nation. We will do whatever is necessary to stand up for the Americans who would disproportionately bear the brunt of this foolish policy.”
June 12, 2020: The Guardian posted an article titled: “Trump administration reverses health protections for transgender people”. From the article:
The Trump administration has finalized a regulation rolling back Obama-era protections for transgender Americans against sex discrimination in health care.
According to the new version of the policy, the Department of Health and Human Services will be “returning to the government’s interpretation of sex discrimination according to the plain meaning of the word ‘sex’ as male or female and as determined by biology”.
The Obama regulation defined gender as a person’s internal sense of being male, female, neither or a combination.
The policy shift, long sought by Donald Trump’s religious and socially conservative supporters, would allow healthcare providers and insurance companies that receive federal funding to refuse to provide or cover transition-related care for trans Americans.
Several organizations have announced they will challenge the change. The Human Rights Campaign announced it would file a lawsuit. The ACLU has also said it would sue to overturn the Trump rule.
Under the Obama-era federal rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in healthcare but does not use the term “gender identity”.
Roger Severino, head of the health department unit that enforces civil rights laws, has said trans people continue to be protected by other statutes that bar discrimination in healthcare on account of race, color, national origin, age, disability and other factors.
But LGBTQ+ groups have long argued protections are needed for people seeking gender confirmation treatment, and for trans people who need medical care for common conditions such as diabetes or heart problems.
Women’s groups say the new regulations also undermine access to abortion, which is a legal medical procedure.
For the administration, it is the latest in a series of steps to revoke newly won protections for LGBTQ+ people in areas ranging from the military to housing and education.
The administration also has moved to restrict military service by trans men and women, proposed allowing certain homeless shelters to take gender identity into account in offering someone a bed for the night, and concluded in a 2017 justice department memo that federal civil rights law does not protect trans people from discrimination at work.
June 12, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “It is outrageous that Trump, in the middle of a pandemic, is working to prevent LGBTQ+ Americans from getting health care they need. Discrimination of any kind has no place in our society. We must defeat Trump, guarantee health care as a right and protect all LGBTQ+ Americans.”
June 12, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Assault on the Health of LGBTQ Women & Vulnerable Populations”. From the press release:
Speaker Nancy Pelosi released the following statement on the finalized Health and Human Services Department rule rolling back Section 1557 of the Affordable Care Act to weaken anti-discrimination protections for LGBTQ Americans, women, communities of color and other vulnerable populations in health care:
“The Trump Administration’s latest shameful rule is a shocking attack on the health and well-being of countless vulnerable communities, including women, LGBTQ individuals and people of color, at a time when access to quality health care is more important than ever. Undermining the Affordable Care Act’s anti-discrimination protections is a direct assault on basic health care services, from comprehensive reproductive care for women and families to life-saving care for communities of color, seniors, the disabled and the LGBTQ community. It is particularly disgraceful that the Trump Administration issued this new rule during LGBTQ Pride Month and on the day marking four years since the tragic Pulse Nightclub shooting.
“Our nation is in the midst of a health and economic crisis of staggering proportions. Instead of working to ensure that every American, regardless of who they are or who they love, has access to the care they need to stay healthy and safe, the Administration is rolling back life-saving protections for some of the most vulnerable communities and enshrining discrimination into vital federal guidelines. Religious freedom is no justification for hatred or bigotry, and every American has the right to seek and recieve care without intimidation or fear. The Administration must immediately abandon this outrageous decision and give all Americans the reassurance that they will never be denied the health care they or their families need.
“House Democrats will continue to hold this Administration accountable for their dangerous assault on our fundamental values of equality and justice, and we will never stop fighting to ensure all Americans are treated with the respect and dignity they deserve.”
June 12, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Condems Trump Administration’s Efforts to Roll Back Protections Against Discrimination in the Affordable Care Act”. From the press release:
Today the Department of Health and Human Services gutted protections against healthcare discrimination provided by Section 1557 of the Affordable Care Act.
NARAL Pro-Choice America’s Chief Research and Communications Officer Adrienne Kimmell released the following statement in response:
“It is unconscionable that this administration is attempting to strip away protections against healthcare discrimination for LGBTQ people, women, persons with disabilities, immigrants and non-native English speakers, and communities of color in the middle of the COVID-19 pandemic. Trump and his allies never fail to show that their extreme ideology comes before people’s health, safety, and lives. This rule will hurt Americans and fall hardest on people who already face barriers to accessing healthcare. The cruelty of this administration knows no bounds.”
Discrimination has no place in healthcare and it should never be allowed to determine the care a patient receives. This rule, finalized today by HHS, undermines protections for individuals and could give the green light for healthcare providers and insurance companies to discriminate against LGBTQ+ people, people who have sought or may in the future seek abortion care, people whose first language is not English, immigrants, people of color, and people with disabilities.
This administration continues to prioritize political gain over the wellbeing of Americans, even in the midst of a public health emergency. This ideologically-motivated rule is dangerous and runs counter to the Affordable Care Act’s promise of expanding healthcare coverage, free from discrimination.
June 15, 2020: Center for Reproductive Rights posted a press release titled: “U.S. Supreme Court’s LGBTQ Anti-Discrimination Ruling Comes Only Days After Federal Rule Strips Protections”. From the press release:
Today, the U.S. Supreme Court issued a landmark civil rights decision affirming that Title VII of the Civil Rights Act of 1964 protects LGBTQ people from employment discrimination. This powerful ruling comes only four days after the Trump administration took a shameful and harmful step in the opposite direction – issuing a federal rule that restricts the rights of LGBTQ people to access health care services.
In Bostock v. Clayton County, the Court affirmed that the Civil Rights Act’s prohibition on discrimination because of sex is both “straightforward” and “sweeping” and includes protections for LGBTQ people.
In stark contrast, the rule issued by the Trump administration on June 12 weakens enforcement of key anti-discrimination protections advanced under the Affordable Care Act’s Health Care Rights Law (Section 1557), which specifically prohibits discrimination based on race, national origin, age, disability or sex, in health programs or in activities that recieve federal funding. The new rule defines discrimination on the bases of sex to eliminate explicit protections relating to termination of pregnancy, sex stereotyping, and gender identity.
It is shamful that this cruel rule attempts to roll back protections against sex discrimination in health care. Health care is a human right and everyone deserves access to health care free from discrimination.
Nancy Northup, President and CEO of the Center for Reproductive Rights
June 15, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris Statement on Supreme Court Decision that Federal Civil Rights Law Protects LGBTQ Employees”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Monday released the following statement in response to the ruling by the U.S. Supreme Court that federal non-discrimination law protects LGBTQ workers.
“The Supreme Court’s ruling today sent a clear message to all Americans: our federal civil rights law protects LGBTQ workers and requires that they be treated with the dignity and respect every person deserves. The Court held that the Civil Rights Act prohibits discrimination in employment on the basis of sexual orientation and gender identity. Today’s decision will go a long way toward ensuring that LGBTQ people are protected in other critical areas, including education, health care, and housing.
“Our work is far from over, but as we celebrate Pride Month, today’s ruling is a step in the right direction in the fight for full equality for the LGBTQ community in all of its diversity, and in every facet of life.”
June 15, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on Supreme Court Ruling on Anti-LGBTQ Workplace Discrimination”. From the press release:
Speaker Nancy Pelosi released this statement on the Supreme Cout’s 6-3 decision in Bostock v. Clayton County, Georgia, ruling that federal employment non-discrimination laws protect all LGBTQ employees:
“Today, the Supreme Court has unequivically affirmed that all Americans, regardless of who you are or whom you love, are protected from discrimination in the workplace under federal law. This momentous decision is a victory for the LGBTQ community, for our democracy and for our fundamental values of equality and justice for all.
“Yet, the Trump Administration continues to advance an outrageous, hateful anti-LGBTQ agenda that risks the health and well-being of countless LGBTQ Americans and their families. And in too many places, LGBTQ individuals face continued persecution, harassment and violence, particularly trans women of color who face a disproportionately high rate of homelessness, HIV, sexual assault and murder. To finally and fully end LGBTQ discrimination, and not just in the workplace, but in every place, last year House Democrats passed the landmark Equality Act. Now, Leader McConnell must end his partisan obstruction and allow the Senate to vote on this critical legislation.
“As we mark LGBTQ Pride Month and celebrate this great legal victory for freedom and equality, we take great pride in how far we’ve come. Now, we must rededicate ourselves to continue marching toward progress to combat the forces of hatred and bigotry that still undermine our communities and our nation. We will not rest until we have secured a brighter, more just and equal future for the LGBTQ community and all Americans.”
June 15, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Lauds Supreme Court Decision Protecting LGBTQ+ Employees from Discrimination”. From the press release:
New York Attorney General Letitia James today applauded the United States Supreme Court for ruling, in a 6-3 decision, that employers cannot fire LGBTQ+ employees based on their sexual orientation or gender identity. The court ruled that employment discrimination against members of the LGBTQ+ population violates Title VII of the Civil Rights Act of 1964. The court’s decision resolved three cases considered together: Altitude Express v. Zarda; Bostock v. Clayton County, Georgia; and R.G. & G.R. Harris Funeral Homes v. EEOC. Last summer, Attorney General James co-led a coalition of 22 attorneys general in filing an amicus brief with the Supreme Court arguing that federal anti-discrimination laws protect LGBTQ+ individuals in the workplace.
“Whom you love or how you identify should have no impact on your employment,” said Attorney General James. “Today’s decision is a victory for millions of individuals who now can rest assured that they will not be fired or disciplined simply for being themselves. While we should celebrate this victory, the struggle is not over, so we will continue to fight for equal rights in every aspect of life for LGBTQ+ New Yorkers and Americans nationwide because no one should ever be singled out or discriminated against in this country — not for their race, their ethnicity, their religion, their gender identity, their sexual orientation, or any other reason.”
In the amicus brief filed last year, Attorney General James and the coalition argued that the prohibition on discrimination based on sex in Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on sexual orientation, sex stereotyping, or gender identity.
June 15, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Responds to Iowa Legislature Passing Extreme Restrictions on Abortion Access”. From the press release:
Late Saturday night the Iowa legislature surreptitiously passed an extreme measure that will force women to undergo a mandatory and medically unnecessary 24-hour delay prior to receiving abortion care.
In a telling sign of misplaced priorities, Republicans in the Iowa House rushed to file the waiting period amendment prior to adjourning the legislative session early Sunday morning, prompting state Rep. Beth Wessel-Kroeschell to condemn her colleagues for “exploiting this moment of national pandemic to advance an ideological agenda that is out of touch with Iowans.”
NARAL Pro-Choice America National Communications Director Kristin Ford released the following statement:
“While the entire country grapples with the ongoing COVID-19 pandemic and courageous Iowans call for racial justice in the midst of a national reckoning about entrenched white supremacy, the GOP in the Iowa statehouse chose to instead focus on blocking access to abortion care. Forced waiting periods simply shame women and create more roadblocks to essential care people need. They are unnecessary and politically motivated restrictions, part of a broader agenda of control.
In the midst of an ongoing public health crisis, this measure will disproportionately hurt people with low incomes who are less likely to have the resources to overcome these barriers to accessing abortion care, such as finding transportation, taking time off of work to travel, and securing child care. This measure is the farthest thing from what Iowans need right now, and Republicans in the legislature should be ashamed of themselves.”
June 16, 2020: EMILY’s List posted a statement titled: “EMILY’s List Statement on Rep. Mike Garcia Cosponsoring Anti-Choice Legislation”. From the statement:
Today, Rep. Mike Garcia cosponsored the anti-choice “LIfe at Conception Act”. Stephanie Schriock, president of EMILY’s List, the nation’s largest resource for women in politics, released the following statement:
“Just one month into his term in office, Congressman Garcia has chosen to cosponsor his first piece of dangerous legislation aiming to criminalize abortion and strip women of their fundamental reproductive freedom. Mike has made it clear that he will blindly support the current administration’s dangerous agenda, regardless of what it costs his constituents. Californians deserve better than an inexperienced legislator who lacks the ability to fight for their interests, and EMILY’s List looks forward to helping Christy Smith defeat him in November.”
June 16, 2020: Representative Ayanna Pressley (Democrat – Massachusetts) posted a press release on her official website titled: “Rep. Pressley, Colleagues Lead More than 100 Members of Congress in Urging FDA to Ease Restrictions on Medication Abortion Drug”. From the press release:
While the Trump administration has encouraged the use of telemedicine across the health care industry during the pandemic, it has refused to relax rules around medication abortion drugs, a move that experts warn may put both patients and providers at greater risk of contracting the coronavirus.
Today, Congresswomen Ayanna Pressley (D-MA), Chair of the Pro-Choice Caucus Abortion Rights & Access Task Force, Diana DeGette (D-CO), Barbara Lee (D-CA), and Jan Schakowsky (D-IL) led a group of 109 lawmakers in urging the Food and Drug Administration (FDA) to ease the dispensing restrictions on mifepristone – the first of two medications used in combination to safely and effectively induce an early abortion or treat an early miscarriage. While the pill has been used in the U.S. for more than 20 years, FDA has long subjected mifepristone, when used for early pregnancy termination, to a set of highly restrictive requirements, known as Risk Evaluation and Mitigation Strategies (REMS). These requirements make it unnecessarily difficult for patients to access care.
One of those policies – the “in-person dispensing requirement” – requires patients to make a potentially unnecessary trip to a hospital, clinic, or medical office just to pick up the mifepristone pill. Out of more than 20,000 FDA-approved drugs, mifepristone is the only drug that FDA requires to be dispensed only in clinical settings while permitting patients to self-administer it at home.
“The REMS in its current form creates an illogical situation in which a patient can meet with her doctor by telehealth from the safety of her home, take the pills at home, safely have her abortion at home, and follow up with her doctor after the abortion by telehealth again, but must first travel in the midst of a global pandemic just to pick up the pills from a registered facility or provider,” the lawmakers wrote to Food and Drug Administration Commissioner Stephen Hahn. “For many patients, this requirement can mean taking public transportation, riding in someone else’s car, or traveling hundreds of miles away from home to another county or state — significantly increasing their risk of exposure to the virus. It also means that some providers and clinic staff are forced to have unnecessary in-person interactions that increase their own exposure risks.”
The United Kingdom has already issued guidance authorizing physicians to mail mifepristone to pregnant patients during the pandemic following a telephone or video consultation, and FDA itself has already suspended enforcement of other types of REMS restrictions necessitating in-person visits, noting that “patients may need to avoid public places and patients suspected of having COVID-19 may be self-isolating and/or subject to quarantine.”
The lawmakers are urging FDA to take immediate action to allow certified prescribers to mail mifepristone to patients during the pandemic…
June 18, 2020: Planned Parenthood posted a press release titled: “Lawsuit Asks FDA to Remove Medically Unnecessary Barriers to Reproductive Health Care During COVID-19”. From the press release:
Tomorrow (June 19), a federal court in Maryland will hear arguments in a lawsuit asking the U.S. Food and Drug Administration (FDA) to temporarily ease restrictions on on the medication mifepristone, in order to ensure patients can safely access abortion and miscarriage care during the COVID-19 pandemic. The suit was filed by the American Civil Liberties Union (ACLU) on behalf of the American College of Obstetricians and Gynecologists (ACOG), SisterSong Women of Color Reproductive Justice Collective, and other leading medical organizations and reproductive health, rights, and justice advocates.
Mifepristone is one of two medications used in a medication abortion and managing an early miscarriage. Research has shown that mifepristone is safe and effective when prescribed through telehealth and self-administered at home; however, the FDA’s Risk Evaluation and Mitigation Strategy (REMS) restrictions unnecessarily require patients to get mifepristone directly from a doctor’s office, hospital, or other health center — rather than from a pharmacy or mail-order as they would for other equally safe medications.
Statement from Alexis McGill Johnson, Acting President, Planned Parenthood Federation of America:
“During a public health crisis, we should be doing everything we can to make sexual and reproductive health care more accessible, not less — especially for Black people, Indigenous people, and other people of color who have long faced systemic racism and are now being disproportionately affected by COVID-19. While Planned Parenthood and other providers have worked to ensure patients can still access essential, time-sensitive care during the pandemic — while minimizing the risk of COVID-19 exposure for both patients and health center staff — the FDA’s restrictions on mifepristone undermine these efforts for patients seeking abortion and miscarriage care.
