This blog post covers that damage that the Trump Administration – and the GOP – have done in an effort to restrict and remove access to health care from the American people. The series could be described as “receipts”.

This blog post has the “reciepts” about the ways that the Trump Administration and the GOP tried to destroy not only the Affordable Care Act, but also Medicaid, Medicare, and other health programs that Americans rely on.

This blog post also highlights everything that the Democrats (and other people outside of government) have done in an effort to protect American’s access health care – of all types. That includes protections for DACA recipients and people who are LGBTQ+.

You may want to take a look at previous blog posts in this series. Doing so will give you an overall picture of what the Trump Administration and the GOP have done to harm American’s health since 2017.

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 Attempt to Destroy Obamacare – Part Four

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four: April, May, June

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four; July, August, September

October

October 1, 2020: American Medical Association (AMA) posted a press release titled: “AMA petitions U.S. Supreme Court to review Title X restrictions”. From the press release:

The American Medical Association (AMA) today petitioned the U.S. Supreme Court to review a Court of Appeals decision upholding a 2019 Trump administration rule that imposed drastic changes on the Title X family planning program, inappropriately interfering with open communications between patients and health care professionals. The AMA’s petition was joined by Planned Parenthood Federation of America (PPFA), the National Family Planning & Reproductive Health Association (NFPRHA), the American Civil Liberties Union (ACLU), Essential Access Health (EAH), the Oregon Medical Association and others.

The petition asserts that the high court’s review is warranted following conflicting decisions by the Fourth Circuit and Ninth Circuit, leaving unresolved questions of law about an essential federal health care program. The Fourth Circuit found the Title X rule invalid, while the Ninth Circuit upheld the rule.

The petitioners argue that until the Ninth Circuit’s erroneous decision is corrected, the administration’s gag rule is harming patient care and causing physicians and other health care professionals to violate ethical obligations by preventing Title X clinics from providing full information to patients about all of their reproductive care options. This marks the first time in recent history the AMA has petitioned the U.S. Supreme Court, further underscoring the government’s significant overstep in issuing the rule.

“The AMA strongly believes that our nation’s highest court must step in to remove government overreach and interference in the patient-physician relationship. Restricting the information that physicians can provide to their Title X patients blocks honest, informed conversations about all health care options—an unconscionable violation that is essentially a gag rule,” said AMA President Susan R. Bailey, M.D. “As physicians and leaders in medicine, we are fighting against the government’s intrusion in the exam room while protecting open communication between patients and physicians, which is the foundation of high-quality medical care.”

Since its inception a half century ago, Title X has served as a vital public health program, ensuring vulnerable populations—especially low-income women—have access to basic, preventive reproductive health care. In addition to restricting physicians and other health care professionals from providing complete information and appropriate referrals for care to their Title X patients, the administration’s rule withholds federal funding from providers that do offer the full range of family planning services, much to the detriment of the millions of Americans who depend on Title X for reproductive care.

The petition states that “the consequences of the rule are clear and stark—and already occurring.” Roughly one in every four Title X providers has withdrawn from the program in response to the rule’s implementation last year, ultimately jeopardizing care for 1.6 million patients nationwide. A recent U.S. Health and Human Services (HHS) estimate supports these figures, acknowledging that Title X services sites decreased by 945 sites and the number of annual patients served in 2019 fell by 21%—despite the Title X rule being in effect for only a few months. In California, for example, it is projected that in 2020, there will be an almost 75% reduction in the number of patients served by Title X in the state. As of August 2020, six states are without any Title X site at all…

…Over the course of its 50-year history, Title X has been an enormous success for patients, their communities, and our country — serving more than 4 million patients a year with critical, often life-saving reproductive care. Without Title X, the rates of unintended pregnancy and abortions would have been 31% higher, according to estimates. Most of the patients served by Title X are economically disadvantaged and live in areas where there are few health care options.

In emphasizing Title X’s immense impact, the petition notes that “for six in 10 women who obtain contraceptive care at a Title X-funded site, that provider was their only source of medical care over the past year.” The petition stresses that patients, physicians, and the health of the nation will be irreparably harmed without the Supreme Court’s review of the case.

October 1, 2020: American Medical Association posted news titled: “Why the Supreme Court should take up Title X gag rule”. It was written by Andis Robeznieks, Senior News Writer. From the news:

The AMA and other parties have filed a petition requesting that the U.S. Supreme Court review AMA v. Azar, a case that seeks to overturn a Department of Health and Human Services (HHS) gag rule that unlawfully dictates what physicians practicing at facilities funded under the Title X family planning grant program can’t say and must say.

“The AMA strongly believes that our nation’s highest court must step in to remove government overreach and interference in the patient-physician relationship,” said AMA President Susan R. Bailey, MD.

“Restricting the information that physicians can provide to their Title X patients blocks honest, informed conversations about all health care options—an unconscionable violation that is essentially a gag rule,” Dr.  Bailey added. “As physicians and leaders in medicine, we are fighting against the government’s intrusion in the exam room while protecting open communication between patients and physicians, which is the foundation of high-quality medical care.”

The case merits Supreme Court review because the questions it raises, according to the petition, “concern the integrity of the patient-provider relationship—founded on open and honest communications, the lynchpin of proper medical care.”

These questions “arise in the context of a vitally important federal health care program—with significant real-world consequences,” the petition says.

The HHS rule prohibits physicians who provide care at Title X-supported facilities from referring their pregnant patients to an abortion provider—even when their patients seek such referrals—and requires physicians to steer patients toward carrying a pregnancy to term. 

The Trump administration’s gag rule, which took effect May 3, 2019, also requires physicians with pregnant patients seeking an abortion to provide those patients with irrelevant information on prenatal care. 

“The gag requirement bans providers from referring their pregnant patients to abortion providers—even when that is the patient’s expressed wish; but it mandates referrals for prenatal care—even when the patient has no such interest,” the petition says. 

October 1, 2020: Urban Institute posted a brief titled: “Changes in New Mothers’ Health Care Access and Affordability under the Affordable Care Act”. It was written by Stacey McMorrow, Emily M. Johnston, Tyler Thomas, and Genevieve M. Kenney. From the brief:

Abstract

Though thousands of new mothers gained insurance following impletation of the coverage provisions of the Affordable Care Act (ACA) in 2014, there has been little documentations of changes in their health care access and affordability. This brief examines changes in access to and affordability of health care services for new mothers using data from the National Interview Survey. Comparing data from 2011-13 and 2015-18, we find that mothers were less likely to report having unmet health care needs due to cost and being very worried about paying their medical bills. In 2015-18, new mothers were more likely to report having seen a general doctor and recieved a flu vaccine in the past 12 months than in 2011-13. Even after these improvements, more than 1 in 10 new mothers were uninsured, and nearly 50 percent were at least somewhat worried about paying their medical bills. Proposals to extend postpartum Medicaid coverage for up to one year could benefit some of these mothers, but additional progress would likely require broader coverage expansions through Medicaid or the Marketplace.


October 2, 2020: Representative Pramala Jayapal (Democrat – Washington) posted a press release titled: “House Passes Jayapal Resolution Condemning Forced Medical Procedures Conducted on Immigrant Women”. From the press release:

The United States House of Representatives passed a resolution today urgently condemning the unwanted, unnecessary medical procedures—including partial and full hysterectomies —performed on immigrant women without their full, informed consent at the private, for-profit Irwin County Detention Center in Ocilla, Ga. H.Res. 1153—co-sponsored by 225 members of Congress and led by U.S. Representatives Pramila Jayapal (WA-07), Annie Kuster (NH-02), Sheila Jackson Lee (TX-18), Sylvia Garcia (TX-29) and Lois Frankel (FL-21)—also calls on the Department of Homeland Security (DHS) to take a series of specific actions including immediately complying with all related investigations. 

“This resolution mandates a real investigation must happen but it also sends a clear message to doctors contracted by private, for-profit incarceration facilities everywhere that we will not stand by and allow you to treat people this way,” said Congresswoman Jayapal. “We will not stand by and allow history to repeat itself—a shameful history of medical abuse targeting Black people, Indigenous people, people of color, immigrants, poor people and people with disabilities. The women at Irwin, those who have been released and those who have been deported are brave and resilient, and I want them to know that the United States Congress sees you, hears you and will never stop fighting for you.”…

…The resolution passed less than one week after members of the House Judiciary Committee and Congressional Hispanic Caucus led a Congressional Delegation to the Irwin County Detention Center. It was there that they heard firsthand from numerous women who had unnecessary gynecological procedures—including surgeries involving their reproductive organs—performed on them by Dr. Mahendra Amin without their knowledge or consent. Many of the procedures resulted in sterilization. Today’s resolution also comes just one week after lawmakers on the House Judiciary Committee sent a letter to DHS Acting Secretary Chad Wolf calling on him to urgently take specified actions and immediately respond to a set of pressing document requests. Additionally, 173 members of Congress urged DHS Inspector General Joseph Cuffari to open an immediate and full investigation in mid-September.

Investigative reporting by the New York Times released this week confirmed that Dr. Amin consistently performed surgeries on immigrant women’s reproductive organs, “even when it did not seem medically necessary at the time and nonsurgical treatment options were available.” The Times found striking similarities in the medical records and patient files they reviewed, and medical experts concluded that there is a, “pattern of excessively aggressive surgical intervention without adequate trial of medical remedies.” This new reporting was consistent with what at least five attorneys told Representative Jayapal during a Sept. 16 legal briefing after the initial release of Dawn Wooten’s whistleblower report

Today’s resolution condemns performing unwanted and unnecessary medical procedures without the full, informed consent of individuals. It also recognizes that everyone deserves to control their own reproductive choices and make informed choices about their bodies. Additionally, the resolution says that further accountability, oversight and transparency is necessary to protect people in the custody of U.S. Immigration and Customs Enforcement (ICE).

The resolution also calls on DHS to take a series of specific actions, including pausing the removal of any individual who experienced any medical procedure at the Irwin County Detention Center and allowing individuals who may have experienced an unnecessary or non-consensual procedure to have immediate access to adequate, safe and consensual medical treatment. Additionally, it calls on DHS to immediately comply with all related investigations and records requests related while ensuring affected individuals are able to freely participate in any investigation without fear of reprisal. Finally, the resolution demands that DHS hold all individuals involved in these incidents accountable and bring them to justice.

The resolution was endorsed by 54 organizations including the AFL-CIO; African Communities Together; Alianza Nacional de Campesinas; American Friends Service Committee; American Immigration Lawyers Association; Amnesty International USA; Asian Americans Advancing Justice | AAJC ; Asian Pacific Institute on Gender- Based Violence; Casa de Esperanza: National Latin@ Network for Healthy Families and Communities; Center for Gender & Refugee Studies; Center for Victims of Torture; Church World Service; Congregation of Our Lady of Charity of the Good Shepherd, U.S. Provinces; Freedom for Immigrants; Human Rights First; In Our Own Voice: National Black Women’s Reproductive Justice Agenda; Jewish Women International; Justice for Migrant Women; MoveOn; NARAL; National Advocacy Center of the Sisters of the Good Shepherd; National Asian Pacific American Women’s Forum (NAPAWF); National Coalition Against Domestic Violence; National Council of Jewish Women; National Fair Housing Alliance; National Immigration Law Center; NETWORK lobby for Catholic Social Justice; Oxfam America; People’s Action; Planned Parenthood Federation of America; Project On Government Oversight; Project South; Southeast Asia Resource Action Center (SEARAC); SPLC Action Fund; T’ruah: The Rabbinic Call for Human Rights; Tahirih Justice Center; UnidosUS; United We Dream; Women’s Refugee Commission; Asian Americans Advancing Justice- Atlanta; Church Council of Greater Seattle; Coalition for Humane Immigrant Rights (CHIRLA); Georgia Detention Watch; Georgia Latino Alliance for Human Rights (GLAHR); Illinois Accountability Initiative; Iowa Coalition Against Domestic Violence; Khmer Anti-deportation Advocacy Group (KhAAG); Maine Coalition to End Domestic Violence; Mekong NYC; National Asian Pacific American Women’s Forum (NAPAWF) Seattle Chapter; OneAmerica; Vermont Network Against Domestic and Sexual Violence; Washington State Coalition Against Domestic Violence and Wind of the Spirit Immigrant Resource Center.

It was co-sponsored by U.S. Representatives Pramila Jayapal, Sylvia Garcia, Ann McLane Kuster, Sheila Jackson Lee, Lois Frankel, Alma S. Adams, Pete Aguilar, Colin Allred, Cindy Axne, Nanette Diaz Barragán, Karen Bass, Joyce Beatty, Ami Bera, Donald S. Beyer Jr., Sanford D. Bishop Jr., Earl Blumenauer, Lisa Blunt Rochester, Suzanne Bonamici, Brendan F. Boyle, Anthony G. Brown, Julia Brownley, Cheri Bustos, G. K. Butterfield, Salud Carbajal, Tony Cárdenas, André Carson, Matt Cartwright, Ed Case, Sean Casten, Kathy Castor, Joaquin Castro, Judy Chu, David N. Cicilline, Gil Cisneros, Katherine Clark, Yvette D. Clarke, William “Lacy” Clay Jr., Emanuel Cleaver, II, James E. Clyburn, Steve Cohen, Gerald E. Connolly, Jim Cooper, J. Luis Correa, Jim Costa, Joe Courtney, TJ Cox, Angie Craig, Charlie Crist, Jason Crow, Henry Cuellar, Sharice Davids, Susan Davis, Danny K. Davis, Madeleine Dean, Peter DeFazio, Diana DeGette, Rosa L. DeLauro, Suzan DelBene, Antonio Delgado, Val Demings, Mark DeSaulnier, Ted Deutch, Debbie Dingell, Lloyd Doggett, Michael F. Doyle, Eliot L. Engel, Veronica Escobar, Anna G. Eshoo, Adriano Espaillat, Dwight Evans, Abby Finkenauer, Lizzie Fletcher, Bill Foster, Marcia L. Fudge, Tulsi Gabbard, Ruben Gallego, John Garamendi, Jesús “Chuy” García, Jimmy Gomez, Vicente Gonzalez, Josh Gottheimer, Al Green, Raúl M. Grijalva, Deb Haaland, Josh Harder, Alcee L. Hastings, Jahana Hayes, Denny Heck, Brian Higgins, Jim Himes, Kendra Horn, Steven Horsford, Chrissy Houlahan, Jared Huffman, Hakeem Jeffries, Eddie Bernice Johnson, Henry C. “Hank” Johnson Jr., Marcy Kaptur, William R. Keating, Robin Kelly, Joseph P. Kennedy, III, Ro Khanna, Dan Kildee, Derek Kilmer, Andy Kim, Ron Kind, Ann Kirkpatrick, Raja Krishnamoorthi, Conor Lamb, James R. Langevin, Rick Larsen, John B. Larson, Brenda L. Lawrence, Al Lawson, Barbara Lee, Susie Lee, Mike Levin, Andy Levin, Ted W. Lieu, David Loebsack, Zoe Lofgren, Alan Lowenthal, Nita M. Lowey, Ben Ray Luján, Elaine Luria, Stephen F. Lynch, Tom Malinowski, Carolyn B. Maloney, Sean Patrick Maloney, Doris Matsui, Lucy McBath, Betty McCollum, A. Donald McEachin, James P. McGovern, Jerry McNerney, Gregory W. Meeks, Grace Meng, Kweisi Mfume, Gwen S. Moore, Joseph D. Morelle, Seth Moulton, Debbie Mucarsel-Powell, Stephanie Murphy, Jerrold Nadler, Grace F. Napolitano, Richard E. Neal, Joe Neguse, Donald Norcross, Eleanor Holmes Norton, Tom O’Halleran, Alexandria Ocasio-Cortez, Ilhan Omar, Frank Pallone, Jr., Jimmy Panetta, Chris Pappas, Bill Pascrell Jr., Donald M. Payne Jr., Ed Perlmutter, Scott H. Peters, Dean Phillips, Chellie Pingree, Stacey Plaskett, Mark Pocan, Katie Porter, Ayanna Pressley, David Price, Mike Quigley, Jamie Raskin, Kathleen M. Rice, Cedric Richmond, Max Rose, Harley Rouda, Lucille Roybal-Allard, Raul Ruiz, C.A. Dutch Ruppersberger, Bobby L. Rush, Tim Ryan, Linda T. Sánchez, John Sarbanes, Mary Gay Scanlon, Jan Schakowsky, Adam B. Schiff, Brad Schneider, Kim Schrier, David Scott, Robert C. “Bobby” Scott, José E. Serrano, Terri Sewell, Donna Shalala, Brad Sherman, Mikie Sherrill, Albio Sires, Elissa Slotkin, Adam Smith, Darren Soto, Abigail Spanberger, Jackie Speier, Greg Stanton, Haley Stevens, Thomas R. Suozzi, Eric Swalwell, Mark Takano, Mike Thompson, Bennie G. Thompson, Dina Titus, Rashida Tlaib, Paul D. Tonko, Norma J. Torres, Xochitl Torres Small, Lori Trahan, David Trone, Lauren Underwood, Juan Vargas, Marc Veasey, Filemon Vela, Nydia M. Velázquez, Peter Visclosky, Debbie Wasserman Schultz, Maxine Waters, Bonnie Watson Coleman, Peter Welch, Jennifer Wexton, Susan Wild, Frederica Wilson and John Yarmuth.

October 2, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Applauds House Passage of Resolution 1153 Condemning Forced Sterilization of Women in Immigration and Customs Enforcement Custody”. From the press release:

Today the U.S. House of Representatives passed by a vote of 232-156 House Resolution 1153,which condemns the heinous acts of forced sterilization of immigrant women in Immigration and Customs Enforcement (ICE) custody. This resolution was introduced by Representatives Jayapal (D-WA), Kuster (D-NH), Jackson Lee (D-TX), Garcia (D-IL) and Frankel (D-FL) in response to whistleblower reports of forced sterilizations at the Irwin County Detention Center (ICDC) in Ocilla, GA.

“Reproductive oppression and forced sterilization is part of a long history of racist violence in this country. White supremacy has always depended on dehumanization and control over the bodies of women of color,” said Ilyse Hogue, president of NARAL Pro-Choice America. “These utterly unconscionable and barbaric acts against immigrant women are designed to silence us, but we know we must call out this violent attempt to control people, especially immigrant women and women of color. We are grateful to see leadership from Democrats in the House seeking to put an end to these atrocities. The silence from Republican leadership in the House and the fact that the overwhelming majority of Republicans voted no, while unsurprising, speaks volumes.”…

October 2, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on House Passage of Resolution Condemning Unwanted Medical Procedures on Immigrant Women”. From the Press Release:

Speaker Nancy Pelosi issued this statement after the House passed House Resolution 1153 condemning the infliction of unwanted, unnecessary medical procedures on women in ICE custody:

“Today, with the passage of H. Res. 1153, the House has sent a clear and unequivocal message: the infliction of unwanted, invasive and life-altering medical procedures on immigrant women is an appalling human rights abuse that demands immediate and full accountability.  I salute Congresswoman Pramila Jayapal and the Democratic Women’s Caucus for their leadership to shine a light on this staggering abuse and to demand answers from the perpetrators.

“With this resolution, the House calls on the Department of Homeland Security to protect women: providing those who have been forced to undergo these procedures with the care that they need and ensuring that they can participate in any investigation without the fear of reprisal.  And we call on DHS to immediately comply with all investigations and hold all individuals involved accountable, and to bring them to justice.

“The profoundly disturbing situation at the Irwin County Detention Center recalls some of the darkest moments of our nation’s history, from the exploitation of Henrietta Lacks, to the horror of the Tuskegee Syphilis Study, to the forced sterilization of a stunning 25 percent of Native American women in the 1970s, to the sterilizations of tens of thousands of Black women in the twentieth century. 

“Sadly, the heartbreaking truth is that these forced sterilizations are part of a years-long campaign of abuse and neglect of our immigrants – some of the most vulnerable people in our midst – at the hands of this Administration.  These reports point to the urgent need to overhaul our unaccountable detention system and its horrific misuse, to ensure that such abuses, and any other human rights abuse, cannot ever again happen.”

October 2, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a blog post titled: “House Passes Bill to Give States Option to Extend Postpartum Medicaid Coverage to New Moms”. It was written by Maggie Clark. From the blog post:

Medicaid and CHIP cover nearly half of all births each year and have critical roles to play to ensure access to postpartum care that supports the lifelong health of mother and baby together. The Helping MOMS Act, passed with a bipartisan majority voice vote in the U.S. House of Representatives this week, would give states a clearer path to ensure that Medicaid and CHIP support women in the postpartum year as they build an essential bond with their child, setting the family on a healthy path.

The bill would give states the option to cover women in pregnancy-related Medicaid and CHIP coverage for one year after delivery, extending their coverage well beyond the current cutoff of 60 days after the end of the pregnancy.  Introduced by Reps. Robin Kelly (D-IL), Michael Burgess (R-TX), Lauren Underwood (D-IL), Cathy McMorris Rodgers (R-WA), Ayanna Pressley (D-MA), and Buddy Carter (R-GA), the bill unanimously passed the U.S. House of Representatives.

Currently, states can only receive federal matching funds to extend postpartum coverage beyond 60 days through a Section 1115 waiver. Three states (Illinois, New Jersey, Missouri) have applied for some version of a postpartum coverage extension waiver, but no state has been approved by CMS. Even more states– more than 20— are on a path to do the same. Still other states, notably California and Texas, are using state-only funds to offer more limited benefits to a subset of postpartum women.

Instead of a waiver application, the bill allows states to submit a Medicaid and CHIP State Plan Amendment (SPA) if they choose to extend coverage for the full postpartum year. States that opt to extend postpartum coverage to women in Medicaid must extend coverage to pregnant women covered in CHIP as well.

After the current 60 day postpartum period ends, states could either offer the current Medicaid benefit package that all mandatory populations in the state receive (which for mothers under age 21 would include the EPSDT benefit), or a benefit package determined by the HHS Secretary to be “substantially similar.” The original bill language included a five percentage point increase in the federal matching rate (FMAP) to incentivize states to take up the option, but that language was dropped from the version that passed.

In addition to coverage, there’s also an effort to close some research gaps in the search for better birth outcomes for women in Medicaid and CHIP. The legislation directs the Medicaid and CHIP Payment and Access Commission (MACPAC) to publish a report on state Medicaid coverage of doula services and make recommendations for increasing access to doula services in Medicaid. GAO too must publish, two years after enactment, a report on gaps in coverage for pregnant and postpartum women in Medicaid and CHIP and to compare rates of insurance churn and mortality and morbidity in the states that elect the postpartum coverage extension and the states that do not.

The bipartisan bill, which now moves to the Senate, responds to the alarming maternal mortality crisis in the U.S., the only developed country in the world where the rate of maternal death is continuing to rise. About 700 women die each year due to pregnancy-related complications. According to the Centers for Disease Control and Prevention (CDC), about 31 percent occur during pregnancy, 36 percent happen during delivery or the week after, and 33 percent of the deaths occur one week to one year after delivery. When Medicaid and CHIP coverage ends at 60 days postpartum, many women become uninsured and miss out on critical access to treatment. Cardiomyopathy, or a weakened heart muscle, is the leading cause of death for women nationally in the week to one year after delivery. About three out of five pregnancy-related deaths are preventable, the CDC reported

…This bill is one small piece of a larger national call for improvements in Medicaid coverage for pregnant and postpartum people, including a package of bills known as the “Momnibus” that includes significant improvements in the maternal health care system, such as investments in research, innovative payment models, and specific funding to community-based organizations that are working to improve maternal health outcomes for Black women.

For years, advocates, including the National Birth Equity Collaborative, Black Mammas Matter Alliance, American College of Obstetrics and Gynecology, March of Dimes, and other maternal health groups have called for improvements in Medicaid to address maternal health equity, coverage extensions that expand access, and better data to understand the causes and prevention of maternal deaths.


October 4, 2020: Senator Alexandria Ocasio-Cortez (Democrat – New York) tweeted: “I want everyone in this country to have the same healthcare I receive as a member of Congress.”


October 6, 2020: Openly posted an opinion piece titled: “OPINION: The appointment of Amy Coney Barrett to the Supreme Court should ring alarm bells for the LGBT+ community”. It was written by Richard Saenz, a senior attorney at Lambda Legal. From the opinion piece:

If Amy Coney Barrett is confirmed to the Supreme Court, the body, already leaning to the right, would be an ultra-conservative court the likes that we have not seen in decades. The new make-up of the court, made up of nine justices, could slam the courthouse doors shut to many incarcerated people and LGBT+ people or those seeking to hold police officers and prison system accountable.

The court could radically change the Eighth Amendment’s prohibition against cruel and unusual punishment. In Farmer v. Breenan, (1994), a case originally filed by Dee Farmer, a Black transgender woman, the court ruled that a prison officials’ “deliberate indifference” to substantial risk of serious harm to an inmate violates the Eighth Amendment.

This standard has been applied in thousands of cases, including Lambda Legal’s cases on behalf of LGBT+ people who experienced violence or sexual assault while in custody, or people who were denied medical treatment such as hormone therapy due to a discriminatory policy.

A more stringent standard could make it even more difficult for incarcerated people to bring cases against officials – especially given the fact that many of these cases are brought without an attorney.

There is already reason for alarm.

In the Fifth Circuit Court of Appeals, a Trump-appointed judge flatly stated that a policy that did not authorize sex reassignment surgery or even an individualized assessment of whether such surgery was medically necessary, did not constitute “deliberate indifference”.

This ignores decades of what the Eighth Amendment requires and installs a blanket ban against gender confirmation surgery, or even an assessment not just for this plaintiff but for other incarcerated transgender people in this circuit. If other courts were to accept this reasoning, then access to healthcare for incarcerated transgender people will be in increased jeopardy.

The modern LGBT+ rights movement was born in response to police violence.

This summer millions took to the streets to further protest against police abuses and the killing of Black and brown and LGBT+ people by officers. The question now is whether people can turn to the courts to hold police departments and officers accountable for violating our communities’ rights.

Last term, the Supreme Court declined to hear cases involving the legal defense of qualified immunity. Under this doctrine, a case can be dismissed if a police officer’s actions were not “clearly established” as a constitutional violation at the time of the event. This has led to a number of cases being thrown out regardless of how egregious the actions of the officials were. U.S. President Donald Trump has opposed limiting qualified immunity.

Finally, an ultra-conservative court undermines our communities’ belief in the criminal legal system. LGBT+ people are entitled, as are all people, to courts that treat them with fairness and respect.

Alarmingly, Judge Coney Barrett has referred to transgender women as “physiological males” and made public statements against same-sex marriage. Other Trump appointed judges have also gone out of their way to refer to trans plaintiffs as “gender dysphoric” or refuse to use correct pronouns, in referring to a trans person or misgender them, while ruling against trans people.

There is much at stake for LGBT+ people.

We know that Trump’s nominees are committed to using the constitution to deny legal protections to this country’s most vulnerable. But this is not the end. We and many others are committed to the fight for equal justice for all.

October 6, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Coalition Seeking Supreme Court Review Against Trump-Pence Administration’s Title X Family Planning Rule”.

California Attorney General Xavier Becerra, along with Oregon Attorney General Ellen Rosenblum and New York Attorney General Letitia James, yesterday led a coalition of 21 states and the District of Columbia in filing a petition to the U.S. Supreme Court. They join the American Medical Association, the Oregon Medical Association, Planned Parenthood Federation of America, the National Family Planning & Reproductive Health Association, and Essential Access Health in seeking review of the U.S. Court of Appeals for the Ninth Circuit’s decision to uphold the Trump-Pence Administration’s Title X rule, which dismantles the nation’s family planning program. The rule restricts access to critical preventive healthcare and access to birth control and prohibits doctors from providing accurate information to patients on their healthcare options including referrals for abortion.

“The Trump-Pence Administration has upended the nation’s family planning network that serves low-income women and families across the country,” said California Attorney General Becerra. “As a result, clinics have closed in many parts of the country and patients are left with no provider for critical reproductive and preventive health services. A patient’s medical decisions are between her and her doctor or healthcare provider, not between her and the President or Vice President. Once again, this Administration is playing games with reproductive healthcare, putting politics ahead of patients. This rule interferes with the practice of medicine and reproductive autonomy. A patient should be able to have honest and frank conversations with her provider and get the care she needs, period. Here in California, we will continue to stand up and fight for the millions of women and families who rely on Title X for healthcare services.” 

The Title X family planning program is instrumental in the delivery of preventive and reproductive healthcare to low-income women and families. In 2019, the Department of Health and Human Services (HHS) issued a rule imposing major changes on the Title X program including: 

  • Limiting the information that can be shared with a patient at a Title X clinic;
  • Prohibiting referrals for abortion, even when a patient specifically requests one;
  • Mandating referrals for prenatal care for all pregnant patients, even if this care is not requested; and
  • Requiring physician and financial separation for clinics for Title X funded services from abortion care

Before 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. 

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. New providers have not filled the gap caused by the withdrawals because these providers don’t provide family planning counseling or birth control. 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 rule went into effect. Even before the onset of the COVID-19 pandemic, the Title X family planning network in California was projected to see fewer than 300,000 patients this year.

Yesterday’s petition is the latest step in Attorney General Becerra’s efforts to protect the Title X program. In May, he and Nevada Attorney General Aaron Ford 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 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. And on July 30, 2018, the Attorney General led a coalition of 13 attorneys general in filing a comment letter opposing the rule.

Joining Attorney General Becerra in filing the petition are the attorneys general of New York, Oregon, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, and the District of Columbia.

A copy of the petition to the U.S. Supreme Court is available here.

October 6, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “I believe every person in America is entitled to the same health care as the President of the United States – with no co-pays, no deductibles and no out-of-pocket expenses. If government-funded health care is good enough for Trump, it is good enough for all of us as a human right.”

October 6, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Leads Coalition Seeking Supreme Court Review of Trump Administration’s Title X Family Planning Rule”. From the press release:

New York Attorney General Letitia James today announced she has led a coalition of 22 attorneys general from around the nation in filing a petition asking the U.S. Supreme Court to review a circuit court decision upholding the Trump Administration’s Title X family planning rule, also known as the “gag rule.” The rule dismantles the nation’s family planning program by reducing access to critical reproductive health care services, including birth control and referrals for abortions.

“Since day one, the Trump Administration has done everything in its power to deny women access to reproductive health coverage,” said Attorney General James. “By removing so many of the vital and essential services funded by Title X, President Trump and his administration are essentially holding women’s reproductive freedoms captive. These rules are baseless, dangerous, and will prevent millions of women from accessing quality, safe reproductive health care, which is why we are asking the Supreme Court to intervene and protect women’s reproductive rights.”

In March 2019, the Trump Administration implemented its gag rule, which places an unlawful and unethical restriction on the ability of health care providers at clinics that receive Title X funds to fully inform patients of the reproductive health services available to them by disallowing referrals for abortions and restricting counseling related to abortions. Another provision requires such clinics to physically segregate abortion services and the provision of referrals for abortion from all Title X funded services — a requirement that is so expensive and so difficult to accomplish that it is driving many providers out of the program and could possibly drive them out of business.  

Immediately, Attorney General James and Oregon Attorney General Ellen Rosenblum, jointly, led a coalition of 21 attorneys general in filing a lawsuit challenging the Trump Administration’s regulations that threaten essential services provided under federal Title X funding.

The Title X family planning program is instrumental in the delivery of preventive and reproductive health care to low-income and underserved women and families. The 2019 rule challenged in this case imposed major changes on the Title X program, including: 

  • Limiting the information that can be shared with a patient at a Title X clinic;
  • Prohibiting referrals for abortion, even when a patient specifically requests one;
  • Mandating prenatal care for all pregnant women, even when this care is not requested; and
  • Requiring physical separation of clinics for Title X funded services from abortion care

Before 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. But, the Trump Administration’s Title X rule has severely reduced and in some cases caused a total loss of access to many of the services provided by Title X nationwide…

October 6, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a blog post titled: “ACA Improved Health Care Access and Affordability for New Mothers, Report Finds”. It was writen by Maggie Clark. From the blog post:

We often get asked whether increases in health coverage rates result in more people getting care. In the case of new mothers following the implementation of the ACA’s major coverage provisions in 2014, a recent report from the Urban Institute shows the answer for this group is yes.

In the years following the 2014 coverage expansions, new mothers were less likely to report unmet medical care or prescription medication needs, and more likely to have seen a general doctor and received a flu shot than in the years before the coverage expansions took effect.

While barriers remain for new mothers to access health care–particularly because pregnancy Medicaid coverage ends just 60 days postpartum–the report findings suggest that the ACA likely contributed to improvements in health care access and affordability for new mothers, and that future coverage expansions could help even more.

The report, which is based on data from the National Health Interview Survey (NHIS), defines “new mother” as women ages 19 to 44 with an infant (younger than age 1) whose NHIS record indicates they are the child’s biological or adoptive mother. Because of sample size, the study periods are the years before and after the major 2014 ACA coverage expansions (2011-2013 and 2015-2018, respectively.)

During these time ranges, the uninsured rate for new mothers dropped dramatically, from about 20.2 percent in 2011 to 11.3 percent in 2015, and remained steady in the following years through 2018. This translated to new mothers being about 60 percent less likely to have unmet needs for prescription drugs and specialist care after the ACA’s coverage provisions took effect in 2014, the authors found. The report findings also build on the evidence that when states expand Medicaid, more people seek preventive care and avoid preventable complications from diseases such as diabetes and hypertension. A recent study showed that the ACA’s Medicaid expansion closed coverage gaps for pregnant women too.

