2020 marks the fourth year of the Donald Trump Presidency. His administration, and the Republicans in Congress, are still trying to destroy Obamacare. They are also going after reproductive health care, Medicaid, Medicare, Social Security Disability, the ability for LGBTQ people to receive health care, and the ability for undocumented children to be covered by Medicaid.

The Guardian reported that President Trump was impeached on December 19, 2019, when the House of Representatives voted 230-197 to approve a first article of impeachment.

This blog post, like the ones that preceded it, has the “receipts” about every bad thing the GOP and Trump tried to do to American’s health care. (It also includes the good things that Democrats – and occasionally some Republicans – did to protect our healthcare.)

If you would like the full story, you may want to start with the blogs I’ve written about this topic so far. They include:

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part One

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Two

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three

A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued

January 2020

January 1, 2020: Speaker Nancy Pelosi tweeted: “For six years, Americans of every age have been protected against health insurance discrimination if they have pre-existing conditions. Now, Trump and Republicans are trying to tear away those protections. #ProtectOurCare”


January 2, 2020: The New York Times posted an article titled: “It Looks Like Health Insurance, but It’s Not. ‘Just Trust God,’ Buyers Are Told.” It was written by Reed Ableson. From the article:

…More than one million Americans, struggling to cope with the rising cost of health insurance, have joined such groups, attracted by prices that are far lower than the premiums for policies that must meet strict requirements, like guaranteed coverage for pre-existing conditions, established by the Affordable Care Act. The groups say they permit people of common religious or ethical belief to share medical costs, and many were grandfathered in under the federal health care law mainly through a religious exemption.

These Christian nonprofit groups offer far lower rates because they are not classified as insurance nd are under no legal obligaition to pay medical claims. They generally decline to cover people with pre-existing illnesses. They can set limits on how much their members will pay, and they can legally refuse to cover treatments for specialities like mental health…

…The main requirement for membership is adherence to a Christian lifestyle. And the alternative sharing plans keep flourshing, especially now that the Trump administration has relaxed rules to permit alternatives to the A.C.A. that don’t provide such generous coverage.

But state regulators in New Hampshire, Colorado, and Texas are beginning to question some of the ministries’ aggressive marketing tactics, often using call centers, and in some cases people who joined them were misled or did not understand how little coverage they would recieve if they or a family member had a catastrophic illness…

…Because the groups are not technically considered insurance, they operate with no government oversight. “Regulators haven’t been willing to assert any control or regulatory authority over these plans,” said Katie Keith, who serves as a consumer representative to the National Association of Insurance Commissioners and teaches health law at Georgetown University. “They feel their hands are tied. At the end of the day, it’s not insurance.”

Families who have joined the groups recount winding up with medical bills not covered by the ministries, with no legal way to appeal decisions to reject coverage for care. Some groups ask their members to push hospitals and doctors to write off their bills rather than use members’ money to pay their expenses…

January 2, 2010: The Hill posted an article titled: “More than 200 Lawmakers urge Supreme Court to ‘reconsider; Roe v. Wade”. It was written by Nathaniel Weixel. From the article:

More than 200 members of Congress want the Supreme Court to “reconsider” the landmark abortion case Roe v. Wade.

Led by Minority Whip Steve Scalise (R-La.), 166 House Republicans and 39 Senate Republicans signed an amicus brief calling the right to an abortion “unworkable.”

Two Democrats, Rep. Collin Peterson (Minn.) and Rep. Daniel Lipinski (Ill.), also signed onto the brief. Lipinski has come under fire for his anti-abortion stance, and is being targeted in his upcoming primary by a progressive Democrat…

…The lawmakers were writing in support of a Louisiana law that would require doctors who preform abortions to have admitting privileges at a nearby hospital, a requirement that critics say is designed to force abortion clinics to close.

The Supreme Court is set to hear oral arguments challenging the law in March. If upheld, the restrictions could leave the state with just one abortion provider…

There is a PDF of the Amici Curiae mentioned in the above article. Here is a list of the members of Congress who signed it in support of Louisiana’s abortion law, and in an effort to overturn Roe v. Wade.