“At odds with expert medical consensus, these restrictions are just another example of how reproductive health care, especially abortion, is treated differently than other kinds of health care in ways that only put patients’ health and lives at risk. It is critical that the FDA ease the restrictions around mifepristone access during this pandemic so patients can get the care they need as safely as possible.”
Out of 20,000 prescription medications regulated by the FDA, mifepristone is the only one for home use currently required to be dispensed in person. Requiring patients to travel to pick up the medication significantly increases the risk of COVID-19 exposure for patients, providers, and health center staff.
In response to the pandemic, federal agencies have encouraged the use of telehealth and allowed providers to forgo unnecessary in-person visits in order to mitigate the risk of COVID-19 exposure, with the exception of mifepristone. Mifepristone is safe, effective, and has been used by more than four million people since the FDA approved it twenty years ago. Leading medical associations have maintained that the FDA’s REMS restrictions on the distribution of mifepristone are not based on evidence and do not benefit patients.
PPFA joined the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP), and other leading health care organizations in signing on to an amicus brief in support of the lawsuit. The brief highlights how removing the in-person requirement on mifepristone during the COVID-19 pandemic would especially benefit patients with low-incomes and patients of color, who already face heightened barriers to care.
Planned Parenthood is proud to offer medication abortion via site-to-site telehealth in 18 states. As the nation’s leading sexual and reproductive health care provider, Planned Parenthood is committed to making sure all patients receive the high-quality health care they need, when they need it — including safe, legal abortion. By providing medication abortion safely and effectively via telehealth, we can keep patients, providers, and health center staff safer during the pandemic and expand access to abortion for people, no matter where they live.
June 18, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on Supreme Court Ruling on DACA”. From the press release:
Speaker Nancy Pelosi issued this statement on the U.S. Supreme Court’s ruling that the Trump Administration acted capriciously and illegally in its effort to terminate the Deferred Action for Childhood Arrivals (DACA) initiative:
“Eight years ago, our nation took a momentous step to advance equality and opportunity in America when President Obama launched the DACA initiative, empowering courageous young Dreamers to come out of the shadows and pursue their American Dream. Our Dreamers are the pride and the constant reinvigoration of our nation.
“Today is a joyous and proud day for our country, as the Supreme Court has rejected the Trump Administration’s illegal, immoral assault on young immigrants who make America more American, which the Court rightfully found to be ‘arbitrary and capricious.’ The Court’s decision upholds our values, the law and the will of the American people. Dreamers have the overwhelming support of the public, with more than three out of four voters saying Dreamers should be allowed to stay – including more than two-thirds of Republicans.
“Our Dreamers need and deserve real, permanent action by the Congress to ensure that they can continue to bless, enrich and strengthen our nation. The House will continue to be relentless in demanding that the Senate take up H.R. 6, the American Dream and Promise Act, to provide a pathway to citizenship for Dreamers and TPS and DED recipients.
“House Democrats will always work to fix our broken immigration system and to fight for our Dreamers, to ensure that Americn remains a nation of hope, freedom, and opportunity for all.
June 18, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James’ Statement on DACA Victory”. From the press release:
New York Attorney General Letitia James today released the following statement after the United States Supreme Court ruled that the Trump Administration’s attempts to cancel the Deferred Action for Childhood Arrivals (DACA) program violated the Administrative Procedure Act. Attorney General James and California Attorney General Becerra led a coalition arguing the case before the Supreme Court in November.
“Today’s decision reaffirms that there is no question that home is here for more than 700,000 Dreamers across the country,” said Attorney General James. “The Supreme Court’s decision today sets aside an inhumane injustice by the Trump Administration and permits young people who go to school here, who work here, who pay taxes here, who raise families here, and who are vital members of our communities to continue to be able to live in their homes without fear of arrest or deportation. America is a country of immigrants; our culture made richer by their contributions and our economy made more prosperous because of their work. I am proud to have co-led the fight to protect this critical program and the more than 700,000 DACA recipients across the country, and more than 150,000 right here in New York. To our Dreamers, know that you are valued, that you are loved, and that we will always fight to protect you. Si se puede!
“I want to thank Attorney General Becerra, the numerous additional state attorneys general, and all the other groups who fought by our side to tirelessly protect DACA.”
The case was heard over the consolidated three cases of Department of Homeland Security v. Regents of the University of California, Trump v. NAACP, and McAleenan v. Vidal.
June 18, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris Applauds Supreme Court Decision Preserving DACA Program”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Thursday released the following statement after the U.S. Supreme Court blocked the Trump Administration’s decision to end the Deferred Action for Childhood Arrivals (DACA) program. President Trump terminated the DACA program on September 5, 2017, throwing the lives of over 600,000 DREAMers into chaos.
“DACA has allowed young immigrants who were brought here by their parents to live and work in this country without fear that they would be deported. Dreamers are part of our communities. They are our classmates, our work colleagues, our role models, and our friends and neighbors.
“The administration’s decision to break our promise to these young people was cruel and inhumane. Since day one of his administration, this president has repeatedly attacked immigrant communities and used them as political bargaining chips instead of treating them like human beings. This administration has, time and time again, used anti-immigrant sentiment to drum up fear. They have shamelessly pushed for a border wall, erected barriers to citizenship, and restricted due process for those seeking refuge in our country. This is all part of a reckless and cruel push to remake the demographics of our country using an anti-immigrant agenda.
“Today’s ruling was important, but it is not a lasting solution. The House of Representatives has put forth strong legislation, the American Dream and Promise Act, which the Senate should vote on today. Every day that passes without protections for DACA recipients set forth in our laws, is another day that these young people must live in fear of being taken away from their families and communities. These young people should not continue to live in fear of one day being turned away from the only country they know as home.”
June 18, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Applauds Landmark Supreme Court Decision on DACA”. From the press release:
California Attorney General Xavier Becerra today applauded the U.S. Supreme Court’s landmark decision upholding the Deferred Action for Childhood Arrivals (DACA) policy. In November of 2019, the California Department of Justice led a coalition of 21 attorneys general in defense of DACA before the Supreme Court. In today’s decision, the Supreme Court held that the Trump Administration acted illegally when it attempted to end DACA. As a result, the policy remains in effect for now, protecting hundreds of thousands of Dreamers across the country.
“Today, justice prevailed for every Dreamer who has worked hard to help build our country — our neighbors, teachers, doctors, and first responders. Today, America told the Dreamers that this is their home,” said Attorney General Becerra. “The highest court in our land saw through the Trump Administration’s illegal, baseless excuses. The Court agreed: If you work hard and play by the rules, you deserve a chance to get ahead. However, our fight doesn’t end here: Congress can permanently fix our broken immigration system and secure a pathway to citizenship. As a former lawmaker who launched bipartisan immigration talks on Capitol Hill, I know first-hand that bipartisan support can — and must — exist. It will take all of us working together to get it done.”
“Justice and the rule of law won the day,” said University of California President Janet Napolitano, who helped create DACA when she served as Secretary of Homeland Security under President Barack Obama. “The Supreme Court’s decision to uphold the University of California and the California Attorney General’s challenge against the Trump Administration’s capricious action is a victory for hundreds of thousands of young people who are making vital contributions to their families, schools, employers, and the nation.”
Currently, there are nearly 650,000 Dreamers who arrived in this country as children and were granted DACA protections. Dreamers come from almost every country in the world, but many have never known any home other than the United States. They are among our nation’s newest college graduates, soldiers, nurses, teachers, and first responders who are boosting the country’s economy and communities every day. For instance, there are approximately 29,000 doctors, nurses, dentists, physician assistants, and other healthcare workers who have benefitted from DACA and contribute to protecting the health of our communities across the country. In California alone, it is estimated that there are more than 8,500 DACA recipients who work in the healthcare industry. DACA recipients and their households are estimated to contribute nearly $9 billion in federal, state, and local taxes each year. Currently, more than a quarter of DACA recipients reside in California…
June 18, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Remarks at Press Event Unveiling the Moving Forward Act”. From the press release:
Speaker Nancy Pelosi joined House Democrats for a press event unveiling H.R. 2, the Moving Forward Act, House Democrats’ bold legislation to rebuild America’s infrastructure. Below are the Speaker’s remarks:
…”When we won in 2018, we said to the American people that, For The People, we would lower the cost of health care by lowering the cost of prescription drugs and preserving the pre-existing condition, lower health care costs. Bigger paychecks by building the infrastructre of America in a green and resiliant way. And third, we would have cleaner government. Cleaner government by improving, enhancing the voice of small donors and the grass roots political process.
Between now and the Fourth of July, we will bring the ACA enhancement legislation to the Floor on June 29th. Next week, we will bring the Justice in Policing Act, part of our democratization bill – initiatives to the Floor. And then, before we leave for the Fourth of July, we’ll bring this imporant legislation we have, the Moving Forward Act…
…And, again, we have something for the Postal Service, the infrastructure piece of the Postal Service. Connective tissue of our country, the Postal Service. Over 90 percent of the medicines received by veterans are through the Postal Service. The list goes on…
June 19, 2020: Planned Parenthood posted a press release titled: “Breaking: Tennessee Legislature Passes Sweeping Abortion Ban in the Middle of the Night”. From the press release:
In an egregious move, the Tennessee legislature, in the dead of night and using police force to keep the public out of the Capitol building, passed a sweeping abortion ban. The bill, one of the most restrictive abortion bills in the country, bans abortion at nearly every stage of pregnancy, including before most people even know they’re pregnant. The bill also includes more medically unnecessary abortion restrictions and anti-science measures like forcing doctors to give patients the misinformation that they can reverse their abortion. It also bans abortion if the reason for the abortion is gender, race, or potential fetal diagnosis. Similar bans throughout the country have been struck down as unconstitutional.
Just last week, the Iowa legislature pulled a similar move — waiting until the wee hours of the night to pass a harmful bill against abortion access. It’s becoming the new shameful playbook for anti-abortion politicians who are willfully ignoring police violence and COVID-19, both public health crises disproportionately killing Black people. Following suit, Tennessee politicians have now passed a deeply racist and discriminatory bill which preys upon inaccurate and offensive stereotypes of communities of color, including Asian Americans and Pacific Islanders, in order to ban abortion.
Furthermore, this bill will do nothing to address actual discrimination against women and girls, and instead would open the door to interfere with doctor-patient relationships, open and honest doctor-patient conversations, and a patient’s right to make private medical decisions.
Each and every one of these bans are part of a coordinated strategy to overturn Roe v. Wade and ban abortion outright.
Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“It is a disgrace that in the face of a true public health crisis, Tennessee politicians wasted their time with this last-minute move to attack abortion access before closing up shop this session. We know that the goal of the politicians behind this bill is simple: a total ban on safe, legal abortion. Politicians know that this bill is blatantly unconstitutional. And they don’t care. Amidst protests against police violence and fear around COVID-19, politicians are doubling down — pushing racist stereotypes and ignoring public health to ban abortion. But we won’t let them. We’re going to do everything in our power to fight back and stand up for reproductive freedom.”
Statement from Ashley Coffield, president & CEO, Planned Parenthood Tennessee and North Mississippi:
“What happened tonight flies in the face of democracy. In the dead of night, Tennessee politicians hellbent on chipping away at abortion access blocked citizens from entering the state Capitol while they used this draconian abortion ban to pass the state budget. While Tennesseans are concerned about their health and safety during a pandemic, politicians used women’s lives as a bargaining chip to push their political agenda. This comes after weeks of Senate leadership making public statements that they would not take up this bill.
“Gov. Lee already failed at trying to exploit the COVID-19 pandemic by banning abortion through an executive order, and now he is trying to use every restriction he can think of to strip patients of their reproductive rights. Tennessee is already grappling with a botched response by Gov. Lee to the pandemic, and the deep racial divide in the state that’s finally getting the attention it deserves. We’ll continue fighting these egregious attacks on our patients’ rights — no matter what.”
June 19, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release on her official website titled: “Pelosi Statement on Amicus Brief in District Court ACA Special Enrollment Case”. From the press release:
Speaker Nancy Pelosi issued this statement after the House of Representatives filed an amicus brief in the District Court for D.C. in the case of City of Chicago v. Azar, supporting a challenge by the city regarding the failure of the Trump Administration to provide a special Affordable Care Act enrollment period in light of the coronavirus pandemic:
“Across the country, communities are being devastated by the staggering impact of the coronavirus on Americans’ lives and livelihoods. As the threat from this crisis grows, the Administration has ignored the advice of health experts and the law, and refused to reopen Affordable Care Act enrollment to ensure millions of uninsured workers and their families get the affordable, lifesaving coverage they need.
“Even in the midst of an unprecedented health crisis, the Trump Administration is doubling down on the outrageous Republican lawsuit to dismantle the entirety of the ACA, including essential protections for 130 million Americans with pre-existing conditions. As we combat this deadly virus and the Administration’s dangerous agenda, House Democrats will always fight to uphold the law and ensure the ACA can continue to provide its vital protections for all Americans.”
The Amicus Brief can be found here.
June 19, 2020: Planned Parenthood posted a press release titled: “Tennessee Abortion Ban Immediately Challenged in Court by Planned Parenthood, the Center for Reproductive Rights, and ACLU”. From the press release:
A bill passed by the Tennessee legislature late last night banning abortion as early as six weeks of pregnancy was challenged in court today by the Center for Reproductive Rights, the American Civil Liberties Union, Planned Parenthood Federation of America, and the American Civil Liberties Union of Tennessee. The bill also prevents patients from obtaining an abortion depending on their reason for seeking the procedure, including the potential for a Down syndrome diagnosis or the sex or race of the fetus. These types of “reason bans” insinuate that pregnant people cannot be trusted to make their own medical decisions, and do nothing to address racism, sexism, ableism, or the serious health disparities faced by marginalized communities.
If Governor Bill Lee signs the bill into law, it will take effect immediately. The emergency lawsuit being filed today asks the court to block the bill immediately.
As the bill was being debated into the early hours of the morning, police officers kept the public out of the Capitol building and arrested some protestors. The passage of these abortion bans come just two months after Governor Lee attempted to ban abortion procedures during the COVID-19 pandemic by labeling abortion care as non-essential, despite opposition from leading national medical groups. That attempt was blocked in court in April after a lawsuit was filed by the same organizations filing today’s case.
Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“Enough is enough. It is abhorrent that Gov. Lee and politicians in Tennessee are exploiting the fear and uncertainty of a global pandemic to push their cruel anti-abortion agenda. This opportunistic attack on our reproductive rights, passed in the middle of the night under the cover of darkness, will disproportionately impact Black Tennesseans due to systemic oppression and concerted efforts to stifle their most basic rights and freedoms. We won’t stand for this, and we are going to do everything possible to fight back against this extremely harmful law.”
Statement from Ashley Coffield, president & CEO, Planned Parenthood Tennessee and North Mississippi:
“This is blatantly unconstitutional, and I am confident that once challenged in court, this legislation will go on the same legal trash heap as the abortion bans that have been struck down in other states. Gov. Lee is wasting valuable taxpayer dollars to defend this unconstitutional law, while COVID-19 cases are rising and our state grapples with our history of systemic racism. Gov. Lee’s failed priorities will fall heaviest on people who already face systemic barriers to care including people of color, people with low incomes, and women. We’ll continue fighting these egregious attacks on our patients’ rights — no matter what.”…
June 22, 2020: Attorney General Xavier Becerra posted a press release titled: “Attorney General Xavier Becerra: California Will Restrict State-Funded Travel to Idaho”. From the press release:
California Attorney General Xavier Becerra today announced that, effective July 1, 2020, California will restrict state-funded travel to Idaho as a result of two discriminatory bills signed into law in Idaho this year despite significant concerns raised by the Idaho Attorney General. The laws, House Bills 500 and 509, directly authorize discrimination against the transgender community. House Bill 500 repeals protections that enabled transgender students to compete on athletic teams consistent with their gender identity and House Bill 509 prohibits the amendment of birth certificates to be consistent with gender identity. The new restrictions on travel to Idaho are prescribed by law in California pursuant to Assembly Bill 1887 (AB 1887), which passed in 2016.