However, the positive results for new mothers were not distributed equally, the report found. Black and Hispanic new mothers still have higher uninsured rates than their white peers, face greater risks of maternal mortality and morbidity, and are less likely to receive postpartum care. The authors also pointed to social barriers, such as lack of transportation, child care, family leave, and the specific barrier of racism for Black women that keep them from accessing quality health care. Future coverage expansions should be designed to reduce inequities for Black and Hispanic women, the authors recommend…


October 7, 2020: Center for Reproductive Rights posted a press release titled: “Center for Reproductive Rights Opposes Confirmation of Judge Amy Coney Barrett”. From the press release:

Statement of Nancy Northup, President and CEO of the Center for Reproductive Rights

For only the second time since our founding in 1992, the Center for Reproductive Rights is opposing the confirmation of a U.S. Supreme Court nominee. Less than three weeks ago, the American people lost a champion for gender equality and reproductive rights with the passing of Justice Ruth Bader Ginsburg. On September 26, President Donald Trump nominated Judge Amy Coney Barrett to replace her.  

The Senate majority is rushing a truncated confirmation hearing process to begin on October 12, barely two weeks after Judge Barrett’s nomination. While this is inadequate time for the Senators and public to fully appraise this nominee, her record in opposition to reproductive rights is clear and alarming. Based on the record of her judicial opinions, academic articles, speeches, and public statements, the Center for Reproductive Rights strongly opposes Judge Barrett’s confirmation to serve as an Associate Justice to the U.S. Supreme Court.  

President Trump has made reversing Roe v. Wade a litmus test for his Supreme Court nominees. Judge Barrett’s record supports that test. From 2010-2016, she was a member in the Notre Dame Chapter of University Faculty for Life. In 2006, she was a signatory on a newspaper advertisement sponsored by St. Joseph County Right to Life. The ad called for an end to Roe v. Wade and Barrett specifically signed onto a statement that she opposes “abortion on demand” and defends “the right to life from fertilization,” an extreme legal position that has implications for contraception, abortion care and fertility treatments. In 2012 she signed onto an advocacy letter that called contraception and sterilization “gravely immoral and unjust” and wrongly characterized emergency contraception as “an abortion-inducing” drug. She subscribes to the judicial philosophy of originalism that rejects constitutional protections for abortion rights. Her writings are clear that she does not view Roe as a “super precedent” and the principle of stare decisis would not be a restraint to overturning Roe. In the two abortion rights cases that have come before her as a federal appellate judge, Judge Barrett joined opinions that suggest upending Supreme Court law on both the substantive right to abortion and the procedural safeguards that allow the right to be vindicated in court.  

In sum, Judge Barrett’s approach to constitutional interpretation, opinions as a federal appellate judge, and vitriolic public advocacy disparaging contraception, opposing abortion, and defending “the right to life from fertilization” lay bare a deep disagreement with the established constitutional protections for reproductive rights. Indeed, Judge Barrett has the most extreme record in opposition to reproductive rights as any Supreme Court nominee since the rejected nomination of Judge Robert Bork over 30 years ago. 

Moreover, Judge Barrett has criticized the Supreme Court’s decisions upholding key provisions of the Affordable Care Act (ACA), which has expanded reproductive health insurance coverage to millions, including affordable contraceptive and maternity care.  This is especially troubling, as the Supreme Court will be hearing the next challenge to the ACA on November 10.  

We do not make our decision to oppose Judge Barrett lightly. We win cases before a wide range of federal judges, who have been appointed by both Republican and Democratic presidents. As an organization that litigates cases in federal courts, including in the Supreme Court, we are rigorous about factual accuracy and careful legal analysis. We are a nonpartisan, nonprofit organization that does not support or oppose political parties or candidates.  

The stakes of this nomination could not be higher. Since the election of President Trump, states have accelerated their decades-long campaign to end abortion services and there are dozens of cases heading toward the Supreme Court. Some are test cases to overturn Roe v. Wade or to render it meaningless by upholding laws that make abortion impossible to access.  The Supreme Court’s vital role in protecting and upholding civil rights and liberties – including reproductive rights – cannot be compromised by a nominee fundamentally hostile to our constitutional rights.  

October 7, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Warns of Pence’s Anti-Choice Radicalism Ahead of Vice Presidential Debate”. From the press release:

As Senator Kamala Harris (D-CA) and Vice President Mike Pence prepare to face off during tonight’s vice presidential debate, expect Pence to attack reproductive freedom. As the Republican Party often does, Pence will likely spew disinformation and attack abortion rights to distract from the Trump-Pence administration’s failed leadership and the illegitimate nomination of Amy Coney Barrett to the U.S. Supreme Court. This debate comes just days after President Donald Trump again pushed lies and fear-mongering about abortion, a tactic he often turns to when he’s in hot water. 

NARAL Pro-Choice America President Ilyse Hogue released the following statement ahead of this evening’s debate:

“Though Americans are already casting ballots, the Trump-Pence administration is prioritizing ramming through a Supreme Court nomination. Instead, they should be providing much-needed relief to Americans. The stakes have never been higher: Our reproductive freedom, our rights, and our democracy are at stake. 

Senator Kamala Harris has proven her prowess and leadership in her role on the Senate Judiciary Committee and as a senator committed to justice for all people. We know she will do the same tonight on the debate stage, not letting Pence off the hook for his regressive and oppressive politics that have harmed so many people in this country. We need proven leaders like her and Vice President Joe Biden now more than ever. There’s no question that this ticket will fight tirelessly for reproductive freedom and work to undo the damage to our fundamental rights waged by Pence and Trump. That’s why we are committed to doing everything we can to make sure they win the White House this November.”

Vice President Mike Pence has made his disdain towards Roe v. Wade clear time and again, saying that the case should be “consigned to the ash heap of history.” The Trump-Pence administration is poised to do just that thanks to its nomination of Amy Coney Barrett to the Supreme Court, a judge with a record of hostility towards reproductive freedom who has even signed on to an ad calling Roe “barbaric.” Polls confirm that the Trump-Pence administration and Mitch McConnell’s rush to confirm Barrett is wildly unpopular. Despite the fact that the American people have already begun casting their ballots, the Republican Party remains laser-focused on ramming through Barrett’s confirmation and continuing their long-standing campaign to stack our courts and gut our rights. 

Pence has long prioritized his anti-choice fanaticism over the health and well-being of those he was elected to serve. He flouted life-saving public health guidance this summer when he embarked on a reckless multi-state tour of fake women’s health centers during the COVID-19 pandemic. As NARAL Pro-Choice America and Global Strategy Group’s new language guide to accurate reporting on abortion explains, these anti-choice organizations, sometimes referred to as “crisis pregnancy centers,” lie to, shame, and mislead those seeking an abortion to block them from accessing care…

October 7, 2020: California Attorney General Xavier Bacerra posted a press release titled: “Attorney General Becerra Leads Coalition in Support of Healthcare Rights for Transgender Americans”. From the press release:

California Attorney General Xavier Becerra today led a coalition of 17 states and the District of Columbia in filing an amicus brief supporting the plaintiffs in Kadel v. N.C. State Health Plan. The plaintiffs, Maxwell Kadel, Jason Fleck, Connor Thonen-Fleck, Julia McKeown, Michael D. Bunting, Jr., C.B., and Sam Silvaine, all state employees and their families, sued the North Carolina State Health Plan for denying health coverage. Specifically, the plaintiffs seek coverage for gender dysphoria or other gender-affirming treatment, arguing that Section 1557 of the Affordable Care Act (ACA) protects transgender individuals from discrimination in healthcare and requires the State to provide them with coverage.

“All people should have access to healthcare, period. This includes transgender individuals who have a right to live their lives with dignity, free from discrimination,” said Attorney General Becerra. “Here in California, we have laws that protect transgender Americans from discrimination in accessing state services and benefits, including healthcare. We’ve seen the positive outcome that ensuring equality brings to our communities. We will continue to fight for equality for all transgender Americans.”

The ACA provides millions of Americans with access to quality, affordable health insurance coverage. It also prevents discrimination in healthcare through Section 1557, which extends prohibitions on sex discrimination to healthcare programs and services. Section 1557 expressly prohibits health programs and activities receiving federal financial assistance, including medical providers, health systems, and health insurers, from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability.

In today’s brief, the coalition argues that by denying transgender individuals coverage for gender-affirming treatment and gender dysphoria, the North Carolina State Health Plan violated Section 1557’s anti-discrimination mandate. Systematic and widespread discrimination against transgender people in healthcare is what Section 1557 aims to prevent and combat. Instead, the Health Plan’s discriminatory tactics put the lives of transgender people at risk by denying them treatment known to improve their physical and mental health. The brief also argues that Section 1557 should be applied uniformly across the country in order to protect Americans from discrimination as Congress intended. The ACA’s reforms, along with state laws like California’s, which prohibit health insurers from excluding coverage for transgender health services, have significantly increased access to healthcare for LGBTQ+ individuals and their families. Allowing the North Carolina State Health Plan to selectively deny coverage to certain disadvantaged groups, like transgender people, causes uncertainty and confusion for people who are already reluctant to seek medical care. Applying Section 1557 uniformly will give all transgender Americans confidence that they will receive quality healthcare no matter where they are…

…In filing the amicus brief, Attorney General Becerra was joined by the attorneys general of Colorado, Delaware, Hawaii, Illinois, Maine, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, Wisconsin, and the District of Columbia.

A copy of the amicus brief is available here.


October 8, 2020: NPR posted an article titled: “Supreme Court Punts on Abortion Pills, Allowing them to be Mailed – For Now”. It was written by Nina Totenberg. From the article:

The U.S. Supreme Court has refused, for now, to reimpose FDA regulations that require women seeking medication abortion to pick up the prescribed pills in person at a clinic instead of by mail.

The court’s decision came Thursday night on a 6-to-2 vote that rejected an emergency appeal from the Trump administration.

The challenge to the Food and Drug Administration regulation was brought by the American College of Obstetricians and Gynecologists after the the agency relaxed similar regulations for other drugs — including opioids — in order to limit patients’ exposure to COVID-19 during the pandemic. The FDA refused to relax the same rule for those with prescriptions for abortions with pills in the first 10 weeks of pregnancy.

Federal Judge Theodore Chuang in Maryland ruled in favor of ACOG, declaring that requiring such in-person pickups of pills during a pandemic posed “a substantial obstacle to women seeking an abortion.” The Supreme Court has long ruled that such substantial obstacles unconstitutionally interfere with a woman’s right to terminate a pregnancy.

On Thursday night, the Supreme Court turned down the Trump administration’s attempt to block the lower court order. But the decision was more of a punt than a long-lasting decree.

The high court said it would hold the Trump administration’s request “in abeyance” to permit the district court judge to promptly consider other efforts by the administration to “dissolve, modify, or stay” its previous order if “relevant circumstances have changed.” And the justices said that their decision did not indicate their views on the merits of the case should it come to them again.

The language of the one-paragraph order seemed to suggest that the court was simply unwilling to make any decision in an abortion case three weeks after Justice Ruth Bader Ginsburg died, and just days before the U.S. Senate is scheduled to take up the nomination of Judge Amy Coney Barrett as Ginsburg’s replacement…

October 8, 2020: The American College of Obstetricians and Gynecologists (ACOG) posted news titled: “Recent Research Study: HPV Vaccination Substantially Reduces Risk of Invasive Cervical Cancer”. From the news:

A recent Swedish study published in the New England Journal of Medicine assessed the association between HPV vaccination and the subsequent risk of invasive cervical cancer. During the study period, the researchers evaluated 1.7 million girls and women, 10 to 30 years old, for cervical cancer. The findings showed that, among Swedish girls and women 10 to 30 years old, quadrivalent HPV vaccination was associated with a substantially reduced risk of invasive cervical cancer, especially in women who were immunized at a younger age.

ACOG recommends that obstetrician–gynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine. Health care professionals play a critical role and should assess and vaccinate adolescent girls age 11–12 years and previously unvaccinated young women during the catch-up period (ages 13–26 years). Additionally, health care professionals may use shared clinical decision making with previously unvaccinated women aged 27–45 years, considering the patient’s risk for acquisition of new HPV infection and whether the HPV vaccine may provide benefit.

Read the full research article.

October 8, 2020: Planned Parenthood posted a press release titled: “Supreme Court Leaves in Place Suspension of Medically Unnecessary Barrier to Abortion During COVID-19 – For Now”. From the press release:

Today, the U.S. Supreme Court delayed ruling on the Trump administration’s attempt to reinstate a U.S. Food and Drug Administration (FDA) requirement that subjected patients to unnecessary COVID-19 exposure risks during the pandemic to access a safe medication for early abortion care.

The FDA’s Risk Evaluation and Mitigation Strategy (REMS) restrictions on mifepristone mandate that patients pick up the medication directly from a doctor’s office, hospital, or other health center – rather than from a pharmacy or by mail, as allowed for other equally safe medications.

The court’s decision to delay acting on the administration’s request follows the death of Supreme Court Justice Ruth Bader Ginsburg, a staunch advocate for reproductive health care and rights. While the court’s decision on the government’s request is delayed for now, 16 other cases on abortion access are one step away from the Supreme Court…

…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 onto an amicus brief opposing the Trump administration’s attempt…

October 8, 2020: Senator Cory Booker (Democrat – New Jersey) posted a press release titled: “Booker, Blackburn Introduce Bipartisan Legislation to Help Improve Maternal Health Outcomes for Pregnant Veterans”. From the press release:

U.S. Senators Cory Booker (D-NJ) and Marsha Blackburn (R-TN) introduced a bipartisan bill, Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, to establish a pilot program to encourage the use of doulas in the Veterans Health Administration to support pregnant veterans and improve maternal health outcomes.

A study in 2010 by the National Center for Biotechnology Information found that veterans returning from Operation Enduring Freedom and Operation Iraqi Freedom who experienced pregnancy were twice as likely to have a diagnosis of depression, anxiety, posttraumatic stress disorder, bipolar disorder, or schizophrenia as those who had not experienced a pregnancy, which can lead to many complications during childbirth.

This has led to an increasing number of doula organizations and veteran stakeholders coming together to advocate for the placement of doulas in the Veterans Health Administration as a support for pregnant veterans.

A 2013 study published in the Journal of Perinatal Education found that “expectant mothers matched with a doula had better birth outcomes than did mothers who gave birth without involvement of a doula.”

“Maternal mortality in the United States is a public health crisis that demands urgent action,” said Senator Booker. “Providing increased access to doula care for veterans—especially those who are survivors of military sexual trauma or experiencing a mental disorder—is a proven, effective way to improve health outcomes for mothers and children and support our veterans.”

“Mental health resources must be readily available for our veterans, and pregnant veterans are no exception,” said Senator Blackburn. “The support of a doula during childbirth has proven to help women feel more at ease as their child comes into the world.“

Under the Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, the Department of Veteran Affairs would be required to measure the impact that doula support services have on pregnant veterans birth and mental health outcomes. The pilot program would allow for six Veterans Integrated Service Networks (VISN), three with the highest percentage of female veterans, and three with the lowest rate of female veterans, to participate and compare results regarding barriers to care. If done successfully, it will lower childbirth complications and incentivize veterans to receive VA care during and after their pregnancy.

The Delivering Optimally Urgent Labor Access for Veterans Affairs Act was borne out of conversations Senator Booker had with female veterans at a roundtable he hosted on Veterans Day in 2018.

Full text of the bill can be viewed here.

October 8, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a report titled: “Children’s Uninsured Rate Rises by Largest Annual Jump in More Than a Decade”. It was written by Joan Alker and Alexandra Corcoran. From the report:

Key Findings

  • After reaching a historic low of 4.7 percent in 2016, the child uninsured rate began to increase in 2017, and as of 2019, jumped back to 5.7 percent. This increase of a full percentage point translates to approximately 726,000 more children without health insurance since the beginning of the Trump Administration when the number of uninsured children began to rise. Much of the gain in coverage that children made as a consequence of the Affordable Care Act’s major coverage expansions implemented in 2014 has now been eliminated.
  • The number of uninsured children increased every year during the Trump Administration. The largest increase was observed between 2018 and 2019 when, despite a strong economy, the number of uninsured children was the largest annual jump seen in more than a decade. Moreover, since this data was collected prior to the pandemic, the number of uninsured children is likely considerably higher in 2020, as families have lost their jobs and employer-sponsored insurance, though it is impossible to know yet by precisely how much.
  • One-third of the total increase in the number of uninsured children from 2016 to 2019 live in Texas. The state saw by far the greatest coverage loss over the period with an estimated 243,000 more children living without health coverage. Florida has the next biggest loss, adding about 55,000 children to the uninsured count over the three-year period. As a consequence, 41 percent of children’s coverage losses during the Trump Administration occured in Texas and Florida. Twenty-nine states experienced an adverse change for children from 2016 to 2019. The only state that bucked national trends and significantly reduced its number of uninsured children during this three-year period was New York.
  • These coverage losses were widespread across income, age, and race/ethnicity, but were largest among White and especially Lationo children (who can be of any race).

Introduction

For many years, the United States was on a positive trajectory in reducing the number and rate of uninsured children; in 2016, the nation attained a historic low of 3.6 million uninsured children. This progress occured as a result of expansions of public coverage – primarily Medicaid and the Children’s Health Insurance Program (CHIP) – and was accelerated by the implementation of the Affordable Care Act’s (ACA) major coverage expansion in 2014. As employer-sponsored insurance became increasingly unaffordable for dependents, public coverage ameliorated the impacts of private coverage losses for children. However, the number of uninsured children began to increase in 2017 as Medicaid enrollment began to decline, and Figure 1 shows, reached 4.4 million in 2019. This represents an increase of 726,000 children during this three-year-period. The rate of uninsured children rose a full percentage point from 4.7 percent to 5.7 percent. Much of the gain in coverage that children made as a consequence of the ACA’s major coverage expansions has now been eliminated. Moreover, the most recent year of data (2018 to 2019) shows the biggest one-year loss in children’s coverage during this time period, with 320,000 more children being uninsured. These coverage losses occured in a healthy economy with the lowest unemployment rate in decades prior to the economic shocks and job losses associated with the COVID-19 pandemic.


October 9, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Leahy, Booker Press Chairman Graham Not to Conduct Supreme Court Hearings Without COVID-19 Testing Procedures In Place”. From the press release:

U.S. Senator Kamala D. Harris (D-CA) on Friday joined Senators Patrick Leahy (D-VT) and Cory Booker (D-NJ) in pressing Judiciary Committee Chairman Lindsey Graham (R-SC) not to proceed with Supreme Court confirmation hearings next week unless stringent COVID-19 testing procedures are implemented immediately. Pointing out that two Judiciary Committee members have tested positive for COVID-19 and others have thus far refused to be tested, the senators told Graham that without testing procedures in place, the hearings could threaten the safety and health of all who attend in person.

The senators wrote, “In the wake of news that Senators Lee and Tillis tested positive for COVID-19 after attending the White House event announcing Amy Coney Barrett’s nomination to the Supreme Court, Judiciary Committee Democrats asked that you postpone her confirmation hearings to ensure that we don’t risk the health and safety of fellow Senators, Senate staff, other Senate employees, as well as Judge Barrett and her family.  To date, we understand that you plan to proceed with these hearings on October 12, 2020, despite the serious risks they present.  We urge you against unsafely moving forward with these hearings while no clear testing regime is in place to ensure that they do not become another super-spreader of this deadly virus.”

The senators continued, “Without these precautionary measures in place, Senators, Senate staff, press, Judge Barrett and her family will face a serious, unnecessary risk of contracting COVID-19.  We also have a moral responsibility to protect the workers who make it possible for us to do our jobs in the Senate each and every day. Absent these protocols, you are ignoring CDC best practices and may force Senators to participate in this hearing remotely which, for such a consequential hearing, would be entirely unprecedented. As Chairman of the Senate Judiciary Committee, your first and foremost obligation is to ensure the safety and well-being of Committee members and staff. We urge you to honor that obligation in the days ahead.”

Full text of the letter can be found HERE.

October 9, 2020: Senator Cory Booker (Democrat – New Jersey) posted a press release titled: “Veterans’ Organizations Endorse Booker Bill to Help Improve Maternal Health Outcomes for Pregnant Veterans”. From the press release:

Last week, U.S. Senator Cory Booker (D-NJ) introduced a bipartisan bill, Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, to establish a pilot program to encourage the use of doulas in the Veterans Health Administration to support pregnant veterans and improve maternal health outcomes. This legislation was borne out of various veteran organizations and leaders such as the Disabled American Veterans (DAV), Service Women’s Action Network, NJ SOS Veteran Stakeholders group, and advocate Lucy Del Gaudio speaking out on the importance to improve maternal health outcomes for pregnant veterans.

A study in 2010 by the National Center for Biotechnology Information found that veterans returning from Operation Enduring Freedom and Operation Iraqi Freedom who experienced pregnancy were twice as likely to have a diagnosis of depression, anxiety, posttraumatic stress disorder, bipolar disorder, or schizophrenia as those who had not experienced a pregnancy, which can lead to many complications during childbirth.

This has led to an increasing number of doula organizations and veteran stakeholders coming together to advocate for the placement of doulas in the Veterans Health Administration as a support for pregnant veterans.

A 2013 study published in the Journal of Perinatal Education found that “expectant mothers matched with a doula had better birth outcomes than did mothers who gave birth without involvement of a doula.”

“Maternal mortality in the United States is a public health crisis that demands urgent action,” said Senator Booker. “Providing increased access to doula care for veterans—especially those who are survivors of sexual trauma or living with mental illness—is a proven, effective way to improve health outcomes for mothers and children and support our veterans.”

“Pregnancy, labor and delivery, and the early days of motherhood can be difficult in the best of circumstances, but for women veterans, they can be further complicated by physical and mental health conditions related to military service,” said Disabled American Veterans (DAV) National Legislative Director Joy J. Ilem. “We owe our veterans the care they need, and the D.O.U.L.A. Act would offer much-needed support to women veterans at a time when they need it most. We thank Senators Booker and Blackburn for taking the needs of pregnant women veterans into account and working to establish this unique pilot program to foster better health outcomes for mother and baby as well as encourage veterans to continue using VA’s comprehensive care services, during and after pregnancy.”

“The Service Women’s Action Network (SWAN) strongly supports Senator Cory Booker’s D.O.U.L.A Act of 2020. This legislation will provide veterans who are new mothers with trusted support as they begin the joyful journey of motherhood,” said Lory Manning, Captain, US Navy Retired, Director of Government Relations for the Service Women’s Action Network (SWAN).

“Thank you Senator Booker for taking the time to listen to the needs of our women veterans and taking action. It’s one step in getting women veterans the healthcare they deserve,” said Co-chair of NJSOSVETS Stake Holder Group Dave Pearson. “We look forward to working with you in the future in giving our veterans a voice and helping to get the services they deserve.”

“Survivors of trauma need to feel fully supported, calm, and confident during their childbirth experience,” said Co-chair of the SOSVETS Stakeholder Groups Women Veteran Subcommittee Lucy Del Gaudio. “The DOULA for VA Act will do that just. This will ensure that women, non-binary, and transgender veterans practicing holistic medicine and wellbeing will be fully supported. I truly appreciate the support that Senator Booker has provided to our sisters in arms and Senator Blackburn for co-sponsoring this bill. It’s an honor and a privilege to work with them both.”

Under the Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, the Department of Veteran Affairs would be required to measure the impact that doula support services have on pregnant veterans birth and mental health outcomes. The pilot program would allow for six Veterans Integrated Service Networks (VISN), three with the highest percentage of female veterans, and three with the lowest rate of female veterans, to participate and compare results regarding barriers to care. If done successfully, it will lower childbirth complications and incentivize veterans to receive VA care during and after their pregnancy.

The DOULA Act was introduced last week by Senators Cory Booker (D-NJ) and Marsha Blackburn (R-TN).

Full text of the bill can be viewed here.

October 9, 2020: Lambda Legal posted a press release titled “The Senate Judiciary Committee Must Oppose Amy Coney Barrett”. From the press release:

Today, Lambda Legal sent a letter to the Senate Judiciary Committee urging the members to oppose Judge Amy Coney Barrett, President Trump’s nominee to fill the seat of the late Justice Ruth Bader Ginsburg on the United States Supreme Court. The rushed confirmation hearings are scheduled to begin on Monday, October 12, while voting for the next president and one-third of the senate is already underway. 

“Judge Amy Coney Barrett’s record is filled with red flags that should disqualify her from sitting on the U.S. Supreme Court. Given her perverse, reactionary judicial philosophy, Judge Barrett is unfit to fill the seat, much less the shoes, of the late Justice Ruth Bader Ginsburg,” said Sasha Buchert, Senior Attorney at Lambda Legal. “Furthermore, this rushed confirmation process undermines the integrity of the Court and betrays the legacy of Justice Ginsburg. The politically motivated decision of the Senate Judiciary Committee to rush this confirmation process will further jeopardize the reputation of the Court, which must have the respect and confidence of the people in order to be effective. Our country cannot afford having the Supreme Court be seen as just another political branch—unbalanced and wielding disproportionate power.

“There is so much at stake for LGBTQ people and everyone living with HIV right now because so much of our civil rights progress has happened in the courts,” Buchert added. “Decades of hard work have led to legal victories such as the right to marry the person we love, to protect our families, to access health care and make decisions about our bodies. Judge Amy Coney Barrett’s record is fundamentally at odds with basic guarantees of equality, liberty, justice and dignity under the law for our communities. It is impossible for LGBTQ people to have confidence in Judge Barrett as her publicly available record makes clear that she would be unable or unwilling to respect and affirm our rights to equal protection of the laws.”

In 2016, then-Professor Barrett gave a presentation in which she expressed that marriage should not be viewed as a fundamental right for same-sex couples and instead should be decided on a state-by-state basis. This approach mistakenly erases the duty of courts to enforce everyone’s constitutional rights. If followed, it would deny equal liberty, dignity and autonomy to LGBTQ people, women, racial minorities and any other marginalized community historically denied those rights. 

In a lecture discussing issues that could soon be before the Supreme Court, then-Professor Barrett took the troubling and legally unsound position that transgender people are not protected by federal protections against sex discrimination. Justice Gorsuch explained why her view is wrong in the Court’s Bostock v. Clayton County decision of this past June. More disturbing yet, she mischaracterizes transgender people. She has opined that “people will feel passionately on either side about whether physiological males who identify as females should be permitted in bathrooms especially where there are young girls present.” This ill-informed misgendering and disrespect of transgender people, and in particular of trans youth, ignores that it is transgender people who are at widespread risk of assault and discrimination. Spreading such inflammatory ignorance is dangerous to their very lives and ability to fully participate in public life.

Further analysis of Amy Coney Barrett’s record reveals opinions that would immediately threaten the Affordable Care Act—which has expanded health care coverage for more than 20 million people, and helped countless LGBTQ people and those living with HIV who are more than twice as likely to be uninsured. She also has showed her lack of concern for racial equity – an important duty of our federal courts – when she denied rehearing of a decision that allowed a company to segregate its employees by race, violating a core tenant of Brown v. Board of Education.

October 9, 2020: Center for American Progress posted an article titled: “Repealing the ACA Would Create Chaos for the Disability Community During a Pandemic”. It was written by Rebecca Cokley. From the article:

…The Patient Protection and Affordable Care Act (ACA), enacted in 2010, was a game-changer for the disability community and was in some ways comparable to the Americans with Disabilities Act (ADA) in terms of the impact the law had on peoples’ lives. While much of the law’s importance has centered on its anti-discrimination protections for people with preexisting conditions—which do have a significant effect on people with disabilities and chronic health conditions—there are a multitude of lesser-known provisions that have had a life-changing impact on the United States’ 61 million people with disabilities and their families, both in terms of their health and their wallets.

On November 10, the Supreme Court is expected to hear oral arguments in California v. Texas, a lawsuit backed by the Trump administration and state attorneys general that seeks to invalidate the entire ACA—including its protections for people with preexisting conditions. The vacancy on the Supreme Court in the wake of Justice Ruth Bader Ginsburg’s recent passing has left President Donald Trump and the Senate majority scrambling to fill the seat with a conservative justice who will side with them in repealing the 10-year old law. If the ACA is repealed, the ramifications for people with disabilities and their families will be widespread and catastrophic—and dramatically exacerbated in the midst of a pandemic. As the Centers for Disease Control and Prevention notes, “[S]ome people with disabilities might be at a higher risk of infection or severe illness because of their underlying medical conditions.”…

Repealing the ACA would harm people with COVID-19

…Individuals who have contracted the coronavirus will face unique health care needs both now and in the future. As scientists and those in the medical profession continue to learn more each day about the virus that causes COVID-19, it is increasingly clear that the long-term effects of the coronavirus are still unknown. More than 7 million people in the United States have been infected with the virus since March and, as such, would likely be considered by insurance companies to have preexisting conditions. Some COVID-19 “long haulers,” or those for whom the effects of the coronavirus have lasted months, are experiencing aggressive side effects of the virus, including paralysis, blood clots, respiratory distress, and cardiac disease. COVID-19 survivors are also finding themselves medical anomalies, facing not only confusion among medical personnel about best courses of treatment but also an inability to receive in-person peer support, a staple in the disability community that has been limited due to social distancing. If the ACA is repealed, millions of Americans who have had COVID-19 will likely find themselves unable to obtain or maintain insurance, as was the case for millions of Americans before the law took effect.

The White House and Senate majority failed to respond to the virus when it first emerged and are now actively working to destroy their health care in the courts and legislature, further affecting people with disabilities. The Safe to Work Act, backed by Sen. John Cornyn (R-TX) and 23 other Republican co-sponsors, proposes allowing employers to waive the ADA and other civil rights laws to discriminate against employees with a history of the coronavirus. The Leadership Conference on Civil and Human Rights called the Safe to Work Act “an extreme bill that would protect businesses at the expense of working people and the public by shifting the burden of the pandemic onto those who are most vulnerable to the health and economic impacts of this crisis.”

Repealing the ACA would lead to coverage losses among people with preexisting conditions

First and foremost, repealing the ACA would roll back anti-discrimination protections for people with preexisting conditions. It is not commonly understood that people with preexisting conditions are regarded as people with disabilities under the ADA, meaning they are covered under the ACA’s anti-discrimination protections and the reasonable accommodations that come with it.

This provision also made it easier for people with disabilities to leave a job and find another one without fear of being denied insurance coverage or jumping through arduous hoops to get covered. People with disabilities no longer had to weigh serious concerns about accessing coverage—which in the past may have caused them to stay in a job that paid poorly or that they had advanced beyond professionally or even to take a job out of state that offered the benefits they needed. The ACA helped guarantee the disability community was not disproportionately penalized when pursuing a career based on their own desires and personal choices rather than out of fear of losing health care. Repealing this law in the midst of a public health and economic crisis would mean a drastic curtailment of autonomy for millions of people…

…Repealing the ACA may mean a return to annual or lifetime caps on coverage

…Prior to the passage of the ACA, insurance companies could enact annual or lifetime caps, or limits, on the benefits policyholders received. Depending on the severity of someone’s disability, or the age at which they acquired it, they could hit their lifetime cap at an expedited rate. This was common for young children with significant disabilities. The fear of an ACA repeal is also a fear that coverage caps will increase the likelihood of institutionalization. Making families pay for all additional medical costs above annual or lifetime limits would force them to make an unconscionable choice between the right of people with disabilities to live in the community, as established in Olmstead v. L.C., and families’ ability to pay for it. For survivors of COVID-19, ongoing health care costs will be highly unpredictable, as the virus’s long-term health effects are only beginning to be understood.

Medicaid expansion, made possible by the ACA, has expanded care and increased employment among people with disabilities

The ACA also allowed states to expand Medicaid, extending eligibility for the program to people with incomes up to 138 percent of the federal poverty level. This has allowed many more people with disabilities to access health care without having to go through the long process of disability determination. It has also allowed people with disabilities who have slightly higher incomes to access benefits.

Medicaid expansion has also increased employment rates among people with disabilities. Prior to expansion, people with disabilities had to go through the disability determination program and meet stringent income and asset limits for coverage. This prevented many people with disabilities from entering employment or returning to work after acquiring a disability due to the fear of making too much money to access needed health care. In states that expanded Medicaid, employment of people with disabilities increased from 41.3 percent to 47 percent, compared with a decrease from 43.5 percent to 41.4 percent in states that did not. Indeed, many of the states that are continuing to battle the pandemic—including Ohio, Pennsylvania, West Virginia, and California—each have hundreds of thousands of enrollees in Medicaid expansion…

October 9, 2020: Lambda Legal posted a press release titled: “Lambda Legal Urges Senate Judiciary Committee to Oppose Confirmation of Amy Coney Barrett”. From the press release:

Today, Lambda Legal sent a letter to the Senate Judiciary Committee urging the members to oppose Judge Amy Coney Barrett, President Trump’s nominee to fill the seat of the late Justice Ruth Bader Ginsburg on the United States Supreme Court. The rushed confirmation hearings are scheduled to begin on Monday, October 12, while voting for the next president and one-third of the senate is already underway. 

“Judge Amy Coney Barrett’s record is filled with red flags that should disqualify her from sitting on the U.S. Supreme Court. Given her perverse, reactionary judicial philosophy, Judge Barrett is unfit to fill the seat, much less the shoes, of the late Justice Ruth Bader Ginsburg,” said Sasha Buchert, Senior Attorney at Lambda Legal. “Furthermore, this rushed confirmation process undermines the integrity of the Court and betrays the legacy of Justice Ginsburg. The politically motivated decision of the Senate Judiciary Committee to rush this confirmation process will further jeopardize the reputation of the Court, which must have the respect and confidence of the people in order to be effective. Our country cannot afford having the Supreme Court be seen as just another political branch—unbalanced and wielding disproportionate power.