U.S. Senate (by State):

  • Arizona: John Boozman
  • Arkansas: Tom Cotton
  • Florida: Marco Rubio
  • Idaho: Mike Crapo, James E. Risch
  • Indiana: Todd Young, Mike Braun
  • Iowa: Jodi Ernst, Chuck Grassley
  • Kansas: Jerry Moran, Pat Roberts
  • Kentucky: Rand Paul
  • Louisiana: John Kennedy, Bill Cassidy, M.D.
  • Mississippi: Cindy Hyde-Smith, Roger F. Wicker
  • Missouri: Roy Blunt
  • Montana: Steve Daines
  • Nebraska: Deb Fischer, Ben Sasse
  • North Carolina: Richard Burr, Thom Tillis
  • North Dakota: Kevin Cramer, John Hoeven
  • Ohio: Rob Portman
  • Oklahoma: James M. Inhofe, James Lankford
  • Pennsylvania: Pat Toomey
  • South Carolina: Tim Scott
  • South Dakota: Mike Rounds, John Thune
  • Tennessee: Marsha Blackburn
  • Texas: John Cornyn, Ted Cruz
  • Utah: Mike Lee, Mitt Romney
  • Wisconsin: Ron Johnson
  • Wyoming: John Barrasso, Michael B. Enzi

House of Representatives (by state):

  • Alabama: Robert B. Aderholt (04), Mo Brooks (05), Bradley Byrne (01), Martha Roby (02), Mike D. Rogers (03)
  • Arizona: Andy Biggs (05), Rick Crawford (01), Paul A. Gosar, D.D.S., (04), French Hill (02), Debbie Lesko (08), Gary Palmer (06), David Schweikert (06), Bruce Westerman (04), Steve Womack (03)
  • California: Paul Cook (08), Doug LaMalfa (01), Kevin McCarthy (23), Tom McClintock (04),
  • Colorado: Ken Buck (04), Doug Lamborn (05), Doug Lamborn (05), Scott Tipton (03)
  • Florida: Mario Diaz-Balart (25), Neal Dunn, M.D. (02), Matt Gaetz (01), Brian Mast (18), Francis Rooney (19), John Rutherford (04), Ross Spano (15), W. Gregory Steube (17), Michael Waltz (06), Daniel Webster (11), Ted S. Yoho, D.V.M (03)
  • Georgia: Rick W. Allen (12), Earl L. “Buddy” Carter (01), Doug Collins (09), A. Drew Ferguson IV (03), Tom Graves (14), Jody B. Hice (10), Barry Loudermilk (11), Austin Scott (08)
  • Idaho: Russ Fulcher (01), Mike Simpson (02)
  • Illinois: Mike Bost (12), Larry Bucshon, M.D. (08), Rodney Davis (13), Adam Kinzinger (16), Darin LaHood (18), Daniel W. Lipinski (03), Greg Pence (06), John Shimkus (15)
  • Indiana: James R. Baird (04), Jim Banks (03), Jackie Walorski (02)
  • Iowa: Steve King (04)
  • Kansas: Chuck Fleishmann (03), Roger Marshall, M.D. (01), Steve Watkins (02)
  • Kentucky: Andy Barr (06), James Comer (01), Hal Rogers (05)
  • Louisiana: Steve Scalise (01), Michael Johnson (04), Ralph Abraham M.D. (05), Garret Graves (06), Clay Higgins (03),
  • Maryland: Andy Harris, M.D. (01)
  • Michigan: Jack Bergman (01), Bill Huizenga (02), Paul Mitchell (10), John R. Moolenaar (04), Tim Walberg (07),
  • Minnesota: Tom Emmer (06), Collin C. Peterson (07), Pete Stauber (08),
  • Mississippi: Jim Hagedorn (01), Steve Palazzo (04)
  • Missouri: Sam Graves (06), Vicky Hartzler (04), Trent Kelly (01), Billy Long (07), Blaine Luetkemeyer (03), Jason Smith (08), Ann Wagner (02)
  • Montana: Greg Gianforte (AL)
  • New York: Peter T. King (02), Lee Zeldin (01
  • New Jersey: Mike Simpson (02), Christopher H. Smith (04)
  • Nebraska: Don Bacon (02), Jeff Fortenberry (01), Adrian Smith (03)
  • North Carolina: Ted Budd (13), Virginia Foxx (05), George Holding (02), Richard Hudson (08), Patrick McHenry (10), Mark Meadows (11), Gregory F. Murphy, M.D. (03), Mark Walker (06)
  • North Dakota: Kelly Armstrong (AL), Dan Bishop (09), David Rouzer (07),
  • Oklahoma: Tom Cole (04), Kevin Hern (01), Markwayne Mullin (02),
  • Ohio: Troy Balderson (12), Steve Chabot (01), Warren Davidson (08), Bob Gibbs (07), Anthony Gonzalez (16), Bill Johnson (06), Jim Jordan (04), Doug LaMalfa (01), Robert E. Latta (05), Michael R. Turner (10), Brad Wenstrup, D.P.M. (02)
  • Pennsylvania: John Joyce (13), Fred Keller (12), Mike Kelly (16), Daniel P. Meuser (09), Scott Perry (10), Guy Reschenthaler (14), Lloyd Smucker (11), Glenn “GT” Thompson (15)
  • South Carolina: Jeff Duncan (03), Ralph Norman (05), Tom Rice (07), William Timmons (04), Joe Wilson (02)
  • South Dakota: Dusty Johnson (AL)
  • Tennessee: Tim Burchett (02), Chuck Fleishmann (03), Mark E. Green M.D. (07), Phil D. Roe, M.D. (01), John Rose (06),
  • Texas: Jodey C. Arrington (19), Brian Babin, D.D. S. (36), Kevin Brady (08), Michael C. Burgess, M.D. (26), Michael Cloud (27), K. Michael Conaway (11), Dan Crenshaw (02), Bill Flores (17), Louis Gohmert (01), Lance Gooden (05), Kay Granger (12), Pete Olsen (22), John Ratcliffe (04), Chip Roy (21), Van Taylor (03), Randy Weber (14), Roger Williams (25), Ron Wright (06)
  • Utah: Rob Bishop (01), John R. Curtis (03), Chris Stewart (02)
  • Virginia: Ben Cline (06), Denver Riggleman (05), Rob Wittman (01)
  • Washington: Dan Newhouse (04), Cathy McMorris Rogers (05)
  • West Virginia: David B. McKinley, P.E. (01), Carol D. Miller (03), Alex X. Mooney (02),
  • Wisconsin: Glenn Grothman (06), F. James Sensenbrenner (05), Brian Steil (01)
  • Wyoming: Liz Cheney (AL)