“Where states legislate discrimination, California unambiguously speaks out,” said Attorney General Becerra. “The State of Idaho has taken drastic steps to undermine the rights of the transgender community, preventing people from playing sports in school or having documentation that reflects their identity. Let’s not beat around the bush: these laws are plain and simple discrimination. That’s why Idaho joins the list of AB 1887 discriminating states.”
Both Idaho laws take active steps to enforce discriminatory regimes against transgender Idahoans. House Bills 500 and 509 were signed into law by Idaho Governor Brad Little on March 30, 2020. Idaho Attorney General Lawrence Wasden had raised concerns about the bills’ compliance with equal protection and privacy laws. House Bill 500, among other things, runs contrary to existing guidance by the National Collegiate Athletic Association that encourages equal opportunity for transgender students to participate in athletics. Dubiously named the “Fairness in Women’s Sports Act,” House Bill 500 overrules existing local school policies in Idaho and directly works to ban transgender girls and women from school sports. Similarly, House Bill 509 not only authorizes but actually requires discrimination by prohibiting the amendment of birth certificates consistent with gender identity, a right previously recognized by an Idaho federal court on equal protection grounds. The laws are currently set to go into effect in Idaho on July 1, 2020.
AB 1887, which took effect beginning in 2017, restricts state-funded travel to states with laws that authorize or require discrimination on the basis of sexual orientation, gender identity, or gender expression. AB 1887’s restriction on using state funds for travel applies to California state agencies, departments, boards, authorities, and commissions, including an agency, department, board, authority, or commission of the University of California, the Board of Regents of the University of California, and the California State University. Each applicable agency is responsible for consulting the AB 1887 list created by the California Department of Justice to comply with the travel and funding restrictions imposed by the law.
For additional information on AB 1887, including the list of states subject to its provisions, visit: www.oag.ca.gov/ab1887.
June 22, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Files Brief Challenging the Trump Administration’s Refusal to Open a Special Enrollment Period on HealthCare.Gov in Response to COVID-19”. From the press release:
California Attorney General Xavier Becerra and Michigan Attorney General Dana Nessel today led a coalition of 14 attorneys general in filing an amicus brief in support of the City of Chicago’s lawsuit challenging U.S. Health and Human Services (HHS) for failing to create a special enrollment period in response to COVID-19 for individuals in the 38 states that rely on the federal exchange, HealthCare.Gov, for health insurance. Millions of Americans have lost their job as a result of the pandemic. In the amicus brief, the coalition argues that there is both a critical need for and a legal obligation to create a special enrollment period on HealthCare.Gov to help these individuals obtain healthcare coverage. The 12 states that run their own exchanges, including California, have already instituted a special enrollment period in response to COVID-19, and thousands of individuals have benefited as a result.
“As this country faces dueling economic and public health crises, HHS’s refusal to open enrollment on HealthCare.Gov is absolutely unconscionable,” said Attorney General Becerra. “This is a time when we need our leaders to step up. Yet the Trump Administration continues to ignore the realities of millions of Americans who find themselves without healthcare in the midst of a devastating pandemic — once again putting its animosity towards the ACA over people. Enough is enough. It‘s time to protect our communities from having to choose between their health and bankruptcy. It’s time to fight for their right to healthcare coverage.”
The Affordable Care Act (ACA) provides HHS Secretary Alex Azar with the authority to create special enrollment periods outside of the normal enrollment period for hardships or special situations that may warrant it. HHS’s failure to open a special enrollment period means uninsured individuals in the 38 states that rely on the federal exchange for coverage may choose to avoid medical care or face massive bills as a result of seeking treatment. As a result of COVID-19, over 40 million Americans have lost their jobs, but under current regulations, only those Americans who already had health insurance with their job are eligible for a special enrollment period. Those Americans who did not have healthcare coverage through their employer, but experienced job loss, are left with no options.
On April 3, 2020, Attorney General Becerra and North Carolina Attorney General Josh Stein led a coalition of 22 attorneys general in sending a letter to HHS urging it to reconsider its shortsighted decision to deny a special enrollment period on HealthCare.Gov during the pandemic. HHS has also ignored repeated calls from Congress, the healthcare industry, and others to open a special enrollment period.
In the amicus brief, the coalition argues that HHS’s failure to open a special enrollment period violates the Administrative Procedure Act and is contrary to the text of the ACA and its regulations for opening special enrollment periods. The coalition urges the court to find HHS’s inaction unlawful and compel the agency to open a special enrollment period.
Attorneys General Becerra and Nessel are joined by the attorneys general of Connecticut, Delaware, Hawaii, Maryland, Minnesota, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Virginia, and the District of Columbia in filing the brief.
A copy of the brief can be found here.
June 22, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Denounces Overnight Passage of Extreme Anti-Choice, Anti-Freedom Bill in Tennessee”. From the press release:
Just after midnight, anti-choice Republicans in Tennessee passed a sweeping set of anti-choice provisions meant to chip away at and ultimately end the right to abortion. Among the bill’s provisions were bans on abortion at almost every stage of pregnancy, including before many women even know they’re pregnant, a forced ultrasound mandate; a requirement to interrogate women about why they’re ending a pregnancy; and criminalizing doctors who provide abortion care.
Rather than showing real leadership to address entrenched white supremacy and police violence or tackle the state’s public health crisis with over 32,000 reported cases of COVID-19, anti-choice Republicans in the legislature and Governor Bill Lee remain laser-focused on their dangerous agenda to ban abortion and roll back reproductive freedom.
Kristin Ford, National Communications Director at NARAL Pro-Choice America, released the following statement in response:
“Tennessee legislators jammed through this extreme bill under cover of darkness, making their priorities crystal-clear: control and punish women and families, rather than help them thrive at a time when our nation is reckoning with pernicious racial injustice and a crippling pandemic. This measure is a panoply of the cruelest restrictions designed to push abortion care out of reach and end the right to abortion once and for all. It is an affront to the values of the 7 in 10 Americans who believe everyone should be able to make their own decisions about pregnancy, without politicians meddling to impose an ideological agenda.”
Anti-choice, anti-freedom politicians who introduced this legislation specifically said their goal was to give the state “multiple shots” at ending Roe v. Wade. Their objectives are clear: control women and restrict their freedom to make their own decisions about pregnancy, effectively outlawing abortion and threatening doctors who provide abortion care with criminal punishment.
June 24, 2020: Center for American Progress posted an article titled: “The Health Care Repeal Lawsuit Could Strip Coverage from 23 Million Americans”. It was written by Nicole Rapfogel and Emily Gee. From the article:
Tomorrow, the Trump administration and 18 Republican governors and attorneys general will file their opening briefs with the Supreme Court in California v. Texas—the health care repeal lawsuit. The lawsuit, criticized across the political spectrum as a “badly flawed” case, threatens to upend the Affordable Care Act (ACA) and strip 23.3 million Americans of their health coverage, according to new CAP analysis—about 3 million (15 percent) more than was forecast before the coronavirus pandemic. The anti-ACA agitators who initiated the health care repeal lawsuit, backed by the Trump administration, continue their attempts to dismantle the ACA, including its coverage expansions and consumer protections, amid the pandemic, during which comprehensive health coverage has never been more important. Millions of Americans who have lost their jobs and job-based insurance due to the current economic crisis are relying on the insurance options made possible by the ACA to keep themselves and their families covered…
...Impact of the coronavirus pandemic on coverage
As the Trump administration and 18 Republican state leaders double down on their push to strip millions of their health coverage and encourage predatory insurance practices, a pandemic that has killed nearly 120,000 Americans and infected over 2.2 million continues to sweep the nation.
Since the impact of the coronavirus pandemic began to unfold in mid-March, more than 44 million joblessness claims have been filed as of June 11. Millions of people have lost their employer-sponsored insurance (ESI)—millions of whom will be unable to replace it and will become uninsured. Thanks to the ACA, many of these newly unemployed Americans who previously were covered by employer-sponsored insurance are able to get health coverage, either through the ACA marketplaces, possibly with financial assistance to make their coverage more affordable, or via Medicaid expansion. The Urban Institute and the Kaiser Family Foundation have estimated that tens of millions of people could lose job-based coverage due to the economic crisis sparked by the pandemic and indicate that millions of people in this situation are eligible for the ACA coverage that is threatened by the health care repeal lawsuit.
National and state level coverage losses
Because the economic crisis stemming from the pandemic is driving millions of people onto coverage programs supported by the ACA, CAP estimates that approximately 3 million more people stand to lose coverage from the health care repeal lawsuit than the 20 million previously estimated. According to a March 2019 analysis by the Urban Institute, full repeal of the ACA would cause enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) to fall by 22.4 percent and enrollment in individual market coverage, including for the ACA marketplaces and other insurance people purchase on their own, to drop by 35.4 percent.
The economic stress of the pandemic has pushed the United States into a recession. The Congressional Budget Office projects that the unemployment rate in the second and third quarters of this year will average 15 percent — higher than it was during the Great Recession. At an unemployment rate of 15 percent, 17.7 million people would lose employment-based health insurance coverage, according to a recent report by the Urban Institute. With access to ACA coverage options, most of these people would find new forms of insurance. Urban estimates that 8.2 million would end up with Medicaid/CHIP coverage, and 4.3million would gain coverage through the ACA marketplaces or other private coverage. About 5.1 million would remain uninsured.
If the ACA is repealed, however, many more people who lose job-based coverage will be without insurance. CAP estimates that because of the pandemic, about 3.4 million additional people are at risk of losing coverage because of the lawsuit. Combining two previous projections by the Urban Institute, CAP’s estimate assumes that 35.4 percent of the 4.3 million people who gain individual market insurance and 22.4 percent of the 8.2 million people who gain Medicaid/CHIP coverage would become uninsured under repeal.
In total, 23.3 million people stand to lose coverage and become uninsured if the ACA is repealed during the pandemic. In Texas alone, the number of people without health coverage would rise by about 2 million…
…The Trump administration and its allied state leaders are attempting to undermine health care in the midst of one of the worst public health disasters in U.S. history. The ACA is crucial to helping families regain coverage and maintain some financial security against health care costs. A Supreme Court ruling against the ACA would take away health coverage from millions of Americans whose lives are already being disrupted by the economic distress and concerns about their health and well-being.
June 24, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Remarks at Press Event Unveiling the Patient Protection & Affordable Care Enhancement Act”. From the press release:
Speaker Nancy Pelosi joined House Democrats for a press event unveiling the Patient Protection and Affordable Care Enhancement Act, House Democrats; For the People legislation to build on the Affordable Care Act to lower health costs and prescription drug prices. Below are the Speaker’s remarks:
Speaker Pelosi: Good morning. Thank you all for being here and on time. My apologies. It is like the middle ofthe day, there is so much that has been going on already.
But here we are to talk about something that is so important in the lives of the American people: their health. It is not only about their health, but about their financial health. And when we ran in 2018, we said we would do three things. For the People, we would lower the cost of health care by lowering the cost of prescription drugs and preserving the pre-existing condition [protections]. We would have – lower health care costs, bigger paychecks by building the infrastructure of America in a green way. And, cleaner government, with H.R. 1, which would make the first two possible by reducing the role of big, dark money in politics preventing us from accomplishing the other goals in the public interest, rather than the special interest.
On the subject of health care, this was a reiteration of waht we had run on in 2006: ‘Six for ’06’. One of our six was to give the Secretary the authority to negotiate for lower prices. We knew then, right Frank? And we know now that was the only way we could take down these prices. Of those “Six for ’06’, five of them became law and one did not. And that was giving the Secretary authority to negotiate for lower prices. That is the heart of H.R. 3, which is very much part of the legislation you will hear very much about today.
I am honored that we are here with Richie Neal by video; Mr. Pallone, whose Committee has so much jurisdiction in terms of health care; Mr. – Chairman of the Education and Labor Committee, Bobby Scott. These three were there from the start developing that, developing the Affordable Care Act. All of them were very much a part of shaping that. We want to enhance it so the leadership of these three committees are here today.
Let me just say that we didn’t envision that when we were doing H.R. 3 in December, that we would be in the middle of a pandemic, but we are. All the more reason, all the more reason for us to remove all doubt of affordability of health care. This is about the lives, the livelihood of the American people…
…I could say a lot about each of the people who are here. Lauren underwood, Colin Allred, Andy Kim, Angie Craig; part of our Freshman class who, from day one – and that’s – where did he – from day one, have taken the lead on this and in terms of asserting Congress’s right to fight in court against the President’s repeal of the Affordable Care Act, repeal of the pre-existing benefits condition, the repeal of so many opportunities for people from day one and they will talk about their roles in that as they join our distinguished chairmen. In between it all, Mr. Ruiz, a physician, many degrees in public health and medicine, as well as a Member of Congress will speak to us about that juxtaposition of policy and good health in our country…
…Speaker Pelosi: …As Congressman Ruiz mentioned, and was alluded to, also, by Mr. Scott, tomorrow, the Supreme Court will hear the brief from the Administration as to taking down the Affordable Care Act, right in the heart of the time of the pandemic. It was wrong any time, now it is beyond stupid. Beyond stupid.
I thank our colleagues and Freshman Members, each of whom has a piece of legislation from their own entrepreneurial thinking, from their experience, whether as a health care professional; the experience of New Jersey, as a person who had your family experience, but also works professionally; with Congresswoman Craig; and, of course, Mr. Allred who started all of this on the first day. That is tomorrow. Today, we will go to Rules Committee to make this legislation in order.
Tomorrow, they will do their brief to take down the Affordable Care Act. And they will remove all, even semblance of reality when they say – I heard one on TV yesterday say, ‘We are all for the benefit of pre-existing condition not being an obstacle to health insurance and health care. We are all for that.’ Oh really? Then get off the case. Well, tell the President to get off the case.
But nonetheless – that’s tomorrow – on Monday, this important legislation will come to the Floor of the House. We hope it will get bipartisan support. It certainly meets the needs of Democrats, Republicans, Independents and Decline To States, whatever they call themselves, across the country, because the issue of health care knows no party. And the issue of the pandemic certainly does not, as well…
…With that, I thank you all. Wash your hands, wear a mask, take care, keep your distance. Thank you all.
June 24, 2020: House Committee on Energy & Commerce posted a press release titled: “Health Committee Chairs Unveil Legislative Package to Make Health Care & Prescription Drugs More Affordable”. From the press release:
As Americans face both the COVID-19 pandemic and the resulting severe economic downturn, Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Ways and Means Chairman Richard E. Neal (D-MA) and Education and Labor Chairman Robert C. “Bobby” Scott (D-VA) today unveiled The Patient Protection and Affordable CareEnhancement Act, a legislative package that will provide much needed relief by making health care and prescription drugs more affordable. The legislation also expands access to health care, strengthens protections for people with pre-existing conditions, reduces racial and ethnic health coverage disparities and reverses the Trump Administration’s harmful actions to sabotage the Affordable Care Act (ACA).
The Patient Protection and Affordable Care Enhancement Act makes health care more affordable by lowering health insurance premiums with strengthened and expanded affordability assistance. Specifically, the legislation expands eligibility for premium tax credits beyond 400 percent of the federal poverty line and increases the size of tax credits for all income brackets. The legislation creates a national reinsurance program to help cover the costs of consumers with expensive medical conditions, which helps lower premiums, and provides funds to states to help lower deductibles and out-of-pocket costs for everyone. It also offers funding to states to establish their own State-Based Marketplaces, which oftentimes have lower premiums.
The legislation also makes prescription drugs more affordable by empowering Medicare to negotiate lower drug prices and making those prices available to Americans with private health insurance. It will stop drug companies from ripping off Americans and charging them more than other countries for the same drugs. The Congressional Budget Office (CBO) estimates that drugs subject to negotiation will see price reductions of up to 55 percent.
“The American people are anxious about their health and their economic future, and this legislation provides critical relief by making health care and prescription drugs more affordable,” Chairman Pallone said. “It’s commonsense legislation that takes the savings from lower prescription drug costs and invests it into lowering health care premiums and expanding access to affordable care. All around, that’s a win for the American people. We must take action to lower these soaring costs, expand access to health care, rein in the Trump Administration’s efforts to sabotage the ACA and protect people with pre-existing conditions.”