“There is so much at stake for LGBTQ people and everyone living with HIV right now because so much of our civil rights progress has happened in the courts,” Buchert added. “Decades of hard work have led to legal victories such as the right to marry the person we love, to protect our families, to access health care and make decisions about our bodies. Judge Amy Coney Barrett’s record is fundamentally at odds with basic guarantees of equality, liberty, justice and dignity under the law for our communities. It is impossible for LGBTQ people to have confidence in Judge Barrett as her publicly available record makes clear that she would be unable or unwilling to respect and affirm our rights to equal protection of the laws.”

In 2016, then-Professor Barrett gave a presentation in which she expressed that marriage should not be viewed as a fundamental right for same-sex couples and instead should be decided on a state-by-state basis. This approach mistakenly erases the duty of courts to enforce everyone’s constitutional rights. If followed, it would deny equal liberty, dignity and autonomy to LGBTQ people, women, racial minorities and any other marginalized community historically denied those rights. 

In a lecture discussing issues that could soon be before the Supreme Court, then-Professor Barrett took the troubling and legally unsound position that transgender people are not protected by federal protections against sex discrimination. Justice Gorsuch explained why her view is wrong in the Court’s Bostock v. Clayton County decision of this past June. More disturbing yet, she mischaracterizes transgender people. She has opined that “people will feel passionately on either side about whether physiological males who identify as females should be permitted in bathrooms especially where there are young girls present.” This ill-informed misgendering and disrespect of transgender people, and in particular of trans youth, ignores that it is transgender people who are at widespread risk of assault and discrimination. Spreading such inflammatory ignorance is dangerous to their very lives and ability to fully participate in public life.

Further analysis of Amy Coney Barrett’s record reveals opinions that would immediately threaten the Affordable Care Act—which has expanded health care coverage for more than 20 million people, and helped countless LGBTQ people and those living with HIV who are more than twice as likely to be uninsured. She also has showed her lack of concern for racial equity – an important duty of our federal courts – when she denied rehearing of a decision that allowed a company to segregate its employees by race, violating a core tenant of Brown v. Board of Education

Read Lambda Legal’s letter here: https://www.lambdalegal.org/in-court/legal-docs/20201009_letter_amy-coney-barrett-opposition-supreme-court


October 12, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Denounces Senate Republicans’ Disgraceful Priorities as Amy Coney Barrett Confirmation Hearings Begin”. From the press release:

This morning, the Senate Judiciary Committee began confirmation hearings for Amy Coney Barrett. More than 7 million voters have already cast their ballots and less than a month remains until Election Day. Still, Senate Republicans continue to prioritize ramming through another Trump justice to the U.S. Supreme Court instead of addressing the suffering the COVID-19 pandemic is causing to our health, safety, and economic well-being.

NARAL Pro-Choice America President Ilyse Hogue released the following statement in response:

“Two things are clear: Barrett poses a clear and present danger to our fundamental rights and this hearing is part of an illegitimate and craven power grab that could affect our Courts for a long time. Plowing ahead with the confirmation of a Supreme Court justice this close to Election Day is an attack on our democracy that we won’t forget. It’s disgraceful for Senate Republicans to continue this partisan charade to maintain control no matter the results of November’s election, all while refusing to help people struggling in the midst of the still-raging pandemic. No confirmation should be considered until after Inauguration Day, period.”

Amy Coney Barrett’s record on reproductive freedom is clear. She has suggested that Roe v. Wade is an “erroneous decision.” She also signed onto an ad calling the landmark ruling “barbaric” and failed to disclose it in the documents submitted to the Senate ahead of her confirmation hearing. She sided with states trying to restrict abortion access, joined anti-choice groups in opposing the Affordable Care Act’s birth control benefit, and is connected to a group that calls for criminalizing in vitro fertilization. Her nomination comes after Trump’s promise to the Radical Right to only consider jurists hostile to reproductive freedom. It’s a vow he ran on in 2016 and doubled down on in a recent campaign letter to the anti-choice movement.

Rather than letting the American people decide, Trump and Mitch McConnell are teeing up one of the most rushed confirmation processes in history in a massive power grab. For the last four years, the Trump administration, Mitch McConnell, and Senate Republicans have waged war on our fundamental rights and our democracy. That’s why we know we must do all that we can to flip the Senate, expand our majority in the U.S. House of Representatives, and send Vice President Joe Biden and Sen. Kamala Harris to the White House…

October 12, 2020: Elle posted an article titled: “Senator Gary Peters Shares His Abortion Story”. It was written by Laura Bassett. From the article:

United States Senator Gary Peters, a low-key, moderate Democrat from Michigan, is in a very tight re-election race that could decide whether his party wins the Senate. But’ he’s not the type of guy who typically makes national headlines…. So it may come a as a surprise that with this story, he will become the first sitting senator in American history to publicly share a personal experience with abortion.

“It’s a story of how gut-wrenching and complicated decisions can be related to reproductive health, a situation I went through with my first wife,” he told me in a phone interview Sunday afternoon.

In the late 1980s in Detroit, Peters and his then wife, Heidi, were pregnant with their second child, a baby they very much wanted. Heidi was four months along when her water broke, leaving the fetus without amniotic fluid—a condition it could not possibly survive. The doctor told the Peters to go home and wait for a miscarriage to happen naturally.

But it didn’t happen. They went back to the hospital the next day, and the doctor detected a faint heartbeat. He recommended an abortion, because the fetus still had no chance of survival, but it wasn’t an option due to a hospital policy banning the procedure. So he sent the couple again home to wait for a miscarriage. “The mental anguish someone goes through is intense,” Peters says, “trying to have a miscarriage for a child that was wanted.”

As they waited, Heidi’s health deteriorated. When she returned to the hospital on the third day, after another night without a natural miscarriage, the doctor told her the situation was dire. She could lose her uterus in a matter of hours if she wasn’t able to have an abortion, and if she became septic from the uterine infection, she could die.

The doctor appealed to the hospital’s board for an exception to their anti-abortion policy and was denied. “I still vividly remember he left a message on the answering machine saying, ‘They refused to give me permission, not based on good medical practice, simply based on politics. I recommend you immediately find another physician who can do this procedure quickly,’” Peters recalls.

The Peters were able to get into another hospital right away because they were friends with its chief administrator. Heidi was rushed into an emergency abortion that saved her uterus and possibly her life. The whole experience was “painful and traumatic,” Heidi shared in a statement. “If it weren’t for urgent and critical medical care, I could have lost my life.”…

Reflecting on the experience now, Senator Peters says it “enacted an incredible emotional toll.” So why go public with it? “It’s important for folks to understand that these things happen to folks every day,” he explains. “I’ve always considered myself pro-choice and believe women should be able to make these decisions themselves, but when you live it in real life, you realize the significant impact it can have on a family.”…

October 12, 2020: Lambda Legal posted a press release titled: “What You Need to Know About Amy Coney Barrett”. From the press release:

On Monday, October 12, at 9 am Eastern, the Senate Judiciary Committee began confirmation hearings for Judge Amy Coney Barrett to the United States Supreme Court.

It is impossible to overstate how consequential a Justice Coney Barrett would be to the rights of LGBTQ people and everyone living with HIV.

Lambda Legal has done a deep dive into her record with respect to the issues that affect our communities the most and put the following guide together explaining exactly what is at stake. 

Marriage Equality

Judge Barrett’s approach to questions of constitutionally protected personal liberty is not only inconsistent with, but would seek to roll back, landmark decisions that have been essential to the ability of LGBTQ people to live authentically, to protect their families, and to make deeply personal decisions without fear of government interference. In 2016, then-Professor Barrett gave a presentation in which she expressed that marriage should not be viewed as a fundamental right for same-sex couples and instead should be decided on a state-by-state basis. This approach mistakenly erases the duty of courts to enforce everyone’s constitutional rights. If followed, it would deny equal liberty, dignity and autonomy to LGBTQ people, women, racial minorities and any other marginalized community historically denied those rights. 

Just last week, Justices Clarence Thomas and Samuel Alito authored a troubling statement in a case involving Kim Davis, the clerk in Kentucky who sought a special exception for issuing marriage licenses to same-sex couples. In their statement, they took issue with the majority opinion in Obergefell v. Hodges, the case that made marriage equality the law of the land, saying that individual states should have been able to “resolve this question through legislation” and claimed the Court wrongfully “bypassed that democratic process.” It is clear that if confirmed, Justice Barrett would be in good company.

In 2015, Coney Barrett signed onto a letter that said that she supports “marriage and family founded on the indissoluble commitment of a man and a woman.”

Transgender Rights

In a lecture discussing issues that could soon come before the Supreme Court, then-Professor Barrett expressed the legally unsound and troubling view that transgender people are not protected by Title IX’s federal prohibitions against sex discrimination in the context of education programs.

Judge Barrett’s approach has been soundly rejected by jurists spanning the political spectrum, perhaps most authoritatively twenty years ago by her mentor, Justice Scalia, for a unanimous Supreme Court, and most recently reaffirmed by Justice Gorsuch for a six-member majority in Bostock v. Clayton County, which extended federal protections against sex discrimination to LGBTQ employees. 

Equally, if not more disturbing, is how Judge Barrett has characterized transgender people. For example, she has opined that “[p]eople will feel passionately on either side about whether physiological males who identify as females should be permitted in bathrooms especially where there are young girls present.” (emphasis added). This misgendering of transgender people, particularly of transgender youth, callously disregards the legitimacy of their identity. Furthermore, this rhetoric invokes defamatory falsehoods suggesting not only that transgender girls are not truly girls, but that they somehow pose a threat to cisgender girls. 

Judge Barrett’s ardent but misguided views about transgender people deserve particular scrutiny due to the number of issues likely to come before the Supreme Court soon, including Title IX’s protections for transgender students, the Trump administration’s ban on military service by transgender people, and numerous rule changes adversely affecting the ability of transgender people to work, stay in school, receive medically necessary care, and fully participate in public life.

Health Care

Despite the Affordable Care Act’s success in making coverage available for millions and although our country is suffering through the worst health crisis in a century, the U.S. Supreme Court will hear oral arguments about the constitutionality of the ACA just one week after the election. 

LGBTQ people and people living with HIV are more than twice as likely to be uninsured as the general population. Also, the judicial repeal of the ACA would unwind the progress made in significantly decreasing uninsured and underinsured rates for people living with HIV following the passage of the ACA. 

It is beyond question that Judge Barrett’s supporters, including President Trump, know they can count on her to remain consistent in her academically fringe view that the ACA is unconstitutional. Given her public positions and the partisan nature of the debates about the law’s fate, any claims to believe she would have an open mind if elevated cannot be credited.

In 2017, then-Professor Barrett wrote that Justice Roberts “pushed the Affordable Care Act beyond its plausible meaning to save the statute” in NFIB v. Sebelius (SCOTUS case upholding the individual mandate a tax valid under the Taxing power). 

Access to health care is an issue of profound importance to LGBTQ people and people living with HIV. The Affordable Care Act (ACA) has expanded health care coverage for over 20 million people and has saved and improved untold numbers of lives. In addition, over 130 million people in the U.S. (including millions of Coronavirus survivors) suffer from preexisting conditions.

Reproductive Rights

In 2006, Judge Barrett signed onto a full-page newspaper ad demanding an end to legal abortion. Following a pattern set by many Trump administration nominees, Judge Barrett then failed to disclose this information on her Senate Judiciary Committee questionnaire. 

Notably, Professor Barrett also has expressed her hostility towards contraceptive insurance by joining a letter in 2012, referring to the ACA’s birth control insurance coverage as “Unacceptable.” Her position reflects not only her personal view that human life should be protected from the moment an egg is fertilized, a view far outside the mainstream, but also that our legal system should support that view despite the equally sincere religious and moral beliefs of those who disagree and whose lives would be directly affected. If views about reproductive health care were to become the law of the land, many thousands of couples – LGBTQ and not – who have depended on infertility medicine to become parents would not be able to start families. 

Racial Equity

We are also deeply troubled by Judge Barrett’s apparent lack of commitment to racial equity. In one especially troubling case, Judge Barrett denied rehearing of a decision in favor of a company that had segregated its employees by race. She took this position despite the explanation given by the dissent that the policy had violated the core teaching of Brown v. Board of Education, that “separate is inherently unequal, because deliberate racial segregation by its very nature has an adverse effect on the people subjected to it.” Judge Barrett’s complicit acceptance of racial segregation in a contemporary workplace is deeply disturbing and demonstrates a profound misunderstanding or minimization both of the harms of such a policy and the overriding responsibility of federal judges to enforce the statutory and constitutional bans on such racialized abuses of power.

Affiliation with Anti-LGBTQ Organizations

Judge Barret has also given lectures for a law student training program sponsored by the Alliance Defending Freedom (ADF), an organization dedicated, among other goals, to recriminalizing same-sex relationships, to preventing marriage equality, and now to expanding religious rights to refuse services to same-sex couples, both married and unmarried, and to exclude transgender people from public life. 

ADF’s overseas advocacy defends harsh criminal penalties for same-sex intimacy and supports forced sterilization of transgender people. In the United States, ADF is among the largest, best known, and most extreme of the many anti-LGBT legal organizations. Judge Barrett’s decision to affiliate herself with this organization demonstrates a marked lack of respect and concern for the countless LGBTQ people who are denied services, shunned, and otherwise harmed due to the advocacy of organizations like ADF. It is impossible to believe that she would be able to administer fair and impartial justice to members of a group she has so disdained.   

October 12, 2020: Senator Kamala Harris posted a press release titled: “Harris: Republicans Are Rushing Confirmation to Strike Down Affordable Care Act”. From the press release:

U.S Senator Kamala D. Harris (D-CA), a member of the Senate Judiciary Committee on Monday participated in the hearing to consider the nomination of Judge Amy Coney Barrett to the Supreme Court of the United States. Senator Harris spoke out against Senate Republicans’ attempt to jam through a nominee who will take away healthcare from millions of Americans – all while our nation is in the midst of a deadly pandemic.

In her statement, Harris highlighted that the legacy of Justice Ruth Bader Ginsburg and the rights she fought to protect are at stake with Barrett’s nomination. Harris demanded the committee wait to confirm a new Supreme Court justice until after the American people – who are currently voting – have the chance to decide who they want in the White House.

Key Experts:

  • This hearing has brought together more than 50 people to sit inside of a closed door room for hours while our nation is facing a deadly airborne virus. This committee has ignored commonsense requests to keep people safe.
  • Senate Republicans have made it crystal clear that rushing a Supreme Court nomination is more important than helping and supporting the American people who are suffering from a deadly pandemic and a devistating economic crisis.
  • A clear majority of Americans want whomever wins this election to fill this seat. And my Republican colleagues know that. Yet they are deliberately defying the will of the people in their attempt to roll back the rights and protections provided under the Affordable Care Act.
  • Republicans finally realized the Affordable Care Act is too popular to repeal in Congress, so now they are trying to bypass the will of voters and have the Supreme Court do their dirty work.
  • By replacing Justice Ruth Bader Ginsburg with someone who will undo her legacy, President Trump is attempting to roll back Americans’ rights for decades to come.
  • Every American must understand that with this nomination, equal rights under law is at stake. Our voting rights are at stake. Workers’ rights are at stake. Consumer rights are at stake. The right to safe and legal abortion is at stake. Holding corporations accountable is at stake.And again there is so much more.
  • I believe we must listen to our constitutients and protect their access to health care, and wait to confirm a new Supreme Court justice until after Americans decide who they want in the White House.

A full transcript of Harris’s statement is posted in that press release (under the bullet-point section.


October 13, 2020: American Journal of Preventative Medicine posted a study titled: “Women’s Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status”. It was done by May Sudhinaraset; PhD, Dovile Vilda; PhD, Jessica D. Gipson, MPH, PhD; and Maeve E. Wallace, MPH, PhD. From the study:

Introduction:

Reproductive rights policies can potentially support or inhibit individuals’ abilities to attain the highest standard of reproductive and sexual health; however, research is limited on how broader social policies may differentially impact women of color and immigrants in the U.S. This study examines the associations among state-level reproductive rights policies, race, and nativity status with preterm births and low birth weight in the U.S….

…Results:

Compared with women in states with the most restrictive reproductive rights policies, women living in the least restrictive states had a 7% lower low birth weight risk… In particular, low birth weight risk was 8% lower among Black women living in the least restrictive states than among their counterparts living in the most restrictive states… In addition, low birth weight risk was 6% lower among U.S.-born Black women living in the least restrictive states than among those living in the most restrictive states, but this was marginally significant. …No other significant associations were found for race-nativity-stratified models.

Conclusions:

Women living in states with fewer restrictions related to reproductive rights have lower rates of low birth weight, especially for Black women…

…Discussion:

Despite the increasing restrictions on reproductive rights in recent years, there are remarkably few empirical studies assessing the association between state-level restrictive reproductive policies and adverse birth outcomes by nativity status and race/ethnicity. This study aligns with other research that has found that women living in less restrictive versus those living in more restrictive states have better birth outcomes. Moreover, this study find that less restrictive policy environments were particularly protective for Black women, with evidence that this may be especially true for U.S.-born Black women.

These findings provide evidence for important policy levers that could be implemented to improve women’s reproductive health generally, with particular benefits for U.S.-born Black women, such as increasing abortion access and mandatory sex education in schools. The U.S. has a long history of oppressive reproductive policies and ideologies that results in the devaluation of certain lives, mainly racial/ethnic minorities. Past examples include the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the racist stereotypes of Black mothers as welfare queens to control reproduction, the eugenics movement; and the country’s history of involuntary and nonconsensual sterilization, especially among immigrant, Black, and incarcerated women. Moreover, new contraceptive technologies have been targeted to Black women, and several states have introduced legislation to restrict sex- and race-selective abortion policies, which are devoid of scientific justification and only serve to propagate stereotypes targeting Asian, Latina, and Black women and to restrict reproductive rights.

There were no significant associations for foreign-born women. This suggests that other factors beyond nativity status may explain the association between reproductive rights and birth outcomes, such as documentation status, length of time in the U.S., social support networks, and broader policy climates. Undocumented women may be systematically excluded from public benefits altogether, whereas those living in mixed-status families may experience spillover/chilling effects owing to social proximity with targeted individuals. Moreover, recent immigrants are more likely to experience a health advantage in regard to birth outcomes, whereas others have found that broader restrictive immigration policies increase adverse birth outcomes among Latinas. Corroborating previous literature, this study also found that the extent to which states collaborate with federal immigration authorities was associated with higher rates of LBW.

When considered jointly, both race/ethnicity and nativity played a role in shaping the risk for adverse birth outcomes associated with the state’s reproductive rights climate. That is, the findings showed significant associations between LBW and states’ reproductive rights climate among U.S.-born but not among foreign-born Black women. This finding is in line with the growing literature on the context-dependent nature of race as a determinant of population health. It may be that U.S.-born Black women’s reproductive health is shaped by the accumulation of insults to health accrued over their lifetime (and even over generations before them) living within a systematically racist society. Foreign-born women, on the other hand, may have had less time exposed to the historical and contemporary features of structural racism that restrict access to health-promoting resources and opportunities among people of color in the U.S. It should be noted, however, that fully adjusted interaction models and stratified models showed marginal significance, and therefore, these results may be due to chance. However, these significant findings persisted in the models run with different combinations of covariates (i.e., state-level poverty instead of poverty and opportunity index) for U.S.-born Black women. Future studies should explore this finding further, including qualitative studies to further examine the lived experiences of Black women….

…Conclusions:

Reproductive rights policies play a critical role in advancing maternal and child health outcomes. Further studies should assess specific evidence-based policies, particularly highlighting women’s lived experiences of policy exclusion or inclusion, and the effects on women and newborn health…

October 13, 2020: Facebook posted information in their Newsroom titled: “Supporting Public Health Experts’ Vaccine Efforts”. It was written by Kang-Xing Jin, Head of Health, and Rob Leathern, Director of Product Management. From the post:

The COVID-19 pandemic has highlighted the importance of preventive health behaviors. While public health experts agree that we won’t have an approved and widely available COVID-19 vaccine for some time, there are steps that people can take to stay healthy and safe. That includes getting the seasonal flu vaccine. So today we’re announcing new steps as part of our continued work to help support vaccine efforts. These include: 

  • Launching a new flu vaccine information campaign on Facebook, including new product features that provide additional vaccine-related content.
  • Rejecting ads globally that discourage people from getting a vaccine
  • Working with global health partner on campaigns to increase immunization rates…

…Prohibiting Ads that Discourage Vaccines

Today, we’re launching a new global policy that prohibits ads discouraging people from getting vaccinated. We don’t want these ads on our platform.

Our goal is to help messages about the safety and efficacy of vaccines reach a broad group of people, while prohibiting ads with misinformation that could harm public health efforts. We already don’t allow ads with vaccine hoaxes that have been publicly identified by leading global health organizations, such as the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC). Now, if an ad explicitly discourages someone from getting a vaccine, we’ll reject it. Enforcement will begin over the next few days…

…Ads that advocate for or against legislation or government policies about vaccines – including a COVID-19 vaccine – are still allowed. We’ll continue to require anyone running these ads to get authorized and include a ‘Paid for by’ label so people can see who is behind them. We regularly refine our approach around ads that are about social issues to capture debates and discussions around sensitive topics happening on Facebook. Vaccines are no different. While we may narrow enforcement in some areas, we may expand it in others….

October 13, 2020: Center for Reproductive Rights posted a press release titled: “Texas Ban on Standard Abortion Procedure Struck Down by Federal Appeals Court”. From the press release:

In a victory for Texans, the U.S. 5th Circuit Court of Appeals today struck down a Texas measure that would have banned the standard method of abortion after approximately 15 weeks of pregnancy, known as D&E. This lawsuit was filed in 2017 by Whole Woman’s Health — which operates three health clinics in the state of Texas — several Planned Parenthood affiliates, and other Texas abortion providers, represented by the Center for Reproductive Rights, Planned Parenthood Federation of America, Morrison & Foerster, and Patrick J. O’Connell. 

In the decision, Judge James L Dennis wrote, “[This law] unduly burdens a woman’s constitutionally-protected right to obtain a previability abortion,” and that the law “also forces abortion providers to act contrary to their medical judgment and the best interest of their patient by conducting a medical procedure that delivers no benefit to the woman.”

Doctors who violate the ban would have faced up to two years in prison. Major medical organizations including the American College of Obstetricians and Gynecologists (ACOG) strongly oppose these types of abortion bans, noting, “These restrictions represent legislative interference at its worst: doctors will be forced, by ill-advised, unscientifically motivated policy, to provide lesser care to patients. This is unacceptable.” Courts have blocked similar bans in Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, and Oklahoma. Last year, the Supreme Court declined to review a lower court decision striking down a D&E ban in Alabama. 

“Today’s win is an important one for people not only in Texas but across the country,” said Amy Hagstrom Miller, President and CEO of Whole Woman’s Health. “Everyone deserves to benefit from advancements in medicine and from expert medical care, no matter where they live. With this victory, our physicians can continue to practice to the highest level of their training, and Texans will continue to benefit from their expertise. We are proud, once again, to lead the charge challenging bad laws and ensuring that all Texans get the healthcare they deserve.” 

“Today’s decision puts a stop to Texas’ strategy to ban one abortion procedure after another until it is all but inaccessible,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Politicians should never decide what medical procedures a patient can and cannot receive. This ruling follows decades of Supreme Court precedent and the Fifth Circuit has joined every other federal court in striking down these types of bans.” …

…The decision comes four months after the Supreme Court struck down a medically unnecessary Louisiana law in June Medical Services v. Russo — a case brought by the Center for Reproductive Rights. If that law had been allowed to take effect, it would have closed all but one of the remaining health centers providing abortion in Louisiana. In 2016, the Supreme Court struck down an identical law in Texas that shuttered half the abortion clinics in the state in Whole Woman’s Health v. Hellerstedt. The Supreme Court ordered the state of Texas to pay $2.3 million in attorney’s fees for that case. 

“Today’s ruling means that my colleagues and I can continue to provide the highest quality medical care for our patients. The state’s attempt to interfere in private, deeply personal health care decisions by banning the most common method of abortion at this stage of pregnancy would have put patients in danger and punished doctors for using our best medical judgment, training, and expertise,” said Dr. Bhavik Kumar, abortion care provider, Planned Parenthood Center for Choice (serves Houston and southeast Texas). “Unfortunately, extremist politicians’ ongoing attempts to restrict access to abortion — method by method, state by state — until it is completely out of reach are all too familiar to physicians like myself. Thankfully, the court today affirmed what we have always known: that private medical decisions should stay between patients and the doctors they trust with their health care.”

Just six months ago, Gov. Greg Abbott and Attorney General Ken Paxton successfully exploited the COVID-19 pandemic to temporarily ban abortion in Texas for approximately one month. While the abortion ban was in effect, patients were forced to travel hundreds of miles to access the care they needed.

Since 2011, state politicians have passed more than 480 restrictions on abortion. Texas already has many onerous  laws and regulations that make it harder for Texans to access abortion, including state-mandated biased counseling, a two-trip requirement and mandatory 24-hour delay in care, a ban on the use of telemedicine to provide medication abortion, a parental consent and notification law, and many more.

This lawsuit challenging Texas’ ban on D&E procedures was filed in 2017 in the U.S. District Court for the Western District of Texas on behalf of Whole Woman’s Health, Planned Parenthood Center for Choice, Planned Parenthood of Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Alamo Women’s Reproductive Services, Southwestern Women’s Surgery Center, and several individual physicians. The plaintiffs are represented by the Center for Reproductive Rights, Planned Parenthood Federation of America, Morrison & Foerster who is serving as pro-bono counsel, and Austin attorney Patrick J. O’Connell.   

October 13, 2020: Slate posted an article titled: “Amy Coney Barrett Explained Why She Doesn’t Care About Preexisting Conditions”. It was written by Jeremy Stahl. From the article:

…On Tuesday, as expected, the Democrats put the matter directly to the nominee. Barrett has expressed disagreement with the court’s reasoning in the 2012 case that upheld the Affordable Care Act, but when asked now, she emphasized that California v. Texas involves a completely different question than the previous decision did. Specifically, she said, the new case is about “severability”—that is, whether, with the act’s insurance mandate now cut down to zero, the rest of the statute can survive on its own or must also be abandoned.

By Barrett’s account, this is a narrow legal question. If the question is decided a certain way, 20 million Americans will lose their health coverage and 100 million people will lose their protections for preexisting conditions. Nevertheless, Barrett told the committee that the upcoming case “doesn’t present the issue” of preexisting condition protections.

Here, despite her efforts to tell the committee as little as possible about her beliefs, Barrett revealed an enormous amount about her judicial philosophy. In her opening statement on Monday, she told the committee that “courts are not designed to solve every problem or right every wrong in our public life.” Evidently, that meant real-world consequences of the decisions she may make should not be relevant to her, the Senate, or the general public.

Here is that revelatory exchange, in which the ranking minority member, Sen. Dianne Feinstein, told a story about a constituent of Wisconsin Sen. Tammy Baldwin’s who, because of a cascade of health care expenses, depended on the ACA’s protections to be able to afford treatment…

As you can see, Barrett answered that the case the court would soon be hearing had nothing to do with those protections, as far as she understood it. Here’s the text of the exchange:

Feinstein: Jimmy is a 34-year-old and member of the Wisconsin state Legislature. In 2010 a drunk driver hit the family’s car as they were returning home from celebrating Jimmy’s 24th birthday. Jimmy’s mother, father, and little brother were killed in the accident. Jimmy was paralyzed from the waist down. His medical recovery was intense. As Jimmy as has said, “Doctors managed to patch me up with dozens of stitches and multiple surgeries and about a pound of steel in my spine.” But soon after, his insurance company told him he was nearing his lifetime maximums and he would have to pay for the rest of his health care expenses. As Jimmy explains: “With hundreds of thousands of dollars still left to go, I didn’t know what I was going to do. I was scared, I was terrified, I was just a student, I didn’t have that kind of money.” Fortunately, a few days later, the insurance company sent him a different letter. This one informed him that the provisions of the ACA had kicked in, which meant there were no longer lifetime maximums and his care would be covered. In Jimmy’s own words, “I was able to put my life back together and I credit the Affordable Care Act for that.” Judge Barrett, how should the loss of the ACA’s protection against lifetime caps, caps that can be used to end coverage for lifesaving care, factor into a court’s consideration of the validity of the ACA?

Barrett: Senator, so far as I know, the case next [month] doesn’t present that issue. It’s not a challenge to preexisting conditions coverage or to the lifetime maximum relief remote cap.

This is a technical distinction so fine as to cross over into dishonesty. Barrett professes not to see how, if she made a ruling in a case that would strip away protections from people with preexisting conditions, that case would be a challenge to those protections. The people would only be losing their protections incidentally as she decided the completely different question of severability.

Later, Vermont Sen. Patrick Leahy asked a series of questions about whether Barrett had any awareness of how many people would lose protections if she were to rule against the ACA after being elevated to the Supreme Court. She responded that she had no clue.

And here’s the text of the exchange:

Leahy: Do you know how many Americans have obtained insurance through the Affordable Care Act?

Barrett: I do not.

Leahy: It’s more than 20 million. And do you know how many children under the age of 26 are able to stay on their parents’ insurance because of the Affordable Care Act?

Barrett: I do not.

Leahy: It’s 2.3 million. And do you know how many Americans are covered under the Affordable Care Act’s Medicaid expansion?

Barrett: I do not.

Leahy: It’s a little more than 15 million. … If the Republicans are successful in what they’re trying to do on Nov. 10, then [my constituent] Alex and actually 60,600 other Vermonters enrolled in Medicaid expansion are going to be left behind. And if you contract COVID-19, that’s seen as a preexisting condition. Do you know approximately how many million Americans have tested positive for the coronavirus and survived?

Barrett: I do not.

Leahy: It’s more than 7,700,000. Those are people now considered to have a preexisting condition. And one of the most common preexisting conditions is diabetes. The CDC estimated about 1 in 10 Americans has diabetes. The ACA’s Medicaid expansion is the single most important factor for expanding access to affordable insulin. Leslie is a Vermonter [who was] diagnosed with diabetes at the age of 25. For years she has depended on Medicaid to keep her alive and out of bankruptcy. … Do you have an idea how much her insulin would increase?

Barrett: No, I do not.

Leahy: I wouldn’t expect you to. There’s no reason you should. Leslie’s cost would more than triple—go up to $11,215 a year.

Barrett doesn’t need to know the cost of insulin; she doesn’t need to know how many people in this country have COVID-19; she doesn’t need to know how many millions of Americans are covered under Medicaid expansion or under the Affordable Care Act as a whole. It’s not the courts’ job to “right every wrong,” even if those wrongs are directly caused by the decision the court would make…

October 13, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Continues Fight to Stop Trump Administration Dangerous “Healthcare Refusal Rule”. From the press release:

California Attorney General Xavier Becerra today filed a brief in the Ninth Circuit Court of Appeals continuing the fight against the Trump Administration’s unconstitutional and illegal “Healthcare Refusal Rule.” The broad, unfettered Rule jeopardizes the health and safety of Californians by allowing anyone remotely involved in a healthcare transaction—from doctors to ambulance drivers or front office staff— to deny care. This exemption would open the door to discrimination, particularly against women, LGBTQ individuals, people of color, individuals in rural and low-income communities, and endanger the timely delivery of critical lifesaving care. In the brief, Attorney General Becerra reasserts that the Rule violates the U.S. Constitution and the Administrative Procedure Act, arguing that the District Court was correct to vacate the rule in its entirety.  

“In the midst of a devastating pandemic, the Trump Administration continues to heartlessly attack Americans’ access to lifesaving healthcare by allowing a blank check for discrimination which will leave our communities vulnerable to loss of care or stigmatized for receiving basic care,” said Attorney General Becerra. “The Healthcare Refusal Rule dangerously and unlawfully throws open the doors to discrimination, going so far as to allow an EMT worker to leave a woman to bleed out by the side of the road. It’s unconscionable that the government would push this heartless rule. California will continue fighting for the right to healthcare and to ensure that this illegal rule will never take effect.”

The Trump Administration’s rule vastly and illegally expands federal law and coerces state compliance by threatening federal funding. For California, nearly half a trillion dollars of federal funding is at stake. The State of California has laws and regulations to protect access to healthcare while respecting “conscience” objections, in accordance with numerous existing federal conscience provisions. However, the Healthcare Refusal Rule issued by the Trump Administration’s U.S. Department of Health and Human Services (HHS) goes far beyond existing provisions, creating a broad exemption that risks access to care. The new rule would allow anyone remotely involved in a healthcare transaction – from front desk staff to emergency personnel to private entities – to object not just for religious reasons, but for “moral, ethical, or other” reasons as well.

In the brief, the attorney general asserts that the Rule would compromise patient access to care, and encourage discrimination against vulnerable patient populations, including women, people of color, LGBTQ individuals, and rural and low-income communities. The Rule would also have devastating impacts on patients and employers: the rule does not require any notice be given to patients who are refused care, and it provides no guidance for employers who must navigate how to accommodate these refusals. Furthermore, the Rule contains no exception for patients who need emergency care, thus threatening serious, potentially irreversible, harm to those in need of life-sustaining care. HHS’ counsel has even conceded that the Rule would permit an ambulance driver to cease driving in the middle of Central Park “en route to hospital…upon learning that the patient sought emergency care for ectopic pregnancy,” and that an employer’s failure to accommodate that ambulance driver could “result in a loss of federal funding.” These harsh outcomes not only conflict with federal law, but would greatly undermine California’s longstanding efforts to ensure access to emergency care for its residents.