January 2, 2020: EMILY’s List tweeted: “Abortion is under attack. Today, 207 members of Congress signed on to a briefing asking the Supreme Court to take up the issue of whether two crucial cases protection abortion – Roe v. Wade and Casey v. Planned Parenthood – should be “reconsidered and, if appropriate, overruled”.

EMILY’s List followed that tweet with another tweet: “The threat to abortion is here. It is real. It is urgent. That’s why it is so important to elect pro-choice Democratic women up and down the ballot across the country. Every single election.”

January 2, 2020: EMILY’s List posted a statement titled: “EMILY’s List Statement on 207 Members of Congress Signing On To An Anti-Choice Amicus Brief”. From the statement:

Today, EMILY’s List President Stephanie Schriock issued the following statement in response to 207 members of Congress signing on to an amicus brief that argues “the unworkability of the ‘right to abotion’ found in Roe and the need for the Court to take up the issue of whether Roe and Casey should be reconsidered and, if appropriate, overruled.”

“Reproductive rights and the ability to make our own health care decisions are fundamental to the freedoms we have under the Constitution. Unfortunately, this amicus brief proves that not only is the threat to those rights very real, but it is at a critical tipping point where the minority is ready to strip our freedom away against the majority’s wishes. More than seven in 10 Americans support the protections given to use by cases like Roe v. Wade and Planned Parenthood v. Casey. It’s past time to replace the politicians who believe a small number of them can outweigh our rights and our views.”

January 2, 2020: Planned Parenthood Action tweeted: “Public: we support Roe v. Wade. 207 Anti-abortion politicians: hey SCOTUS, “if appropriate, overrule” what the people want. New year, same nonsense.