“While Republicans continue their efforts to dismantle America’s health care system in the midst of a pandemic, Democrats are putting forward a plan to expand access to care and lower costs,” said Chairman Neal. “We slash prescription drug prices, create larger premium tax credits available to more people, and devote funding to reduce out-of-pocket costs for everyone. With this legislation, we also take important steps to ensure patients are protected. The bill encourages remaining states to expand Medicaid and support vulnerable Americans, puts an end to the expansion of ‘junk’ insurance plans, and prevents states from using federal waivers to allow discrimination against patients with pre-existing conditions. And importantly, we also address the inequities in care that COVID-19 has brought to the fore through targeted assistance for Hispanic, Black, and Native Americans. For the health and financial security of workers and families across the country, Congress needs to pass this legislation.”
“This global health emergency is a stark reminder of our responsibility to expand access to affordable health care, and that is exactly what the Affordable Care Enhancement Act would achieve,” said Chairman Scott. “This proposal builds off the progress we made in the Affordable Care Act by lowering the cost of Marketplace plans, cutting the price of prescription drugs, and strengthening patient protections by reversing the expansion of junk health care plans. It is telling that in the middle of a public health emergency, House Democrats are proposing to strengthen and enhance the Affordable Care Act, while the Trump Administration is asking the Supreme Court to rip health coverage away from millions of Americans.”
The Patient Protection and Affordable Care Enhancement Act also:
- encourages states that have not expanded their Medicaid programs to do so by renewing the ACA’s original expanded federal match. If all states expanded Medicaid, about 4.8 million more Americans would be eligible for Medicaid, including an estimated 2.3 million people who are uninsured;
- reverses the Trump Administration’s efforts to give states waivers to undermine pre-existing condition protections and weaken standards for essential health benefits;
- stops the expansion of junk insurance plans that allow insurance companies to discriminate against people with pre-existing conditions, put consumers at financial risk, and drive up comprehensive insurance costs;
- restores critical outreach and enrollment funding that has been gutted by the Trump Administration and provide funding for navigators to assist consumers in signing up for health care;
- combats the maternal mortality epidemic, which continues to particularly impact Black and Native American people, by extending Medicaid or Children‘s Health Insurance Program (CHIP) coverage to new mothers from the current 60 days post-partum to one year;
- further reduces racial and ethnic health inequities by expanding coverage and premium assistance to more Black and Hispanic Americans; and
- protects vulnerable populations from losing health coverage by ensuring that Medicaid and CHIP beneficiaries receive a full 12 months of coverage once enrolled, protecting them from interruptions due to fluctuations in their income throughout the year.
A one-page summary is available HERE.
A section-by-section is available HERE.
Text of the bill is available HERE.
June 25, 2020: Representative Charlie Crist (Democrat – Florida) posed a press release on his official website titled: “Crist: Dismantling Affordable Care Act would leave 1.75 Million Floridians Without Coverage”. From the press release:
U.S. Representative Charlie Crist (D-St. Petersburg) released the following statement after the Trump Administration filed a brief with the U.S. Supreme Court asking the justices to strike down the Affordable Care Act.
Amid a global public health crisis and economic emergency caused by the outbreak of COVID-19, Congressman Crist cites a newly released report finding that the number of Americans who would lose health coverage if the Administration’s lawsuit succeeds has grown to more than 23 million, including 1.75 million Floridians. The House of Representatives filed its brief with the Supreme Court in support of the Affordable Care Act in early May, and oral arguments in the case are expected this fall.
“As our country continues to face the largest and most unprecedented public health crisis in modern history, the Trump Administration continues its heartless attack on the Affordable Care Act that would leave millions across America without the access to care they need,” said Rep. Crist. “In Florida, which sadly has become a COVID hot spot, striking down the ACA would mean 1.75 million of our neighbors and loved ones would lose their coverage. That’s unconscionable. The People’s House remains steadfast in our commitment to lowering the cost of care in this country, not raising it, and expanding access to affordable health care for all Americans. I’m calling on the Trump administration to end this attack on Americans’ care, and put the people first.”
This week, House Democrats introduced the Patient Protection and Affordable Care Enhancement Act, legislation that builds on the Affordable Care Act to lower health costs and prescription drug prices while reducing the ranks of the uninsured. The bill will cap premiums at 8.5 percent of income, reducing costs for everyone.
Should the Trump Administration succeed in striking down the Affordable Care Act, the following protections, coverage, and programs are at risk:
- Protections for 135 million Americans with pre-existing conditions.
- Medicaid expansion, which covers 17 million people.
- Reopening the Medicare donut hole, raising prescription drugs for nearly 12 million seniors.
- 2.3 million adult children will no longer be able to stay on their parents’ insurance.
- Insurance companies will be able to charge women 50 percent more than men.
- Repealing premium subsidies that make marketplace coverage affordable for 9 million people.
- Reinstate lifetime caps on coverage.
- Allow insurance companies to deny prescription drugs and maternity coverage.
June 25, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becrra Files Opposition to Sutter Health’s Delay of Landmark Settlement of Anticompetitive Practices”. From the press release:
California Attorney General Xavier Becerra today filed opposition to a motion by Sutter Health (Sutter) to delay final approval of the groundbreaking preliminary settlement agreement reached in December 2019. The settlement agreement resolves allegations by the Attorney General, the United Food and Commercial Workers International Union and Employers Benefit Trust (UEBT), and class action plaintiffs, that Sutter’s anticompetitive practices led to higher healthcare costs for consumers in Northern California compared to other places in the state. When approved, the settlement will require Sutter to pay $575 million in compensation, prohibit Sutter from anticompetitive conduct, and require Sutter to follow certain practices to restore competition in California’s healthcare markets. On June 12, Sutter filed a motion for continuance, attempting to delay final approval of this landmark settlement. In today’s opposition filing, Attorney General Becerra highlights that prompt approval of the settlement is in the public’s best interest, particularly in the face of the COVID-19 pandemic…
…This litigation began in 2014 when the UEBT and numerous individual plaintiffs — later consolidated into a class action — filed their lawsuit challenging Sutter’s practices in rendering services and setting prices. They sought compensation for what they alleged were unlawful, anticompetitive business practices, which caused them to pay more than necessary for healthcare services and products. In March of 2018, Attorney General Becerra filed a similar lawsuit against Sutter on behalf of the people of California, principally seeking injunctive relief to compel Sutter to correct its anticompetitive business practices moving forward. The separate lawsuits were combined by the court into one case. In October of 2019, on the eve of trial, the parties reached an agreement to settle. The final settlement was filed with the court on December 19, 2019 together with an unopposed motion for its preliminary approval. Since then, three different hearing dates for the settlement’s approval have been scheduled, with the latest being set on June 22, 2020. Shortly before that hearing date, on June 12, Sutter filed a motion for continuance, attempting to further delay approval of the settlement and implementation of the critical injunctive relief provisions that benefit consumers.
In his opposition, Attorney General Becerra argues that approval of the settlement, now months old, is in the best interest of Californians. Further, the opposition calls into question Sutter’s arguments for delay of the settlement approval, including use of COVID-19 to delay the process. Until the settlement receives final approval, Sutter can continue its anticompetitive practices, which harm healthcare consumers and our State’s economy. Attorney General Becerra asserts that emergencies such as COVID-19 are not an excuse for Sutter, or any other healthcare entity, to skirt their obligations under antitrust law. Moreover, the settlement itself contains mechanisms by which material changes in the healthcare environment may be used to seek appropriate modifications. Sutter has received more material financial aid related to the pandemic from taxpayers – and is in a far better financial position to weather any ill effects of COVID-19 – than many other providers in the state. Thus, Sutter’s issues regarding COVID-19’s financial impact are better directed to the federal and state governments and not to the Court in seeking to delay this settlement.
When approved, the settlement will require Sutter to:
- Pay $575 million to compensate employers, unions, and others covered under the class action and to cover costs and fees associated with the legal efforts;
- Limit what it charges patients for out-of-network services, helping ensure that patients visiting an out-of-network hospital do not face outsized, surprise medical bills;
- Increase transparency by permitting insurers, employers, and self-funded payers to provide plan members with access to pricing, quality, and cost information, which helps patients make better care decisions;
- Halt measures that deny patients access to lower-cost plans, thus allowing health insurers, employers, and self-funded payers to offer and direct patients to more affordable health plan options for networks or products;
- Stop all-or-nothing contracting deals, thus allowing insurers, employers, and self-funded payers to include some but not necessarily all of Sutter’s hospitals, clinics, or other commercial products in their plans’ network.
- Cease anticompetitive bundling of services and products which forced insurers, employers, and self-funded payers to purchase for their plan offerings more services or products from Sutter than were needed. Sutter must now offer a stand-alone price that must be lower than any bundled package price to give insurers, employers, and self-funded payers more choice;
- Cooperate with a court-approved compliance monitor to ensure that Sutter is following the terms of the settlement for at least 10 years. The monitor will receive and investigate complaints and may present evidence to the court; and
- Clearly set definitions on clinical integration and patient access considerations. The settlement makes clear that for Sutter to claim it has clinically integrated a system, it must meet strict standards beyond regional similarities or the mere sharing of an electronic health record, and must be integrating care in a manner that takes into consideration the quality of care to the patient population. This is important because clinical integration can be used to mask market consolidation efforts by hospital systems, when in fact there is no true integration of a patient’s care. For example, saying that hospitals are regionally close or that hospitals are sharing electronic health records is not enough, there must be close coordination that will lead to less costly, higher quality care for local communities.
…A copy of the opposition is available here. A copy of the settlement provided to the Court is available here. Additional declarations supporting plaintiff’s opposition are available on the electronic version of this release here.
June 25, 2020: SCOTUSblog (which is NOT run by the Supreme Court of the United States) posted a thread that started with this tweet: “The United States just filed its brief in the major constitutional challenge to the Affordable Care Act that will be argued next term. The government says the entire ACA is invalid but leaves room for the court to leave in place certain provisions that don’t harm the plaintiffs.”
That tweet included a screenshot from the brief:
III. The individual mandate cannot be severed from the remained of the ACA. Congressional findings incorporated into the ACA’s text clearly indicate that Congress would not have adopted the guaranteed-issue and community-rating provisions absent the individual mandate’s requirement to purchase insurance. This court recognized the interrelatedness of these three provisions in NFIB and King v Burwell, 135 S. Ct. 2480 (2015). And Congress’s 2017 amendment does not alter the severability analysis because it left it intact in the critical statutory findings about the interconnectedness of these provisions – findings that were and remain the functional equivilante of an inseverability clause.
The ACA’s remaining provisions are likewise inseverable, because it is evident that Congress would not have enacted them without the individual mandate and the guaranteed-issue and community-rating provisions .The NFIB joint dissent would have so held, and that conclusion is still equally valid today. Nothing the 2017 Congress did demonstrates it would have intended the rest of the ACA to continue to operate in the absence of these three integral provisions. The entire ACA thus must fall with the individual mandate, through the scope of relief entered in this case should be limited to provisions shown to injure the plaintiffs.
NOTE: In 2017, there was a Republican president, with a Republican majority Senate and a Republican majority House. The decision to reduce the penality for not buying health insurance – the individual mandate – to $0 was done by the Republicans. If the Supreme Court decides the ACA must fall because of Republican shenanigans – the Republicans are entirely to blame for it.
June 25, 2020: SCOTUSblog continued the thread with this tweet: “The case, California v. Texas, is the third direct challenge to the ACA to reach the Supreme Court and will likely be the blockbuster case of the term that begins in October.
June 25, 2020: SCOTUSblog continued the thread with this tweet: “The federal government’s full brief is here: A separate brief — from a group of red states asking the court to strike down the entirety of the ACA — was filed earlier in the day. That brief is here:”
June 25, 2020: SCOTUSblog ended the thread with this tweet: “A group of blue states filed a brief defending the law back in May. That brief is here:
June 25, 2020: Senator Kamala Harris (Democrat – California) tweeted: “20M more Americans have health insurance because of the Affordable Care Act. 135M people with pre-existing conditions are now protected. 12M seniors now pay lower prescription drug costs. Yet Trump continued to advance his lawsuit to repeal the ACA. During a pandemic.
June 25, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release on her official website titled: “Pelosi Statement on Trump Brief Asking Supreme Court to Strike Down Affordable Care Act Amid Coronavirus”. From the press release:
Washington, D.C. – Speaker Nancy Pelosi released the following statement after the Trump Administration filed its brief in the health care lawsuit before the Supreme Court, asking the justices to strike down the entirety of the Affordable Care Act:
“President Trump and the Republicans’ campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty.
“If President Trump gets his way, 130 million Americans with pre-existing conditions will lose the ACA’s lifesaving protections and 23 million Americans will lose their health coverage entirely. There is no legal justification and no moral excuse for the Trump Administration’s disastrous efforts to take away Americans’ health care.
“On Day One of this Congress, the House Democratic Majority voted to throw the full legal weight of the House of Representatives against this dangerous lawsuit. While President Trump tries to tear away protections for people with pre-existing conditions, Democrats are working to build on the Affordable Care Act to lower health costs and prescription drug prices For The People. Next week, the House will continue that effort by passing the Patient Protection and Affordable Care Enhancement Act.”
June 25, 2020: California Attorney General Xavier Becerra tweeted: “We’re in court today fighting the Trump Administration’s burdensome rule attacking safe, legal abortion care and threatening loss of health coverage over a $1 missed payment”. This tweet is the start of a thread.
June 25, 2020: California Attorney General Xavier Becerra tweeted: “As we face a public health crisis, @HHSGov should be doing all it can to protect and streamline care, not fighting to take it away when we need it most.”
June 25, 2020: California Attorney General Xavier Becerra tweeted: “The 1303 rule is a solution in search of a problem, and to finanize during #COVID19 shows this Admin’s prioritization of politics over people once again. Health policy should be based in science, not creating even more propaganda in the @RealDonaldTrump war on women’s health”. This tweet was the end of the thread.
June 25, 2020: House Committee on Energy & Commerce posted a press release titled: “E&C Investigation Finds Millions of Americans Enrolled in Junk Health Insurance Plans That Are Bad For Consumers & Fly Under The Radar Of State Regulators”. From the press release:
Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Health Subcommittee Chairwoman Anna G. Eshoo (D-CA) and Oversight and Investigations Subcommittee Chair Diana DeGette (D-CO) today released a report on the Committee’s year-long investigation into the anti-consumer practices of Short-Term, Limited Duration Insurance (STLDI) health care plans and the insurance brokers who sell and sign people up for these junk plans.
“The Committee’s investigation finds that the Trump Administration’s policy to expand unregulated and misleading plans is a threat to the health and financial well-being of American families, particularly during the COVID-19 crisis,” Pallone, Eshoo and DeGette said. “These plans are a bad deal for consumers and oftentimes leave patients saddled with thousands of dollars in medical debt. The heavy-handed tactics uncovered in this investigation demonstrate why Congress must reverse the Trump Administration’s expansion of these junk plans. It also shows how dangerous a post-ACA world would be if Republican Attorneys General and the Trump Administration are successful in striking down the law and its protections for coverage of pre-existing conditions.”
The investigation found that enrollment in these plans, which offer bare bones health coverage and engage in heavy-handed tactics to avoid paying medical claims, increased significantly to approximately three million consumers in 2019, a 27 percent increase from 2018. The growth in enrollment came after the Trump Administration issued a final rule in August 2018 that extended the maximum duration of the plans and allowed them to be sold alongside plans that comply with the Affordable Care Act’s (ACA) consumer protections. Earlier this week, Health Committee leaders unveiled The Patient Protection and Affordable Care Enhancement Act, which would reverse the Administration’s expansion of these junk plans.
The Committee investigation finds these plans are bad for consumers:
- All eight insurers deny claims for medical care after putting consumers through an extensive and invasive claims review process. The insurers subject consumers to a post-claims review process to determine whether the medical condition for which the claim was submitted may have arisen from a pre-existing condition or whether the health condition should have been disclosed by the applicant in the plan application. All eight insurers deny a medical claim if a determination is made that the medical claim was due to a pre-existing condition and subject to the pre-existing condition exclusion, or that it resulted from a pre-existing condition. Claims are also denied if the STLDI insurers determine that there were risk factors present at time of enrollment, or the medical condition manifested itself in such a manner that would have caused an ordinary prudent person to seek medical advice or treatment. The investigation also found that some STLDI insurers sometimes refuse to pay for medical claims that are not due to pre-existing conditions or subject to any of the plan’s exclusions and limitations. The claims are processed only after consumers retain attorneys or file complaints with state regulators.