Attorney General Becerra also argues that the Rule violates the Administrative Procedure Act and the U.S. Constitution’s Spending Clause by threatening federal funding for California’s programs that provide crucial health, education, and labor services, including:

  • $63 billion for healthcare services such as Medi-Cal;
  • $1.5 billion for public health initiatives including emergency preparedness and vaccination programs;
  • $6 billion for in-home supportive services;
  • $2.5 billion for child welfare and refugee assistance
  • $3.8 billion for educational programs, including child care and state preschool programs, migrant education, adult education, education for homeless children, special education, and vocational education; and
  • $900 million for providing short-term income to unemployed individuals, funding local workforce development, and providing services to job seekers and employers…

…Attorney General Becerra filed today’s brief alongside Santa Clara County, the City and County of San Francisco, Trust Women Seattle, Los Angeles LGBT Center, Whitman-Walker Clinic, Inc., Bradbury Sullivan LGBT Community Center, Center on Halsted, Hartford Gyn Center, Mazzoni Center, Medical Students For Choice, The Association of LGBT+ Psychiatrists, American Association of Physicians For Human Rights: Health Professionals Advancing LGBT Equality, and individual plaintiffs. 

A copy of the brief can be found here

October 13, 2020: Former Vice President Joe Biden (Democrat) tweeted: “Donald Trump has been trying to throw out Obamacare for years. And now he sees an opportunity to finally get it done, all while ignoring the will of the people. We can’t let him.”


October 14, 2020: Planned Parenthood posted a press release titled: “Federal Court Strikes Down Tennessee’s Forced Waiting Period for Abortions”. From the press release:

Today, a federal district court struck down a Tennessee law that forced patients to wait at least 48 hours before they can access abortion services, after receiving in-person, state-mandated counseling written by anti-abortion politicians. The law had been in effect since 2015. Roughly half of the states in the U.S. have similar forced waiting period laws on the books. The case was brought by reproductive health care providers in the state, represented by the Center for Reproductive Rights, Planned Parenthood Federation of America (PPFA), Kramer Levin Naftalis & Frankel LLP, Barrett Johnston Martin & Garrison, LLC, and Jessee & Jessee. 

In the decision, Judge Bernard Friedman wrote, “Defendants’ suggestion that women are overly emotional and must be required to cool off or calm down before having a medical procedure they have decided they want to have, and that they are constitutionally entitled to have, is highly insulting and paternalistic – and all the more so given that no such waiting periods apply to men.” He went on to write, “It is apparent that this waiting period unduly burdens women’s right to an abortion and is an affront to their ‘dignity and autonomy,’ ‘personhood’ and ‘destiny,’ and ‘conception of . . . [their] place in society.’” …

…This decision comes four months after the Supreme Court struck down a medically unnecessary Louisiana law in June Medical Services v. Russo. If that law had been allowed to take effect, it would have closed all but one abortion clinic in Louisiana. 

The Center is challenging waiting period measures in Arizona, Florida, Louisiana, Mississippi, and Oklahoma. PPFA, the ACLU, and the Center are also challenging a waiting period measure in North Carolina.  

These laws have particularly harsh consequences for those who already face systemic barriers to comprehensive reproductive health care, including individuals with low incomes, people of color, people living in rural areas, and individuals in abusive relationships, which are compounded by the mandatory delay and two-trip requirement. At trial in September 2019, Tennessee abortion providers testified that most patients are waiting much longer than 48 hours. The providers also testified that after this waiting period took effect in 2015, they saw a decrease in the number of patients with low incomes obtaining abortions at their facilities and a rise in the number of patients obtaining procedures later in pregnancy. Tennessee has one of the highest poverty rates in America, with poverty disproportionately impacting women, especially those who already have children. 

Delays in accessing abortion increase the costs associated with the procedure, and although abortion is extremely safe throughout pregnancy, the medical risks increase as pregnancy progresses. Major medical associations denounce these restrictions, and the American College of Obstetricians and Gynecologists (ACOG) states these laws “marginalize abortion services from routine clinical care and are harmful to women’s health.” 

In addition to the mandatory delay, Tennessee laws impose other barriers on abortion access, including limits on when state and public insurance can cover abortion services, a ban on the use of telemedicine to administer medication abortion, and a requirement that minor patients obtain parental consent. The Center and PPFA are currently challenging a series of abortion bans passed earlier this year in Tennessee and a law that forces doctors to tell their patients false information about medication abortion. Both laws are currently blocked.  

October 14, 2020: Senator Tammy Baldwin (Democrat – Wisconsin) tweeted: “Republicans in Congress tried repeatedly & failed to repeal the #ACA in Congress. So Trump’s Justice Department is asking the Supreme Court to overturn the health care law completely, including protections for people with pre-existing conditions #WhatsAtStake”.

October 14, 2020: Lambda Legal posted a press release titled: “Advocates Urge Federal Court to Affirm Ruling Striking Down Trump Administration Denial of Care Rule”. From the press release:

Today, Lambda Legal, Americans United for Separation of Church and State, the Center for Reproductive Rights, and the County of Santa Clara filed an answering brief with the U.S. Court of Appeals for the Ninth Circuit urging the court to affirm a lower court ruling striking down the Denial of Care Rule proposed by the U.S. Department of Health and Human Services (HHS).

In that earlier ruling issued in November, 2019, U.S. District Court for the Northern District of California Judge William H. Alsup found the proposed Denial of Care Rule “saturated with error,” and struck the rule down in its entirety. Judge Alsup became the third judge in rapid succession last November to vacate the rule, joining judges for the Eastern District of Washington and Southern District of New York.

“There is no rationale for breathing life into a rule Judge Alsup found ‘so saturated with error’ that he could find literally no aspect of it that passed constitutional muster,” said Camilla Taylor, Director of Constitutional Litigation, Lambda Legal. “Three separate federal judges last November recognized the Denial of Care Rule for what it is, an egregious and unconstitutional attack on women, LGBTQ people and other vulnerable populations. It deserved to be relegated to the dustbin of history, and it deserves to stay there.” 

The Denial of Care Rule, which was issued in May, 2019, by the U.S. Department of Health and Human Services, invited any health care worker – including doctors, nurses, EMTs, administrators, janitors and clerical staff – to deny medical treatment, information and services to patients because of personal religious or moral beliefs. Health care facilities risked losing essential federal funding if they did not grant employees carte blanche to deny services. Because the rule was confusing and infeasible to implement, many health care facilities would likely have been forced to eliminate services such as reproductive and LGBTQ care, leaving millions across the United States without access to critical health care.

On November 6, 2019, the U.S. District Court for the Southern District of New York issued a ruling in State of New York v. HHS completely vacating the Denial of Care Rule. The next day, November 8, 2019, Judge Stanley Bastian of the U.S. District Court for the Eastern District of Washington ruled from the bench in State of Washington v. Azar, agreeing with the ruling out of New York. Judge Alsup’s ruling in three cases combined for argument – County of Santa Clara v. HHSCity and County of San Francisco v. Azar, and State of California v. Azar – issued on November 19, 2019.

In addition to the County of Santa Clara, which runs an extensive health and hospital system that serves as a safety-net provider for the county’s 1.9 million residents, the plaintiffs in County of Santa Clara v. HHS include: the health providers Bradbury-Sullivan LGBT Community Center in Allentown, Pa.; Center on Halsted in Chicago; Hartford GYN in Connecticut; Los Angeles LGBT Center; Mazzoni Center in Philadelphia, and Whitman-Walker Health in Washington, D.C.; the associations AGLP, GLMA, and Medical Students for Choice; and five doctors. 

Read today’s filing here. In addition to the three cases combined in County of Santa Clara v. HHS, the Ninth Circuit has also added State of Washington v. Azar for purposes of the appeal.

October 14, 2020: Planned Parenthood posted a press release titled: “Texas Ban on Standard Abortion Procedure Struck Down by Federal Appeals Court”. From the press release:

In a victory for Texans, the U.S. 5th Circuit Court of Appeals today struck down a Texas measure that would have banned the standard method of abortion after approximately 15 weeks of pregnancy, known as D&E. This lawsuit was filed in 2017 by Whole Woman’s Health — which operates three health clinics in the state of Texas — several Planned Parenthood affiliates, and other Texas abortion providers, represented by the Center for Reproductive Rights, Planned Parenthood Federation of America, Morrison & Foerster, and Patrick J. O’Connell.

In the decision, Judge James L Dennis wrote, “[This law] unduly burdens a woman’s constitutionally-protected right to obtain a previability abortion,” and that the law “also forces abortion providers to act contrary to their medical judgment and the best interest of their patient by conducting a medical procedure that delivers no benefit to the woman.”

Doctors who violate the ban would have faced up to two years in prison. Major medical organizations including the American College of Obstetricians and Gynecologists (ACOG) strongly oppose these types of abortion bans, noting, “These restrictions represent legislative interference at its worst: doctors will be forced, by ill-advised, unscientifically motivated policy, to provide lesser care to patients. This is unacceptable.” Courts have blocked similar bans in Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, and Oklahoma. Last year, the Supreme Court declined to review a lower court decision striking down a D&E ban in Alabama…

…The decision comes four months after the Supreme Court struck down a medically unnecessary Louisiana law in June Medical Services v. Russo — a case brought by the Center for Reproductive Rights. If that law had been allowed to take effect, it would have closed all but one of the remaining health centers providing abortion in Louisiana. In 2016, the Supreme Court struck down an identical law in Texas that shuttered half the abortion clinics in the state in Whole Woman’s Health v.Hellerstedt. The Supreme Court ordered the state of Texas to pay $2.3 million in attorney’s fees for that case. 

Just six months ago, Gov. Greg Abbott and Attorney General Ken Paxton successfully exploited the COVID-19 pandemic to temporarily ban abortion in Texas for approximately one month. While the abortion ban was in effect, patients were forced to travel hundreds of miles to access the care they needed.

Since 2011, state politicians have passed more than 480 restrictions on abortion. Texas already has many onerous laws and regulations that make it harder for Texans to access abortion, including state-mandated biased counseling, a two-trip requirement and mandatory 24-hour delay in care, a ban on the use of telemedicine to provide medication abortion, a parental consent and notification law, and many more.

This lawsuit challenging Texas’ ban on D&E procedures was filed in 2017 in the U.S. District Court for the Western District of Texas on behalf of Whole Woman’s Health, Planned Parenthood Center for Choice, Planned Parenthood of Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Alamo Women’s Reproductive Services, Southwestern Women’s Surgery Center, and several individual physicians. The plaintiffs are represented by the Center for Reproductive Rights, Planned Parenthood Federation of America, Morrison & Foerster who is serving as pro-bono counsel, and Austin attorney Patrick J. O’Connell.   

October 14, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Joins Coalition in Fight Against Pharmaceutical Company AbbVie Inc.’s Anticompetetive Practices”. From the press release:

California Attorney General Xavier Becerra yesterday joined a coalition of 20 state attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Seventh Circuit to address significant issues of antitrust and anticompetitive pharmaceutical agreements involving AbbVie Inc.’s drug, Humira. AbbVie employed numerous strategies to prevent any competition to Humira, including entering into multiple anticompetitive agreements with rival drug companies that allowed AbbVie to raise the price of Humira and limit options for patients. Humira is used to treat inflammation that leads to autoimmune diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and plaque psoriasis.

“California residents spend billions of dollars on prescription drugs like Humira,” said Attorney General Becerra. “When companies like AbbVie are allowed to monopolize the market and hike up the price of these drugs, they put the lives of Californians at risk. During a global pandemic when people have more to worry about than ever, they shouldn’t also have to worry about whether they can afford their prescription medication. My office will continue to tackle these dangerous, collusive pay-for-delay agreements head on.”

Humira is the world’s largest selling drug, generating sales of some $20 billion a year and costing approximately $39,000 per year for treatment. AbbVie’s anticompetitive agreements, known as pay-for-delay agreements, allowed rival companies to compete against Humira outside the United States in 2018. But the agreements required the rival companies to delay the introduction in the U.S. of a competitive counterpart to Humira until 2023. With these pay-for-delay agreements, AbbVie could freely raise the price of Humira in the U.S. by 6.2 percent in 2019 followed by a 7.4 percent increase this year. While Humira prices are increasing in the U.S., they are decreasing in Europe where there is competition. Humira’s sky-high price tag and its scheme to protect the inflated Humira price hurts employers, patients, insurers and the government, who all shoulder the burden of those inflated prices.  

In California, Assembly Bill 824, which went into effect on January 1, 2020, gives the Attorney General a stronger platform to investigate and prosecute these illegal and harmful drug pricing practices.

In the brief, the coalition argues:

  • The District Court misapplied the U.S. Supreme Court’s decision in FTC v. Actavis, Inc. (Actavis) to AbbVie’s agreements with its competitors. In Actavis, the U.S. Supreme Court held that the Federal Trade Commission could challenge pay-for-delay agreements under federal antitrust law. The attorneys general argue the lower court decision effectively resurrects the very antitrust immunity that the U.S. Supreme Court specifically rejected in FTC v. Actavis. They assert that the lower court’s approach will embolden other pharmaceutical companies to fashion illegal settlements to creatively evade scrutiny.
  • The Appeals Court should follow the majority of the Courts of Appeal and apply the California Motor Transport rule to serial sham petitioning. Four U.S. Courts of Appeals have reached this conclusion, and in cases alleging serial sham petitioning, the court is presented with more information and is therefore better equipped to assess whether AbbVie misused the government process to curtail competition…

…In yesterday’s filing, Attorney General Becerra joined the attorneys general of Washington, Colorado, Connecticut, Delaware, Idaho, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Mexico, New York, North Carolina, Oregon, Rhode Island, Virginia, and Wisconsin.

A copy of the brief is available here.

October 14, 2020: The Texas Tribune posted an article titled: “New Texas rule lets social workers turn away clients who are LGBTQ or have a disability”. It was written by Edgar Walters. From the article:

Texas social workers are criticizing a state regulatory board’s decision this week to remove protections for LGBTQ clients and clients with disabilities who seek social work services.

The Texas State Board of Social Work Examiners voted unanimously Monday to change a section of its code of conduct that establishes when a social worker may refuse to serve someone. The code will no longer prohibit social workers from turning away clients on the basis of disability, sexual orientation or gender identity.

Gov. Greg Abbott’s office recommended the change, board members said, because the code’s nondiscrimination protections went beyond protections laid out in the state law that governs how and when the state may discipline social workers…

…The nondiscrimination policy change drew immediate criticism from a professional association. Will Francis, executive director of the Texas chapter of the National Association of Social Workers, called it “incredibly disheartening.”

He also criticized board members for removing the nondiscrimination protections without input from the social workers they license and oversee…

…The Republican-led Texas Legislature has long opposed expanding nondiscrimination protections to LGBTQ Texans in employment, housing and other areas of state law.

Alice Bradford, the board’s executive director, said she received an email from the governor’s staff recommending the change Friday, three days before the board’s Monday vote.

The vote happened during a joint online meeting of the social work board and the Texas Behavioral Health Executive Council, which oversees a host of regulatory agencies for professions related to mental health…

…The social work board’s ban on discriminating against clients based on sexual orientation was approved in 2010, Francis said, and gender identity and expression protections were added in 2012.

The board fielded comments from the public after it had already changed the rule. Austin social worker Tracy Abzug told board members that “it’s actually quite disturbing to me that the Texas State Board of Social Work Examiners has agreed today to lower our standards as it relates to discrimination towards sexual orientation and gender identity.”…


October 14, 2020: Center for Reproductive Rights posted a press release titled: “Federal Court Strikes Down Tennessee’s Forced Waiting Period for Abortions”. From the press release:

Today, a federal district court struck down a Tennessee law that forced patients to wait at least 48 hours before they can access abortion services, after receiving in-person, state-mandated counseling written by anti-abortion politicians. The law had been in effect since 2015. Roughly half of the states in the U.S. have similar forced waiting period laws on the books. The case was brought by reproductive health care providers in the state, represented by the Center for Reproductive Rights, Planned Parenthood Federation of America (PPFA), Kramer Levin Naftalis & Frankel LLP, Barrett Johnston Martin & Garrison, LLC, and Jessee & Jessee.

In the decision, Judge Bernard Friedman wrote, “Defendants’ suggestion that women are overly emotional and must be required to cool off or calm down before having a medical procedure they have decided they want to have, and that they are constitutionally entitled to have, is highly insulting and paternalistic – and all the more so given that no such waiting periods apply to men.” He went on to write, “It is apparent that this waiting period unduly burdens women’s right to an abortion and is an affront to their ‘dignity and autonomy,’ ‘personhood’ and ‘destiny,’ and ‘conception of . . . [their] place in society.’”

“We hope today’s decision serves as a wake-up call to lawmakers trying to interfere with patients’ personal medical decisions,” said Autumn Katz, Senior Counsel at the Center for Reproductive Rights. “Patients do not need politicians to dictate their decision-making process. Patients should be trusted to make decisions about their own families and health care. This law is demeaning and actually harms patients by imposing unnecessary costs and pushing abortion later in pregnancy.” 

“We are so glad that we can now schedule our patients for care in a manner that centers their needs, not the political vagaries of our state government,” said Rebecca Terrell, executive director of CHOICES Memphis Center for Reproductive Health.

“Today’s decision is a win for patients who deserve to be trusted, free of shame and stigma, to make the best health care decisions for themselves and their families. With 17 abortion-related cases one step away from the Supreme Court — including one from Tennessee banning abortion at nearly every stage of pregnancy — it’s clear that the right to access safe, legal abortion is under attack like never before,” said Ashley Coffield, President & CEO, Planned Parenthood of Tennessee and North Mississippi. “So many patients in our region regularly face barriers to care due to a lack of nearby health centers and systemic inequities that make it harder for people with low incomes and people of color to access care. Intrusive, unnecessary, and medically dangerous restrictions like the 48-hour waiting period only make it harder to access basic health care. At Planned Parenthood, we empower people with the information and the care they need to decide the course of their own lives. We will continue to defend their right to bodily autonomy, against any politician or bill that threatens it, no matter what.”

This decision comes four months after the Supreme Court struck down a medically unnecessary Louisiana law in June Medical Services v. Russo. If that law had been allowed to take effect, it would have closed all but one abortion clinic in Louisiana.

The  Center is challenging waiting period measures in Arizona, Florida, Louisiana, Mississippi, and Oklahoma. PPFA, the ACLU, and the Center are also challenging a waiting period measure in North Carolina.

These laws have particularly harsh consequences for those who already face systemic barriers to comprehensive reproductive health care, including individuals with low incomes, people of color, people living in rural areas, and individuals in abusive relationships, which are compounded by the mandatory delay and two-trip requirement. At trial in September 2019, Tennessee abortion providers testified that most patients are waiting much longer than 48 hours. The providers also testified that after this waiting period took effect in 2015, they saw a decrease in the number of patients with low incomes obtaining abortions at their facilities and a rise in the number of patients obtaining procedures later in pregnancy. Tennessee has one of the highest poverty rates in America, with poverty disproportionately impacting women, especially those who already have children.

Delays in accessing abortion increase the costs associated with the procedure, and although abortion is extremely safe throughout pregnancy, the medical risks increase as pregnancy progresses. Major medical associations denounce these restrictions, and the American College of Obstetricians and Gynecologists (ACOG) states these laws “marginalize abortion services from routine clinical care and are harmful to women’s health.”

In addition to the mandatory delay, Tennessee laws impose other barriers on abortion access, including limits on when state and public insurance can cover abortion services, a ban on the use of telemedicine to administer medication abortion, and a requirement that minor patients obtain parental consent. The Center and PPFA are currently challenging a series of abortion bans passed earlier this year in Tennessee and a law that forces doctors to tell their patients false information about medication abortion. Both laws are currently blocked.

October 14, 2020: Lambda Legal posted a press release titled: “Advocates Urge Ninth Circuit Court of Appeals to Affirm Ruling Striking Down Trump Administration Denial of Care Rule”. From the press release:

Today, Lambda Legal, Americans United for Separation of Church and State, the Center for Reproductive Rights, and the County of Santa Clara filed an answering brief with the U.S. Court of Appeals for the Ninth Circuit urging the court to affirm a lower court ruling striking down the Denial of Care Rule proposed by the U.S. Department of Health and Human Services (HHS).

In the earlier ruling, issued in November, 2019, U.S. District Court for the Northern District of California Judge William H. Alsup found the proposed Denial of Care Rule “saturated with error,” and struck the rule down in its entirety. Judge Alsup became the third judge in rapid succession last November to vacate the rule, joining judges for the Eastern District of Washington and Southern District of New York…

…The Denial of Care Rule, which was issued in May, 2019, by the U.S. Department of Health and Human Services, invited any health care worker – including doctors, nurses, EMT’s, administrtators, janitors and clerical staff – to deny medical treatment, information and services to patients because of personal religious or moral beliefs. Health care facilities risked losing essential federal funding if they did not grant employees carte blanche to deny services. Because the rule was confusing and infeasible to implement, many health care facilities would likely have been forced to eliminate services such as reproductive and LGBTQ care, leaving millions across the United States without critical access to care.

On November 6, 2019, the U.S. District Court for the Southern District of New York issued a ruling in State of New York issued a ruling in State of New York v. HHS completely vacating the Denial of Care Rule. The next day, November 8, 2019, Judge Stanley Bastian of the U.S District Court for the Eastern District of Washington ruled from the bench in State of Washington v. Azar, agreeing with the ruling out of New York. Judge Alsup’s ruling in three cases combined for argument – County of Santa Clara v HHS, City and County of San Francisco v. Azar, and State of California v. Azar – issued on November 19, 2019.

In addition to the County of Santa Clara, which runs an extensive health and hospital system that serves as a safety-net provider for the county’s 1.9 million residents, the plaintiffs in County of Santa Clara v. HHS include: the health providers Bradbury-Sullivan LGBT Community Center in Allentown, Pa.; Center on Halsted in Chicago; Hartford GYN in Connecticut; Los Angeles LGBT Center; Mazzoni Center in Philadelphia, and Whitman-Walker Health in Washington, D.C.; the associations AGLP, GLMA, and Medical Students for Choice; and five doctors. 

Read today’s filing here. In addition to the three cases combined in County of Santa Clara v. HHS, the Ninth Circuit has also added State of Washington v. Azar for purposes of the appeal.

More information about County of Santa Clara v. HHS is available here


October 15, 2020: Senator Jack Reed (Democrat – Rhode Island) tweeted: “Having #healthinsurance can be the difference between life & death. The Trump Admin is suing in federal court to get #SCOTUS to strike down the #ACA & eliminate critical health protections for millions of Americans. We must #ProtectOurCare. The best way to do that is to vote.”

October 15, 2020: Center for Reproductive Rights posted a press release titled: “Center’s Legal Analysis Outlines Judge Barrett’s Extreme Record on Reproductive Rights”. From the press release:

…The Center for Reproductive Rights has issued an analysis of the judicial rulings, writings and public advocacy of Amy Coney Barrett, President Trump’s nominee to the U.S. Supreme Court to replace Justice Ruth Bader Ginsburg. Based on the analysis, the Center concludes that Judge Barrett “stands all too ready, if not eager, to undermine women’s basic liberty rights”—including the right to abortion. Based on these findings, the Center opposes Judge Barrett’s confirmation.

The Center conducted an extensive review of Judge Barrett’s judicial rulings during her three years as an Appellate Court judge, her academic writings and speeches as a law professor at Notre Dame Law School, and her public statements and advocacy. Those records, according to a recent statement issued by the Center, show that “Judge Barrett has the most extreme record in opposition to reproductive rights of any Supreme Court nominee since the rejected nomination of Judge Robert Bork over 30 years ago.“ 

Highlights of the Center’s analysis include:

  • On the U.S. Court of Appeals for the Seventh Circuit, Judge Barrett ruled against abortion rights both times the issue was before her. In those cases, she joined opinions that suggest upending Supreme Court law on both the substantive right to abortion and the procedural safeguards that allow the right to be vindicated in court.
  • In the first case, Planned Parenthood v. Indiana Department of Health, in 2018, the opinion suggested that the government can ban abortion based on a woman’s reason for having one.
  • In the second case, in 2019, Planned Parenthood v Adams (later Box), the opinion questioned long-standing precedent that abortion providers may challenge restrictive laws before they go into effect.
  • Judge Barrett subscribes to a judicial philosophy of originalism that rejects constitutional protections for abortion rights. Her writings make it clear that she does not view Roe v. Wade as a “super precedent” and she has suggested that if confronted with a conflict between precedent and her interpretation of the Constitution, she would side with the latter and overturn precedent – endangering settled law on abortion rights.
  • She has publicly advocated to end Roe v. Wade and defends “the right to life from fertilization,” an extreme legal position that has implications for contraception, abortion care and fertility treatments.

The stakes of this nomination could not be higher. The next Supreme Court justice will hear cases impacting people’s lives for generations to come – not only on issues of reproductive rights, but on access to health care, voting rights, LGBTQ rights, and disability rights. On abortion rights alone, more than a dozen cases are in the Supreme Court pipeline – some test cases to overturn Roe v. Wade or to chip away at Roe’s protections to make them meaningless.

The Supreme Court’s vital role in protecting and upholding civil rights and liberties cannot be compromised by a nominee fundamentally hostile to our constitutional rights. The Center for Reproductive Rights opposes the confirmation of Judge Amy Coney Barrett – and urges all supporters of reproductive rights to tell their Senators to vote no on her confirmation.

October 15, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Takes Action to Ensure Californians Have Access to Mental Health Care”. From the press release:

California Attorney General Xavier Becerra today urged California’s four largest health insurance providers: Anthem Blue Cross, Blue Shield of California, Health Net of California, and Kaiser Permanente, to demonstrate their compliance with state and federal mental health parity laws. In letters addressed to each of the managed care insurance companies, the Attorney General requested information that would help determine if they are providing coverage for mental health benefits and services without putting limitations or conditions on the coverage that are more restrictive than permitted by the law. Equal treatment for mental health conditions in insurance plans is mandated by state and federal laws, including the California Mental Health Parity Act, the federal Mental Health Parity and Addiction Equity Act of 2008, and the Affordable Care Act (ACA). The plans have until November 16, 2020, to voluntarily comply with the information request.

“One out of every six Californians experiences some type of mental illness, which is why it is important to ensure our mental health laws are being followed,” said Attorney General Becerra. “It is the job, mandated by the law, of health insurance providers to make access to care for mental health conditions as accessible as care for a medical illness. Now, when people are seeing their mental health worsen as they navigate the COVID-19 pandemic, is a critical time to ensure those who need it have access to care.”

Despite multiple laws, including the California Mental Health Parity Act and the ACA, which expanded access to mental health treatment across the country, many Californians still struggle to find appropriate mental health treatment. Many Californians with insurance are also exponentially more likely to go out of network for mental health treatment than for medical services. According to a survey by the Kaiser Family Foundation/California Health Care Foundation, two-thirds of the individuals surveyed reported that they or one of their family members sought but were unable to locate mental health services.

In order to investigate mental healthcare coverage, the Attorney General requested documents and information that would ensure Anthem Blue Cross, Blue Shield of California, Health Net of California, and Kaiser Permanente are following mental health parity laws. 

A copy of the letter to Anthem Blue Cross is available here.
A copy of the letter to Blue Shield of California is available here.
A copy of the letter to Health Net of California is available here.
A copy of the letter to Kaiser Permanente is available here.

October 15, 2020: National Organization for Women (NOW) posted a press release titled: “Women Won’t Tolerate Mitch McConnell and Lindsey Graham’s Trickery”. From the press release:

The Senate Judiciary Committee wasn’t even finished hearing testimony on the nomination of Judge Amy Coney Barrett to the U.S. Supreme Court when Lindsey Graham railroaded her onto the agenda for a final confirmation vote.  He knows that he has no time to spare to make his goal of a final Senate floor vote just days before the election. 

Amy Coney Barrett couldn’t be a more dangerous choice for women, families, and the future of our democratic freedoms.  Her record speaks for itself and shows that she is not someone who will work on behalf of the American people. In fact, she has consistently proven she will not hesitate to suppress our civil rights and freedoms. 

She has been outspoken in her opposition to the Affordable Care Act and called for the “barbaric legacy” of Roe to end. She took thousands of dollars from a group that was designated an anti-LGBTQIA+ hate group and affirmed a ruling that allowed a company to segregate its employees by race.  Judge Barrett repeatedly ruled against the rights of immigrants, said Title IX protections do not extend to transgender Americans, and wrote that Supreme Court justices should not follow precedent with which they disagree. 

Graham and McConnell know that if Donald Trump loses the election, and the Republicans lose their Senate majority, they will face tough questions from their constituents that they cannot answer.   

Why have they enabled Trump to divert the work of the Senate away from the urgency of Covid relief for so long? Why should a lame-duck Senate be allowed to radically redefine the Supreme Court?  Why are they hijacking the Senate agenda in the middle of a global pandemic to seat Amy Coney Barrett on the Supreme Court—where she can enshrine their opposition to abortion rights, equal pay, paid leave, affordable health care, voting rights, consumer protections, and other progressive policies for generations to come? 

We know the answer. It’s because they want to hijack democracy and steal another Supreme Court seat for Donald Trump. They don’t want to be held accountable for any of their actions or take the time to listen to what the overwhelming majority of this country has to say.   

But as Kamala Harris would say, “we’re speaking.”  We’re speaking up for democracy, equality, and justice.  

NOW calls on Democrats in the Senate to do everything they can to stop this vote from coming to the floor this month.  We will be turning our words into action with our votes—and the Senate must deal with the consequences. 


October 16, 2020: Former Vice President Joe Biden tweeted: “We need a president who will expand access to health care – not one who does everything he can to tear it away.”

October 16, 2020: The Kansas City Star posted an article titled: “KC hospitals ‘bursting at the seams” with record numbers of COVID-19 patients”. It was written by Anna Spoerre. From the article:

Some Kansas City area hospitals, facing their biggest influx of coronavirus patients since the pandemic began, are refusing ambulances because their beds are already filled, according to a leading doctor at St. Luke’s Health System.

On Wednesday night, eight metro hospitals and emergency departments reported such high volumes of patients that they temporarily stopped accepting ambulances, Marc Larsen, Operations Director of Saint Luke’s COVID Response Team, said in a phone interview Thursday.

Two of the eight were part of the St. Luke’s system, according hospital spokesperson, who did not identify the other medical centers.

As of 1 p.m. Thursday, five were still diverting ambulances for all who weren’t in most critical need, such as stroke, heart attack and trauma patients, Larsen said. When this happens, alternative care areas accept the patients instead.

“We’re bursting at the seams in the metropolitan area, and really across the state and the region,” said Larsen, who is also an emergency physician.

The worsening conditions in Kansas City come as Missouri reports record hospitalizations and rural Kansas hospitals say they are under pressure.

On Wednesday, Ascension Via Christi Hospital in Pittsburg, Kansas, put out a statement saying they are pausing elective and non-emergent procedures because of capacity concerns.

In western Kansas, about 300 miles west of Kansas City, more than 50 employees at the Gove County Medical Center have been infected with the virus, the hospital said in a statement Tuesday. At least 25 staff members have recovered and two are hospitalized.

In Kansas City, the St. Luke’s Health System hit a record number of COVID-19 patients — more than 100 — on Tuesday, more than double their August average. They had 90 coronavirus patients across their hospitals as of Thursday afternoon.

The situation has worsened over the course of the year. In May and June, the hospital system averaged 15 patients a day. In July and August it was 50. In September, 63. In the first 14 days of October, Larsen said, St. Luke’s averaged 85 patients a day.

The worsening conditions in Kansas City come as Missouri reports record hospitalizations and rural Kansas hospitals say they are under pressure.

On Wednesday, Ascension Via Christi Hospital in Pittsburg, Kansas, put out a statement saying they are pausing elective and non-emergent procedures because of capacity concerns.

Through this growth, the volume of sickest patients remains high, he added. As of Thursday, 25 of the 90 patients with coronavirus were in the intensive care unit.

Some pre-operation and recovery rooms are being transformed into ICUs, Larsen said.

“All of the systems across the metropolitan area are continually struggling with having adequate capacity for the surge that we are continually seeing and experiencing,” Larsen said.

He pointed to New York City, Louisiana and Texas as examples of what can happen when hospital systems reach capacity.

“I worry that if we don’t start taking this seriously as a metropolitan area, we’re going to be the next New York,” he said. “We’re going to be the next hot spot, because though we have a lot of hospitals, we have a lot of capacity in the area, we are filling up fast.”

Larsen noted that flu season, when hospitals are often taxed with more patients, is not yet in full swing. He said it was the important that people get a flu shot this year…

October 16, 2020: Kaiser Family Foundation (KFF) posted information titled: “KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care”. From the information:

Key Findings

  • The confirmation hearings for Judge Barrett, President Trump’s appointment to fill the Supreme Court seat previously held by Justice Ginsburg, are underway this week and the future of the ACA’s protections for people with pre-existing conditions have been front-and-center. The latest KFF Health Tracking Poll finds a large majority of the public – including majorities of Democrats (91%), independents (81%), and Republicans (66%), now say they do not want to see the Supreme Court overturn the ACA’s pre-existing condition protections. The share who do not want to see these protections overturned has increased by double digits from one year ago for each group.
  • Six in ten adults say they do not want to see the Supreme Court overturn the entire ACA, up 10 percentage points from one year ago. This includes majorities of both Democrats (89%) and independents (66%), but three-fourths of Republicans still want to see the entire law overturned. Overall views of the Affordable Care Act are slightly more positive this month, with 55% of the public saying they view the law favorably. This ties its highest favorability measured in ten years of KFF polling (tied with February 2020).
  • Vice President Biden has the advantage over President Trump on all health policy issues included in the survey including at least a 20 percentage point advantage on who voters think has the better approach (Biden or Trump) to make decisions about women’s reproductive health choices and services, including abortion, family planning, and contraception (57% v. 34%), determining the future of the ACA (57% v. 37%), and maintaining protections for people with pre-existing health conditions (56% v. 36%). He also holds an advantage on surprise medical bills, the coronavirus outbreak and distribution of a vaccine, and lowering health care costs for individuals.
  • While both presidential candidates say they have plans to ensure pre-existing condition protections, most Democrats and independent say they do not think President Trump has a plan to maintain such protections. Slightly more than half (53%) including majorities of Democrats (90%) and independents (57%) say they “do not think President Trump has a plan to maintain protections for people with pre-existing health conditions.” On the other hand, a large majority of Republicans (85%) say President Trump “has a plan” to maintain these protections afforded by the ACA.