January 3, 2020: Speaker Nancy Pelosi posted a press release on the Speaker’s official website titled: “Pelosi Statement on House Seeking Expedited Supreme Court Ruling on GOP’s ACA Lawsuit”. From the statement:

Speaker Nancy Pelosi released the following statement as the House of Representatives filed a petition for a writ of certiorari in Republicans’ Texas v. U.S. lawsuit, asking the Supreme Court to act swiftly to uphold the Affordable Care Act in the face of the GOP’s effort to strike down the whole law. Last month, the 5th Circuit Court of Appeals had sided with Republicans and given instructions to the District Court to redetermine how much of the law to strike down, almost certainly delaying a final ruling into 2021 or later.

“Everyday that Republicans’ anti-health care lawsuit is allowed to endure is a day that American families will be forced to live in uncertainty and fear. Unless the Supreme Court acts, families will continue to face needless disruption in their coverage and premiums, states will be unable to plan for the future and protections for people with pre-existing conditions will remain in peril.

“The Trump Administration and its GOP allies want to delay judgement on the disaster they have sought to unleash on the health care of the American people, but there is no legal or practical justification for doing so.

“The Supreme Court should hear this case now and recognize Congress’s clear intent to preserve protections for people with pre-existing conditions and other benefits and protections of the Affordable Care Act.”

The writ of certiorari mentioned in the Speaker’s above statement can be viewed (as a PDF) here.

January 3, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James Seeks Supreme Court Review Of ACA Case”. From the press release:

New York Attorney General Letitia James and a coalition – which includes 19 additional states and the District of Columbia – today filed a petition asking the U.S. Supreme Court to review a recent decision by the U.S. Court of Appeals for the Fifth Circuit in Texas v U.S. The decision affirmed a lower court’s ruling that the individual mandate of the Affordable Care Act (ACA) is unconstitutional, yet refused to rule on the validity of the rest of the ACA – calling into question whether the remaining provisions of the statute could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that may harm the health of millions of Americans – in addition to doctors, clinics, patients, and the healthcare market – Attorney General James and the coalition are petitioning the Supreme Court to take up the case and resolve it before the end of the court’s current term in June.

The lawsuit – originally filed by a Texas-led coalition and supported by the Trump Administration – argued that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for noncompliance with the law to $0. The plaintiffs further argued that the rest of the ACA should be held invalid as a result of that change. A coalition of attorneys general – that included New York – 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, countries, cities, and more. The Fifth Circuit held the individual mandate to be unconstitutional, but declined to further rule on the validity of the ACA’s remaining provisions. The court instead sent the case back to the Northern District of Texas to determine which provisions of President Obama’s signature health care law are still valid.

Today’s petition makes clear that states, patients, doctors, hospitals, employers, pharmaceutical companies, and more will be impacted by the looming uncertainty caused by the Fifth Circuit’s decision. It asks the Supreme Court to review the case this term. The petition also highlights the important advancements in health care access made under the ACA, including:

  • More than 12 million Americans now receive health coverage through the ACA’s Medicaid expansion;
  • Nearly nine million individuals nationwide receive tax credits to help subsidize their health insurance coverage through individual marketplaces;
  • Millions of working families rely on high-quality employer-sponsored health insurance plans;
  • Important protections prohibit insurers from denying health insurance to the 133 million Americans with pre-existing conditions, like diabetes, cancer, or pregnancy, or from charging individuals higher premiums because of their health status; and
  • Nearly $1.3 trillion in federal funding has been dedicated to keeping Americans healthy and covered, which includes spending through Medicaid expansion and public health dollars.

Filing today’s petition with Attorney General James are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky.

January 3, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Leads Coalition Seeking Supreme Court Review of ACA Repeal Case”. From the press release:

California Attorney General Xavier Becerra today, leading a coalition of 20 states and D.C., filed a petition to the U.S. Supreme Court seeking review of the Fifth Circuit’s recent decision in Texas v. U.S. The decision held the individual mandate of the Affordable Care Act (ACA) unconstitutional and called into question whether the remaining provisions of the ACA could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that may harm the health of millions of Americans, as well as doctors, clinics, patients, and the healthcare market, Attorney General Becerra and his coalition are petitioning the Supreme Court to take up the case and resolve it before the end of the Court’s current term in June.