- Most STLDI insurers rescind coverage, leaving consumers uninsured and with large medical bills. Most STLDI insurers rescind the underlying policy if a determination is made that the enrollee had a prior health condition that should have been disclosed in the plan application, or if there were certain risk factors present at the time of enrollment that the individual failed to disclose. Some STLDI insurers disenroll consumers and deny claims for individuals who develop medical conditions after enrollment. These individuals often have their claims denied for medical conditions that they were not previously diagnosed with or sought treatment. In these instances, these companies assert that the consumer failed to disclose they had testing performed or were advised to have treatment or further medical evaluation. Some STLDI plans also rescind policies of cancer patients and deny claims related to cancer treatment.
- STLDI insurers systematically exclude coverage for most major medical conditions resulting from pre-existing conditions, as well as coverage of basic medical services that consumers would reasonably expect to be covered by health insurance. STLDI insurers exclude coverage for most common medical diagnoses resulting from pre-existing conditions, including diabetes, cancer, stroke, arthritis, heart disease, and substance use and mental health disorders. Some of these plans impose significant coverage limitations and exclusions on the limited benefits and services that are covered, including emergency services, hospitalization, substance use and mental health disorders, and prescription drugs. In a few cases, STLDI plans exclude coverage of routine care such as basic preventive care, wellness exams, pelvic exams, pap smears and birth control.
- STLDI plans impose limitations on the benefits covered. Many of these plans impose significant limitations on doctor’s office visits, hospitalization, emergency services, substance use and mental health disorders, and prescription drugs. For instance, some of these plans impose a maximum of $500 per policy period for doctor’s office visits, a maximum of $1,000 per day for hospitalization, $500 per visit for emergency services, and a maximum of $2,500 per surgery for surgeon services. Consumers who fall sick while enrolled in one of these plans may incur huge, potentially financially ruinous, medical costs.
- STLDI insurers screen consumers for health status and discriminate against people with pre-existing conditions and women. Most of the insurers under investigation require consumers seeking coverage to complete invasive and complex plan applications that require disclosure of medical history. These same insurers deny coverage altogether to individuals with pre-existing conditions. They also discriminate against women by denying women basic medical services and charging women more than men for the same coverage.
- On average, less than half of the premium dollars collected from consumers are spent on medical care. The investigation found that on average across the eight companies that offer STLDI products only 48 percent of premium dollars a consumer pays are paid out in the form of health care claims and medical benefits. This is in stark contrast to ACA-compliant individual market plans, which are required to spend at least 80 percent of all premium dollars on health care claims.
- Marketing materials provide consumers misleading information. The Committee finds that some marketing materials for the STLDI plans provide incomplete and often misleading information about a plan’s limitations and exclusions. Misleading and fraudulent marketing practices are particularly concerning amid the COVID-19 public health emergency. Many uninsured individuals may be seeking to enroll in health coverage, and given the Trump Administration’s refusal to allow for an Open Enrollment period on the ACA Marketplaces, uninsured individuals may turn to STLDI plans as an alternative form of coverage.
- Brokers receive up to ten times the compensation rate for STLDI plans than for ACA-compliant plans. The Committee reviewed 14 companies’ broker compensation rates and found that the average commission rate for STLDI plans was 23 percent. The commission rate for ACA-compliant plans was an average of 2 percent in 2018. As a result, brokers may be incentivized to engage in deceptive and fraudulent misleading marketing practices or led consumers to these plans instead of ACA-compliant plans.
The Committee’s investigation also found millions of Americans are enrolled in these plans that fly under the radar of state regulators:
- STLDI plans represent a significant and growing proportion of the individual health care market. Approximately three million consumers enrolled in STLDI plans during the 2019 plan year across nine insurers, which was an increase of 600,000 over the 2018 plan year. Additionally, enrollment by brokers increased by approximately 60 percent in December 2018, and by over 120 percent in January 2019, compared to previous months. The increase in enrollment in December and January suggests that these plans are benefiting from, and possibly capitalizing on the marketing and advertising around the ACA’s open enrollment season.
- STLDI plans operate in a significant regulatory gap, with little oversight. The Committee finds that among states that allow these plans to be sold, some states have little information about the availability and type of STLDI plans sold in their states. State regulators also face challenges in taking disciplinary action and enforcement against insurers found to be in violation of their state laws. For example, insurers who offer STLDI plans through out-of-state associations can bypass state laws and regulations in states in which they do not file their products. As a result, states face significant challenges in monitoring and regulating STLDI plans. Currently, 24 states have banned or restricted the sale of STLDI plans.
In March 2019, the Committee officially launched its investigation by sending letters to 14 companies that either sell or assist consumers in enrolling in STLDI plans, requesting documents and information about industry practices. The Committee also conducted phone calls with all of the companies and followed up over the past 12 months to request additional information and seek clarification as needed.
Read the full Committee report HERE.
June 26, 2020: ABC News posted an article titled: “Amid pandemic, Trump administration asks Supreme Court to overturn Obamacare”. It was written by Devin Dwyer. From the article:
In the midst of a pandemic and without an alternative health plan of its own, the Trump administration formally called on the U.S. Supreme Court to completely strike down the Affordable Care Act.
The administration makes the case in a legal brief filed late Thursday in the case brought by 20 Republican-led states that want to completely invalidate the law.
The justices will hear oral arguments as soon as October, which is just weeks before the general election.
Two lower federal courts have ruled that the ACA’s individual mandate is unconstitutional after the GOP Congress in 2017 zeroed out the penalty for going without health insurance. The Supreme Court had previously upheld the mandate on the grounds that it was a tax.
The lower courts also called into question the viability of the entire law without the mandate.
“The individual mandate cannot be severed from the remainder of the ACA,” writes Trump solicitor general Noel Francisco in his brief to the Supreme Court. “The entire ACA thus must fall with the individual mandate.”
California and 19 other Democrat-led states are defending the law.
“The ACA has been life-changing and now through this pandemic, we can all see the value in having greater access to quality healthcare at affordable prices,” said California attorney general Xavier Becerra who is leading the defense. “Now is not the time to rip away our best tool to address very real and very deadly health disparities in our communities.”
Nearly half a million Americans have signed up for health plans through the ACA so far in 2020, according to the Department of Health and Human Services — a surge of enrollment, up 46% from this time last year, from workers who lost their jobs and employer-based insurance coverage in the coronavirus pandemic.
“We intend to win this,” Becerra added…
June 26, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris Condems Trump’s Latest Attempt to Strip Health Care Away from Millions of Americans”. From the press release:
U.S Senator Kamala D. Harris (D-CA) released a statement after the Trump administration demanded the Supreme Court to strike down the entire Affordable Health Care Act.
“Donald Trump is trying to strip health coverage from millions of Americans just to spite President Obama. It’s cruel and dangerous,” said Harris. “People need health insurance that is affordable and covers what they need it to– especially during a pandemic.
“By stalling COVID-19 testing and trying to rip health insurance away from people, the president is knowingly putting lives at risk for political gain. Republicans and Democrats have a moral responsibility to speak out against Trump’s unprecedented sabotage of Americans’ health,” Harris added.
June 26, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Transcript of Pelosi Weekly Press Conference Today”. From the press release:
Speaker Pelosi: Good morning…
…And what is really important about all of this right now is the health of the American people. Martin Luther King said, ‘Of all,’ he said exactly, ‘Of all forms of inequality, injustice in health is the most shocking and the most inhuman,’ he said, ‘and the most inhuman, because it also – it often results in physical death.’ Of all forms of injustice, inequality, health care, the most inhuman.
So, it is unfathomable, unfathomable, that as we gathered here, late at night, last night, in the midst of a pandemic, the White House, the Administration, in the dark of night, filed their brief in the Supreme Court to overturn the Affordable Care Act, saying to the American people, [130] million families, if you have a pre-existing condition, you will no longer have the benefit of access to quality care. And the list goes on of the benefits that it would overturn. Lifetime limits that they support, that we want to overturn; that, if you have a pre-existing condition, that there is no lifetime limit on the amount of coverage that you would receive.
Midst of a pandemic, 130 million Americans with pre-existing conditions will lose ACA’s life‑saving protection, 23 million Americans will lose their health – access to quality, affordable health care. The ACA’s ban on annual lifetime limits, young people staying on other people’s – being a woman no longer a pre-existing condition. Forget about it. The Administration wants to do away with all of that.
As bad as that is, they think they can get away with saying, ‘Oh, we support a benefit for a pre-existing condition,’ when they don’t. So, when they say that, understand they are in court to overturn that now. They continue to be, and now they have filed their briefs. And all of this as the ACA enrollment has increased by 46 percent by a similar period last year, showing an increased need during the coronavirus.
So many people have lost their jobs, and, hence, in some cases, their insurance benefits. Therefore, they are turning to the Affordable Care Act. Again, in the middle of a pandemic, the President is saying, ‘We want to slow down the testing.’ The testing….
…And, as I said, many more people are signing up for the Affordable Care Act. And, so, I am so pleased that on Monday we will be putting forth our Patient Protection and Affordable Care Enhancement Act. It will lower health care costs, negotiate lower prices, expand coverage and push hold-out states to adopt Medicaid expansion, combat inequity in health coverage, combat junk plans. The list goes on.
Now, let me say this. As I said earlier, many people who have lost their jobs have turned to the Affordable Care Act because their job – their health care was tied to their job. So, hopefully, they will get their jobs back, but, in the meantime, they have that access. That’s what the President is trying to overturn in the courts. So, God-willing, the courts will do the right thing, but we just don’t know. So, we are getting prepared for what comes next in all of this – in all of this.
But let me tell you this about the ACA enhancement. It has – why we have some things in it and some things aren’t that were saved for another day, because the President said he would support these things. He said he would support negotiating for lower prices. That is what he said during the campaign.
That has been for years our – one of our priorities that we have never been able to get 60 votes in the Senate and get it passed into law. But the President said during the campaign he was going to, ‘Negotiate like crazy.’ Crazy, that is a good description of his actions throughout. But, ‘negotiate like crazy’ apparently means not negotiate at all. That is the only way you are going to get the prices – the lowered prices.
And, in the bill – the Affordable Care Act – it brings down the cost of prescription drugs, which we are promising to the American people, and the savings to the Federal government from not having to pay those prices will go to expand, in a way – bigger expansion of Medicare since its inception. Benefits for hearing, for visual and for dental. It’s quite remarkable. It has other advantages for seniors in terms of cost of prescription drugs as well. But we are very, very proud of that aspect, very understandable about everyone…
June 26, 2020: California Attorney General Xavier Becerra posted a press release titled: “State Senate Advances Legislation to Avert Anticompetitive Health System Consolidation Which Increases Costs for Patients”. From the press release:
California State Senator Bill Monning (D-Carmel) and Attorney General Xavier Becerra today applauded the passage in the State Senate of Senate Bill 977 (SB 977), legislation to avert anticompetitive behavior and over-consolidation in the healthcare sector. Decreased competition is a known driver of increased prices for consumers. SB 977 calls for California Department of Justice oversight when large healthcare systems, hedge funds or private equity groups seek to acquire or affiliate with other healthcare facilities or providers. The oversight serves as a check to ensure that these transactions targeting health facilities of critical importance to local communities improve care coordination or increase healthcare access for those communities. The bill provides new enforcement tools to reduce anticompetitive behavior. SB 977 now moves to the State Assembly.
“With our communities battling the coronavirus pandemic, our healthcare system must operate at peak performance. That means all hands on deck. But we’ve learned the hard way that too often “consolidation” really means higher prices and a reduction of services which the surrounding community relies on,” said Attorney General Becerra. “Communities deserve to know that their local hospital won’t be treated like a commodity that’s up for sale but, instead, like the provider of critical health services that families in the area depend on. Under SB 977, the Department of Justice will provide the independent set of eyes that our communities need for them to know that consolidations targeting local hospitals or providers won’t result in anticompetitive, monopolistic operations that force our families to swallow higher prices and diminished services.”
“The COVID-19 pandemic has exposed the disproportionate access to healthcare in California,” said Senator Monning. “SB 977 will hold unscrupulous healthcare systems accountable to ensure existing services are protected and patient health is the top priority of providers. We must do everything we can at the state level to guarantee Californians have access to affordable healthcare.”
Anticompetitive behavior in the healthcare sector is a growing concern because large healthcare systems can flex their market power to raise prices for patients, employers, and insurers while limiting services and decreasing the quality of care offered to Californians. For example, average prices for hospital care are 35 percent higher in Northern California, where healthcare systems are more consolidated, than in Southern California. The impact of consolidation on prices was reinforced by a 2018 study by professor Richard Scheffler and the Petris Institute at the University of California, Berkeley, which found the percentage of physicians in practices owned by hospitals increased from about 25 percent in 2010 to more than 40 percent in 2016. This increased hospital ownership resulted in an estimated 12 percent increase in premiums from 2014 to 2016 and has led these physician groups to be less flexible and adaptable during the pandemic.
SB 977 would work to improve healthcare affordability and limit anticompetitive behavior by requiring large healthcare systems to gain approval from the Attorney General’s Office before moving forward with any planned affiliation agreement or acquisition. The Attorney General’s determination to approve or deny a transaction will rely on two factors:
- Whether the transaction would truly increase care coordination and/or increase access and affordability of care to an underserved population; and
- Whether the transaction is substantially likely to result in anticompetitive effects that outweigh any benefits.
In addition, SB 977 would declare that healthcare systems that exercise substantial market power may not engage in behavior that has a significant likelihood of anticompetitive effects. These behaviors include: raising market prices, diminishing the quality of care, reducing choice, increasing the total cost of care, and diminishing access or availability of healthcare services. Under SB 977, the Attorney General’s Office would have the ability to file civil actions to recover damages and obtain civil penalties against those that abuse market power.
June 26, 2020: California Attorney General Xavier Becerra tweeted: “My bill w/Sen. Monning to crack down on anticompetitive behavior in the healthcare market & protect patients passed the Senate! With our communities battling the coronavirus pandemic, our healthcare must operate at peak performance.” This tweet was the start of a short thread.
June 26, 2020: California Attorney General Xavier Becerra tweeted: “That means all hands on deck. But we’ve learned the hard way that too often “consolidation” reallly means higher prices and a reduction of services which the surrounding community relies on.”
June 26, 2020: California Attorney General Xavier Becerra tweeted: “W/#SB977, CADOJ will provide the independent set of eyes that communities need to know that consolidations targeting local hospitals or providers won’t result in anticompetitive, monopolistic operations that force our families to swallow higher prices and diminished services.” This was the last tweet in the short thread.
June 26, 2020: Los Angeles Times posted an opinion piece titled: “Opinion: Amid pandemic and recession, the Trump administration attacks 20 million Americans’ health coverage”. It was written by Los Angeles Times Deputy Editorial Editor Jon Healey. From the opinion piece:
The COVID-19 pandemic caused a huge spike in layoffs, leaving tens of millions of Americans without the employer-sponsored health insurance that had protected their families. But the 2010 Affordable Care Act offered a safety net for them — laid-off workers can sign up for replacement coverage for themselves and their families through their state insurance exchanges. And according to the Kaiser Family Foundation’s estimates, nearly 80% of those who’d lost their coverage at work in the pandemic’s first two months were eligible for federal subsidies that lowered the cost of those new policies.
Yet on Thursday, the Trump administration urged the Supreme Court to throw out the ACA because two self-employed Texans assert that the law injures them. In fact, the administration’s brief makes a wholly specious argument that the sections of the law it connects to the plaintiff’s injuries cannot be separated from the portions of the law that extend Medicaid to more poor Americans, improve the quality of care, cut prescription drug costs for the elderly, explore ways to slow the growth of healthcare costs, increase the supply of doctors and nurses, let young adults stay on their parents’ insurance policies, and make it cheaper for everyone to get preventive health services.