The Affordable Care Act and the Supreme Court

This week marked the beginning of the U.S. Senate’s confirmation hearings for President Trump’s appointment to fill the seat held by the late Justice Ruth Bader Ginsburg. One of the major focuses of the Senate Judiciary Committee’s hearings for Judge Amy Coney Barrett has been her views of the constitutionality of the 2010 Affordable Care Act (ACA). The Court is set to hear oral arguments for California v. Texas, a case backed by the Trump administration challenging the future of the law, on November 10th.

Eight in ten adults (79%) say they do not want to see the Supreme Court overturn the protections for people with pre-existing conditions established by the Affordable Care Act and a majority of U.S. adults (58%) also say they do not want to see the Supreme Court overturn the entire 2010 law. Majorities of Republicans (66%), independents (81%), and nine in ten Democrats (91%) say they do not want to see the Supreme Court overturn the pre-existing condition protections in the ACA. Nine in ten Democrats (89%) and two-thirds of independent (66%) also say they do not want to see the Supreme Court overturn the entire law while three-fourths of Republicans (76%) say they would like to see the entire law overturned…

…The ACA’s protections for people with pre-existing medical conditions has been a dominant issue in the 2020 presidential campaign since the passing of Supreme Court Justice Ginsburg and larger shares of the public now saying they do not want to see these protections overturned (up 17 percentage points from last November). A majority of Republicans now say they do not want to see the pre-existing condition protections overturned (up 19 points from last year), and while majorities of Democrats and independents had previously said they did not want to see these protections overturned, the share among these groups has also increased (16 percentage points and 18 points, respectively)…

…While both presidential candidates say they intend to ensure pre-existing condition protections, most Democrats and independent say they do not think President Trump has a plan to maintain such protections. Slightly more than half (53%) including majorities of Democrats (90%) and independents (57%) say they “do not think President Trump has a plan to maintain protections for people with pre-existing health conditions.” On the other hand, a large majority of Republicans (85%) say President Trump “has a plan” to maintain these protections afforded by the ACA. While President Trump signed an executive order on Sept. 24th saying people with pre-existing conditions should be able to obtain health insurance at an affordable rate, the order does not guarantee coverage if the ACA is overturned…

October 16, 2020: NARAL Pro-Choice America tweeted: “Healthcare is on the line right now. Let that sink in. In the middle of a pandemic, another Trump Justice paves the way to gut the #ACA and take healthcare away from millions of Americans. #WeDissent @OurCourt”

October 16, 2020: Senator Maria Cantwell (Democrat – Washington) tweeted: “If the #ACA is struck down, the # of uninsured Washingtonians could double. More than 21 million Americans could lose heath insurance coverage. Taking away health care options during a pandemic that has left millions of Americans out of work is dangerous & unconscionable.”

October 16, 2020: Senator Catherine Cortez Mastro (Democrat – Nevada) tweeted: “Republicans in Congress have tried to repeal the #ACA over 70 times. Americans have made it clear that they don’t support repeal. So Republicans have resorted to far-fetched arguments in the courts and jamming through an unfit #SCOTUS nominee to dismantle the law.”

October 16, 2020: Senator Tom Udall (Democrat – New Mexico) tweeted: “#SCOTUS will hear a case on the #ACA a week after the election. If Trump’s rushed nominee is on the bench, 130 million Americans – and 834,700 New Mexicans – could lose protections for preexisting conditions. This is #WhatsAtStake.”

October 16, 2020: California Governor Xavier Becerra posted a press release titled: “Attorney General Becerra Fights Latest Challenge to California’s Landmark Anti-Pay-for-Delay Law”. From the press release:

California Attorney General Xavier Becerra yesterday filed a brief opposing the Association for Accessible Medicine’s (AAM) latest attempt to challenge Assembly Bill 824 (AB 824), the California law that tackles illegal, anticompetitive deals between pharmaceutical companies known as pay-for-delay agreements. These so-called “pay for delay agreements” happen when a brand name drug maker enters an agreement and pays money to a generic company to keep them off the market. This results in fewer choices for patients and higher costs. AAM, a group of generic drug manufacturers, is seeking another preliminary injunction in its second lawsuit challenging the legislation. In July, the U.S. Court of Appeals for the Ninth Circuit ruled in the Attorney General’s favor, rejecting AAM’s initial challenge of AB 824 and preliminary injunction request.

“Californians shouldn’t have to pay extra to pad the profits of pharmaceutical companies,” said Attorney General Becerra. “Our state’s anti-pay-for-delay law helps protect families from paying outrageous prices for life-saving medication. AAM already challenged this law before and lost in court. We believe we will be successful against them again.”

AB 824 went into effect on January 1, 2020, and became the first law in the country to combat illegal, secretive pay-for-delay agreements. In a pay-for-delay agreement, one drug company pays its competition to delay the research, production, or sale of a competing version of its drug. As a result, pay-for-delay agreements stifle competition and allow pharmaceutical companies to raise the price of medications to often exorbitant amounts, leaving patients with few options and in many cases, the inability to afford their prescriptions.

In the brief, Attorney General Becerra argues that as in its previous attempt, AAM does not have standing to challenge AB 824. The Attorney General also argues that AAM’s motion for preliminary injunction should be denied because: 

  • AAM is not likely to succeed on the merits;
  • AAM has not demonstrated imminent and irreperable harm; and
  • Enjoining AB 824 would not be in the public interest

…A copy of the brief is available here.

October 16, 2020: Kaiser Family Foundation (KFF) posted information titled: “KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care”. It was written by Ashley Kirzinger, Lunna Lopes, Audrey Kearney, and Mollyann Brodie. From the information:

Key Findings:

  • The confirmation hearings for Judge Barrett, President Trump’s appointment to fill the Supreme Court seat previously held by Justice Ginsburg, are underway this week and the future of the ACA’s protections for people with pre-existing conditions have been front-and-center. The latest KFF Health Tracking Poll finds a large majority of the public – including majorities of Democrats (91%), independents (81%), and Republicans (66%), now say they do not want to see the Supreme Court overturn the ACA’s pre-existing condition protections. The share who do not want to see these protections overturned has increased by double digits from one year ago for each group.
  • Six in ten adults say they do not want to see the Supreme Court overturn the entire ACA, up 10 percentage points from one year ago. This includes majorities of both Democrats (89%) and independents (66%), but three-fourths of Republicans still want to see the entire law overturned. Overall views of the Affordable Care Act are slightly more positive this month, with 55% of the public saying they view the law favorably. This ties its highest favorability measured in ten years of KFF polling (tied with February 2020).
  • Vice President Biden has the advantage over President Trump on all health policy issues included in the survey including at least a 20 percentage point advantage on who voters think has the better approach (Biden or Trump) to make deciisions about women’s reproductive health care choices and services, including abortion, family planning, and contraception (57% v. 34%), determining the future of the ACA (57% v. 37%), and maintaining protections for people with pre-existing conditions (56% v. 36%). He also holds an advantage on suprise medical bills, the coronavirus outbreak and distribution of a vaccine, and lowering health care costs for individuals.
  • While both presidential candidates say they have plans to ensure pre-existing condition protections, most Democrats and Independent say they do not think President Trump has a plan to maintain such protections. Slightly more than half (53%) including majorities of Democrats (90%) and independents (57%) say they “do not think President Trump has a plan to maintain protections for people with pre-existing health conditions.” On the ohtehr hand, a large majority of Republicans (85%) say President Trump “has a plan” to maintain these protections afforded by the ACA…

October 16, 2020: Planned Parenthood posted a press release titled: “Federal Court Reinstates Kentucky Law That Was Designed To Eliminate Abortion Access In The State”. From the article:

The Sixth Circuit Court of Appeals ruled today to uphold a Kentucky law that was used by former Governor Bevin to try to close abortion clinics and cut off access in the state. The court’s decision forces the Commonwealth’s two clinics, EMW Women’s Surgical Center and Planned Parenthood of Indiana and Kentucky, to apply for an unnecessary waiver from the health department every 90 days to continue providing abortion services.

Today’s ruling lifts a 2018 injunction from the District Court and reinstates a politically motivated, medically unnecessary requirement that clinics obtain a written transfer agreement with a local hospital and a transport agreement with an ambulance in order to operate. Despite evidence that these agreements serve no medical benefit to patients, and that abortion is one of the safest medical procedures, the Sixth Circuit still overturned the 2018 ruling from the lower court. Short of further action by the courts, health care providers’ only recourse is to navigate this needless red tape every 90 days. If at any time the governor refuses to grant the waiver, Kentucky could become the first state without any abortion providers.

In his dissenting opinion, Judge Clay wrote: “Today, the majority openly disregards our standard of review and discards binding precedent. In doing so, it condones the evisceration of the constitutional right to abortion access in Kentucky…At the end of the day, no matter what standard this Court is bound to apply, the majority’s decision today is terribly and tragically wrong.”

The Commonwealth has passed numerous burdensome restrictions on abortion care in recent years, including an attempt to ban abortion when many people do not even know they are pregnant. The law at issue in this case is similar to abortion restrictions previously passed in Texas and Louisiana, both struck down by the Supreme Court in Whole Woman’s Health v. Hellerstedt and June Medical Services v. Russo, respectively. It is just one of more than 480 restrictions on abortion passed by states since 2011 as part of a coordinated, nationwide effort to push abortion care out of reach.

“This law threatens abortion access in the state. When health care access is attacked, it is Black and Brown people who are forced to navigate racist and discriminatory systems and who suffer the most,” said Alexis McGill Johnson, president and CEO, Planned Parenthood Federation of America. “Let me be clear: we will not allow Kentucky to be the first state in the country without a single abortion provider. Planned Parenthood Federation of America will continue working with our partners to ensure every person can access the care they need no matter who they are, where they live, or how much they earn, no matter what.”…

…This case was brought by the American Civil Liberties Union, the ACLU of Kentucky, and Lynch, Cox, Gilman & Goodman P.S.C. on behalf ofE.M.W Women’s Surgical Center, and Planned Parenthood Federation of America and Orrick on behalf of Planned Parenthood of Indiana and Kentucky.


October 17, 2020: Former Vice President Joe Biden (Democrat) tweeted: “In the middle of a pandemic, President Trump is trying to eliminate Obamacare and increase health care costs for millions. Now, he’s rushing through a U.S. Supreme Court justice to help him get it done. It’s unconscionable. Make no mistake: Health care is on the ballot.”

October 17, 2020: Former Vice President Joe Biden (Democrat) tweeted: “As president, I’ll protect and build on Obamacare by:

Giving Americans the choice to buy a new public option

Lowering premiums, deductibles, and co-pays

Standing up to prescription drug corporations

We’re going to make sure every American has access to the care they need.”

October 17, 2020: Senator Catherine Cortez Masto (Democrat – Nevada) tweeted: “Trump and Republicans in Congress claim they’re concerned about people with preexisting conditions, but their actions say otherwise. If they really want to help folks with preexisting conditions, why don’t they withdraw their lawsuit that could overturn the #ACA?”


October 20, 2020: Urban Institute posted a blog post titled: “Overturning the ACA Would Increase Uninsurance among People of All Ages, Races, and Ethnicities”. It was written by Linda J. Blumberg, Michael Simpson, Matthew Buettgens, Jessica Banthin, and John Holahan. From the blog post:

…In our recent analysis, we found if the Supreme Court overturns the ACA, an additional 21.1 million people nationwide would be uninsured in 2022. We also found the following consequences of eliminating the ACA:

  • 9.3 million people would lose income-related subsidies for marketplace insurance in 2022;
  • Medicaid and Children’s Health Insurance Program coverage would decline by 15.5 million people in 2022; and
  • federal government spending on health care would fall by $152 billion per year in 2022.

Based on this study, we produced additional, state-level estimates on the effects of coverage by age group… and race and ethnicity… if the ACA is overturned… Some of our key findings include:

1) Invalidating the ACA will increase uninsurance among the nonelderly in every age group. Children ages 18 and younger will feel the smallest effect because their pre-ACA eligibility for public insurance coverage (through Medicaid and the Children’s Health Insurance Program) is greatest. Still, 1.7 million more children will be uninsured, an increase of 48 percent. Adults ages 50-64 will experience a 95 percent increase in uninsurance, an additional 5.6 million people. And 4.9 million young adults ages 19-26 will be uninsured, a 76% increase compared with current law. Adults ages 27 to 49 will experience a 60 percent increase in uninsurance, 8.8 million more uninsured.

2) States experiencing the largest coverage gains under the ACA will experience the largest increases in the uninsured. These states include those that expanded Medicaid eligibility under the law, those with high enrollment rates in the ACA-subsidized Marketplaces, and those that had high uninsurance rates before implementation of the law.

For example, Pennsylania and Michigan are among the most populous states that will have the largest percent increases in the uninsured if the ACA is overturned. In Pennsylvania, the uninsurance rate among young adults will climb by more than 170 percent (to 27 percent uninsured). For adults ages 27 to 49, the uninsurance rate will increase will increase by 152 percent (to 20 percent uninsured), and for adults ages 50 to 64, by 154 percent (to 16 percent uninsured). In Michigan, the uninsurance rate for young adults will increase by nearly 200 percent (to 31 percent uninsured), by more than 150 percent for adults ages 27 to 49 (to 23 percent uninsured), and by 148 percent for adults ages 50 to 64 (to 18 percent uninsured).

Among states that have not expanded Medicaid eligibility, Florida will experience the largest increases in the uninsured in both absolute numbers and percentage terms because the state has high enrollment in the ACA Marketplace. In Florida, the insurance rate among young adults will increase 35 percent (to 36 percent uninsured). For 27-to-49-year-olds, it will increase 52 percent (to 30 percent uninsured), and for 50-to-64-year-olds, it will increase 89 percent (to 25 percent uninsured).

3) People of all races and ethnicities will experience large increases in uninsurance. Again, the largest increases across rates and ethnicities will occur in states that expanded Medicaid eligibilty under the law. In 10 states with insufficient sample sizes to measure the effects (Michigan, California, Idaho, Montana, New Mexico, Utah, Washington, New Jersey, Virginia and Ohio), uninsurance rates will more than double among American Indians and Alaska Natives. In Louisiana, Kentucky, Michigan, Indiana, and Pennsylvania, uninsurance rates for non-Hispanic Black people will nearly triple or more. Uninsuraed non-Hispanic white people will more than double the number in 29 states. Uninsurance among the Hispanic population will more than double in Pennsylvania and New Mexico.

4) States that did not expand Medicaid eligibility under the ACA stand to lose somewhat less coverage, but uninsurance will still increase substantially among people of all races and ethnicities. Across all nonexpansion states combined, uninsurance among American Indians and Alaskan Natives will increase 26 percent (to 23 percent uninsured). Among Asian and Pacific Islander populations, uninsurance will increase by 25 precent (to 21 percent uninsured). Among non-Hispanic Black people, uninsurance will increase by 34 percent (to 19 percent uninsured). The number of uninsured Hispanic people will increase 15 percent in these states (to 33 percent uninsured). Uninsurance among non-Hispanic white people will increase 36 percent (to 15 percent uninsured), and uninsurance among other races and ethnicities will increase by 28 percent (to 14 percent uninsured)…

…However, the implications of the policies of the law being invalidated have far greater reach than we can estimate, because virtually all insurers, providers, and households across the nation have been affected by the law’s many provisions. Policymakers have straightforward legislative options that could protect the ACA as it is operating under current law if they are passed before the court issues its decision; thus far, Congress has not passed bills to do so.


October 21, 2020: Senator Kamala Harris (Democrat – California) tweeted: “Tearing down the Affordable Care Act has been one of Republicans’ top priorities for more than a decade. They’ve tried 70 times to repeal or roll back the ACA in Congress. Now, they’re rushing through Trump’s Supreme Court nominee to ensure it finally happens.”

October 21, 2020: Senator Kamala Harris (Democrat – California) tweeted: “Today, I joined @SenWarren in urging the administration to stop supporting a lawsuit to strike down the Affordable Care Act. It’s unconsscionable, especially during a pandemic. And it has to stop.”

October 21, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Continues Fight to Stop Health Care Discrimination Promulgated by Trump Administration.” From the press release:

New York Attorney General Letitia James today announced she has led a coalition of 22 attorneys general in continuing the fight to stop the Trump Administration’s attempts to make it easier for health care providers to refuse to provide necessary and desired health coverage to individuals on the basis of their health care providers’ “religious beliefs or moral convictions.” In an amicus brief filed in support of the states of California and Washington in their lawsuits brought against the U.S. Department of Health and Human Services (HHS), Attorney General James leads the coalition in opposing the Trump Administration’s ‘Refusal-of-Care’ rule. Attorney General James led her own lawsuit against the Trump Administration’s ‘Refusal-of-Care’ rule in May of 2019.

“As we continue to battle a public health crisis that has only been exacerbated by the Trump Administration’s incompetence, the Department of Health and Human Services is still doing what it can to make it easier for health care providers to deny health coverage to millions of Americans,” said Attorney General James. “The ‘Refusal-of-Care’ rule gives health care providers free license to openly discriminate and deny care to patients, masking their bigotry and hatred in an invisible cloak of religious freedom. The courts have rejected this hatred every step of the way and we are confident they will do the same once again.”

In May 2019, the Trump Administration’s HHS introduced a final rule that would vastly and unreasonably expand the ability of health care providers to deny patients access to certain lawful and medically needed procedures, services, and information, including that related to abortion, sterilization, and aid-in-dying — all while purporting to implement various federal conscience statutes. In reality, however, the rule violates the careful balance Congress struck in the underlying statutes by simultaneously expanding the job functions that objectors may refuse to perform based on their personal views and severely restricting the actions that employers may take to plan for and accommodate such objections while ensuring that patients receive uninterrupted care. The rule would disproportionately impact women and members of the LGBTQ+ community.

Every federal court that has considered the rule has agreed that it is not authorized by law and has accordingly vacated the rule in full, including the U.S. District Court for the Northern District of California and the U.S. District Court for the Eastern District of Washington. After those losses, the Trump Administration appealed to the U.S. Court of Appeals for the Ninth Circuit. Attorney General James and the coalition filed this amicus brief in support of California and Washington in that appeal.

The coalition argues, in the amicus brief, that the rule’s definition of “discrimination” is inconsistent with statute and is thus contrary to the Administrative Procedures Act and that HHS acted arbitrarily and capriciously in promulgating the rule. Specifically, HHS failed to acknowledge that the redefinition of “discrimination” represented a change in position, failed to consider the reliance interests created by HHS’s own past guidance as to the scope of the federal conscience statutes’ anti-discrimination provisions, and relied on empirical justification for the rule that is contradicted by the administrative record.

Further, the coalition explains that the rule not only threatens to harm countless patients in disrupting their access to medically necessary care, but also places at risk billions in critical federal health care funding that Congress has appropriated to the states…

October 21, 2020: NARAL Pro-Choice America posted an press release titled: “NARAL Pro-Choice America President Ilyse Hogue Responds to Latest Evidence of Amy Barrett’s Extremism and Hostility to Reproductive Freedom”. From the press release:

This afternoon, news broke that Democrats on the Senate Judiciary Committee will boycott tomorrow’s planned vote to advance Amy Barrett’s confirmation to the U.S. Supreme Court. Their move will send a clear message about this power grab less than two weeks before Election Day, when over 42 million Americans have already voted. 

The development comes on the heels of Barrett submitting responses to written questions from senators following her Senate Judiciary Committee hearing. In response to questions from Senator Sheldon Whitehouse (D-RI), she flat out refused to answer whether states could make abortion care a felony if Roe v. Wade is overturned or punish people seeking abortion care with the death penalty. She also refused to answer whether states could prosecute people for using contraception if Roe is overturned. 

This after Barrett refused to answer even basic questions in the hearing. Meanwhile, Senate Republicans tried to play coy about their agenda to end legal abortion and Barrett’s role in realizing their decades-long goal of overturning Roe v. Wade. Now we have even more cause for concern.  

“Amy Barrett’s refusal to make clear that putting a woman to death for seeking abortion care is wrong and should never be permitted is both shocking and disqualifying,” said Ilyse Hogue, president of NARAL Pro-Choice America. “This country has a clear consensus around basic freedoms and rights and these non-answers not only undermine those, but put them in perilous danger. We strongly applaud the Senate Democrats making clear how egregious and antidemocratic this entire process is by refusing to dignify it with their presence. We will be outside with them calling attention to the dystopian future this nominee represents where women and pregnant people are controlled and criminalized by politicians with a malicious agenda.”

October 21, 2020: The American College of Obstetricians and Gynecologists posted a statement titled: “ACOG Statement on Recent Waiver Approvals that Limit Medicaid Coverage”. From the statement:

Maureen G. Phipps, MD, MPH, chief executive officer of the American College of Obstetricians and Gynecologists, released the following statement:

“ACOG is deeply disappointed that, by recently approving restrictive state Medicaid waivers in Georgia and Nebraska, the Centers for Medicare & Medicaid Services (CMS) continues to make Medicaid coverage and access to Medicaid-covered services more difficult for our patients to obtain. Medicaid was established to ensure that health care is available to all who are eligible, without condition. The waivers that CMS has approved in recent weeks and months serve the sole purpose of making coverage less accessible and will ensure that the program fails to meet its essential mission.

“These Medicaid changes will no doubt fall heaviest on low-income women. Women represent almost two-thirds of those at risk of losing coverage under work requirements. Further, women have increased health care needs compared to men, so may be negatively affected by the excessive out-of-pocket costs imposed in these waivers. Rather than punishing women by making it harder for them to access health care, the government should be focusing on how improved access to reliable health coverage, including Medicaid coverage to 12 months after delivery, can address the ongoing maternal mortality crisis and, importantly, help us improve health equity across the country. Moreover, the approval of these waivers runs counter to the stated goal of the Department of Health and Human Services to improve maternal health outcomes.

“It is especially unsettling that CMS and state bureaucrats are moving forward with restrictive health care policies in the middle of an unprecedented pandemic, which has already cost more than 200,000 lives across the country and underscores the critical importance of the Medicaid protram. Health care coverage must be reliable and stable for all of our patients now as we continue to battle COVID-19. Taking coverage away from those who have already been disproportionately impacted by the virus will certainly cost additional lives.”


October 22, 2020: California Governor Gavin Newsom (Democrat – California) tweeted: “We’re in a pandemic. We need the Affordable Care Act.”

October 22. 2020: California Attorney General Xavier Becerra posted a press release titled: “Members of Congress, Medical Associations, Policy Experts, Nonprofits, States, Counties, and Cities Support Fight Against Healthcare Refusal Rule”. From the press release:

California Attorney General Xavier Becerra today announced that a diverse group that includes members of Congress, state attorneys general, healthcare providers, healthcare policy experts, and more filed amicus briefs this week in the U.S. Ninth Circuit Court of Appeals supporting California’s fight against the Trump Administration’s unconstitutional and illegal “Healthcare Refusal Rule”. The rule, which was halted by multiple courts, would allow anyone involved in healthcare to deny care to an individual for religious, moral, ethical, or other reasons. This exemption would open the door to unfettered discrimination, particularly against women, LGBTQ individuals, people of color, and individuals in rural and low-income communities.

“A diverse coalition consisting of individual citizens, elected leaders, experts, advocacy groups and others have helped shed light on the substantial negative impact of the Trump Administration’s Healthcare Refusal Rule on our healthcare system,” said Attorney General Becerra. “As we continue to battle a global pandemic, now is the time to ensure access to quality care, not create barries to care.”

In a brief filed this month, the Attorney General reasserted that the Trump Administration’s Healthcare Refusal Rule violates the U.S. Constitution and the Administrative Procedure Act, arguing that the District Court was correct to vacate the rule in its entirety. The amici support California’s fight to protect marginalized communities from potential healthcare discrimination resulting from the rule. The amicus briefs highlight the human cost of allowing this rule to stand.

  • Rachael Lorenzo, Mindy Swank, and Meghan Eagen, three individuals who were denied essential, stabilizing treatment because medical professionals refused to provide emergency abortions: Mindy’s story: “Even though Saint Francis and Genesis knew that Mindy’s pregnancy was not viable and would ultimately put her life in danger if not terminated, doctors delayed the emergency care she needed. Not only did this risk the loss of Mindy’s ability to have children in the future and lead to the prolonged suffering of her baby after birth [who struggled to breathe for three hours after being born unconscious before dying], but it also put her life in jeopardy and resulted in lasting emotional trauma.”
    A copy of the brief is available here.
  • Coalition of 158 Members of the U.S. Congress: “Congress has consistently sought to protect and expand access to medical care in the United States, including by passing the Affordable Care Act in 2010, and in other statutes and legislation enacted over the last fifty years. HHS’s Rule is one in a series of more recent attempts to turn back this progress and limit access to care, especially abortion care.”
    A copy of the brief is available here.
  • Coalition of 21 states and the District of Columbia: “That unprecedented redefinition poses severe disruptions to Amici States’ health care systems and our ability to deliver seamless patient care while accommodating conscience objections, and is thus particularly harmful to Amici States’ interests as health care providers, employers, and regulators.”
    A copy of the brief is available here.
  • Coalition of cities and counties: “The Final Rule invites providers of emergency care to discriminate against the distressed patients they are duty-bound to treat, and attempts to undermine local governments’ antidiscrimination policies and laws in the provision of healthcare with the threat of withdrawal of critical federal funding.”
    A copy of the brief is available here.
  • American Public Health Association: “By permitting any individual who works at a healthcare facility to elevate their personal beliefs above the health needs of the patient, the Rule disregards the most core principles of public health.”
    A copy of the brief is available here.
  • Coalition of leading medical organizations: “The Rule endangers patients in emergency situations…For example, when a registered nurse anesthetist lodges a last-minute objection to assisting a patient with an urgent need, and s/he cannot be replaced because all colleagues are in COVID-19 ICUs, the patient may die. The COVID-19 crisis thus heightens the dangers the Rule threatens to the provision of necessary and urgent care.”
    A copy of the brief is available here.
  • National Center for Lesbian Rights and a coalition of 27 nonprofit organizations: “The Final Rule will compound barriers to health care for LGBTQ people, particularly those who are transgender, by inviting health care workers to refuse services or referrals to LGBTQ people.” 
    A copy of the brief is available here.
  • The Williams Instituteand a coalition of experts on the health of lesbian, gay, bisexual, and transgender people: “Being denied healthcare can be devastating. Being denied care for discriminatory reasons compounds that harm and can result in avoidance of necessary care in the future. In turn, the minority stress associated with healthcare denials contributes to health disparities for the LGBT population.”
    A copy of the brief is available here.
  • Institute for Policy Integrity: “It is difficult to imagine how a rule could cause more workers to assert a right to deny care without also causing an increase in denials of care. HHS cannot have it both ways.” 
    A copy of the brief is available here.

October 22, 2020: National Organization for Women (NOW) posted a press release titled: “NOW Denounces Senate Judiciary Committee’s Illegitimate Push for Amy Coney Barrett”. From the press release:

The only way Donald Trump and Mitch McConnell were going to get away with stealing another Supreme Court nomination was to do what they always do— break rules and rig the system. 

After forcing into practice a new standard for filling a Supreme Court vacancy before a presidential election, they went back on their own new rules and are now rushing to hold a floor vote on Amy Coney Barrett days before the election.  

Amy Coney Barrett’s nomination is being rushed through to consolidate conservative power and turn back the clock on voting rights, reproductive freedoms, and access to health care.   

This has been a cynical, partisan political exercise from the beginning.   

NOW calls on Senators to use whatever tools are at their disposal to push this vote past the election. Republican Senators who lost their races because of Donald Trump may realize they can redeem their place in history after years of enabling him by what they do in a lame-duck session – which includes passing years of legislation currently in the Senate graveyard and voting “nay” on Amy Coney Barrett’s confirmation. 

NOW is more motivated than ever –  to show how the largest, grassroots feminist force in history will turn the tide in this election.  We will elect a new president, the first woman vice president, and a feminist Senate—that will soon vote on a feminist nomination to the Supreme Court. 

October 22, 2020: Lambda Legal posted a press release titled: “Senate Judiciary Committee Advances Nomination of Anti-LGBTQ Judge, Amy Coney Barrett to Supreme Court”. From the press release:

Today, pressing ahead in flagrant disregard of longstanding rules and procedures, Senate Republicans voted unanimously to advance the nomination of Judge Amy Coney Barrett to the United States Supreme Court. Senate Democrats on the committee walked out from the vote in protest and were counted as absent. The nomination, which Senate Republicans are jamming through at breakneck speed, now moves on to a full Senate floor vote. Judge Barrett could be confirmed as soon as Monday, October 26. In response, Lambda Legal CEO Kevn Jennings issued the following statement:

“Rushing a U.S. Supreme Court nomination like this is reckless and just plain despicable. This has been an affront to our democracy and the will of the American people, 35.9 million of whom have already cast ballots and the majority of whom believe the next president should choose Justice Ruth Bader Ginsburg’s replacement. This shouldn’t even be happening. Every Senator who will soon vote on this nomination has a choice to make; our democratic values or partisan ideology.

“It is impossible for LGBTQ peopel to have confidence in Judge Barrett. During the hearings, she refused to answer questions about some of the most pressing issues facing our nation’s highest Court and refsused to say whether she believed cases that are the backbone of the legal rights of LGBTQ people – such as Lambda Legal’s landmark case, Lawrence v. Texas, which decriminalized same-sex intimacy,and Obergefell v. Hodges, which legalized same-sex marriage – were correctly decided. She even used loaded and outdated terms like ‘sexual preference,’ which is explicitly intended to erase our identities and deny the validity of our claim to equal protection under the law. We can read between the lines of her coded language and what we’re reading isn’t good. Nothing we heard allayed our concerns, and much of what we heard raised red flags about what her confirmation will mean for the LGBTQ community.”

October 22, 2020: California Attorney General Xavier Becerra posted a press release titled: “Members of Congress, Medical Associations, Policy Experts, Nonprofits, States, Counties, and Cities Support Fight Against Healthcare Refusal Rule”.

California Attorney General Xavier Becerra today announced that a diverse group that includes members of Congress, state attorneys general, healthcare providers, healthcare policy experts, and more filed amicus briefs this week in the U.S. Ninth Circuit Court of Appeals supporting California’s fight against the Trump Administration’s unconstitutional and illegal “Healthcare Refusal Rule.” The rule, which was halted by multiple courts, would allow anyone involved in healthcare to deny care to an individual for religious, moral, ethical, or other reasons. This exemption would open the door to unfettered discrimination, particularly against women, LGBTQ individuals, people of color, and individuals in rural and low-income communities.

“A diverse coalition consisting of individual citizens, elected leaders, experts, advocacy groups and others have helped shed light on the substantial negative impact of the Trump Administration’s Healthcare Refusal Rule on our healthcare system,” said Attorney General Becerra. “As we continue to battle a global pandemic, now is the time ti ensure access to quality care, not create barriers to care.”

In a brief filed this month, the Attorney General reasserted that the Trump Administration’s Healthcare Refusal Rule violates the U.S. Constitution and the Administrative Procedure Act, arguing that the District Court was correct to vacate the rule in its entirety. The amici support California’s fight to protect marginalized communities from potential healthcare discrimination resulting from the rule. The amicus briefs highlight the human cost of allowing this rule to stand…

October 22, 2020: Urban Institute posted a brief titled: “Urgent Action Needed to Address Children’s Unmet Health Care Needs During the Pandemic”. It was written by Stacey McMorrow, Dulce Gonzalez, Clara Alvarez Caraveo, and Genevieve M. Kenney. From the brief:

Abstract

It has become increasinglyclear that the pandemic has had dramatic spillover effects on the reciept of health care services unrelated to the coronavirus. In this brief, we review the evidence on children’s unmet needs during the pandemic and identify promising strategies to address these gaps, as well as barriers to widespread implementation of these strategies. We find large declines in childhood vaccinations in 2020 compared with prior years and serious concerns about children’s access to specialized therapies and mental health services. Children of color, children with special health care needs, children in families with low incomes or members with limited English proficiency, and children in rural areas face higher risks of unmet health care needs. We also find that health care providers have implemented several strategies to encourage reciept of needed care during the pandemic, including telehealth options, mobile clinics, pharmacist-administered vaccines, and expanded school-based services. But limitations in funding, access to internet-enabled devices,and interpretation and translation services can prevent widespread and successful adoption of these strategies.

Thus, more coordinated, publicly funded, and focused efforts to reduce children’s unmet needs are urgently needed. State Medicaid and Children’s Health Insurance Programs, and the private managed-care plans that cover many children in these programs, have both policy tools and financial resources that could help address the declines in preventive care receipt among their child enrollees. Targeted to federal funding to underresourced providers and communities and more concerted efforts to incorporate children’s health needs into policies for both in-person and virtual education would also be beneficial. Without these efforts to address children’s needs and reduce long standing inequities, racial and socioeconomic disparities in children’s health and health care access will likely widen as the pandmeic continues.