“While the Trump Administration fights to strip access to healthcare, our coalition moves forward to defend it – because a pre-existing medical condition should never again disqualify you from receiving affordable healthcare”, said Attorney General Becerra. “This dangerous repeal case jeopardizes the lives of our families, neighbors, and millions of Americans who rely on the ACA for their healthcare. We’ll continue to fight because our communities are healthier when everyone can access affordable care – whether that means gaining coverage from Medicaid expansion or by staying on a parent’s health insurance. We’re asking the Supreme Court to swiftly resolve this repeal lawsuit for the sake of saving lives and ending uncertainty in our healthcare system.”…

January 3, 2020: Law.Com posted an article titled: “Donald Verrilli Returns to SCOTUS to Defend Obamacare”. It was written by Jacqueline Thomsen. From the article:

The U.S House of Representatives and a Democratic group of state attorneys general on Friday placed the issue of the Affordable Care Act before the Supreme Court again, asking justices to review an appellate court decision that struck down the health care law’s individual mandate as unconstitutional.

Alongside their petitions for writ of certiorari filled with the court, both the state officials and the House separately asked the justices to take up the matter on an expedited basis and schedule oral arguments for this spring.

If the Supreme Court agrees to follow that schedule, that means an opinion could come down just months ahead of the 2020 presidential election, placing healthcare at the heart of the political debate…

…And the House’s petition, signed on by former Solicitor General Donald Verrilli, who previously defended the Affordable Care Act before the Supreme Court, said the Fifth Circuit ruling “has created an intolerable situation”…


January 7, 2020: New York Attorney General Letitia James posted a press release titled: “AG James Continues Fight To Block Trump Admin Public Charge Rule”. From the press release:

After oral arguments today regarding the Trump Administration’s efforts to reverse a nationwide preliminary injunction on the public charge rule, Attorney General Letitia James issued the following statement:

“The Trump Administration’s public charge rule is an egregious attempt to infringe upon the values of this country. We vigorously defended the nationwide preliminary injunction today in court, because citizens and non-citizens alike will be adversely impacted if the rule is implemented. We remain committed to fighting against this misguided rule and will continue to pursue every legal tool available to permanently stop it.”

January 7, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Multistate Amicus Brief Defending Women’s Reproductive Rights”. From the press release:

California Attorney General Xavier Becerra today led a multistate coalition in filing an amicus brief in the Eighth Circuit Court of Appeals in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutledge, a lawsuit that seeks to protect a woman’s right to safe and legal abortion care. The multistate coalition supports the last surgical abortion clinic in Arkansas in its challenge to four state laws that would restrict women’s access to safe and legal abortion by banning abortion after 18 weeks and otherwise restricting women’s access to reproductive care. 

“We’re standing up to protect women’s reproductive rights,” said Attorney General Becerra. “No woman should be blocked from making health decisions about her body that she is entitled to under the Constitution. We will continue to fight to ensure that all women can access affordable comprehensive reproductive healthcare.”

In 2019, the Arkansas state legislature passed several laws intended to restrict access to abortion services. The laws would criminalize abortions performed after 18 weeks and impose other undue burdens on women’s constitutional right to abortion. 

On July 28, 2019, the U.S. District Court granted the plaintiff’s motion for preliminary injunction, which temporarily blocked the Arkansas laws restricting abortion care. Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter.

In the brief, the coalition argues that the Arkansas laws violate women’s constitutional right to choose under Roe v. Wade. The coalition further argues that limiting or eliminating women’s access to safe and legal abortion leads to worse health and socioeconomic outcomes for women. These outcomes include forcing women to endure negative pregnancy side effects, the limitation of physical activity, restriction from full-time employment, and increased reliance on publicly funded safety-net programs. The brief describes the different ways that states promote women’s health without impeding women’s rights upheld by the Constitution.

In filing today’s brief, Attorney General Becerra is joined by the Attorneys General of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

A copy of the brief is available here.

January 7, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James Fights To Stop Restrictions On Women’s Reproductive Rights From Taking Effect”. From the press release:

New York Attorney General Letitia James, along with a coalition of 19 additional attorneys general from around the nation, today filed a multistate amicus brief in support of a lawsuit that seeks to protect a woman’s right to safe and legal abortion care without the burdensome restrictions imposed by Arkansas laws. The brief – filed in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutlidge, now before the Eighth Circuit Court of Appeals – supports the last surgical abortion clinic in Arkansas as it challenges four state laws that would restrict the ability for women in Arkansas to access abortions by banning abortions after 18 weeks and otherwise restricting women’s access to reproductive care.