Not to put too fine a point on it, but in the middle of a pandemic the administration is demanding the elimination of a law that has extended coverage to roughly 20 million Americans, and that protects some 50 million Americans with preexisting conditions from being gouged or dropped by their insurers…
…The notion that Obamacare does more harm than good has been central to the Republican argument against the law since the day it went into effect. And there’s no question that some people, like the two individual plaintiffs in California et al. vs. Texas et al., have been forced to pay more for coverage, even as millions of others benefited from the new federal subsidies. That’s because the law sought to rein in “junk” policies that didn’t cover many important forms of care and to spread individuals’ risks and costs more broadly. As a consequence, the comprehensive policies offered on the exchanges are costlier than the more limited ones that had typified the market for non-group coverage. And under the law’s individual mandate, every adult American was required to obtain healthcare coverage or pay a tax penalty (unless they qualify for an exemption, such as the one for financial hardship).
The case before the Supreme Court uses that claim of injury to tee up a too clever by half attempt to kill the entire ACA, based on Congress’ decision to excise one small but important part of the law. Unable to repeal the entire act after they took complete control of Congress in 2017, Republicans settled for eliminating the widely disliked tax penalty for people who did not comply with the individual mandate, which remains on the books.
That’s a problem, the plaintiffs in California vs. Texas argue, because the Supreme Court upheld the individual mandate in 2014 only as an exercise of Congress’ power to levy taxes. Removing the tax rendered the mandate unconstitutional, which upends the insurance reforms that are the heart and soul of the law. And if those insurance reforms are off the table, Congress wouldn’t have enacted any of the other provisions of the ACA. Or so the plaintiffs and the Trump administration argue.
The administration is right about one thing here: Congress (and many analysts) viewed the individual mandate as an important stabilizing force for insurers once they were required to take all comers and ignore preexisting conditions. But it was hardly the only stabilizing force; as we’ve seen in the two years since the tax penalty was repealed, average insurance premiums have declined in the state exchanges. The facts on the ground are the strongest argument against the administration’s case.
Oddly, the Trump brief argues most forcefully against the insurance reforms designed to protect people with preexisting conditions — the people Trump insists he cares about, despite Republicans’ multiple efforts to expose them to higher costs. Those provisions are the reason congressional Republicans ultimately abandoned their effort to repeal the ACA, which is why it makes no sense to argue, as the Trump brief does, that Congress wouldn’t want those protections to survive if the individual mandate dies. There’s no need for the court to guess lawmakers’ intent on that issue…
June 27, 2020: President Donald Trump tweeted: “Now that the very expensive, unpopular and unfair Individual Mandate provision has been terminated by us, many States & the U.S. are asking the Supreme Court that Obamacare itself be terminated so that it can be replaced with a FAR BETTER AND MUCH LESS EXPENSIVE ALTERNATIVE…”
June 27, 2020: President Donald Trump tweeted: “…Obamacare is a joke! Deductible is far too high and the overall cost is ridiculous. My Administration has gone out of its way to manage OC much better than previous, but it is still no good. I will ALWAYS PROTECT PEOPLE WITH PRE-EXISTING CONDITIONS, ALWAYS, ALWAYS,ALWAYS!!!”
June 27, 2020: California Attorney General Xavier Becerra responded to President Trump’s second tweet with a tweet of his own: “Bogus: It was just 2 days ago that the Admin. told #SCOTUS they think the ACA “must fall.” Here’s what Trump doesn’t say: The ACA has protected 133+ million people W/PREEXISTING CONDITIONS. We intend to win this fight as we won DACA: w/the facts, law & American people on our side”
June 27, 2020: The Guardian posted an article titled: “Covid-19 survivors could lose health insurance if Trump wins bid to repeal Obamacare”. It was written by Dominic Rushe and Amanda Holpuch. From the article:
Millions of Americans who have survived Covid-19 or face future infections could lose their insurance or be barred from getting coverage should the Trump administration successfully repeal Obamacare.
The Trump administration asked the supreme court late Thursday to overturn the Affordable Care Act – a move that, if successful, would bring a permanent end to the health insurance reform law popularly known as Obamacare.
Under the ACA, insurance companies cannot deny coverage for pre-existing conditions. Its abolition would mean millions of Americans who have had or have cancer, multiple sclerosis or other diseases would struggle to find insurance.
Anyone applying for insurance who subsequently contracts Covid-19 could also find their insurance invalidated or be denied coverage in the future. If they were allowed to keep their insurance, they could still be charged higher premiums or have future treatment for coronavirus turned down.
“Abolishing the ACA would cause tremendous damage and cause chaos throughout the country,” said Karen Pollitz, senior fellow at the Henry J Kaiser Family Foundation.
Anyone buying health insurance who subsequently contracted the coronavirus would face loss of coverage, she said. “If you bought the insurance and then caught the virus, you would be out of luck,” she said.
The abolition of pre-existing condition coverage is especially difficult for those who have Covid-19, because so little is known about the long-term health impact of the disease. There is evidence that the respiratory illness causes permanent damage in some patients. Those who have had the disease and recovered would have to disclose their status to apply for insurance, and could be turned down for coverage.
“We could see tens of millions of people thrown out of coverage,” said Pollitz. “There would be an onslaught of un-insurance.”…
…The supreme court has not scheduled a date for oral arguments in the case, but it is expected to take place in the autumn and a decision would likely not arrive until after the November election…
June 29, 2020: NPR posted an article titled: “Supreme Court Hands Abortion-Rights Advocates A Victory In Louisiana Case”. It was written by Nina Totenberg and Brian Naylor. From the article:
As sharply divided U.S. Supreme Court stood by its most recent abortion-rights precedent Monday, delivering a major defeat to abortion opponents who had hoped for a reversal of fortunes at the court with the addition of two new Trump-appointed justices.
By a 5-4 vote, the court struck down a Louisiana law that was virtually identical to a Texas law it invalidated just four years ago. Chief Justice John Roberts cast the fifth and decisive vote.
Four years ago, the chief justice was among the dissenters when the court struck down a Texas law that required doctors performing clinic abortions to have admitting privileges at a nearby hospital. But on Monday, Roberts joined the court’s liberals in striking down a nearly identical law in Louisiana, even as he stood by the reasoning in his earlier dissent.
The chief justice justified the change in his vote by pointing to the doctrine of stare decisis, which says the court should usually stand by its precedents. It “instructs us to treat like cases alike,” he wrote, and “the Louisiana law burdens women seeking previability abortions to the same extent as the Texas law” did four years ago.
The value of following precedent, he added, is that it “promotes the evenhanded, predictable, and consistent development of legal principles, fosters reliance on judicial principles, and contributes to the actual and perceived integrity of the judicial process.” While precedent is not an “inexorable demand,” simple disagreement with a previous decision is not enough to justify reversing course, he wrote.
In this case, he observed, not only was the Louisiana law at issue virtually identical to the one the court struck down in 2016, but the District Court judge found after an extensive trial that if the law were to go into effect, at minimum two of the three abortion clinics in the state would be forced to close, women would have to wait longer and drive farther for abortions, and only one doctor would likely be left to fill the demand for 10,000 women seeking abortions in the state each year…
…The decision was also a particular repudiation of the 5th U.S. Circuit Court of Appeals, which not only disregarded the Supreme Court’s earlier decision in the Texas case, but disregarded the factual findings of the District Court judge in the Louisiana case. As Roberts observed, the District Court judge, before his ruling, held a six-day trial in the case, and for 18 months monitored the attempts of clinic doctors, who, without success, sought in “good faith” to get the required admitting privileges.
Leah Litman, a professor at the University of Michigan Law School, cautioned that Roberts’ opinion sets out a standard different from the one the court previously adopted.
“The chief justice’s reasoning was actually quite permissive in what it would allow states do to restrict abortions,” she observed.
That said, the decision does appear to send the signal that Roberts is not prepared to uphold state laws that, for instance, ban abortions at six, eight or 12 weeks, or any other time before fetal viability….
…Meanwhile, former Vice President Joe Biden, the presumptive Democratic nominee for president, applauded the Supreme Court for “[reaffirming] that states cannot put in place laws that unduly burden a woman’s right to make her own health care decisions with her doctor.”…
June 29, 2020: EMILY’s List posted a statement on U.S. Supreme Court Ruling in June Medical Services V. Russo”. From the statement:
Today, Stephanie Schriock, president of EMILY’s List, the nation’s largest resource for women in politics, released the following statement on the United States Supreme Court’s ruling in June Medical Services v. Russo, which will protect access to abortion care in Louisiana.
“Today’s Supreme Court decision is a victory for people in Louisiana, particularly communities of color and low-income people, and a blow to deceptive and political efforts to limit abortion access. Even though the Republican Party will stop at nothing to turn back the clock on our reproductive freedom, we’re proud to stand with our allies in the reproductive freedom and justice communities and the majority of Americans in supporting everyone’s ability to make their own health care decisions. While we are grateful for today’s decision, this case is yet another reminder how vital it is to have pro-choice majorities in the Senate and in state legislatures around the country. Voters will not forget that Senators like Susan Collins, John Cornyn, and Joni Ernst confirmed justices who put our reproductive freedom in danger. EMILY’s List won’t stop fighting to elect pro-choice Democratic women at every level of office who will protect essential abortion access.”
June 29, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on June Medical Services v. Russo”. From the statement:
The following is a statement from Maureen G. Phipps, MD, MPH, FACOG, chief executive officer of the American College of Obstetricians and Gynecologists, on today’s decision from the U.S. Supreme Court in the case of June Medical Services, LLC, v. Russo:
“Today, obstetrician-gynecologists from around the country celebrate the Supreme Court’s decision that will help protect the ability of their patients to receive essential care and that affirms physicians’ roles in advocating for their patients. Once again, just as in 2016, the Court has declared that placing onerous, unreasonable requirements on physicians and clinicians who provide abortion creates an unconstitutional burden on patients in violation of the U.S. Constitution.
“ACOG is grateful that the Court continues to consider the expert views of the nation’s medical community, citing the brief we led with 13 other major medical organizations in recognizing that ‘local admitting-privileges requirements for abortion providers offer no medical benefit and do not meaningfully advance continuity of care.’ We are also encouraged that the Court appreciates the patient-physician relationship, which includes for the ability of physicians to advocate in all ways for the health and well-being of their patients, including in the courts.
“ACOG has long led the medical community in opposing burdensome requirements on clinicians who provide essential care, including abortion. Such restrictions do nothing to protect or advance patient safety. As our brief explained, abortion is a very safe medical procedure, and restricting access only makes our patients less safe by forcing them to delay needed abortions or forego them altogether.
“Today’s decision once again affirms that abortion access is a constitutionally protected right. While we celebrate the decision, we also know that access to care continues to be delayed or denied for many women due to systemic inequities and inequalities. We therefore urge legislators to build on the Court’s decision and drive policy solutions that will advance equitable care across the country. ACOG and its members will continue to advocate at every level to enhance our patients’ ability to access quality, essential care.”
June 29, 2020: Center for Reproductive Rights posted a press release titled: “Supreme Court Follows Precedent in Victory for Abortion Rights”. From the press release:
Today, the U.S. Supreme Court ruled in favor of the Center for Reproductive Rights, striking down a Louisiana law that would have closed all but one abortion clinic in the state. The medically unneccessary law would have banned doctors from providing abortion care unless they had admitting privileges at a hospital within 30 miles. The ruling in June Medical Services v. Russo–the first abortion rights case to be heard under the current makeup of the Supreme Court–allows the state’s three remaining clinics to stay open.
Today’s ruling follows precedent from just four years ago in Whole Woman’s Health v. Hellerstedt–a case also won by the Center–in which the Court struck down an identical law in Texas. In that case, the Court held that laws that create more burdens than benefits for people seeking abortion care are unconstitutional. Today’s ruling applies Whole Woman’s Health and reverses the lower court decision that would have upheld the law.
Justice Breyer, delivering a plurality opinion, wrote, “Given the facts found, we must… uphold the District Court’s related factual and legal determinations. These include its determination that Louisiana’s law poses a ‘substantial obstacle’ to women seeking an abortion; its determination that the law offers no significant health-related benefits; and its determination that the law consequently imposes an ‘undue burden’ on a woman’s constitutional right to choose to have an abortion. We also agree with its ultimate legal conclusion that, in light of these findings and our precedents, Act 620 violates the Constitution.”
Statement from Nancy Northup, president and CEO of the Center for Reproductive Rights, reacting to today’s pivotal ruling in favor of abortion providers:
This is a big win that vindicates what we’ve said all along, which is that the Louisiana admitting privileges law is unconstitutional. This is a victory for the people of Louisiana and the rule of law, but this case never should have gotten this far. We won an identical case four years ago in Whole Woman’s Health v. Hellerstedt, and the fact that we had to fight so hard again goes to show that nothing should be taken for granted when it comes to protecting abortion rights. Indeed, the Court did not speak with a clear majority opinion which could muddy the waters when clarity is needed to protect abortion rights.
As a result of this decision, the clinics in Louisiana can stay open to serve the one million women of reproductive age in the state.
This is critical because access to abortion care has a profound impact on a person’s health and life. For this reason, the Constitution protects the most intimate decisions that a person makes about their body, their health, their life, and their future.
Yet for decades, opponents of reproductive rights have relentlessly sought to deny the promise of Roe v. Wade with an avalanche of laws targeting providers, clinics, and patients. These laws disproportionately impact communities of color, young people, rural communities, and people living in poverty. In Louisiana, abortion restrictions disproportionately harm African Americans who already live under the weight of systemic racism that pervades every aspect of American life including housing, voting, education, employment, and health. Louisiana lawmakers should be addressing these ingrained inequities rather than taking people’s rights away.
Unfortunately, the Court’s ruling today will not stop those hell-bent on banning abortion. We will be back in court tomorrow and will continue to fight state by state, law by law to protect our constitutional right to abortion. But we shouldn’t have to keep playing whack-a-mole. It’s time for Congress to pass The Women’s Health Protection Act, a federal bill that would ensure the promise of Roe v. Wade is realized in every state for every person.
June 29, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris Statement on Supreme Court Striking Down Unconstitutional Restriction on Abortion”. From the press release:
U.S. Senator Kamala D. Harris (D-CA) on Monday released the following statement in response to the ruling by the U.S. Supreme Court in the case June Medical Services LLC v. Russo.
“Today’s Supreme Court decision preserved access to abortion. Thanks to this ruling, health clinics in Louisiana will be able to remain open and continue providing safe, legal abortion care. The Court struck down a Louisiana law designed to shutter reproductive health clinics and make abortion virtually impossible to access for people in the state. This ruling is especially important for low-income people and people of color whose health and financial security are more likely to be impacted by barriers to comprehensive reproductive health care.
“While the Court reached the right result today, we must nonetheless keep up the fight to protect access to abortion. That is why it is incumbent upon Congress to pass the Women’s Health Protection Act, which would prohibit states from enacting laws that impose burdensome requirements on access to abortion.”
June 29, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on June Medical Services v. Russo”. From the press release:
Speaker Nancy Pelosi issued this statement after the U.S. Supreme Court struck down Louisiana’s draconian abortion restrictions:
“Today, the Supreme Court issued a victory for women’s health and freedoms and for the Constitution. The highest court in the land has adhered to precedent as it maintains the constitutional right to women’s basic reproductive health care.
“As Republicans continue their assault nationally on Roe v Wade, they are also fighting on a state by state basis. Louisiana’s draconian abortion ban was a clear and intentional violation of the Constitution, explicitely designed to permanently destroy women’s reproductive freedoms and dismantle their right to make their own decisions about their health, bodies and timing and size of their families. This ruling is a win for the people of Louisiana – but we must be ever-vigilant against the Republicans’ dangerous, nationwide assault against women’s reproductive health freedoms.
“Democrats will continue to fight partisan attacks on women’s health and freedoms, as we defend the constitutional right to comprehensive health care and reproductive freedoms.”