October 23, 2020: WBUR posted an article titled: “Overturning The Affordable Care Act Would Be Catastrophic – Especially For People With Disabilities”. It was written by Elizabeth Warren and Matthew Cortland. From the article:

For the 61 million Americans who live with a disability, there’s an important date on the calendar this fall: November 10, the day the Supreme Court will hear a case about whether to overturn the Affordable Care Act. President Donald Trump and Senate Republicans have picked a Supreme Court nominee whose position is clear: she doesn’t like the ACA, or the previous court rulings that upheld it. There is so much at stake.

Before the ACA, the disability community faced critical barriers to high-quality medical care. Health insurers could deny or cancel coverage for people with pre-existing conditions — including millions of people with disabilities. Insurers regularly imposed “lifetime limits” on their coverage, a gut punch for people with disabilities whose medical needs cost a lot of money. For babies born prematurely and children with disabilities, this sometimes meant hitting their lifetime caps before they were even old enough for school.

This lack of basic health protections put people with disabilities in an economic bind, too. Many were forced to hold on to dead-end, low-paying jobs for the sake of keeping health insurance they couldn’t find anywhere else. Meanwhile, if people with disabilities couldn’t find insurance and had to turn to Medicaid, they could only qualify by going through a cumbersome disability determination process and declaring their inability to work. If they wanted to work, they were forced to give up their insurance — an impossible choice no one should have to make.

The ACA made a lot of progress. It banned the cruel practice of lifetime limits, ensuring that children with disabilities and their families won’t have to go bankrupt to get the care they need. It protected people with pre-existing conditions. It ensured that people with disabilities could buy insurance in the Marketplace and expanded the Medicaid program, making it easier to get high-quality, affordable care without leaving the job market. In fact, Medicaid expansion increased employment rates among people with disabilities. And for young people with disabilities, being able to stay on their parents’ insurance until the age of 26 means the opportunity to build a career for themselves, without having to worry about whether they will continue to have access to life-saving health care.

The ACA didn’t just expand access to health insurance. It also meant that people with disabilities could actually get the high-quality services and treatments they need. The Community First Choice Program in the ACA helps states provide home- and community-based services that allow people with disabilities to live with their families and in the community, rather than in institutions. Especially at a time when people living in nursing homes, assisted living facilities, and group homes are at heightened risk from the COVID-19 pandemic, these supports are more crucial than ever. We still have a long way to go: I’m fighting in Congress for better funding for home- and community-based services and better oversight of nursing homes and assisted living centers. But overturning the ACA would reverse all the important gains we’ve made.

The ACA also ensured that mental health care is treated as exactly what it is: health care. People with disabilities have higher rates of depression and may face barriers to getting treatment for mental and behavioral health conditions. The ACA made mental and behavioral health treatment an Essential Health Benefit — one that all insurers are required to cover.

All of these guarantees were important before the pandemic, but they are even more essential now. More than 7 million people in the United States have been diagnosed with COVID-19. Many of these survivors may have long-lasting health effects that we are only beginning to understand. In other words, the number of Americans with pre-existing conditions is growing every day. Without the ACA in place, anyone who ever tested positive for COVID-19 could be denied coverage because of a pre-existing condition. At the same time, economic turmoil and social isolation have created a mental health crisis. There has never been a greater need for quality, accessible, affordable mental health care.

With the election just days away, the president, Senate Majority Leader Mitch McConnell, and their enablers are trying to ram through Amy Coney Barrett’s nomination before the American people have a chance to make their voice heard. They want her on the bench on November 10 to help accomplish what Republicans have been trying to do since the beginning: end the ACA and rip health care away from 21 million people, including millions of people with disabilities.

But we won’t tolerate it. Disabled people are used to uphill battles, and they know how to persist. Together, we’re fighting to stop this nomination and to make our voices heard by sharing our stories and voting to protect the health care that people with disabilities — and all Americans — deserve.

October 23, 2020: Georgetown University Health Policy Institute Center for Families and Children posted a blog post titled: “What’s New for 2021 Marketplace Enrollment?” From the blog post:

On November 1, the eight open enrollment period begins for marketplace coverage under the Affordable Care Act. This year there are several policy changes that could have an impact on the affordability of plans on the marketplace including:…

  • Public Charge Rule: Beginning Feburary 24, 2020, the current test to determine a person’s application for admission to the U.S. or permanent residency expanded. Previously, only an applicant’s use of two public benefits – cash assistance and institutional long-term care – were negatively effected when making a public charge determination. The Trump Administration expanded this policy to include an individual’s application for health programs such as Medicaid (with some important exceptions including reciept of Medicaid for children under 21) and the Supplemental Nutrition Assistance Program (SNAP) as factors for consideration. Application and enrollment in marketplace coverage and the application for and use of premium tax credits and cost-sharing reductions, however, will not be negatively factored into the public charge test. Though this rule has been finalized nationwide, the expansion has been blocked in New York, Connecticut and Vermont…
  • ACA Litigation at SCOTUS: The constitutionality of the Affordable Care Act (ACA) will again be considered by the United States Supreme Court. A decision on this case is not expected until Spring 2021 and until that happens the ACA’s insurance reforms, the marketplaces, and federal assistance remains in place…
  • New Special Enrollment Period (SEP) for Individuals Newly Eligible for Advanced Premium Tax Credits (APTCs): In prior years, individuals who were covered under an employer-sponsored plan or a plan purchased through the marketplace could access a SEP if they became newly eligible for APTCs. However, individuals who purchased an individual market plan outside of the marketplace (“off-marketplace”) could not. In 2020, HHS expanded this opportunity to allow individuals who are enrolled in off-marketplace plan and who experience a decrease in income that makes them newly eligible for APTCs to use a SEP to enroll in an on-marketplace plan. However, this may not be immediately available in all states, and consumers may have to contact the marketplace call center to access the opportunity…
  • Retroactive Effective Dates: CMS has streamlined its rules and processes for retroactive coverage for consumers who recieve a special enrollment period, a favorable appeal decision, or a processing delay. Consumers have the option to pay the premiums for all the months of retroactive coverage, or only pay the premium for one month of coverage and receive prospective coverage only…
  • Two Payment Rule for Abortion Services: A federal judge has enjoined a Trump Administration regulation that requires insurers to send two separate monthly bills, one for abortion coverage and one for coverage of all other service. Pending the outcome of this litigation, consumers are still able to pay their monthly premium a single transaction.
  • Contraception Mandate: In July of 2020, the U.S. Supreme Court ruled that federal rules expanding exemptions to the ACA’s contraceptive coverage requirement could go into effect. These rules, previously subject to a nationwide injunction, allow eligible organizations including employers, insurers, and universities to exclude contraceptive coverage on the basis of “sincerely held religious beliefs or moral convictions.” While previously, the federal government required these entities to provide an accomodation so that plan enrollees could still access contraceptive coverage, that accommodation process is now optional. Some plan enrollees could still access contraception coverage. The rules are subject to further legal proceedings…

October 25, 2020: The Hill posted an article titled: “Lesley Stahl: Giant health care book in Trump interview had ‘no comprehensive health care plan'”. It was written by Brooke Seipel. From the article:

CBS’s Lesley Stahl said the giant book presented to her as the president’s health care plan after President Trump walked out of a “60 Minutes” interview had “no comprehensive healthcare plan.”

The moment took place just after Trump cut short an interview last week. Press secretary Kayleigh McEnany then walked in to deliver what she said was the White House health care plan, warning it was a little heavy. Stahl can be heard saying, “I can’t lift it” in the interview.

Then, in a voiceover for Sunday’s “60 Minutes” episode, Stahl says the book lacked a health care plan.

“Kayleigh McEnany, gave us a heavy book she described as the president’s health care plan. It was filled with executive orders and congressional initiatives, but no comprehensive healthcare plan,” she said…

October 25, 2020: CBS Philly posted an article titled: “Sen. Bob Casey Says Affordable Care Act Now In Danger With Amy Coney Barrett’s Assured Confirmation To Supreme Court”. From the article:

Pennsylvania Sen. Bob Casey says the Affordable Care Act is now in danger with Judge Amy Coney Barrett’s assured confirmation to the Supreme Court. On Sunday night, Casey joined other Democratic senators on a Zoom call.

The Affordable Care Act faces a legal challenge before the Supreme Court.

The senators fear Barrett will cast the deciding vote to overturn the law.

Casey says the elimination of the ACA would have a negative impact on Pennsylvania.

“Much is at stake. You all know the numbers, the 135 million with preexisting conditions translates into 5-and-a-half million in Pennsylvania,” Casey said. “The 23 or so million who would lose coverage that had gained it translates into 1, or one of the 23, million.”

The Supreme Court will hear the challenge to the Affordable Care Act on Nov. 10.

October 25, 2020: Senator Diane Feinstein (Democrat – California) tweeted: “I voted AGAINST advancing Judge Barrett’s nomination today. She represents the conservative vote to overturn the Affordable Care Act, strip protections from Americans with pre-existing conditions, overturn Roe v. Wade and undermine many other fundamental rights.”


October 26, 2020: Senator Kamala Harris (Democrat – California) tweeted: “It’s this simple: Republicans are trying to bypass the will of voters and have the Supreme Court dismantle the Affordable Care Act.”

October 26, 2020: Senator Kamala Harris (Democrat – California) tweeted: “Today Republicans denied the will of the American people by confirming a Supreme Court justice through an illegitimate process – all in their effort to gut the Affordable Care Act and strip health care from millions with pre-existing conditions. We won’t forget this.”

October 26, 2020: Senator Diane Feinstein (Democrat – California) tweeted: “I just voted against Judge Barrett’s confirmation. The American people want an independent jurist, not one who Republicans rushed onto the Supreme Court to help strike down the Affordable Care Act, end women’s reproductive rights and strip away voting rights.”

October 26, 2020: California Attorney General Xavier Becerra tweeted: “Our fight continues. One week after Election Day, I’ll be at the Supreme Court to stop Trump and his GOP allies from dismantling the Affordable Care Act. We intend to win.”

October 26, 2020: Oregon Governor Kate Brown (Democrat – Oregon) tweeted: Accessible, affordable health care saves lives. Now the Supreme Court is poised to rip away protections in the middle of a pandemic. Thanks to the Affordable Care Act, up to 94% of Oregonians have had health care coverage. Without the ACA? 546,000 + Oregonians could lose coverage.”

October 26, 2020: Senator Dick Durbin (Democrat – Illinois) tweeted: “I am deeply concerned about Judge Barrett’s views on the Affordable Care Act – along with her downright refusal to answer questions about whether a President could delay an election, whether tehre should be a peaceful transfer of power, and the legality of voter intimidation.”

October 26, 2020: Planned Parenthood Affiates of Calfornia tweeted: “Tonight’s confrmation of Amy Coney Barrett is a devistating attack on reproductive rights. But in CA — your right to critical health care is still protected, and Planned Parenthood is going to fight like hell to ensure it stays that way. But we need you to VOTE #WeDissent”. This was the start of a short thread.

October 26, 2020: Planned Parenthood Affiliates of California tweeted: “In the legacy of Justice Ginsburg, we commit to not only fight to protect the rights she fought for – repro rights, affordable health care, racial equity, gender equity – but to work with CA’s leaders to close the widening gap between rights and true access. #WeDissent #SCOTUS”

October 26, 2020: Planned Parenthood Affiliates of California tweeted: “With Barrett’s confirmation, 17 abortion-related cases one step from #SCOTUS, and the #ACA are about to be considered, the future of our health care is on the line. We need CA leadership @CAgovernor @AssemblyDems @CASenateDems to work to ensure health care access is protected #WeDissent”. This was the last tweet in the short thread.

October 26, 2020: California Attorney General Xavier Becerra tweeted: “Our fight continues. One week after Election Day, I’ll be at the Supreme Court to stop Trump and his GOP allies from dismantling the Affordable Care Act. We intend to win.”

October 26, 2020: Speaker of the House Nancy Pelosi (Democrat – California) tweeted: “President Trump and Senate Republicans have committed an act of supreme despiration: jamming through a Supreme Court nominee just days before Election Day as part of their years-long campaign to destroy Americans’ health care.”

October 26, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Denounces Senate Republicans’ Illegitimate Confirmation of Amy Barrett to the Supreme Court”. From the press release:

Senate Republicans today jammed through Amy Barrett’s confirmation to the Supreme Court, in spite of her record of anti-choice, anti-freedom extremism and as over 61 million Americans have already voted in the presidential election. With roughly a week left until Election Day, Republicans disregarded the will of the people, who believe that the next president should have filled the vacancy on the Court and that the Senate should prioritize much-need COVID-19 relief instead.  

NARAL Pro-Choice America President Ilyse Hogue released the following statement in response to this illegitimate confirmation: 

“This power grab by Donald Trump and Mitch McConnell is a shameful attack on our democracy. Amy Barrett’s extreme position on our fundamental rights is disqualifying. We know that they cannot be shamed, so we will see every single Republican who has played a role in this charade at the ballot box.”

Further underscoring the Trump administration’s willingness to put its own political agenda above the health and well-being of the American people, they are planning to recklessly hold an in-person swearing-in ceremony for Barrett this evening. The event is scheduled to take place despite the fact that her nomination ceremony is believed to have been a “superspreader” event…

October 26, 2020: Center for Reproductive Rights posted a press release titled: “Center for Reproductive Rights Statement on the Confirmation of U.S. Supreme Court Justice Amy Coney Barrett”. From the press release:

Statement of Nancy Northup, President and CEO

Today, in a deeply divided nation while an election is already underway, the U.S. Senate confirmed Amy Coney Barrett as an Associate Justice to the U.S. Supreme Court by a vote of 52-48. The American public deserved a comprehensive vetting and full assessment of the legal views of the person nominated to replace Justice Ruth Bader Ginsburg. What the public got was a shamelessly truncated and woefully partisan process. 

Justice Barrett’s academic writings, court decisions, and public advocacy reveal a legal view that the U.S. Constitution does not protect an individual’s personal liberty to make decisions about their reproductive health. This has incredibly troubling implications for the Supreme Court’s settled jurisprudence that the Fourteenth Amendment protects the right to access contraception and abortion care. Counter to her clear and documented record of extreme opposition to reproductive rights, Justice Barrett testified in her Senate Judiciary Committee hearing that she would join the Court with no agenda. Only time will be the judge of that.

Dozens of abortion-rights cases are heading toward the Supreme Court and one is already there; the state of Mississippi is seeking review of its 15-week abortion ban, which the Center for Reproductive Rights successfully blocked in the lower courts as unconstitutional under Roe v. Wade. Also in the pipeline are other cases we are litigating on abortion access, contraception, and the ability to make our own healthcare decisions. The stakes are too high for us to back down.   

We go to court because it matters to people’s lives. We don’t bring cases to vindicate abstract legal theories; we bring cases to ensure that the promise of the Constitution is realized for everyone. The Supreme Court has long recognized the fundamental truth that control over reproductive decisions critically impacts “[t]he ability of women to participate equally in the economic and social life of the Nation.” We see this every day in the way women in the U.S. live their lives. The overwhelming majority use contraception. One in four will make the decision to end a pregnancy. Increasingly, people are turning to assisted reproduction in creating their families. Millions have already benefited from the Affordable Care Act, including gaining access to maternal health care, no co-pay contraception, and coverage for pre-existing conditions. And when access to reproductive healthcare is burdened, when clinics are closed, and when healthcare is unaffordable, the consequences fall hardest on Black, Indigenous and people of color, rural communities and people living in poverty. This is why we go to court.   

Daunting challenges are ahead but we are undaunted.  

We will fight in the courts. We will push for federal and state legislation that will remove barriers to accessing reproductive healthcare, including the Women’s Health Protection Act and the EACH Woman Act. 

October 26, 2020: National Organization for Women (NOW) posted a press release titled: “NOW Denounces Amy Coney Barrett’s Confirmation to SCOTUS”. From the press release:

Amy Coney Barrett says when it comes to interpreting the Constitution, she’s an “originalist” in the mold of her mentor, Antonin Scalia. This means that she interprets the Constitution exactly how the authors wrote it.   However, the white male authors of the Constitution (many of whom were also slave owners) left out women, people of color, religious minorities, and LGBTQIA+ people.  According to this interpretation, none of these groups are considered people deserving of equal rights.  

And that’s exactly how Justice Amy Coney Barrett will treat these groups. She has been groomed to overturn many of the important equality gains of the last 60 years, starting with a challenge to the Affordable Care Act that will come before the Court a week after Election Day. She has been outspoken in her opposition to abortion care, affordable birth control, LGBTQIA+ rights, and environmental protections, and she told the Senate she thought the science of climate change is still “in dispute.”  

NOW knows that even if Amy Coney Barrett and a conservative-leaning SCOTUS are not willing to defend our right to equality, that our voices still matter and we will not stop until we are heard. We’re reminded of how crucial a progressive, feminist majority in the Senate is to the future of the Supreme Court, and the women’s rights agenda. NOW members are even more energized than ever to turn out the largest feminist voting force in history to defeat Donald Trump, elect Joe Biden and Kamala Harris, and flip the Senate.  We know what’s at stake—everything. 

October 26, 2020: Senator Kamala Harris (Democrat – California) posted a statement titled: “Harris Statement on Confirmation of Judge Amy Coney Barrett”. From the statement:

U.S. Senator Kamala D. Harris (D-CA), a member of the Senate Judiciary Committee, on Monday released the following statement on her vote against the confirmation of Judge Amy Coney Barrett to be Associate Judge of the Supreme Court of the United States.

“Senate Republicans jammed through this nomination in the middleof an election where over 60 million Americans have already voted. Senate Republicans have ignored the will of the people, decideing instead to replace Justice Rute Bader Ginsburg – who devoted her life to fighting for equal justice – with someone who was selected to undo her legacy.

“President Trump repeatedly made it clear that he would only nominate judges who would get rid of the Affordable Care Act. President Trump and Senate Republicans are determined to take away health care coverage and protections for people with pre-existing conditions. On November 10, Trump administration lawyers will be before the Supreme Court arguing to strike down the Affordable Care Act in its entirity. This is a big reason why Senate Republicans rushed this confirmation. If they succeed, millions of people will lose access to health care in the middle of a devistating pandemic that has killed over 225,000 Americans and sickened millions more.

“The American people see this confirmation for what it is: an illegitimate move that will set our country back for generations. Access to health care is now in jeopardy. Our voting rights are now in jeopardy. Workers’ rights are now in jeopardy. LGBTQ equality is now in jeopardy. The right to a safe and legal abortion is now in jeopardy. The ability to address a changing climate is now in jeopardy. And so much more.

I share the American people’s outrage at this rushed process to confirm a nominee who has the potential to do great harm.”

October 26, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Confirmation of Justice Amy Coney Barrett”. From the press release:

Speaker Nancy Pelosi issued this statement after the Republican Senate confirmed Amy Coney Barrett to the U.S. Supreme Court:

“Eight days from Election Day, after 60 million Americans have already cast their ballots, President Trump and the GOP Senate have committed an act of supreme desperation by jamming through a Supreme Court justice – all so they can achieve their years-long campaign to destroy Americans’ health care.

“Now, Americans must continue to make their voices heard in the election. Congress will have to reverse the damage of a radical Republican court and defend pre-existing condition protections together with every other benefit and protection of the Affordable Care Act.

“With this usurped Supreme Court seat, the President is ripping away millions of families’ health care in the middle of a pandemic that has infected over 8.6 million and killed nearly one-quarter of a million Americans. In her confirmation hearing, Justice Barrett refused to answer whether she believes that Medicare is constitutional. She refused to acknowledge the scientific fact that climate change is happening, saying she isn’t a scientist, calling it ‘controversial.”

“The President’s Supreme Court manipulation threatens the very values and rights that define and distinguish our nation: a woman’s constitutional right to make her own medical decisions, the right of LGBTQ Americans, the right of workers to organize and collectively bargain for fair wages, the future of our planet and environmental protections, voting rights and the right of every American to have a voice in our democracy.

“We must have a Congress that is prepared to remedy what the Supreme Court will do to undermine the health, financial security, and well-being of American families.”

October 26, 2020: Former President Barack Obama tweeted: “In the middle of a pandemic, this administration is trying to dismantle the Affordable Care Act in the Supreme Court. Here’s how Joe and I fought to expand health care, protect millions of Americans with preexisting conditions, and actually get it done:”

The tweet includes a link to an article titled: “The President Looks Back on His Toughest Fight“. It is in The New Yorker and was written by Barack Obama.

October 26, 2020: Lambda Legal posted a press release titled: “Lambda Legal Responds to Confirmation of Amy Coney Barrett to Supreme Court”. From the press release:

This evening, with a 52-48 vote, the Senate confirmed Judge Amy Coney Barrett to the United States Supreme Court. In response, Lambda Legal CEO Kevin Jennings issued the following statement:

“This is a dark day for our justice system and American democracy. The Supreme Court of the United States, the court of last resort for justice in our country, should not be up for a power grab, but that is exactly what happened today. Amy Coney Barrett deeply alarmed us during her confirmation hearings when she refused to say whether she believed cases that are the backbone of the legal rights of LGBTA people – such as Lambda Legal’s landmark case, Lawerence v. Texas which decriminalized same-sex intimacy, and Obergfell v. Hodges, which legalized same-sex marriage – were correctly decided. We fear that all the progress we have made in recent years is now at risk.

“But as perverse as this nomination and forced confirmation against the will of American voters has been, we are not deterred. We have fought for the rights and dignity of LGBTQ people and everyone living with HIV for almost 50 years, and we will not stop now. Party politics may have prevailed today, but Lambda Legal will continue to fight; our communities can count on that.”

Read Lambda Legal’s letter to Senate members opposing the nomination of Judge Amy Coney Barrett to the Supreme Court: https://www.lambdalegal.org/in-court/legal-docs/20201022_letter_amy-coney-barrett-opposition-supreme-court-senate


October 28, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a blog post titled: “Georgia’s Medicaid Waiver is Fiscally Foolish and Anti-Family”. It was written by Joan Alker and Allexa Gardner. From the blog post:

On October 15th, the Centers for Medicare and Medicaid Services Administrator Seema Verma traveled to Atlanta to announce the approval of Georgia’s “Pathways to Coverage” Section 1115 Medicaid demonstration. The approval is the latest in CMS Administrator Verma’s ideological crusade to “reframe” Medicaid and promote her signature initiative — work requirements. The creation of a maze of complex rules to ensure that people don’t get health care when they need it will drive up administrative costs and discriminate against parents with young children who will find it nearly impossible to pass the many tests presented in the state’s demonstration.

Interestingly, the state’s companion and dangerous Section 1332 proposal, which was expected to be approved at the same time, has still not been approved. CMS has said it is working with the state to “finalize the terms and conditions for approval.”

The state’s Medicaid approach is the kitchen sink of bad ideas that have been bumping around for years and found a home together in Georgia’s misguided approach. Administrator Verma and Governor Kemp’s mutual antipathy toward the Affordable Care Act has led to this misguided approach under the facade of “expanding” coverage. The state’s proposal will not qualify for the ACA’s enhanced 90% match, so,  as a consequence, the state will receive its regular match rate of 67% (currently enhanced by 6.2% during the public health emergency) for those individuals who do get coverage after navigating an extremely difficult set of barriers including work reporting requirements.

Currently, Georgia is one of 12 states that has not expanded Medicaid and has some of the highest uninsured rates in the nation for both children and adults. The state also has significant health disparities, yet only provides Medicaid coverage to adults who are parents and deep in poverty — below 35 percent of the federal poverty level ($634 per month for a family of three)…

…Under the approved demonstration, adults between ages 19 and 64 with incomes under 100 percent of the federal poverty level (FPL) must meet a requirement of 80 hours of work or “qualifying activities” (i.e. work hours or “community engagement”) per month  to be eligible for Medicaid coverage. Once enrolled, these individuals must complete and report 80 hours of work or qualifying activities every month to maintain their health coverage. People with incomes between 50 percent ($905 per month for a family of three) and 100 percent FPL ($1,810 per month) are also required to pay a monthly premium to maintain coverage. It will not only be very difficult for individuals to break through these enrollment barriers, but it will also be arduous for them to maintain coverage.  Individuals will have their benefits suspended, and will eventually be disenrolled from Medicaid, if they fail to meet the work requirements or pay their monthly premiums

If that wasn’t enough, CMS also approved the elimination of 3-month retroactive coverage, non-emergency medical transportation (NEMT) services, and hospital presumptive eligibility (the first state to receive approval to do so). Other approved elements include cost-sharing and copayments for non-emergency use of the emergency department.

The entire demonstration was approved under (a)(2) expenditure authority, which our colleague Andy Schneider has written about as part of Administrator Verma’s new litigation strategy to impose work requirements and other restrictions without being stopped by the courts. For a demonstration that claims to expand coverage, almost all of the provisions actually limit benefits and put low-income beneficiaries’ health coverage at risk.

The per person cost of the demonstration is high and few would get coverage — especially when compared to the number of people who would be covered under a standard Medicaid expansion. Over the five-year demonstration period, the state estimates approximately 64,300 individuals will be covered (pg. 17 of cover letter). There are no meaningful budget neutrality estimates provided to show the estimated number of beneficiaries enrolled by year, or the total cost of the demonstration, nor does the state provide any hard estimates of the administrative costs that would result from such a complex system of rules.[1] Because of the kitchen sink of approved policies with proven disenrollment effects, the state likely won’t come close to its predicted enrollment.

The state previously estimated that if Georgia fully expanded Medicaid without the work requirements and other barriers to coverage, between 486,500 and 598,300 adults would be covered once the program reached full enrollment. This means at full enrollment, which is unlikely given all of the red tape, Georgia’s waiver will only cover 11% to-13 % of the potential expansion population with the state paying a greater share of the per-person cost, bringing far fewer federal dollars into the state, and incurring much higher administrative costs...

…Of the 12 work requirement approvals, Georgia’s is one of the harshest we have seen for parents. Because meeting the work requirement is a condition of eligibility, the demonstration provides no exemptions for individuals who may not be able to meet the work requirement because they are taking care of children. Every other state work requirement includes an exemption for parents or caregivers with dependent children, at least until age 6.

As a result of these restrictions, parents will be the least likely to gain coverage. There are no accommodations made for parents who may need child care – child care is not a qualifying activity for meeting the requirement nor are there any flexibilities for parents of children with disabilities. Child care is unaffordable for many low-income families, creating a barrier for parents to be able to meet the work requirement…


October 29, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a blog titled: “National Strategy Needed to Close Health Care Gaps, Protect Children’s Health and Well-Being”. It was written by Kelly Whitener. From the blog post:

…The new research from the Urban Institute should serve as a wake-up call to policymakers…

…Well-child visits and vaccination rates are down, children with special needs are struggling to access needed care, and adolescents are missing out on impotant reproductive health care. Prolonged worry and stress brought on by the pandemic are harmful to mental health for both children and parents. The authors point out that approximately 35 percent of adolescents reported receiving their mental health services in schools before the pandemic so the transition to virtual learning has likely decreased children’s access to behavioral health care. All of the challenges posed by the pandemic add to existing pediatric behavioral health workforce shortages that could lead to the social and emotional needs of children being further neglected.

The good news is there are known solutions. Modifications to in-person health care have made it safer for children to continue to seek preventative care. Expanded access to telehealth and hybrid care models, with both virtual and in-person components, have made it easier for families to access needed care without unnecessary exposure to the novel Coronavirus. Outreach and education campaigns from state leaders and health care providers have helped parents stay informed about the importance of ongoing preventative care and how they can meet their children’s health care needs safely.

The bad news is that without intervention from federal leaders, these interventions will not be distributed evenly, modified to remove remaining barriers, or targeted to children who need them most. States, providers, and child health advocates have been pushing the federal government for more support for months, but there’s been no movement on meaningful COVID relief in the Senate since March. Thankfully, states have intervened when possible and there is more they can do while we continue to wait for Godot…

…Lawmakers left Washington earlier this wek, but their work is far from done.

November

November 1, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on First Day of Open Enrollment in the ACA Insurance Marketplaces Across the Country”. From the press release:

Speaker Nancy Pelosi released this statement on the first day of open enrollment for Affordable Care Act marketplaces for 2021, which runs from November 1, through December 15:

“Affordable health coverage is more essential than ever during the pandemic. While Republicans try to tear down the Affordable Care Act in the Supreme Court, families can enroll knowing that Democrats in Congress stand ready to defend and strengthen pre-existing conditions protections and every other benefit of the ACA. Despite Republicans ‘ continued sabotage campaign, millions of Americans will have access to quality, affordable plans, with most people using the Marketplaces qualifying for financial help and, as a result, many will be able to find plans for as little as $10 per month.

“Democrats will continue our work For The People to lower health care costs and prescription drug prices while protecting the pre-existing condition benefit for all Americans.”


November 2, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becera Condemns Latest Trump Administration Attack on Health and Well-Being of Immigrant Families”. From the press release:

California Attorney General Xavier Becerra today led a coalition of state and local governments in a comment letter condemning the Trump Administration’s new efforts to restrict family-based immigration through a proposed regulation that directly threatens state health care systems and efforts to combat the coronavirus. The proposed rule by the U.S. Department of Homeland Security (DHS) would force many U.S. citizens and green card holders to sacrifice the reciept of benefits for which they qualify – including Medicaid and the Supplemental Nutrition Assistance Program – to preserve their best opportunity to sponsor a family member for lawful permanent residency. The proposal is part of the Trump Administration’s ongoing effort to racially transform public charge law. In the comment letter, the coalition urges the Trump Administration to immediately withddraw the rule and postpone consideration of any similar rules until after the resolution of the ongoing global pandemic and national public health emergency.

“Keeping citizen and immigrant families apart is a cruel but defining characteristic of the Trump Administration,” said Attorney General Becerra. “DHS’s proposal runs counter to America’s core values and the law. It threatens public health in the middle of a pandemic. No family should ever be forced to choose between accessing healthcare and food assistance or bringing the family together in this time of pandemic.”

On October 2, 2020, DHS proposed a new regulation to drastically alter requirements for affidavits of support, which are contracts signed by a sponsor to show that their close family member who is applying for a green card is not likely to become dependent on the government. Among the harsh changes sought, DHS has proposed a joint-sponsor requirement when sponsors or their household members have received a public benefit for which they qualify within the 36-month period prior to the execution of an affidavit of support. The proposed rule would disqualify individuals from serving as a joint sponsor if they have received such a benefit within the same time period. It would preclude sponsors from pooling their income with the income of other relatives who reside with them and are willing to promise support for the intending immigrant if needed, except where the relative is the sponsor’s own spouse. The proposal also needlessly subjects sponsors and their household members to onerous documentation requirements. Ultimately, the new requirements would significantly hinder family unification and — like the public charge rule — penalize modest income and working-class families for accessing public benefits for which they are eligible — all during an economic and public health crisis of historic proportions that has infected more than 9.1 million Americans and resulted in the deaths of more than 229,000 people across the country.

In the comment letter, the attorneys general assert that the proposed rule will:

  • Deter eligible U.S. citizens from receiving critical public benefits, endangering public health;
  • Generate confusion with regards to immigration laws and increase administrative burdens on state and local governments;
  • Weaken states’ response to the pandemic by sowing distrust in government services and creating reluctance to seek needed healthcare — exacerbating the disparate impacts of the pandemic on our communities; and
  • Violate federal statutes, failing to pass muster under laws such as Immigration and Nationality Act and the Administrative Procedure Act..

…In filing the comment letter, Attorney General Becerra is joined by the attorneys general of Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Virginia, Washington, Wisconsin, and the District of Columbia, as well as the Cook County State’s Attorney, Corporation Counsel of New York City, and County Counsel of the County of Santa Clara County.

A copy of the comment letter is available here.

November 2, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a blog post titled: “New CMS Rule Would Weaken Families First Continuous Coverage Protection in Medicaid”. It was written by Edwin Park. From the blog post:

On October 28, the Trump Administration announced that it would weaken the current continuous coverage protection for Medicaid beneficiaries by permitting states to cut or scale back benefits and increase cost-sharing charges.

The Families First COVID-19 relief legislation provided a temporary 6.2 percentage point increase in the federal Medicaid matching rate (FMAP) through the end of the calendar year quarter in which the current public health emergency expires (PHE).  Because the Secretary of Health and Human Services extended the PHE through at least January 20, 2021, this means the FMAP increase remains in effect through at least March 31, 2021.

Under a maintenance-of-effort (MOE) requirement, as a condition of receiving the increased Families First FMAP, state Medicaid programs must not implement eligibility standards, methodologies and procedures that are more restrictive or charge higher premiums than were in place on January 1, 2020.  They must also cover COVID-19 testing and treatment without cost-sharing.  They must also not disenroll any beneficiaries who were enrolled as of March 18, 2020 (or newly enrolled beneficiaries after such date) through the end of the month in which the PHE ends.  That means that state Medicaid programs must maintain enrollment through at least January 31, 2021.  This last “continuous coverage” requirement is critical to ensuring that low-income individuals and families have access to health coverage and to needed care during the pandemic…

…CMS, however, is issuing a new interim final rule reversing its earlier sound reading of the continuous coverage requirement.  Under the most harmful change, state Medicaid programs would now be permitted to eliminate optional benefits such as dental coverage and reduce the amount, duration and scope of covered benefits (like imposing lower visit limits or adding other utilization controls), compared to what was covered on March 18, 2020.  They may also now increase co-payment and other cost-sharing levels (subject to federal limits) and require nursing home residents to contribute more to the monthly cost of their care (known as post-eligibility treatment of income), above what was required on March 18, 2020.