“Roe v. Wade has been the law of the land for 47 years and despite attempts by politicians across the country to undermine this national precedent and assert control over women’s bodies, we will not go backwards,” said Attorney General James. “We will continue to be relentless in our defense of a woman’s right to choose, relentless in safeguarding women’s freedoms, and relentless in protection the ability for women to control their own bodies. Our coalition won’t allow Arkansas, nor any other state, to make it harder for women to exercise their constitutional right to an abortion. And we will continue to use every legal tool available to prioritize the health, safety, wellness, and rights of women.”

In March of last year, the governor of Arkansas signed into law several bills intended to restrict a woman’s access to abortion services throughout the state. The laws would criminalize abortions performed after 18 weeks and impose additional undue burdens on a woman’s constitutional right to an abortion. The Little Rock Family Planning Services clinic argues that these laws would make abortion care unavailable and health care services less safe for women.

In July, the U.S. District Court for the Eastern District of Arkansas granted a preliminary injunction and temporarily blocked the laws restricting abortion care from taking effect. The State of Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter.

In the brief filed today, Attorney General James and the coalition of attorneys general argue that the Arkansas laws violate a woman’s constitutional right to choose under Roe v Wade. The coalition further argues that limiting or eliminating women’s access to safe and legal abortion leads to worse health and socioeconomic outcomes for women.

In July, the U.S. District Court for the Eastern District of Arkansas granted a preliminary junction and temporarily blocked the laws restricting abortion care from taking effect. The State of Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter.

In the brief filed today, Attorney General James and the coalition of attorneys general argue that the Arkansas laws violate a woman’s constitutional right to choose under Roe v. Wade. The coalition further argues that limiting or eliminating women’s access to safe and legal abortion leads to worse health and socioeconomic outcomes for women. The brief describes the different ways that states can promote women’s health without impeding women’s rights upheld by the U.S. Constitution.

Today’s brief is just the latest action in a long list of measures Attorney General James has taken to protect women’s reproductive freedom. Last month, Attorney General James filed an amicus brief defending the right to maintain full and equal access to birth control guaranteed under the Affordable Care Act for tens of thousands of women nationwide…

January 7, 2020: California Attorney General Xavier Bacerra posted a press release on his official website titled: “Attorney General Becerra Leads Multistate Amicus Brief Defending Women’s Reproductive Rights”. From the press release:

California Attorney General Xavier Becerra today led a multistate coalition in filing an amicus brief in Eighth Circuit Court of Appeals in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutledge, a lawsuit that seeks to protect a woman’s right to safe and legal abortion care. The multistate coalition supports the last surgical abortion clinic in Arkansas in its challenge to four state laws that would restrict women’s access to safe and legal abortion by banning abortion after 18 weeks and otherwise restricting women’s access to reproductive care.

“We’re standing up to protect women’s rights,” said Attorney General Becerra. “No woman should be blocked from making health decisions about her body that she is entitled to under the Constitution. We will continue to fight to ensure that all women can access affordable comprehensive reproductive healthcare.”..

January 7, 2020: HuffPost posted an article titled: “Trump Administration Quietly Goes After Disability Benefits”. It was written by Arthur Delaney. From the article:

Some Americans could lose Social Security Disability Insurance benefits under a recent Trump administration proposal – a change that could affect thousands of people but that has recieved little attention since it was first floated in November.

Under the proposed change, the government would look more closely at whether certain disability recipients still qualify as “disabled” after they’ve already been awarded those benefits. While recipients already have to demonstrate their continuing disability every few years, the proposal would ramp up the examinations, potentially running still-eligible beneficiaries out of the program.

The extra reviews will help “maintain appropriate stewardship of the disability program,” the administration said in the proposal, arguing current rules fail to account fully for the possibility of medical improvement…

…Democrats and disability advocates said the proposed new regulation would only hurt disabled people, that it hasn’t been vetted and that the rule-making process should be delayed. More than 8 million of Americans receive disability benefits based on past employment and a loss of wage income due to the onset of a severe disability…

…The regulation could affect hundreds of thousands of SSDI and Supplemental Security Income recipients, [Kathleen] Romig [senior policy analyst at Center on Budget and Policy Priorities] said, potentially ending benefits for tens of thousands. The administration didn’t estimate how many would lose benefits, but said the proposal would save over $2.6 billion over a decade.