June 29, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Helps Win Supreme Court Case Guaranteeing Women’s Access to Abortion Coverage”. From the press release:
New York Attorney General Letitia James today helped win a major victory at the U.S. Supreme Court that will protect the ability of women across the nation to maintain access to safe, legal abortions. Attorney General James led a coalition of 22 attorneys general in filing an amicus brief in support of the plaintiffs in the case of June Medical Services v. Gee, in which a medical provider sought to overturn a decision from the U.S. Court of Appeals for the Fifth Circuit that upheld a Louisiana law requiring abortion providers to maintain admitting privileges at local hospitals. The law at issue was identical to the Texas law that the Supreme Court invalidated in Whole Woman’s Health v. Hellersedt, in 2016. The Supreme Court today reaffirmed its ruling in Whole Woman’s Health and held that the Louisiana law was unconstitutional, as it infringes on women’s reproductive freedoms and the right to access an abortion, enshrined in the landmark Supreme Court decision of Roe v. Wade in 1973.
“More than 45 years after Roe v. Wade etched into law a woman’s right to access an abortion, states continue to look for ways to chip away at this constitutional guarantee and place burdensome restrictions on women’s reproductive freedoms,” said Attorney General James. “But today’s Supreme Court decision once again makes clear that this right and constitutional guarantee cannot be infringed upon and no roundabout law will push us back to a time of back alley abortions. Despite all the progress made in women’s freedoms over the last five decades, the state of Louisiana has continued to strive to regulate women’s bodies and deprive them of one of their most important constitutional rights. This law was simply about controlling women’s bodies, controlling their choices, and controlling their freedom, which is why we fought it every step of the way.”
In 2014, Louisiana enacted a law that requires abortion providers to maintain admitting privileges at local hospitals. Had the Supreme Court not struck down this law today, Louisiana would be left with, at most, two physicians at only two clinics across the state who could provide abortion services, despite the fact that roughly 10,000 women obtain abortions in Louisiana each year. Louisiana’s admitting-privileges requirement was identical to a Texas statute that was invalidated and found to be unconstitutional by the Supreme Court in Whole Woman’s Health v. Hellerstedt. Earlier in the case, the U.S. District Court for the Middle District of Louisiana granted a permanent injunction against implementation of the Louisiana law, but, in 2018, the U.S. Court of Appeals for the Fifth Circuit reversed that decision. June Medical Services and two physicians appealed the decision to the Supreme Court, which granted an emergency application to stay the law from taking effect, pending the outcome of the appeal.
In December, Attorney General James led a coalition of attorneys general in filing an amicus brief in the case because states have an interest in ensuring the availability of safe, medically sound abortion services and in protecting the health and safety of women seeking abortion services, as well as defending the long-recognized, substantive due process right to choose to terminate a pregnancy and the undue-burden standard that governs review of regulations implicating that right. In the brief, the attorneys general argued that Louisiana’s law is an unnecessary and onerous burden that fails to promote women’s health and would end up further limiting the number of abortion providers available to women in Louisiana.
This case was handled by Assistant Solicitor General Ester Murdukhayeva, Deputy Solicitor General Andrea Oser, and Solicitor General Barbara D. Underwood — all of the Division of Appeals and Opinions.
June 29, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Floor Speech in Support of the Patient Protection and Affordable Care Enhancement Act”. From the press release:
Speaker Nancy Pelosi delivered remarks on the Floor of the House of Representatives in support of H.R. 1425, the Patient Protection and Affordable Care Enhancement Act, House Democrats’ For the People legislation to build on the Affordable Care Act to lower health costs and prescription drug prices. Below are the Speaker’s remarks:
…But here, today, we are focused on that first For The People priority. Access to affordable care is a matter of life and death. That’s so self-evident as we see every day in the COVID-19 crisis, which has killed more than 125,000 Americans, infecting 2.5 million Americans and that has left tens of millions of people without jobs.
As Dr. King once said, ‘Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.’ Yes. As lives are shattered by the coronavirus, the protections of the Affordable Care Act are more important now, more than ever. And this is a health justice issue.
Democrats, with this bill, will strengthen America’s health and financial security during this time of crisis and for years to come. It lowers Americans’ health care coverage, significantly increasing the Affordable Care Act’s affordability subsidies to be more generous and cover more middle-class families. It negotiates lower prescription drugs, drawing from our H.R. 3 legislation, to ensure that Americans no longer have to pay more for our medicines that big pharma charges for the same drugs overseas.
This has been a long-term goal of Democrats in the Congress. In 2006, when we were running and won the Majority, our For The People agenda, that equivalent agenda was ‘A New Direction for America: Six for ’06,’ and we had six bills we said would pass immediately after obtaining the Majority. Well, we passed all six of them in the House of Representatives. Five of them became law. Only one of them did not: the law enabling the Secretary of HHS to negotiate for lower prescription drug prices.
This has been a fight over the years that we continue to make it because it is central to not only to the health, but financial health and security of America’s working families. In addition, this legislation expands coverage and pushes hold-out states to adopt Medicaid expansion for the 4.8 million cruelly excluded from the coverage. It combats inequities in health coverage faced by communities of color, expanding more affordable coverage to vulnerable populations and fighting the maternal mortality epidemic. And it cuts down on junk plans. They are such a rip: ‘Let me just pay you every – all the time for my health insurance but you won’t be there for me when I need care.’ So, it cracks down on those junk plans and strengthens coverage for people with pre-existing conditions.
What is interesting in this whole debate is to hear the President and Members on the other side of the aisle say, oh, they are all for protecting pre-existing conditions. Oh really? Then why are you in the United States Supreme Court to overturn them?
And, now, just back to this bill, according to the Center for Budget and Policy Priorities, our legislation that we have on the Floor today would help well over – would lower the costs for well over 17 million more Americans and safeguard the Affordable Care Act’s life-saving protections for the 130 million Americans with pre-existing conditions.
When they say they are for allowing people with pre-existing conditions to get coverage, they don’t say at what costs. This is one of the biggest differences – well, with stiff competition – but one of the biggest differences between Democrats and Republicans, we guarantee affordability and protect the pre-existing medical condition as not being an obstacle to access. They are in court trying to overturn it.
Sadly, and this is a stark contrast as I pointed out, as Democrats unveiled our legislation last week, President Trump went to the Court doubling down on his lawsuit to tear down the ACA and dismantle every one of its protections, including the pre-existing medical condition benefit. At a time when families need health care more than ever, the President is trying to strip protections from about 130 million Americans with pre-existing conditions and take coverage away from 23 million Americans. That does not even go into what he is trying to do to the enhanced benefit that all Americans with health care enjoy.
We need to build on the progress of the Patient Protection Affordable Care Act to lower health costs and prescription drug costs, not rip Americans’ health care in the middle of a pandemic. What sense does that make?
One day – on day one of this Congress, led by Representative Allred, the House voted to throw our legal weight in [defeating] this lawsuit. Yet, 190 Republicans voted against that Resolution, choosing to be fully complicit in the President’s attempt to tear away health protections. We continue to call on the President to abandon his lawsuit to destroy the Affordable Care Act and urge him, instead, to call on the fourteen states who have refused to expand Medicaid, to do so.
Doesn’t it just make sense at a time of a pandemic? It’s always important. It would have been amusing if this were not deadly serious to hear Senator Cornyn say, ‘Well, these people who’ve lost their jobs because of this pandemic can always sign up for the Affordable Care Act.’ Really, but you’re trying to take it down? The Administration has a responsibility to defend the law of the land, not to tear it down.
Today, Members of Congress have the choice: to strengthen America’s health care protections and lower health care costs or be complicit, once again I use that word, in President Trump’s campaign to dismantle families’ health care. Make no mistake, a vote against this bill is a vote to weaken Americans’ health and financial security during a pandemic…
…With this bill, Democrats in the House are offering our salute to good health to the American people, and we hope the Republicans would join us in that salute to good health to the American people.
With that, I urge a strong vote for the Patient Protection Affordable Care Enhancement Act, for the people, for the children, for the future. With that, I yield back.
June 29, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL President Ilyse Hogue Comments on Supreme Court Decision in June Medical Services v. Russo”. From the press release:
The U.S. Supreme Court today issued its decision in June Medical Services LLC v. Russo, striking down a medically unnecessary clinic shutdown law in Louisiana as unconstitutional. The law threatened to decimate abortion access in Louisiana, where access is already extremely restricted. NARAL Pro-Choice America President Ilyse Hogue released the following statement in response to the decision:
“Today’s decision is a win for women in Louisiana who will continue to have access to the time-sensitive abortion care they need. It’s a win for truth and fact-based decision making, as even a Court tilted so far right couldn’t ignore the concrete arguments and data showing that public health is compromised by these burdensome restrictions on abortion. Finally, today’s decision shows that advocates can make a difference. Support for Roe v. Wade is at an all-time high in this country and so many made their voices heard through this process. The Court’s legitimacy in the eyes of the public will be threatened if they follow through on Trump’s promise to end legal abortion.
This win, however, doesn’t change the simple fact that reproductive freedom in the United States remains on the line thanks to anti-choice extremists who have shown time and again that they will stop at nothing to advance their dangerous ideological agenda and a Court still looking for ways to accommodate them.
In this moment of turmoil for our country, fighting for the fundamental rights of every body is more important than ever. That’s why we cannot and will not back down in the face of these relentless attacks on our ability to determine our own destinies. We will fight with everything we have to make sure the politicians like Senators Susan Collins, Joni Ernst, Thom Tillis, and Cory Gardner, who rubber-stamped Trump and Mitch McConnell’s efforts to stack our courts with radical right ideologues, are held accountable for putting our freedom at risk. Anti-choice politicians be warned: The 77% of Americans who support the legal right to abortion care won’t forget what you did—and you’ll be answering to us this November.”
June Medical Services LLC v. Russo challenged a dangerous Louisiana law that would have gutted abortion access in the state by requiring doctors to have medically unnecessary admitting privileges at a local hospital. The clinic shutdown law at issue in the case was identical to one blocked in another case, Whole Woman’s Health v. Hellerstedt, decided by the Supreme Court in 2016 before Brett Kavanaugh and Neil Gorsuch joined the Court. These restrictions are based on disinformation pushed by the anti-choice, anti-freedom movement that falsely claims restrictions like this help women, though there is no medical benefit to mandating admitting privileges and they do nothing to make women safer. In truth, the evidence overwhelmingly shows that abortion care is extremely safe and leading medical experts oppose restrictions like the one the Supreme Court considered in this case because they block “access to quality, evidence-based medicine.”
Reproductive freedom is under attack in the United States like never before. Since Brett Kavanaugh’s confirmation to the U.S. Supreme Court tipped the balance of the bench to an anti-choice, anti-freedom majority, lawmakers hostile to abortion have launched an all-out assault on reproductive rights in hopes that a challenge will make its way to the Court and end Roe v. Wade. Since Kavanaugh’s confirmation, emboldened anti-choice politicians have pounced on any and every opportunity to gut the landmark abortion rights case. Extreme bans on abortion were introduced, passed, or signed in 31 states in 2019 alone, and more than two dozen cases are in the pipeline that could completely overturn Roe.
As NARAL has said from the beginning, we can’t forget who put Justices Kavanaugh and Gorsuch on the Court in the first place. Donald Trump’s judicial nominees are beholden to the anti-choice movement and with a majority on the Court hostile to reproductive freedom, our fundamental rights remain on the line.
As the Trump administration and anti-choice extremists across the country target reproductive rights in their quest to maintain white patriarchy and control women, NARAL has embarked on its multi-faceted, largest-ever electoral program for the 2020 election. Key to NARAL’s strategy is reaching, persuading, and mobilizing key voter segments including soft-partisan persuadable women voters, and low-propensity pro-choice voters who are motivated by Trump and Republicans’ commitment to ending Roe v. Wade, criminalizing abortion, and punishing women. These critical voting blocs value reproductive freedom and align with the 77% of Americans who support Roe v. Wade.
The anti-choice movement has spent decades working overtime to destroy access to abortion, state by state, law by law. This Louisiana law was just one part of a coordinated effort by the anti-choice radical right to gut Roe v. Wade and advance their agenda of power and control. Since 2011, anti-choice politicians have pushed nearly 450 laws restricting reproductive freedom through state legislatures.
This case underscores the need for federal protections for abortion rights. Passing the Women’s Health Protection Act (WHPA) would guarantee the right to abortion and defend against the onslaught of abortion bans and restrictions from state legislatures across the country—even if the Supreme Court guts Roe or state governments pass legislation restricting reproductive freedom.
June 29, 2020: Center for Reproductive Rights posted a press release titled: “STATEMENT: Supreme Court Rules in favor of Abortion Providers in June Medical v. Russo”. From the press release:
Statement from Nancy Northup, president and CEO of the Center for Reproductive Rights, reacting to today’s pivotal ruling in favor of abortion providers:
This is a big win that vindicates what we’ve said all along, which is that the Louisiana admitting privileges law is unconstitutional. This is a victory for the people of Louisiana and the rule of law, but this case never should have gotten this far. We won an identical case four years ago in Whole Woman’s Health v. Hellerstedt, and the fact that we had to fight so hard again goes to show that nothing should be taken for granted when it comes to protecting abortion rights. Indeed, the Court did not speak with a clear majority opinion which could muddy the waters when clarity is needed to protect abortion rights.
As a result of this decision, the clinics in Louisiana can stay open to serve the one million women of reproductive age in the state.
This is critical because access to abortion care has a profound impact on a person’s health and life. For this reason, the Constitution protects the most intimate decisions that a person makes about their body, their health, their life, and their future.
Yet for decades, opponents of reproductive rights have relentlessly sought to deny the promise of Roe v. Wade with an avalanche of laws targeting providers, clinics, and patients. These laws disproportionately impact communities of color, young people, rural communities, and people living in poverty. In Louisiana, abortion restrictions disproportionately harm African Americans who already live under the weight of systemic racism that pervades every aspect of American life including housing, voting, education, employment, and health. Louisiana lawmakers should be addressing these ingrained inequities rather than taking people’s rights away.
Unfortunately, the Court’s ruling today will not stop those hell-bent on banning abortion. We will be back in court tomorrow and will continue to fight state by state, law by law to protect our constitutional right to abortion. But we shouldn’t have to keep playing whack-a-mole. It’s time for Congress to pass The Women’s Health Protection Act, a federal bill that would ensure the promise of Roe v. Wade is realized in every state for every person.
June 30, 2020: American Academy of Pediatrics (AAP) posted news titled: “Study: Public charge rule having a chilling effect on immigrant families’ use of public programs”. It was written by Melissa Jenco. From the news:
Nearly one-third of low-income immigrant families with children avoided using public benefits because of green card concerns, according to a new study.
“Such chilling effects are very concerning given that access to nutritious food, affordable health insurance coverage and stable housing are essential to children’s healthy development and to families’ material well-being and psychological health, particularly during the COVID-19 pandemic when the need for public assistance is high,” researchers from the Urban Institute wrote in their report.
In 2018, the Trump administration proposed changing the public charge rule, expanding authorities’ ability to consider immigrants’ use or likely use of public programs when deciding whether they can enter the U.S. or advance through the immigration process. The rule went into effect earlier this year despite opposition from the Academy and other advocates who feared immigrant families would forgo essential health services.
Urban Institute researchers measured this chilling effect through a nationally representative survey in December 2019 that included 949 adults from immigrant families living with children.
They found 20% avoided a public health benefit such as the Supplemental Nutrition Assistance Program, Medicaid or housing assistance that year. Among low-income families, 31.5% avoided these programs.
Drilling down further, the data showed 11% of the families, including 17% of those who are low-income, avoided a nutrition program. Roughly 11% of the immigrant families and 16% of those who were low-income avoided a medical program. Authors said these figures may be even higher now that the rule has gone into effect.
Some families avoided programs they may not have realized were not part of the public charge rule such as the Special Supplemental Nutrition Program for Women, Infants, and Children and free or reduced-price school lunches. Many parents did not know the rule excludes benefits used by children.
Some families avoided programs they may not have realized were not part of the public charge rule such as the Special Supplemental Nutrition Program for Women, Infants, and Children and free or reduced-price school lunches. Many parents did not know the rule excludes benefits used by children.
“Although the public charge rule excludes benefits used by children as a factor in their parents’ public charge determination, reluctance to participate in public programs out of fear or confusion about immigration consequences could make it even harder for immigrant families with children to address their basic needs,” authors wrote.