In addition, states would be permitted to transfer beneficiaries from one eligibility category to another if they are no longer eligible under their original category, even if it may reduce the benefits available to them. For example, if an expansion state has opted to cover 19 and 20 year-olds under their child eligibility category, the continuous enrollment protection would no longer require the state to maintain the young person in the child eligibility category when they turn age 21 and could instead transfer them to the adult expansion group. This, however, means the beneficiary would lose access to the comprehensive Early Periodic Screening Diagnostic and Treatment (EPSDT) benefit. Similarly, a near-elderly Medicaid beneficiary enrolled in the expansion who turns age 65 and becomes eligible for Medicare could be switched to the Medicare Savings Programs (which only covers Medicare premiums and cost-sharing, not other Medicaid benefits that may not be covered by Medicare)…

…Finally, CMS indicates that a state would not be out-of-compliance with the continuous coverage requirement if it disenrolls a beneficiary who was not validly enrolled in the first place (the eligibility determination was erroneous or the result of fraud and abuse). Beneficiaries found enrolled in two or more states who fail to respond to a request for information related to residency may also be disenrolled. In addition, states that have opted to cover full benefits for lawfully residing children and pregnant women in in the first 5 years after entry into the United States would be required to limit their coverage to emergency services if individuals are found to no longer meet the definition of such children and pregnant women.

These changes would be effective immediately (upon public display of the interim final rule). Notably, while CMS issued its original interpretation of the continuous coverage requirement as guidance, it is now reversing it through an interim final rule. That both makes these changes harder for a different Administration to modify procedurally but also essentially takes away meaningful public comment, as these changes will already be in effect well before any comments are submitted, let alone considered.


November 3, 2020: The Denver Post posted an article titled: “Colorado Prop 115 results: Ban on most later-term abortions defeated”. It was written by Judith Kohler. From the article:

A ban on most abortions at 22 weeks or later in pregnancy was defeated Tuesday night as voters rejected the fourth attempt since 2008 to more stringently regulate abortions in Colorado.

About 1.6 million voters, or 59.2%, rejected Proposition 115 with 83% of the vote counted, while 1.1 million, or 40.8%, supported it.

Proponents, who said they had strong grassroots support, were vastly outspend by opponents. Proponents spent $505,488, compared to opponents’ nearly $9 million, according to the Colorado News Collaborative’s FollowtheMoneyCO project.

The ballot measure would have subjected doctors ever attempting to perform a later-term abortion to misdemeaner charges and at least a three-year suspension of their license. The only exception would have been for an abortion that is immediately required to save the woman’s life….

…those campaigning against Proposition 115 said it would have undermined women’s rights to reproductive health…

…Colorado was the first state in the country to decriminalize abortion, passing a law in 1967 to allow the procedure in cases of rape, incest, if the woman’s life was threatened or if the unborn child might have birth defects.

The vote on abortion restrictions came as the confirmation of Amy Coney Barrett to the U.S. Supreme Court has raised the stakes for the fate of Roe vs. Wade, the 1973 ruling that legalized abortion. Barrett has been involved in organizations opposed to abortion…

November 3, 2020: Lift Louisiana posted news titled: “Louisiana Coalition for Reproductive Freedom Responds to Passage of Amendment 1”. From the news:

Louisiana voters approved Amendment 1, which explicity states there is no righ to an abortion and the funding of an abortion in the Louisiana Constitution. The Louisiana Coalition for Reproductive Freedoms (LCRF), which is a statewide alliance of organizations and individuals, fought against the amendment for a number of reasons including that it would deny the personal freedom of bodily autonomy and would hurt already marginalized communities:

  • Black
  • Indigenous
  • people of color
  • young people
  • undocumented people
  • people living on low or no income; and people experiencing homelessness; and
  • LGBTQ+ people

Everyone should have the right and freedom to make decisions about their bodies and whether, when, and how they become a parent. Proponents of the amendment tried to say it would prevent public funding of abortion, but state and federal laws have prohibited public funds from being used for abortion services in Louisiana for more than 40 years.

The right to an abortion is still unconstitutionally protected by the United States Supreme Court’s Roe v. Wade decision, but Amendment 1 could prevent a judicial intervention for abortion rights should Roe ever be overturned. With Amy Coney Barrett’s confirmation to the Supreme Coirt, there are many who feel Roe is in jeopardy. Louisiana, which has passed 89 abortion-restrictive laws since the 1973 Roe decision, has only three remaining abortion care facilities, making it one of the most difficult states to obtain abortion care…

November 3, 2020: The Hill posted an opinion piece titled: “COVID-19 could become a widespread pre-existing condition in a post-ACA world”.

It was written by Carter C. Price (a senior mathematician at the nonprofit, nonpartisan RAND Corporation who worked on the COMPARE microsimulation model to study the impact of health reform.) It was also written by Raffaele Varadavas (a mathematician at RAND and a member of Pardee RAND Graduate School faculty who constructs and analyzes epidemic models.). From the article:

On Nov. 10, the U.S. Supreme Court will hear oral arguments in Californai v Texas, a cast that asks: When Congress eliminated the penalty for not carrying health insurance, did that make the whole Affordable Care Act (ACA) unconstitutional? In the midst of the pandemic, this question takes urgency for COVID-19 survivors.

If the ACA is struck down, protections for pre-existing conditions will go with it. That could mean tens of millions of Americans could be charged higher premiums or even denied health insurance coverage altogether…

…Given the chronic problems associated with some COVID-19 cases, it is possible that some insurers would place restrictions on anyone who had a confirmed case of COVID-19. As of late October, there have been about 5.8 million confirmed cases among people under the age of 65 (and therefore not eligible for Medicare in most circumstances), and those numbers keep rising. If a history of COVID is considered to be a pre-existing condition, access to affordable insurance will be greatly diminishedfor those in the South and parts of the Great Plains (North and South Dakota, in particular) and Midwest.

Access to testing was limited in the earlier days of the pandemic, so many other COVID-19 infections were not identified. But some of those may be detected in the future with antibody testing. A portion of this population may also have significant long-term health consequences, and insurers may want to avoid that risk, which would put a total of 23 million people or more at risk of being flagged with a pre-existing condition.

More than a quarter of people in the state of New York could be at risk of being flagged as having had a pre-existing condition based on antibody testing. Louisiana, Illinois and states in the mid-Atlantic and portions of New England also have high levels of positive antibody tests that could be considered signs of a pre-existing condition. These numbers will only grow and could be more than two or three times as high or higher before the pandemic is under control. In practice, it may be challenging for insurance companies to exclude or apply rescission on all COVID-19 survivors without a positive test, but this does suggest a scale of the population who may be vulnerable.

COVID-19 has not spread evenly through the population. Black and Latino populations, low-income Americans and essential workers have been particularly hard hit. In a world without the ACA, this would, perversely, mean that the demographic groups most affected by COVID-19 will have the least access to affordable health care.

The threat of being denied insurance because of a COVID-19 diagnosis could also change behavior. Specifically, individuals might avoid getting tested. Conversely, the same threat may encourage some people to take precautions like wearing face masks and social distancing and to get vaccinated when available…


November 4, 2020: The RAND Blog posted a blog post titled: “COVID-19 Could Become a Widespread Preexisting Condition in a Post-ACA World”. It was written by Carter C. Price and Raffaele Vardavas. From the blog post:

On November 10, the U.S. Supreme Court will hear oral arguments in California v. Texas, a case that asks: When Congress eliminated the penalty for not carrying health insurance, did that make the whole Affordable Care Act (ACA) unconstitutional? In the midst of the pandemic, this question takes an urgency for COVID-19 survivors.

If the ACA is struck down, protections for preexisting conditions will go with it. That could mean tens of millions of Americans could be charged higher premiums or even denied health insurance coverage altogether…

…Without these ACA protections, there are several ways that an insurance company might consider COVID-19 to be a preexisting condition to discriminate against applicants and policyholders.

Given the chronic problems associated with some COVID-19 cases, it is possible that some insurers would place restrictions on anyone who had a confirmed case of COVID-19. As of late October, there have been about 5.8 million confirmed cases among people under the age of 65 (and therefore not eligible for Medicare in most circumstances), and those numbers keep rising. If a history of COVID-19 is considered to be a preexisting condition, access to affordable insurance will be greatly diminished for those in the South and parts of the Great Plains (North and South Dakota, in particular) and Midwest…

…Access to testing was limited in the earlier days of the pandemic, so many other COVID-19 infections were not identified. But some of those may be detected in the future with antibody testing. A portion of this population may also have significant long-term health consequences, and insurers may want to avoid that risk, which would put a total of 23 million people or more at risk of being flagged with a preexisting condition…

…The threat of being denied insurance because of a COVID-19 diagnosis could also change behavior. Specifically, individuals might avoid getting tested. Conversely, the same threat may encourage people to take precautions like wearing face masks and social distancing and to get vaccinated when available…


November 7, 2020: Joan Alker (ED of Georgetown Center for Children and Families) tweeted: “Goodbye and good riddance to Medicaid work requirement waivers”.


November 9, 2020: Planned Parenthood posted a press release titled: “More than a Dozen Countries Call for U.S. to Advance Sexual and Reproductive Health and Rights as Part of U.N. Review”. From the press release:

Today, as part of the Universal Periodic Review (UPR) process, representatives from United Nations (UN) member states offered recommendations to the U.S. on how to correct recent human rights abuses. Many representatives focused on regressive policies from the Trump administration, and its allies across the U.S. government, that attack sexual and reproductive health and rights. With the election of President-elect Joe Biden and Vice President-elect Kamala Harris, two champions for sexual and reproductive health, this critical work of restoring policies that advance human rights can begin…

…The UPR process involves a review of the human rights records of all UN member states every four years, with the aim of improving the human rights situation on the ground. Planned Parenthood Federation of America submitted a report for the UPR on the U.S. human rights record, including recommending to overturn the Title X and global gag rules and to repeal the Hyde and Helms Amendments. During today’s session, the following countries offered recommendations to the U.S. to ensure universal access to sexual and reproductive health, and address policies that limit access to family planning through the Title X program and restrict funding for sexual and reproductive rights, including abortion, through U.S. foreign aid: Australia, Austria, Canada, Denmark, Iceland, Finland, France, Luxembourg, Malaysia, Mexico, Netherlands, New Zealand, Norway, and the United Kingdom.

These damaging policies that restrict sexual and reproductive health access have been in place, and been harming people across the globe, for years. But tragically, the COVID-19 pandemic has magnified health care disparities, in turn impacting reproductive rights. In the U.S., one in three women have reported delays in accessing sexual and reproductive health care, with this rate even higher among Black and Hispanic women. Similar disruptions are occurring in other countries and are exacerbated by U.S. policies like the global gag rule.

The impact of these regressive policies are clear. Upon taking office, the Biden administration must end the global and domestic gag rules so that health care providers and patients can speak freely about all reproductive healthcare options. The administration must also propose a budget that reflects a committment to sexual and reproductive health – including ending the Hyde and Helms Amendment.

November 9, 2020: American Civil Liberties Union (ACLU) posted news titled: “The Affordable Care Act – and With It, Our Civil Rights – Are Under Attack”. It was written by Lousie Melling, Deputy Legal Director and Director of Ruth Bader Ginsburg Center for Liberty. From the news:

…But the Affordable Care Act is now imperiled. This week, the Supreme Court will hear arguments in California v. Texas – a case that puts this critical law in jeopardy of being struck down in its entirety. While most legal scholars think such a ruling unlikely, any decision striking the law would have devistating ramifications for the civil liberties advancements that the ACA has provided. And it would have particlarly cruel and deadly consequences in the midst of a pandemic and recession. Dismantling the ACA now would exacerabate the longstanding, systemic disparities in access to health care, economic opportunities, and other resources faced by Black, Latinx, and disabled people in this country – disparaties that are now approaching epic proportions in light of the pandemic.

The Affordable Care Act made huge advancements for many groups of people to whom stable health insurance and health care were often denied, whether because of express discrimination or the effects of discrimination.

Women: The ACA bars sex discrimination, full stop. This means, for example, that at long last insurers may no longer charge women higher rates. The ACA as implemented covers care long excluded from insurance coverage that was seen as exclusively women’s care: mammograms, screenings for cervical cancer, contraception coverage and counseling, lactation support, and prenatal care. These forms of discrimination had material consequences. Before passage of the Affordable Care Act, women were estimated to spend 68 percent more than men in out of pocket health care costs. The ACA takes aim at discrimination that perpetuates gender inequity, including the discrimination in health care that perpetuates gender disparities in wealth.

LGBTQ people: The ACA’s bar on sex discrimination also means that LGBTQ people can’t be subject to discrimination in federally funded institutions, public health care programs, or by insurance companies. The ACA eliminates barriers that many LGBTQ people previously faced in receiving health care — a crucial step toward ensuring health care is accessible to all — regardless of gender identity or sexual orientation.

People of color: The ACA makes important strides to address racial injustice in health care as well. It bars discrimination based on preexisting conditions, a provision critical to ensuring that those who are sick — and thus most in need of health insurance — aren’t effectively barred from accessing it. While this provision is important to people of all races, it is also an essential part of beginning to redress the health disparities that reflect the legacy of race discrimination in the country. This is evident in  the higher rates of hypertension among Black people, for example, and the disproportionate rates of COVID-19 infections and deaths among Black and Latinx communities. 

The data is striking: Because of the ACA, between 2013 and 2017, the coverage gap between Black and white Americans declined from 11 to 5.3 percentage points. Similarly, during the same period, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 to 16.6 percentage points. Additionally, the ACA expanded Medicaid for people whose income is below 138 percent of the federal poverty level. In short, the ACA has helped make important strides in reducing racial, ethnic and economic disparities in in access to health care and coverage. 

People with disabilities: The ACA has been a life saver for people with disabilities. It protects against coverage limitations based on preexisting conditions or lifetime limits, and guarantees coverage of services for mental illnesses and developmental disabilities. It provides access to long-term, home-based health care, which can mean the difference between institutionalization and independence for people with disabilities. And it expressly precludes discrimination in access to health care based on disability.

People experiencing poverty: The ACA also expanded Medicaid for people up to 138 percent of the federal poverty level — although not every state availed itself of the option, despite its literal life-giving opportunities. Prior to the ACA’s passage, Medicaid eligibility for parents was limited to those with very low incomes (often below 50 percent of the poverty level), and adults without dependent children were ineligible under federal rules, regardless of their income level, according to a report from the Kaiser Family Foundation.

The ACA is part of the path to equity — remedying systems of oppression and discrimination — that runs to the core of living or dying, particularly during the time of COVID-19. As we said in our 2012 brief, the ACA “advances the twin goals of liberty and equal protection.” The ACA is worth fighting for. Our civil liberties and civil rights are worth fighting for.

November 9, 2020: California Attorney General Xavier Becerra posted a press release titled: “On Eve of Oral Arguments in the U.S. Supreme Court, Attorney General Becerra Issues Statement in Defense of the Affordable Care Act”. From the press release:

California Attorney General Xavier Becerra today issued a statement on the Affordable Care Act (ACA) ahead of tomorrow’s oral arguments before the United States Supreme Court in the healthcare repeal case, California v. Texas. The California Attorney General’s Office is leading a coalition of 20 states and the District of Columbia in defense of the ACA including the law’s protections for people with preexisting conditions, public health investments, and Medicaid expansion, among others. In the midst of rising COVID-19 cases and deaths nationwide, the Trump Administration and the Texas-led state coalition are risking the healthcare of millions of Americans and financial support for states. The State of California alone, would stand to lose an estimated $160.2 billion in federal program funding, and millions of people would lose their healthcare coverage as a result of the loss of the ACA.

“COVID-19 has made one thing undeniable: We must safeguard the Affordable Care Act – lives depend on it,” said Attorney General Becerra. “Every nation around the world has had to confront the devistating impact of the global pandemic. The United States, under President Trump’s watch, continues to set records going in the wrong direction. Millions infected, hundreds of thousands dead. As if on cue, the Trump Administration cavilerly continues its march to dismantle the ACA and strip Americans of their healthcare. We will do everything we can to defeat this unprecedented assault on a critical federal law by a sitting president.”…

…Every American could be affected if the ACA is destroyed. In particular, the following is at stake:

  • Healthcare for the 20 million Americans who are able to afford insurance either through Medicaid expansion or thanks to tax credits and employer-sponsored plans through healthcare exchanges, such as Covered California;
  • Guaranteed coverage for the 133 million Americans who have a pre-existing condition, including 17 million kids, and benefit from the law’s protection against discrimination and higher costs based on health status;
  • Healthcare for young adults under the age of 26 covered by a parent’s plan;
  • Families of children with chronic health conditions who are currently protected from lifetime insurance limits; and
  • Funding for our nation’s public health system, including investments in local and state public health systems that help during the pandemic, FDA biosimilars which power drug costs, and more including Medicare payment reforms, Indian Health Services, and work to fight the opioid epidemic…

November 9, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Defends ACA on Eve of Supreme Court Oral Arguments”. From the press release:

New York Attorney General Letitia James today continued her strong defense of the Patient Protection and Affordable Care Act (ACA) ahead of tomorrow’s oral arguments before the United States Supreme Court in the health care repeal case, California v. Texas. Attorney General James and a coalition that includes 20 states and the District of Columbia are defending the many provisions of the ACA — including coverage of preexisting conditions, public health investments, and Medicaid expansion, among others — against the Trump Administration and a Texas-led state coalition seeking to dismantle the health care reform law that has provided new coverage to at least 20 million Americans. The Trump Administration and the Texas-led state coalition’s actions are even more dangerous given their attempts to strip health care coverage away from millions of Americans as coronavirus disease 2019 (COVID-19) deaths and infections — which hit numerous highs last week — continue to rise exponentially across the nation.

“For years, Donald Trump and Republicans across the country have tried to repeal the ACA and strip health coverage away from millions of Americans, but we will continue to fight this assault on our health care,” said Attorney General James. “Even more dangerous is that this attack comes in the middle of the COVID-19 pandemic, which has killed more than 237,000 Americans and infected more than 10 million. That’s 10 million Americans who now have a pre-existing condition and who Republicans want to charge more for coverage. Eight years ago, the Supreme Court ruled that the ACA was legal, so we will not allow President Trump and his Republican allies to dismantle the ACA, piece-by-piece, or undo all the progress made since the law’s passage after failing to get Congress to do its dirty work.”…

…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 U.S. Court of Appeals for 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 addition to New York, the coalition arguing before the Supreme Court tomorrow includes 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.

November 9, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “Every year, 68,000 Americans die because they can’t afford to go to a doctor on time – almost 200 people a day. Health care is a human right. Lack of health care is a death sentence. We must guarantee health care to everyone through a Medicare for All, single-payer program.”

November 9, 2020: American Academy of Pediatrics posted a news release titled: “Leading Children’s Health Groups Urge Lawmakers and Administration to Address Troubling Trends in Children’s Uninsurance”. From the news release:

Leading children’s health groups are urging comprehensive and immediate action by Congress and the Administration to protect and improve access to health care coverage for all children. The call to action comes on the heels of recent data from the U.S. Census Bureau showing that 320,000 fewer children had health insurance coverage in 2019 than in 2018, even before the COVID-19 pandemic. Today, a new report from the Georgetown University Center for Children and Families shows that in 2019, an estimated 4.4 million children did not have health insurance coverage, an increase of 726,000 or nearly 20 percent more children without insurance since 2016, when the nation reached a historic low in children without coverage. The child uninsured rate has grown from 4.7 to 5.7 percent over the same time period.

The American Academy of Pediatrics, Children’s Defense Fund, Family Voices, First Focus on Children, Georgetown University Center for Children and Families, March of Dimes, and the National Association of Pediatric Nurse Practitioners issue the following statement:

“Our organizations are sounding the alarm over the growing number of children without health insurance. Recent data show the largest increase in the number of uninsured children in more than a decade. A new report today shows that years of progress in covering more children has been eroded, with widespread coverage losses across income, age, racial and ethnic groups.

“Since 2016, the number of uninsured children has grown each year. Especially concerning is that these 2019 numbers do not reflect the devistating consequences of the COVID-19 pandemic and economic downturn this year, which has caused millions of families to lose jobs and employer-sponsored insurance. These data underscore that the children’s health coverage landscape was already headed in a dangerous direction, even before the pandemic hit.

“Without health care coverage, children’s health suffers. Often, no coverage means no care, which means fewer preventive screenings to catch conditions before they become severe and costly. It means no access to affordable dental coverage, vaccines, or prenatal services for pregnant mothers. While the latest data show that children across all regions and income levels experienced coverage losses in 2019, the greatest coverage losses were among Hispanic children. The COVID-19 pandemic, which has had a disproportionate impact on communities of color, only exacerbates the impact on children and families who lack access to affordable, comprehensive and high-quality health coverage. We know that children without health coverage could also suffer long-term harm, ending up in poorer health, with less emotional attainment and less financial security in adulthood.

“Before the pandemic, the Administration’s actions – such as the public charge rule, which has reduced immigrant families’ willingness to enroll their children in Medicaid and the Children’s Health Insurance Program (CHIP), and other problematic policy changes that impeded access to Medicaid and the CHIP and private insurance – are contributors to this erosion of children’s coverage. The ongoing global pandemic and subsequent economic recession lead us to believe coverage losses for children will only continue to get worse.

“Children need health care coverage that they can rely on. Congress took the first step to protect children and families by providing greater financial support for Medicaid in the Families First Coronavirus Response Act, along with its continuous coverage protections ensuring that children, pregnant women, and families won’t lose Medicaid coverage due to red tape during the pandemic. We call on Congress and the Administration to advance policies that ensure all children and families have health care coverage, not policies that stand in the way of making that possible. Our children’s futures depend on our ability to act now.”


November 10, 2020: The American College of Obstetricians and Gynecologists (ACOG) posted news titled: “ACOG Statement on the Affordable Care Act”. From the news:

The following is a statement from Eva Chalas, MD, FACOG, FACS, President of the American College of Obstetricians and Gynecologists (ACOG), and Maureen G. Phipps, MD, MPH, Chief Executive Officer of ACOG, regarding the challenge to the Patient Protection and Affordable Care Act (ACA) before the U.S. Supreme Court:

“The ACA has revolutionized access to care for tens of millions of women by helping them obtain meaningful health coverage, ensuring that essential care is covered by insurers, and protecting patients from unfair practices. ACOG urges the Supreme Court to recognize that overturning the ACA will leave tens of millions of patients without reliable access to care. In any year, this would be devastating, and during a global pandemic, it is unconscionable and would be one of the most singularly disruptive acts to be committed during this public health crisis.

“Years of data clearly demonstrate how the ACA has changed lives by improving patient access to care, reducing out of pocket costs, enhancing peace of mind, and bettering the health and wellbeing of so many individuals and families.

“ACOG is hopeful that tens years after its historic enactment, the ACA will continue to stand. Moving forward, we are eager to work with policymakers to build on the advances of the ACA to continue to protect meaningful health coverage, eradicate preventavle maternal mortality, and achieve health equity in the United States.”

Access the amicus brief that ACOG filed with other major medical associations.

November 10, 2020: National Organization for Women (NOW) posted a press release titled: “We Refuse To Go Backwards, We Must Protect Our Health Care”. From the press release:

Donald Trump packed the Supreme Court with justices the could count on to strike down the Affordable Care Act (ACA). Today, in the midst of a global pandemic when health care is needed most, we are watching to see if Amy Coney Barrett, Brett Kavanaugh, and Neil Gorsuch deliver the goods to the outgoing President.

Women and the most vulnerable in our society know what’s at stake today. The repeal lawsuit, supported by the Trump administration, will be heard by the Supreme Court in California v. Texas and could end ACA as we know it.

The ACA is what allows parents to keep their children on their health insurance plans until age 26, ensures women are able to obtain preventative care services such as mamograms, and helps protect access for birth control. Prior to the ACA, women could be charged more for insurance and could be denied maternal coverage like pregnamcy care and childbirth. Additionally, insurance companies could deny LGBTQIA+ individuals insurance coverage, services related to gender transition, or charge higher rates based on sexual orientation or gender identity.

Perhaps the most alarming aspect of a ACA repeal would be the loss of the prohibition against denying coverage for those with pre-existing conditions. According to the Department of Health and Human Services, this could impact anywhere between 50 and 129 million individuals. And as the COVID pandemic takes an exponential toll on Americans and the nation’s mental health, if the ACA is overturned, mental illness and even COVID-19 itself may soon be the most common pre-existing condition.

The ACA’s essential health benefits ensure everyone with insurance can have comprehensive care, including mental healthcare, maternity care, and more. NOW members are monitoring today’s arguments carefully. These justices cannot allow themselves to be used as partisan pawns, intent on eviscerating our healthcare system. It is the duty of the Supreme Court to uphold the Constitution and protect our civil rights and liberties.

We refuse to go back to a dangerous time when insurance companies could deny or charge more for coverage and discriminate against the millions of people with pre-existing conditions. Repealing access to health care, with no alternative plan in sight moving forward, will only put the lives of women and families at risk.

November 10, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James’ Statement on ACA Supreme Court Oral Arguements”. From the press release:

New York Attorney General Letitia James and a coalition that includes 20 states and the District of Columbia today defended the Patient Protection and Affordable Care Act (ACA) in the United States Supreme Court in the health care repeal case, California v. Texas. The coalition defended the many provisions of the ACA agaisnt the Trump Administration and a Texas-led state coalition seeking to dismantle the health care reform law that has provided new coverage to at least 20 million Americans.

“The Affordable Care Act has been the law of the land for a decade now, but President Trump, his administration, and Republicans allies are trying to take us backwards in time by stripping health coverage away from millions of Americans,” said Attorney General James. “Today, Donald Trump and Republicans fought to kick children off their parents’ health care plans, fought to rip health coverage away from the 133 million with pre-existing conditions, fought to charge women more for no other reason than being a woman, fought to increase the cost of prescription drugs for seniors, and fought to deprive millions of Americans access to quality, affordable health care. Time after time, President Trump and his Republican allies have failed to get Congress to do its dirty work and has instead attempted to dismantle the ACA, piece-by-piece. We are confident the court will reject Republicans’ arguments today, just like it did in 2012, and that we will prevail in protecting Americans’ right to health care.”

Every American across the nation could be affected if the ACA is dismantled. At risk is:

  • Health care for the 20 million Americans who are able to afford insurance either through Medicaid expansion or thanks to tax credits and employer-sponsored plans through health care exchanges.
  • Guaranteed coverage for the more than 133 million Americans who have a pre-existing health condition, including 17 million kids, that benefit from the law’s protections against discrimination and higher costs based on health status.
  • Health care for young adults under the age of 26 covered by a parent’s plan.
  • Health care for families of children with chronic health conditions who are currently protected from lifetime insurance limits.
  • Funding for our nation’s public health system, which includes investments in local and state public health systems that have helped during the COVID-19 pandemic; FDA biosimilars, which power drug costs; and more, including Medicare payment reforms, Indian health services, and work to fight the opioid epidemic.

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 U.S. Court of Appeals for 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 addition to New York, the coalition that argued the case before the Supreme Court included 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.

November 10, 2020: National Women’s Law Center posted a press release titled: “NWLC responds to Supreme Court’s ACA oral arguements”. From the press release:

Today, the newly comprised U.S. Supreme Court will hear oral arguments to decide whether or not the Affordable Care Act (ACA) is constitutional, the first with Justice Amy Coney Barrett, who was confirmed just a week before the election.

Invalidation of the ACA will force at least 20 million people to immediately lose health care, in addition to critical reforms and protections that ended discriminatory and harmful insurance industry practices that disproportionately impacted wimen as highlighted in our amicus brief.

Because of the ACA:

  • Insurance companies are prohibited from denying coverage based upon pre-existing conditions, and 68 million women with pre-existing conditions have access to health coverage.
  • The practice of charging women significantly more than men for the same health insurance is banned, saving them approximately $1 billion a year.
  • Expanded Medicaid eligibility covers 18% of women across the country, including 27 percent of Latinas and 31 percent of Black women ages 15-44.
  • There is a broad federal protection against discrimination in health care based on race, color, national origin, age, disability, or sex, including gender identity, sex stereotyping, pregnancy, termination of pregnancy, childbirth, or related medical conditions.
  • Plans must cover women’s preventive services without out-of-pocket costs, including breast and cervical cancer screenings; comprehensive breastfeeding support services; and the full range of FDA-approved methods of contraception for women and related education and counseling. Over 64 million women now have coverage of preventive services without cost-sharing.
  • Plans must cover a baseline of essential health benefits for individual and small group insurance, including maternity and newborn care, preventative services, mental health and substance abuse disorder services, and prescription drugs.
  • Insurance companies are prohibited from setting lifetime limits on coverage.
  • Young adults can stay on their parents’ health insurance plan until they turn 26.

The following statement is from Fatima Goss Graves, president and CEO of the National Women’s Law Center (NWLC):

“It’s deeply disturbing that this politically motivated effort to take health coverage away is at the Court for a third time, while COVID-19 cases continue to skyrocket. The Court should see this for what it is: Trump’s agenda to destroy the ACA, without a legal basis. People across the country know what’s at stake, and a decisive majority just voted for progress. People need and deserve expanded access to health care, especially during a pandemic. We will fight to make this a reality, no matter the decision of the Court.”

November 10, 2020: U.S. News posted an article titled: “Obamacare’s Birth Control Coverage May Have Reduced Unplanned Pregnancies”. It was written by Cara Murez. From the article:

When Obamacare made contraception affordable, the rate of unplanned pregnancies among poor Americans declined, a new study reports.

The Affordable Care Act’s (ACA) elimination of out-of-pocket costs for birth control was tied to fewer births in all income groups, but especially among poorer women, the new research found. In fact, the lowest income group had a 22% decline in births after the law as passed.

“Our findings suggest that expanded coverage of prescription contraception may be associated with a reduction in income-related disparities in unintended pregnancy rates,” said lead author Dr. Vanessa Dalton. She’s an obstetrician-gynecologist at Michigan Medicine Von Voiglander Women’s Hospital, in Ann Arbor…

…For the study, the researchers examined birth rates among 4.6 million women aged 15 to 45 who had employer-sponsored health plans between 2008 an 2013, before the ACA eliminatd cost-sharing for contraceptives. It compared those rates to the time period between 2014 and 2018, after the ACA (also known as Obamacare) was passed.

The investigators found lower birth rates, as well as a decrease in women not filling their birth control prescriptions.

The ACA included contraception as a preventative service that most employer-sponsored insurance plans were required to provide. This gave women access to birth control, including long-acting forms of birth control such as intrauterine devices, with no co-pays or deductible payments…

November 10, 2020: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi, Schumer Joint Statement on Supreme Court Oral Arguments for Trump-GOP Lawsuit to Strip Health Care Coverage from Millions of Americans”. From the press release:

House Speaker Nancy Pelosi (D-CA) and Senate Democratic Leader Chuck Schumer (D-NY) today issued the following joint statement on the Supreme Court hearing of the Trump-Republican backed lawsuit to strip health care protections from millions of Americans during a global pandemic:

“Today, the Trump-Republican plan to repeal the Affordable Care Act and strip health care away from millions of Americans during a global pandemic was on full display as the California v. Texas lawsuit was heard by the Supreme Court. Republicans have tried and failed to repeal the ACA at least 70 times in Congress and twice through the courts, but as it was heard in today’s oral arguments, the Supreme Court must be deferential to Congress’s intent and uphold the law. With their legal argument detached from reality, Senate Republicans rushed through the nomination of Judge Amy Coney Barrett to the Supreme Court just days before the election, in an obvious attempt to make good on President Trump’s promise to only appoint judges who would ‘terminate’ the ACA.

“With support for the ACA at an all-time-high, Republicans are still waging a decade-long war against Americans’ health care protections. If the Trump-GOP lawsuit is successful, more than 20 million Americans could lose their health care coverage, 130 million Americans with pre-existing conditions could lose protections, and drug costs could skyrocket for seniors. Republicans voted just weeks ago to greenlight this lawsuit but still falsely try to claim they will protect Americans with preexisting conditions. It is clear that striking down the ACA is what Republicans want.

“Democrats believe this lawsuit has no merit, and we will continue to fight to make coverage more affordable for all Americans.”


November 11, 2020: Center for Reproductive Rights posted a press release titled: “Court Lets Part of Tennessee Abortion Ban Take Effect”. From the press release:

Today, a 6th Circuit Court of Appeals panel granted a request from the state of Tennessee, letting part of a law take effect that prohibits abortion based on a patient’s reason, including a potential Down syndrome diagnosis or the sex or race of the fetus. These “reason bans” were signed into law in July as part of a larger abortion bill that also contains a series of gestational age bans prohibiting abortion starting at six weeks in pregnancy — all of which were immediately blocked by a lower court.

Today’s ruling will allow the reason bans to take effect while the litigation continues. The groups that brought this case will be going back to the district court later tonight to ask for a temporary restraining order blocking these reason bans once again, on the grounds that it is a violation of the constitutional right to abortion before viability. These kinds of reason bans inflict harm by peddling stigma around abortions and stereotypes of Asian Americans and Black and brown communities, and by attempting to co-opt the mantle of disability rights.

“These bans are just another way anti-abortion politicians are attempting to limit the constitutional right to abortion care and to create stigma,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “Decisions about whether and when to continue or end a pregnancy are best made by the individual and their family. We will continue to fight these bans in the courts.”…

…More than a dozen states have passed similar reason bans. Tennessee’s gestational age bans, which would ban abortion at nearly every stage of pregnancy starting as early as six weeks, remain blocked through this same lawsuit.