The findings come just weeks after another Urban Institute report found the COVID-19 pandemic has exacerbated hardships for low-income and minority families. Authors said Congress should include immigrant families in pandemic relief efforts and that community organizations should be prepared to provide additional assistance. Advocates also should ensure families know they can seek testing and treatment for COVID-19 without it being counted against their green card or visa application.
June 30, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on New Florida Law Requiring Written Consent for Pelvic Examinations”. From the statement:
The following is a statement from Maureen G. Phipps, MD, MPH, FACOG, chief executive officer of the American College of Obstetricians and Gynecologists, and Guy I. Benrubi, MD, FACOG, chair of ACOG District XII:
“Government serves a valuable role in the protection of public health and safety and the provision of essential health services. The American College of Obstetricians and Gynecologists (ACOG) supports this proper role of government. Laws that veer from these functions and unduly interfere with patient–physician relationships are not appropriate. Absent a substantial public health justification, government should not interfere with individual patient–physician encounters. The patient–physician relationship is essential to the provision of safe and quality medical care and should be protected from unnecessary governmental intrusion.
“Doctors and patients weigh a variety of factors when making joint care decisions. A patient’s medical needs, history, symptoms, and personal values and preferences are all part of shared decision-making. When legislators dictate specific medical practices, it represents a gross intrusion in the patient–physician relationship.
“On June 18, 2020, Governor Ron DeSantis signed a bill into law that imposes burdensome requirements on women’s health care through requiring written consent for any pelvic examination, whether it be done in a hospital setting, physician’s office, by a nurse practitioner, or otherwise. This law takes effect on July 1, 2020. While the goal of this bill was initially to protect patients in certain training contexts, the legislation was amended to contain broad-sweeping language that means that in Florida any health care practitioner is prohibited from providing any pelvic examination on a patient—a common, medically appropriate procedure—without the written consent of the patient.
“All too often, legislators single out women’s health for regulations and mandates. This is not only another specific example but could set a dangerous a precedent for further efforts to single out women’s health, particularly their sexual health.
“The ethical principle of informed consent requires a process defined by individualized conversations based on individual patients’ needs. Patient autonomy and informed consent cannot be realized by a state-mandated form or scripted conversation. Rather, it is achieved through mutual sharing of information and individualized conversations between health care professionals and their patients based on each patient’s unique needs. This fundamental principle guides our practices.
“While this legislation may have been well intended in its original form, it was changed very late in the legislative session to broaden the original intended scope. The actual impact will be to interfere in the patient–physician relationship and to hold women’s health care to a different standard than other care. ACOG opposes this intrusion in the patient–physician relationship and will be working with other allied groups who are impacted by this new law to repeal this requirement.”
June 30, 2020: The Hill posted an article titled: “Florida governor signs abortion bill requiring parental consent for minors”. It was written by J. Edward Moreno. From the article:
Florida Gov. Ron De Santis (R) on Tuesday signed a bill that requires anyone under 18 to receive parental consent for abortions.
The bill, which was passed by the legislature earlier this year and goes into effect on July 1, would prohibit doctors from performing the procedure on minors unless they first get a notarized letter from a parent or guardian. Under previous law, people under the age of 18 needed to inform a parent or legal guardian before undergoing the procedure.
Doctors who perform abortions without parental consent will face third-degree felony penalties.
A minor is able to petition their corresponding circuit court and receive a judicial waiver of parental consent…
…Planned Parenthood of Florida said that the law passed Tuesday could put minors experiencing abuse in danger.
“Even as other states like Massachusetts and Illinois are realizing the damage these forced parental consent laws are doing and working to reverse them, Florida is moving full speed to endanger young people who, in many cases, have experienced abuse at the hands of their own parents or guardians,” the organization said in a statement.
June 30, 2020: Florida Alliance of Planned Parenthood Affiliates posted a press release titled: “DeSantis signs bill opening door to all out abortion ban”. From the press release:
In spite of Florida still being in the thick of a pandemic, today Gov. Ron DeSantis signed HB 265/SB 404, forced parental consent for abortion, into law.
“This law will put already at-risk young people in even greater danger at the worst possible time,” said Stephanie Fraim, President and CEO of Planned Parenthood of Southwest and Central Florida. “What’s worse, it could open the door to a reinterpretation of our constitutional right to privacy and the right to a safe and legal abortion in Florida.”
Even as other states from Massachusetts to Illinois are realizing the damage these forced parental consent laws are doing and working to reverse them, Florida is moving full speed ahead to further endanger young people who, in many cases, have experienced abuse at the hands of their own parents and guardians.
Throughout the legislative process, supporters of the bill argued it would keep young people safer but medical experts have concluded just the opposite.
According to the American Academy of Pediatrics, in the best of times, “legislation mandating parental involvement does not achieve the intended benefit of promoting family communication, and it increases the risk of harm to the adolescent by delaying access to appropriate medical care.”
The truth is, most young people already seek the advice of their parent or guardian in this situation. Too often, for the ones who don’t it’s because they fear retribution. It could even be that their parent or guardian is an abuser and the reason they’re pregnant in the first place.
The bill sponsors point to a process where these young people can go to court to get a bypass allowing them to access abortion care without parental consent in certain cases. Unfortunately, research has shown more than half the county clerks of court in Florida could offer little to no information about this process when surveyed. And that was before the coronavirus pandemic that is overwhelming health care providers and has closed down not just hotels and restaurants, but many of our courts.
Given the restricted access to our courts, we’re concerned this public health crisis may now make a difficult situation – accessing timely abortion care – nearly impossible for our most at risk young people, including Black and Latinx youth.
Black and Latinx communities have had less access to health care and dramatic health care disparities. We see these results in the ravages of COVID-19.
If Black and Latinx people do not have the right to bodily autonomy to live their daily lives — or protest the violence against their lives — without the fear of violence or murder, we can never achieve justice, let alone reproductive freedom.
“We have opposed this legislation from the start as bad public policy,” said Lillian Tamayo, President and CEO of Planned Parenthood of South, East and North Florida. “But the truth is, it’s worse than that. When this law goes into effect on July 1 Florida will be a more dangerous place for our young people. And if this is used, as has been threatened, as a stepping stone to an all-out abortion ban, the last place in the southeast to access safe and legal abortion will be gone.”
June 30, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Tester, Colleagues to Trump Administration: Don’t Rip Away Health Care for Millions During Public Health Crisis”. From the press release:
As the Trump Administration moves full-steam ahead to dismantle the health care law that provides coverage for millions of Americans, U.S. Senator Kamala D. Harris (D-CA) on Tuesday joined Senator Jon Tester (D-MT) and 46 of their colleagues in introducing a resolution putting in the official Senate record their condemnation of that “reckless” effort and demanding the Department of Justice (DOJ) to defend existing law in court and halt its efforts to repeal the health care protections for millions – including 133 million Americans with pre-existing conditions— in the middle of a public health emergency.
“The Trump administration’s latest attempt to rip health care away from millions of Americans in the midst of pandemic is cruel,” said Harris. “Without the Affordable Care Act, millions of people in California and across the nation would be denied quality health coverage. While the administration continues to attempt to dismantle the ACA, we must remain committed to ensuring that everyone has access to affordable health care.”
“This reckless effort puts millions of Americans – and thousands of Montanans – at risk at a time when they can afford it least,” Tester said. “Ripping away health coverage during a public health crisis is as irresponsible as it is cruel, and jeopardizes lives, our economy, and the rural Montana hospitals that rely on it to keep their doors open. While the Affordable Care Act is not perfect, scrapping it with no replacement would mean putting millions out in the cold in the middle of a global health emergency, and I will keep fighting every day to make sure access to quality, affordable health care is there for the folks who rely on it most.”
Last week, the DOJ and a group of Republican Attorneys General submitted a brief to the U.S. Supreme Court urging it to invalidate the Affordable Care Act (ACA) and pull the rug out from underneath the millions of Americans with pre-existing conditions who depend on the law for health care coverage. If the Supreme Court agrees and overturns the ACA, 112,000 Montanans could lose coverage, including the 85,000 Montanans enrolled through Medicaid expansion and 7,000 Montanans under the of age 26 who have stayed on their parents’ health coverage could lose their care.
Additionally more than 425,000 Montanans who have a pre-existing conditions could once again face annual or lifetime caps, medical underwriting for their insurance coverage, or denials for the care they need. Across the board, the state would lose billions of dollars in federal funds, causing significant job losses and jeopardizing the viability of Montana’s rural and frontier hospitals. All of this would happen in the midst of a global health crisis that has already strapped providers across Montana.
The resolution urges DOJ to reverse its position and instead protect the millions of people who rely on the ACA for health care coverage amid the COVID-19 pandemic that has infected more than 2.5 million Americans and killed more than 125,000.
The resolution is also backed by Senators Jeanne Shaheen (D-NH), Joe Manchin (D-WV), Tim Kaine (D-VA), Mark Warner (D-VA), Doug Jones (D-AL), Tina Smith (D-MN), Mazie Hirono (D-HI), Jack Reed (D-RI), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Michael Bennet (D-CO), Tom Carper (D-DE), Dick Blumenthal (D-CT), Ed Markey (D-MA), Dick Durbin (D-IL), Ben Cardin (D-MD), Patty Murray (D-WA), Jacky Rosen (D-NV), Debbie Stabenow (D-MI), Chris Murphy (D-CT), Ron Wyden (D-OR), Maggie Hassan (D-NH), Gary Peters (D-MI), Amy Klobuchar (D-MN), Martin Heinrich (D-NM), Elizabeth Warren (D-MA), Kyrsten Sinema (D-AZ), Angus King (I-ME), Tom Udall (D-NM), Sheldon Whitehouse (D-RI), Bob Menendez (D-NJ), Dianne Feinstein (D-CA), Brian Schatz (D-HI), Chris Coons (D-DE), Patrick Leahy (D-VT), and Bernie Sanders (I-VT).
A copy of the resolution is available HERE.
June 30, 2020: Planned Parenthood Advocates in Missouri posted a press release titled: “In the Midst of a Pandemic, Missouri Supreme Court Delivers a Victory for Patients Who Need Care”. From the press release:
In a decision issued today, the Missouri Supreme Court ruled that the effort by politicians in the state legislature to prevent Medicaid patients from receiving care from Planned Parenthood was unlawful. The Missouri Legislature unlawfully used the budget to “defund” Planned Parenthood health centers, which provide thousands of Missouri safety-net patients with vital preventive care like birth control, cancer screenings, and STI testing and treatments. The decision came during a public health emergency amidst a worldwide pandemic. Despite this ruling, Gov. Parson today signed off on another unlawful budget that discriminates against patients.
Statement from M’Evie Mead, director of policy and organizing at Planned Parenthood Advocates in Missouri:
“Today is a victory for Planned Parenthood patients who rely on public health insurance programs to stay healthy. Planned Parenthood health centers across the state have protected our communities’ health care needs by providing preventive services to thousands of patients. It’s unconscionable for Gov. Parson to continue trying to defund safety-net providers like Planned Parenthood while Missouri is struggling to contain the COVID-19 pandemic.
“At a time when our health care system is stretched to the brink and our state is in the middle of a public health crisis, Gov. Parson and the legislature should be doing everything they can to support safety-net providers and the patients they serve, not trying to score political points by cutting access to care.”
This case underscores aggressive attacks from state lawmakers and Gov. Parson on all aspects of reproductive health care. Under Parson’s watch, public health outcomes are alarming. Maternal mortality rates in Missouri are more than one third higher than the national average. Black women are three to four times likelier than white women to die from pregnancy-related complications. A syphilis outbreak is sweeping the state. Gov. Parson says he values life, but his actions are endangering Missourians’ health and yes, their lives.
Missouri’s 11 Planned Parenthood health centers are a crucial component of the safety net, providing comprehensive and accessible health care to thousands of patients each year. Planned Parenthood offers Pap tests and a full range of birth control options, including long-acting reversible contraception (LARC) — the most effective form of birth control. Additionally, each Planned Parenthood has evening or weekend hours, and offers patients same-day or next-day appointments in most cases.
A report found that besides Planned Parenthood, only seven percent of more than 600 safety-net providers in the state offer comprehensive and accessible care. Missouri’s health care safety net is already strained — it needs more resources, not fewer providers. “Defunding” Planned Parenthood leaves many patients with nowhere to turn for the vital preventive care they need because the remaining health centers cannot absorb them.
June 30, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Tester, Colleagues to Trump Administration: Don’t Rip Away Health Care for Millions During Public Health Crisis”. From the press release:
As the Trump Administration moves full-steam ahead to dismantle the health care law that provides coverage for millions of Americans, U.S. Senator Kamala D. Harris (D-CA) on Tuesday joined Senator Jon Tester (D-MT) and 46 of their colleagues in introducing a resolution putting in the official Senate record their condemnation of that “reckless” effort and demanding the Department of Justice (DOJ) to defend existing law in court and halt its efforts to repeal the health care protections for millions – including 133 million Americans with pre-existing conditions— in the middle of a public health emergency.
“The Trump administration’s latest attempt to rip health care away from millions of Americans in the midst of pandemic is cruel,” said Harris. “Without the Affordable Care Act, millions of people in California and across the nation would be denied quality health coverage. While the administration continues to attempt to dismantle the ACA, we must remain committed to ensuring that everyone has access to affordable health care.”
“This reckless effort puts millions of Americans – and thousands of Montanans – at risk at a time when they can afford it least,” Tester said. “Ripping away health coverage during a public health crisis is as irresponsible as it is cruel, and jeopardizes lives, our economy, and the rural Montana hospitals that rely on it to keep their doors open. While the Affordable Care Act is not perfect, scrapping it with no replacement would mean putting millions out in the cold in the middle of a global health emergency, and I will keep fighting every day to make sure access to quality, affordable health care is there for the folks who rely on it most.”
Last week, the DOJ and a group of Republican Attorneys General submitted a brief to the U.S. Supreme Court urging it to invalidate the Affordable Care Act (ACA) and pull the rug out from underneath the millions of Americans with pre-existing conditions who depend on the law for health care coverage. If the Supreme Court agrees and overturns the ACA, 112,000 Montanans could lose coverage, including the 85,000 Montanans enrolled through Medicaid expansion and 7,000 Montanans under the of age 26 who have stayed on their parents’ health coverage could lose their care.
Additionally more than 425,000 Montanans who have a pre-existing conditions could once again face annual or lifetime caps, medical underwriting for their insurance coverage, or denials for the care they need. Across the board, the state would lose billions of dollars in federal funds, causing significant job losses and jeopardizing the viability of Montana’s rural and frontier hospitals. All of this would happen in the midst of a global health crisis that has already strapped providers across Montana.
The resolution urges DOJ to reverse its position and instead protect the millions of people who rely on the ACA for health care coverage amid the COVID-19 pandemic that has infected more than 2.5 million Americans and killed more than 125,000.
The resolution is also backed by Senators Jeanne Shaheen (D-NH), Joe Manchin (D-WV), Tim Kaine (D-VA), Mark Warner (D-VA), Doug Jones (D-AL), Tina Smith (D-MN), Mazie Hirono (D-HI), Jack Reed (D-RI), Chris Van Hollen (D-MD), Catherine Cortez Masto (D-NV), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Michael Bennet (D-CO), Tom Carper (D-DE), Dick Blumenthal (D-CT), Ed Markey (D-MA), Dick Durbin (D-IL), Ben Cardin (D-MD), Patty Murray (D-WA), Jacky Rosen (D-NV), Debbie Stabenow (D-MI), Chris Murphy (D-CT), Ron Wyden (D-OR), Maggie Hassan (D-NH), Gary Peters (D-MI), Amy Klobuchar (D-MN), Martin Heinrich (D-NM), Elizabeth Warren (D-MA), Kyrsten Sinema (D-AZ), Angus King (I-ME), Tom Udall (D-NM), Sheldon Whitehouse (D-RI), Bob Menendez (D-NJ), Dianne Feinstein (D-CA), Brian Schatz (D-HI), Chris Coons (D-DE), Patrick Leahy (D-VT), and Bernie Sanders (I-VT).
A copy of the resolution is available HERE.
A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four: April, May, June is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.
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