Tennessee has many additional abortion restrictions on the books, including a ban on the use of telehealth for medication abortion; limits on when state and public insurance can cover abortion services; and a requirement that minors obtain parental consent. A federal district court struck down the state’s 48-hour waiting period for abortion in October in a case litigated by the Center and Planned Parenthood. The Center, Planned Parenthood, and the ACLU filed another case challenging the state’s medication abortion “reversal” law in August, and that law has been temporarily blocked from taking effect.

The case was filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, the American Civil Liberties Union, and the ACLU of Tennessee on behalf of the Memphis Center for Reproductive Health, Planned Parenthood Tennessee and North Mississippi, Knoxville Center for Reproductive Health, carafem, and two abortion providers in Tennessee.

November 11, 2020: National Women’s Law Center posted an article titled: “What you might have missed this week: Voters Protect Abortion Access in Colorado but Louisiana Legislators Pass Yet Another Anti-Abortion Measure”. It was written by Anna Rodriquez. From the article:

…Colorado

Prop 115 would have banned abortion after 22 weeks gestation, with no exceptions for health or individual circumstances. The proposal was intentionally confusing and a threat to people who become pregnant as a result of rape, people whose health is endangered by carrying a pregnancy to term, and pregnant people with a lethal fatal diagnosis. Bans on abortion like Prop 115 particularly target Black, Latinx, and Indigenous people; LGBTQ+ people; people with low-income; and folks who live rurally.

A coalition lead by Abortion Access for All, among others, successfully defended Coloradans’ access to abortion care yet again. This was the fourth time in twelve years Coloradans have voted against anti-abortion ballot measures. Lucy Olena, Campaign Manager at No on 115 Campaign’s stated, “when we build a diverse movement and educate people about the complex realities of abortion later in pregnancy, voters unite to reject the bans.”

This is another example of how Colorado is a leader on reproductive health, rights and justice, but this win is not just a victory for Coloradans. Colorado has become a safe-haven for out-of-state families, many who travel from states, like Texas, due to abortion restrictions.

Louisiana

Louisianans have faced an onslaught of medically unnecessary abortion restrictions, with anti-abortion legislators passing over 89 abortion restrictions since the passage of Roe, well above any other state. Just a few months ago, the Supreme Court slapped down one of Louisiana’s anti-abortion laws, in June Medical Services v. Russo, but Louisiana lawmakers are still at it – no matter the consequences for Louisiana families and healthcare providers.

Anti-abortion legislators got their wish when voters approved Amendment 1. The Amendment adds language to the state constitution stating “to protect human life, a right to abortion and the funding of abortion shall not be found in the Louisiana Constitution.”…


November 12, 2020: American Civil Liberties Union (ACLU) posted news titled: “President-Elect Biden’s Reproductive Freedom To-Do List”. It was written by Georgeanne M. UsovA, Legislative Counsel. From the news:

After four years of attacks on our reproductive rights and health by the Trump administration and the anti-abortion legislators it has emboldened around the country, there is much to repair. When President-elect Biden and Vice President-elect Harris take office, their administration must make it a top priority to not just undo the damage, but to take bold, visionary steps to make reproductive health care — including abortion — accessible to all, regardless of their income or ZIP code. Congress, too, has a key role to play in ensuring that everyone is afforded the dignity to make our own decisions about our lives.

Here are just a few of the many items that should top our elected officials’ to-do list:

Reverse dangerous Trump administration regulations targeting reproductive health care including:

  • The refusal of care rule, which aimed to dramatically expand health care institutions’ and workers’ ability to withhold and obstruct access to essential, even life-saving medical care and information — with no regard for patients’ well-being. While it was rightly struck down in court, it is one of many attempts by the Trump administration to invoke religious or personal beliefs to justify discrimination, particularly against LGBTQ people and people seeking reproductive health care. The Biden administration must ensure that religious liberty is never used as a license to discriminate, and that patients’ needs always come first in health care.
  • The rule undermining the ACA’s birth control benefit, which allows employers and universities to deny their employees or students insurance coverage for contraception by invoking religious or moral objections. This is yet another example of how the Trump administration has discriminated against those seeking health care under the guise of protecting religious liberty. In July, the Supreme Court allowed this discriminatory rule to take effect, potentially robbing hundreds of thousands of people of their no-cost birth control coverage, and forcing employees and students to instead pay out of pocket. The Biden administration must guarantee that no one is denied birth control coverage because of where they work or where they go to school.
  • The rule that has devastated Title X, the 50-year-old family planning program that has provided 4 million patients with low or no incomes with affordable birth control, cancer screenings, STI testing and treatment, and other critical preventive care. The rule prohibits family planning clinics that participate in the program from referring patients for abortion care and imposes other onerous and dangerous requirements. It has resulted in the widespread loss of Title X providers and reduced access to family planning services for those who rely on the program. The Biden administration must restore and rebuild the critical Title X program.

Ensure safe access to medication abortion during the pandemic and beyond.

During the pandemic, the Trump administration went all the way to the Supreme Court to make it as difficult as possible for people to safely access medication abortion care — specifically mifepristone, a prescription medication that has been used to safely end early pregnancies and treat early miscarriages for 20 years. The administration has refused to allow patients to obtain their prescription by mail, insisting that patients travel to a health center solely to pick up a pill, subjecting patients to needless COVID-19 risks. This is despite the Food and Drug Administration having suspended similar requirements for other, far less safe medications during the pandemic. The ACLU won in court, blocking the in-person requirement during the pandemic, but the Supreme Court will soon consider the Trump administration’s request to reinstate it.

This in-person dispensing requirement is part of a longstanding package of outdated, medically unnecessary FDA restrictions that, even prior to COVID-19, have obstructed access to medication abortion — particularly for people with low incomes and communities of color. The Biden administration must immediately pause enforcement of the mifepristone in-person dispensing requirement during the public health emergency. And the FDA should undertake a comprehensive review of the full set of restrictions on mifepristone to ensure that, beyond the pandemic, patients’ access to this safe, effective medication is based on the latest science and medical evidence. 

Make the Hyde Amendment history once and for all.

President-elect Biden has pledged his support for ending the Hyde Amendment, a harmful ban on abortion coverage for people enrolled in Medicaid and other insurance programs. For decades, Hyde and related bans have pushed abortion care out of reach for people struggling to make ends meet, particularly women of color — the same communities that face severe health care disparities as a result of structural inequality and are now being hit hardest by the pandemic and economic crisis
Now it’s time for Biden to take the critical first step toward ending these discriminatory coverage bans by striking Hyde and all related abortion coverage restrictions from his first budget. This, along with calling on Congress to pass the EACH Woman Act to lift coverage bans, will send a clear message that this administration will work to make abortion not only legal, but also accessible to all. 

Enact a natiowide safeguard against state restrictions.

States have passed more than 460 politically motivated laws to push abortion care out of reach over the last decade çefforts buoyed recently by Trump’s appointment of multiple Supreme Court justices. These laws range from bans on abortion from the earliest days of pregnancy, to laws that interfere with the provider-patient relationship like forced ultrasounds and mandatory delay periods, to clinic shutdown laws that force patients to travel long distances (paying for transportation, lodging, and child care in the process) to obtain care. These restrictions have so severely eroded access to care across vast regions of the country, leaving the right to abortion effectively hollow for many people. 

President-elect Biden should also call for swift passage of the Women’s Health Protection Act to address the crisis of state attacks on abortion access. WHPA would put a stop to these state attacks and, paired with EACH, would make care more affordable and accessible for people throughout the country…

November 12, 2020: Lambda Legal posted a press release titled: “West Virginia Medicaid Participants and State Employees File Lawsuit to Challenge Unlawful Ban on Transgender Health Care Coverage”. From the press release:

A federal lawsuit challenging West Virginia’s blanket exclusions for coverage of gender-affirming care in West Virginia’s Medicaid and state employee health insurance plans was filed today. The class-action lawsuit was filed in the U.S. District Court for the Southern District of West Virginia on behalf of Christopher Fain, a Medicaid participant; and Zachary Martell and Brian McNemar, a dependent and state employee, respectively. The suit was filed by Lambda Legal, Nicholas Kaster, PLLP, and the Employment Law Center, PLLC.

“Transgender and nonbinary West Virginians are denied coverage for essential, and sometimes life-saving, gender-confirming care – while cisgender West Virginians recieve coverage for the same kind of care as a matter of course. The exclusions of gender-confirming care in West Virginia’s state health plans are unconstitutional and discriminatory, and deny transgender and nonbinary West Virginians basic dignity, equality, and respect,” said Avatara Smith-Carrington, Tyrone Garner Memorial Fellow at Lambda Legal and lead attorney on the case.

Fain v. Crouch is a class action lawsuit challenging blanket exclusions of coverage for gender-affirming care in West Virginia’s state health plans. The blanket exclusions of coverage for care are stated expressly in the health plans offered to Medicaid participants and to state employees. West Virginia’s state health plans serve approximately 564,000 Medicaid participants and 15,000 state employees…

…Christopher Fain studies nonprofit leadership at Marshall University and works at a clothing store in Huntington. He is enrolled in Medicaid, the nation’s largest healthcare provider for low-income individuals, but the program does not cover his testosterone prescription, forcing Mr. Fain to cover his care out-of-pocket, creating a stressful and inequitable financial burden. The Medicaid plan’s exclusion of coverage for his care has caused Mr. Fain economic hardship and humiliation.

Zachary Martell is married to Brian McNemar, who works as an accountant at a state hospital. Both Mr Martell and Mr McNemar rely on the state employee health plan for coverage. Mr. Martell – who receives coverage for care as Mr. McNemar’s dependent – has been denied coverage both for his prescriptions and office visits with his healthcare provider becasue the state employee health plans explicitly exclude coverage of “treatments associated with gender dysphoria.” As a result, Mr. Martell and Mr. McNemar have been forced to pay out-of-pocket for Mr. Martell’s care and, at times, even delay or forego care altogether…

…Learn more about the case: https://www.lambdalegal.org/in-court/cases/fain-v-crouch

Read the complaint: https://www.lambdalegal.org/in-court/legal-docs/fain_wv_20201112_complaint

November 12, 2020: Georgetown University Health Policy Institute Center for Family and Children posted a blog post titled: “What Can We Expect from Biden Administration on Work Requirement Waivers?”. It was written by Joan Alker. From the blog post:

…As we have blogged about countless times, this group of “demonstrations” is nefarious policy that doesn’t support employment but does seem to result in people losing their health insurance. Promoting this approach has been a centerpiece of CMS Administrator Seems Verma’s legacy and part of a larger pattern of efforts by the Trump Administration to eliminate the Affordale Care Act, hobble Medicaid, and generally limit access to public coverage.

So, what should we expect from a Biden-Harris Administration, the team that made access to health insurance a central tenet of their campaign, when they take office in January 2021? How easy is it to say goodbye and good riddence to these demonstrations?

First, let’s review the basic law of Section 1115 demonstration waivers. States apply to the Secretary of Health and Human Services for permission to use federal funds to try out and evaluate new approaches to improving Medicaid coverage, As the recent litigaition on work requirement waivers has reminded us all – they are only granted at the discretion of the Secretary of Health and Human Services. And the Secretary of HHS must determine that the demonstration project is “likely to assist in promoting the objectives of title…XIX”…

…It is worth noting that no state is currently implementing work requirements – as a consequence of judicial intervention, states voluntarily delaying them, or postponed implementation. Moreover, while Medicaid’s disenrollment freeze associated with the public health emergency remains in efect, no state could terminate anyone’s Medicaid coverage for non-complyance with a work reporting requirement…

…Every waiver approval has a long list of “terms and conditions” many of which are boilerplate material that appear in every Medicaid demonstration. Either party – the state or federal government may terminate the demonstration. For a state to wind down a demonstration there are more conditions involved including public notice and comment etc. Federal CMS may withdraw approval of waivers “at any time if it determines that continuing the waivers… would no longer be in the public interest or promote the objectives of title XIX”. The state is guaranted the right to a hearing to challenge the federal determination…

…So there is no question that a new Secretary can unwind these demonstrations but when and how that will happen remains to be seen. It is not possible that this will happen overnight, but an early and strong signal of the intention of a new Biden Administration would be to quickly withdraw the 1/11/18 “Dear State Medicaid Director” letter issued by the Trump Administration encouraging states to apply for “community engagement” waivers. This would also have the effect of letting states know that pending or future requests for work requirements will not be granted…


November 17, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Secures Victory in Lawsuit Defending Medicaid In-Home Supportive Service Workers”. From the press release:

California Attorney General Xavier Becerra today secured a court decision blocking the Trump Administration’s efforts to implement a rule that would have undermined the rights of more than half a million healthcare workers in California’s In-Home Supportive Services (IHSS) Medicaid program, and several hundred thousand more workers nationwide. In California, these workers have the right to collectively bargain for better wages, benefits, and training, which results in a more stable, quality IHHS program for beneficiares. The court held that the rule would have unlawfully created barriers for states to deduct employee benefits and union dues from workers’ paychecks, a practice which makes it easier or workers to stand up together for their workplace rights and to provide quality home-and community-based care to those in need. The court found that the Trump Administration’s rule was illegally promulgated and vacated it.

“When the President attacks unionized healthcare workers, he puts the care of hundreds of thousands of vulnerable Californians at risk. Now more than ever, our healthcare workers are heroes serving on the front lines of the pandemic, and should be applauded for their work,” said Attorney General Becerra“Fortunately, the court saw through the administration’s faulty posturing and sent them packing. This ruling is a victory for our state and for the collective bargaining rights of homecare workers who play a vital role in our healthcare system. Together, we’ll continue to stand up for workers every step of the way.”…

…Attorney General Becerra was joined in the case by the attorneys general of Connecticut, Illinois, Massachusetts, Oregon, and Washington.

A copy of the decision is available here.


November 19, 2020: National Women’s Law Center posted an article titled: “Celebrating the Wins: A Reminder the ACA is Working”. It was written by Lauren Wallace. From the article:

…Here’s what we do know. The National Women’s Law Center has calculated that – thanks to the ACA – 84.3 million women have insurance coverage of preventative services, including birth control, without out-of-pocket costs (166 million people total). This is a 5% increase from 2019, meaning that nearly 3 milion more women had no-cost birth control coverage in 2020 than they did the year before. While this news alone is enough to rejoice in celebration, there’s even more to enjoy! A new study conducted by the University of Michigan reports that eliminating out-of-pocket costs for birth control is tied to narrowing the disparity in unintended pregnancy rates between lower-and higher-income women who have employer-sponsored health insurance. The investigators not only found that birth control benefit reduced unintended pregnancies, but also reduced the rate of women not filling their birth control prescriptions….


November 18, 2020: Center on Budget and Policy Priorities updated research titled: “States’ Experiences Confirm Harmful Effects of Medicaid Work Requirements”. It was written by Jennifer Wagner and Jessica Schubel. From the research:

Beginning in 2018, the Trump Administration encouraged states to adopt policies taking Medicaid coverage away from people not meeting work requirements. While 12 states received approval for these policies, several were blocked by the courts, and none are currently in effect. But data from Arkansas’ ten-month implementation of its policy and brief implementation in Michigan and New Hampshire provide direct evidence of these policies’ harmful effects.

  • A large fraction of people subject to the policies lost coverage or were at risk of losing coverage. In Arkansas more than 18,000 people – nearly 1 in 4 of those subject to work requirements – lost coverage over the course of just seven months. In New Hampshire, almost 17,000 people, or about 40 percent of those subject to work requirements, would have lost coverage had state policymakers not put the policy on hold. Some 80,000 Michiganders – nearly 1 in 3 of those subject to work requirements – were in danger of losing coverage had a court not stopped the policy.
  • In all three states, evidence suggests that people who were working and people with serious health needs who had been eligible for exemptions lost coverage or were at risk of losing coverage due to red tape. Large numbers of beneficiaries in both states reported that they didn’t know about the work requirement or whether it applied to them. It’s likely that people with disabilities were paritcularly at risk.
  • Taking coverage away from people not meeting work requirements also increases financial hardship and reduces access to care. A survey of people with low incomes in Arkansas and neighboring states showed that the people who lost coverage because of Arkansas’ work requirements experienced adverse consequences, including having problems paying off medical debt and delaying care or forgoing medications because of cost.
  • Arkansas’ work requirement increased uninsured rates without increasing employment, studies by Harvard researchers found. In both an initial and a follow-up survey of people with low incomes in Arkansas and neighboring states, researchers found evidence that Arkansas’s policy increased uninsured rates; people who lost Medicaid did not transition to other coverage. The researchers found no evidence that it increased employment.

…In January 2018, the Trump Administration began approving state work requirements in Medicaid, which the federal government had never previously permitted. Between June 2018 and March 2019, Arkansas, the first state to implement a work requirement, required some enrollees in the Affordable Care Act’s (ACA) Medicaid expansion to document that they worked or engaged in work-related activities (e.g., job training or volunteer work) for at least 80 hours per month, unless they reported that they qualified for limited exemptions. In June 2019, New Hampshire began implementing its work requirement, requiring all expansion enrollees to work or engage in work-related activities for 100 hours each month or obtain an exemption. And in January 2020, Michigan began implementing its work requirement, requiring all expansion enrollees to work or engage in work-related activities for 80 hours each month or obtain an exemption.

In March 2019, a federal district court vacated the Department of Health and Human Services’ (HHS) approval of Arkansas’ work requirement policy (and a similar waiver in Kentucky, which had not yet been implemented), thereby preventing Arkansas from continuing to implement it. In February 2020, a federal appeals court upheld this decision, which the Trump Administration is now appealing to the Supreme Court. New Hampshire voluntarily suspended its work requirement in July 2019. A few weeks later, the same federal district court vacated HHS’ approval of New Hampshire’s policy, and in March 2020, it vacated HHS’ approval of Michigan’s work requirement policy as well.

Arkansas is the only state to have taken coverage away from people for not meeting work requirements, but Michigan and New Hampshire did not pause their requirements until they were on the brink of doing so. Thus, all three states’ experiences provide important information about who loses coverage and why as a result of these policies.

The Trump Administration has approved similar policies in other states, but due to court decisions, voluntary moratoriums states have adopted, and federal protections put in place during the pandemic, none of the others have been implemented (at least to date)…

…A study by Harvard researchers found that the uninsured rate among low-income Arkansans aged 30-49 – the group potentially subject to work requirements – rose from 10.5 percent in 2016 to 14.5 percent in 2018, after the work requirement took effect. There was no similar increase for low-income Arkansans of other ages or for low-income people aged 30-49 in other, similar states. This finding refutes claims, for example from HHS Secretary Alex Azar, that most people leaving Medicaid due to the policy did so because they found jobs with health insurance…

…Work Requirements Endanger People With Disabilities

When the Centers for Medicare & Medicaid Services (CMS), in announcing the Administration’s support for Medicaid work requirements, notified states that the policies must comply with the Americans with Disabilities Act, we and others warned that protecting people with disabilities would prove impossible without extensive efforts. Indeed, Arkansas didn’t adequately explain beneficiaries’ rights under the Act, and it lacked a comprehensive system for providing reasonable modifications to protect people with disabilities, such as modifying the hourly requirement or providing support to help people meet the reporting requirement. Due to the lack of protections and the design of the work requirement itself, individuals with disabilities lost coverage and may face serious harm as a result. In fact, “people with disabilities were particularly vulnerable to losing coverage under the Arkansas work and reporting requirements, despite remaining eligible,” a Kaiser Family Foundation study concluded.

Losing coverage is especially harmful to people with disabilities who rely on regular care to manage their conditions. Coverage interruptions and subsequent gaps in care can lead to increased emergency room visits, hospitalizations, and admissions to mental health facilities. In addition, the financial risk from medical expenses and debt is high for people with disabilities, who are already a greater risk of homelessness; additional financial hardship could make it harder for people with disabilities to afford other necessities like housing and food, which could contribute to bankruptcy or homelessness and further jeopardize their health…


November 20, 2020: Lambda Legal posted a press release titled: “Lambda Legal Condemns Eleventh Circuit Ruling Striking Down Palm Beach County Conversion Therapy Ban”. From the press release:

The U.S. Court of Appeals for the Eleventh Circuit today reversed a lower court ruling and struck down local Palm Beach County, Florida, and the City of Boca Raton ordinances banning so-called conversion therapy on minors. Lambda Legal CEO Kevin Jennings issued the following statement:

“The City of Boca Raton and Palm Beach County joined states and municipalities across the country who have properly banned the discredited and harmful practice of so-called ‘conversion therapy’ on minors in order to protect LGBTQ youth. Laws prohibiting this dangerous practice have withstood legal challenges in numerous courts. Today’s decision is a marked departure from precedent and an incredibly dangerous decision for our youth.

“So-called ‘conversion therapy’ is nothing less than child abuse. It poses documented and proven critical health risks, including depression, shame, decreased self-esteem, social withdrawal, substance abuse, self-harm and suicide. Youth are often subjected to these practices at the insistance of parents who don’t know or don’t believe that the efforts are harmful and doomed to fail: when these efforts predictably fail to produce the expected result, many LGBTQ children are kicked out of their homes.

“Both judged joining today’s decisions were appointed by President Trump. We fear that today’s decision may be the tip of the iceburg in terms of the harm that may come from a federal judiciary that has been packed for the last four years with dangerous ideologues. The damage done by this misguided opinion is incalcuable and puts young people in danger.


November 22, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “Health care is a human right, not a job benefit. We cannot continue spending twice as much per capita as any other country, while 92 million are uninsured or under-insured, and 68,000 die unnecessarily each year. Medicare for All is coming sooner or later. Let’s make it sooner.”


November 23, 2020: Senator Maria Cantwell (Democrat – Washington) tweeted: “The Affordable Care Act stops companies from charging women more than men for the same health care plan. And the #Medicaid expansion in the #ACA has helped people in every corner of the State of Washington. That’s why it is so important to keep fighting for the ACA.”

November 23, 2020: Planned Parenthood posted a press release titled: “Federal Court Allows Texas Politicians To Block Health Care Access for Medicaid Patients”. From the press release:

Today, the 5th Circuit Court of Appeals ruled that Texas politicians will be able to block Medicaid patients from accessing care at Planned Parenthood health centers. These terminations are a blatantly political attack that will jeopardize critical health care access for Texans with low incomes during a global pandemic. This ruling has not yet taken effect, and for now Planned Parenthood health centers in Texas continue to serve Medicaid patients across the state.

Today’s ruling is the latest in a long history of Texas’ attempts to score political points with relentless attacks on Planned Parenthood and access to health care. Earlier this year, Gov. Abbott blocked access to time-sensitive, essental abortion care in the early days of the COVID-19 pandemic, forcing some patients to travel hundreds of miles to neighboring states for the care they need. And during the 2019 legislative session, Texas politicians passed Senate Bill 22 – banning local governments from partnerships with trusted provideres, such as Planned Parenthood, for health care and education services.

Generations of racism and discriminatory policies force a disproportionate number of people of color and women to enroll in public health programs like Medicaid. When politicians attack Medicaid patients, people of color and women who already navigate inherently discriminatory systems with fewer freedoms than others, lose the ability to choose the best provider for them. It’s just one more assault against the same communities that face unjust, systemic barriers to basic human rights, including access to affordable health care, education, and housing…

…Three additional states – Tennessee, South Carolina, and Idaho – have pending Medicaid waivers in front of Centers for Medicare & Medicaid Services that would restrict the ability of people enrolled in Medicaid to access Planned Parenthood health centers. Numerous other states have tried to terminate Planned Parenthood providers from Medicaid for baseless reasons, but most have been blocked by courts from doing so.

This decision follows years of attempts by Texas to cut off Medicaid patients from Planned Parenthood based on a series of elaborate, false, and debunked claims peddled by the Center for Medical Progress. In 2011, Texas replaced its own state-funded program when the Obama administration refused to allow the Texas to exclude Planned Parenthood and other abortion providers from its Medicaid program. Earlier this year, the Trump administration allowed federal funds to go back into Texas’ failed program.

November 23, 2020: The American College of Obstetricians and Gynecologists (ACOG) posted news titled: “ACOG Updates Committee Opinion on Increasing Access to Abortion”. From the news:

In updated guidance, the American College of Obstetricians and Gynecologists (ACOG) reaffirms its longstanding position that access to safe abortion is a necessary component for comprehensive health care. The updated Committee Opinion on Increasing Access to Abortion responds to an increasingly restrictive policy environment and outlines specific legislative, structural, societal, and financial barriers that must be addressed in order to protect and expand equitable access to abortion care. The document also explains how stigma and fear of violence can be just as powerful as other factors in imposing barriers to care.

Although abortion is extremely safe, it is often targeted for medically unnecessary, arbitrary requirements that restrict the ability of patients to access abortion care. Specifically, the Committee Opinion calles for the cease and repeal of:

  • bans on abortion at arbitrary gestational ages,
  • requirements that only physicians or obstetrician-gynecologists may provide abortion care,
  • telemedicine bans,
  • restrictions on medication abortion,
  • requirements for mandatory counseling and forced delay before obtaining care,
  • ultrasound requirements,
  • mandated parental involvement, and
  • facility and staffing requirements known as Targeted Regulation of Abortion Provider (TRAP) laws.

“Abortion is important to the health and lives of our patients, yet access remains a legislative and regulatory target at both the state and the federal levels,” said Eva Chalas, MD, FACOG, FACS, President of ACOG. “Data have shown that when abortion is restricted, our patients’ health suffers. That’s why ACOG is committed to leading the medical community in pursuing evidence-based policies and structural change that will make essential abortion care accessible and available.”

“For the sake of patients across the country, we must continue to advocate for the repeal of barriers to abortion access and for patient-focused, constructive policies to protect the health and well-being of patients and to promote equitable care,” said Daniel Grossman, MD, who contributed to the Committee Opinion. “But beyond that, we must work together as a community to address the stigma and fear that prevents some patients from getting the care they need and that prevents some clinicians from offering comprehensive reproductive medical care that includes abortion.”

“Restrictions and barriers on access to abortion care disproportionately impact those who are historically marginalized from medical care more broadly. This includes young people, people of color, those living in rural areas, those with low incomes, and individuals who are incarcerated” said Jamila Perritt, MD, MPH, Chair of the ACOG Committee on Health Care for Underserved Women, which issued the guidance. “Focusing our efforts on improving access for communities most affected by these barriers and restrictions will improve health outcomes for all.”

Protecting comprehensive reproductive health care access is a policy priority for ACOG. This year, ACOG secured a nationwide temporary injunction against the U.S. Food and Drug Administration’s in-person dispensing requirement for mifepristone, providing many ACOG members with the option of prescribing medication abortion to patients through the duration of the COVID-19 pandemic without exposing themselves and their patients to unnecessary risk of infection or travel delays.

November 23, 2020: Lambda Legal posted a press release titled: “Lambda Legal Takes Blue Cross Blue Shield of Illinois to Court Over Anti-Transgender Policy”. From the press release:

Today, Lambda Legal and Sirianni Youtz Spoonemore Hamberger PLLC filed a federal lawsuit challenging Blue Cross Blue Shield of Illinois’s (“BCBSIL”) administration of a blanket exclusion of gender-affirming care in an employer-provided health insurance plan provided by Catholic Health Initiatives Franciscan. The lawsuit was filed in the United States District Court for the Western District in Washington in Tacoma on behalf of a 15-year-old transgender boy “C.P.”, and his parent, and argues that the exclusion is in direct violation of the nondiscrimination provisions under Section 1557 of the Affordable Care Act.

“My son needs the medical care that will allow him to live, be healthy, and to thrive. However, because he is transgender, I have to fight and jump through hoops for him to have access to the care that he needs, is legally entited to and that he deserves,” said Pattie Prichard, C.P.’s mother and the primary beneficiary on the employer-provided health benefit plan that BCBSIL administers. “This denial also sends a message to my son and all transgender people, that their health care needs aren’t real or they’re not worthy of care. I won’t accept that.”

BCBSIL is a “covered health entity” under the ACA, which means BCBSIL cannot, and it has represented that it does not, discriminate on the basis of race, national origin, sex, age, and disability. The ACA’s Section 1557, which BCBSIL agrees it must abide by, prohibits discrimination on the basis of sex and gender identity, such as in the provision of transition-related care. As such, BCBSIL cannot administer the discriminatory terms of the health plan provided by Pattie Pritchard’s employer – St. Michael Medical Center in Bremerton, Washington, which is part of the Catholic Helath Initiatives Franciscan Health System, now known as CommonSpirit Health.

“The law is clear, Blue Cross Blue Shield of Illinois cannot deny C.P., or any transgender person, the health care that he needs,” said Omar Gonzalez-Pagan, Senior Attorney and Health Care Strategist for Lambda Legal. “Section 1557 of the ACA expressly prohibits categorical bans on gender-affirming care because it is discrimination on the basis of sex, plain and simple. BCBSIL cannot adopt or administer discriminatory terms on behalf of others. As a covered entity under the ACA, BCBSIL has to play by the same rules as everyone else, no exceptions.”…

…C.P. is a dependent on his mother’s employer-provided health insurance plan and began receiving medically necessary gender-affirming care three years ago. Recently, however, C.P. and his family were informed that some of his care would not be covered because of an exclusion of any care “for or leading to gender reassignment surgery”, including the same care and medical interventions that other cisgender patients receive without question or problem. C.P.’s family has had to pay out-of-pocket for his care, causing unnecessary financial stress…

…The case is C.P. v. Blue Cross Blue Shield of Illinois and is being litigated by Lambda Legal Senior Attorney and Health Care Strategist Omar Gonzalez-Pagan, Law and Policy Director Jennifer C. Pizer and Eleanor Hamburger of Sirianni Youtz Spoonemore Hamburger PLLC, in Seattle, Washington.

Read the complaint here: https://www.lambdalegal.org/in-court/legal-docs/cp_wa_20201123_complaint

Learn more about the case here: https://www.lambdalegal.org/in-court/cases/cp-v-bcbsil


November 25, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “The year 2020 has been very difficult for mental health. The pandemic, isolation and economic downturn has greatly increased depression, anxiety and suicidal ideation. When we talk about real health care reform, we mean a major expansion of mental health services.”


November 27, 2020: Senator Bernie Sanders (Independent – Vermont) tweeted: “The United States cannot continue to be the only major country not to guarantee health care to all. Too many people are unnecessarily dying, getting sick or going bankrupt because of thsie cruel and dysfunctional system. Health care is a human right, not a privilege Let’s do it”.


November 29, 2020: Georgetown University Health Policy Institute Center for Children and Families posted a report titled: “HIV and Medicaid Expansion: Failure of Southern States to Expand Medicaid Makes Elimination of HIV Infection in the United States Much Harder to Achieve”. It was written by Adam Searing, JD, MPH and Adaora A. Adimora, MD, MPH. From the report:

Key Findings

  • Advances in public health programs and medical treatment mean HIV can be treated successfully in the long term, improving the health of individuals and significantly reducing the spread of the infection. Ending the HIV epidemic in the United States is achievable. However, lack of health coverage is a major barrier to success in the fight against HIV as without health coverage, individuals are unable to access medical treatment that can improve their health and minimize the spread of HIV.
  • These medical treatments combined with a robust health campaign, have led to a decline in HIV infection and transmission in many states. The HIV epidemic has slowed. Approximately 45 percent of all people living with an HIV diagnosis in the U.S. live in the South despite the region containing only about one-third of the total U.S. population. In addition, more than half (52 percent) of all new HIV diagnoses in 2017 were in the South.
  • Medicaid expansion is a key building block to ending the HIV epidemic. Unfortunately, 12 states – largely in the South – are still refusing the federal funding for Medicaid expansion and leaving many people and families who could benefit from HIV interventions still lacking access to comprehensive health coverage. Only 5 percent of people with HIV remain uninsured in states that have been implemented the Medicaid expansion, compared to a 19 percent uninsured rate among people with HIV in non-expansion states. Expanding Medicaid would significantly improve health care in coverage for people with HIV and their families and move the U.S. forward in the public health fight to end the HIV epidemic

Introduction

Advances in public health programs and medical treatment mean HIV can be treated successfully in the long term, improving the health individuals and reducing the spread of the virus. While the federal government has multiple initiatives aimed at addressing and eventually eliminating HIV, a fundamental base to ensure successful health outcomes for people with HIV and the families is access to comprehensive, affordable health care coverage. A proven way to increase levels of coverage is for states to expand Medicaid under the federal Affordable Care Act (ACA).

Unfortunately, the 12 states—largely in the South—still refusing the federal funding for Medicaid expansion leave many people and families who could benefit from HIV interventions still lacking access to comprehensive health coverage. Expanding Medicaid would significantly improve health care and coverage for people with HIV and their families. Medicaid is the key building block to ending the epidemic. States that have not expanded medicaid coverage experience more

HIV infections and higher mortality rates from the condition. Failure to prioritize Medicaid expansion in dealing with HIV ignores extensive research and the fact that the center of the epidemic in the United States—the South—is also the center of resistance among states to expanding Medicaid. Federal and state plans to reduce and eliminate HIV infection must acknowledge the important role of Medicaid expansion.

Layered on top of the HIV epidemic is the current COVID-19 pandemic. Striking parallels between the response to HIV and COVID-19 were pointed out earlier this year in the course of the pandemic. The urgency of dealing with COVID-19 severely complicates the ongoing response to the HIV epidemic, making response to HIV and multiple other public health challenges more difficult. However, the basic fact remains that successful response to the HIV epidemic requires more health coverage through Medicaid expansion.