The rule would not take effect until sometime after the administration releases a final version, for which no date has been set – and as with other regulations the administration has issued without imput from Congress, a lawsuit could stop it…

…The draft rule would add a new category: medical improvement likely, as in likelier than possible, but not as likely as expected. Reviews would occur “approximately every two years,” as opposed to within 18 months for people with expected medical improvement and within three years for those with possible improvement. Overall, according to the administration, there would be 2.6 million more reviews, an 18% increase, at an anticipated cost of $1.8 billion – almost wiping out the $2.6 billion worth of savings on benefits…

January 7, 2020: Senator Bernie Sanders tweeted: “10,000 Americans died waiting for Social Security Disability Insurance in 2017. Instead of addressing this crisis, Trump wants to make it harder for people with disabilities to get the help they need to get by. Unacceptable. We must protect and expand SSDI and SSI.” This tweet was the start of a short thread.

January 7, 2020: Senator Bernie Sanders tweeted: “As president, I will reverse this disastrous rule on day one of my presidency. Together, we will guarantee every person with a disability the right to live in the community with dignity and independence.”


January 8, 2020: New York Attorney General Letitia James posted a press release titled: “AG James Stops Public Charge Rule From Taking Effect”. From the press release:

New York Attorney General Letitia James issued the following statement after the United States Court of Appeals for the Second Circuit denied the Trump Administration’s efforts to immediately reverse a nationwide preliminary injunction on the president’s Public Charge Rule:

“Today is a victory for the millions of immigrants in our state and in this country that have been sidelined, disrespected, and demeaned by the Trump Administration. Generations have come to this country with nothing more than a dream in their pockets, but the president’s Public Charge Rule is an egregious attempt to infringe upon the values of our nation. The court’s decision to enforce the preliminary injunction and block the president from expediting his plan to discriminate against communities of color is welcome news to millions across New York and this country. We remain committed to fighting against this misguided rule and will continue to pursue every legal tool available to permanently stop it.”

In August 2019, Attorney General James and a coalition that includes the attorneys general of Connecticut and Vermont, as well as the City of New York, filed a lawsuit challenging the Trump Administration’s Public Charge Rule, which aims to deny green cards and visas to immigrants that use or have used government assistance programs. The program specifically targets immigrants of color, while putting these communities at risk, and would have short- and long-term impacts on public health and the economy.

In September, Attorney General James and the coalition filed a motion for a preliminary injunction to stop the rule from going into effect. After the court order the preliminary injunction, President Trump and his Administration filed to stay the order but were denied in their efforts today.

The overall health and wellbeing of New York’s immigrant communities that use vital public benefit programs would be negatively impacted by the Public Charge Rule. Additionally, with the anticipated decline in Medicaid enrollment, individuals who would have otherwise had access to healthcare are at risk of living with undiagnosed and untreated conditions. Economically, impacted communities can be expected to experience increased poverty rates, housing instability, a reduced workforce, and an overall decrease in total economic productivity.

January 8, 2020: Minnesota Governor Tim Walz posted a press release titled: “Walz’s New Law to Address Prescription Drug Prices Takes Effect”. From the press release:

As of January 1, 2020, pharmacy benefit managers operating in Minnesota are now required to be licensed and are subject to increased regulation and reporting requirements, thanks to a new law signed by Governor Tim Walz that aims to increase transparency in prescription drug costs.

“For too long, Minnesotans have been kept in the dark about why their prescription drug prices are so high,” said Governor Tim Walz. “This new law is a step in the right direction to begin to take a close look at those costs and ultimately, work to create additional policy solutions to lower drug prices for Minnesotans.”

Pharmacy benefit managers (PBMs) are hired by health insurance companies and employers to manage prescription drug benefits. PBMs can be tasked with processing or paying pharmacy claims, creating or updating prescription drug formularies, administering and negotiating rebates from drug manufacturers or establishing a pharmacy network.

Under the new law, the Minnesota Department of Commerce has overall licensing, transparency reporting and enforcement authority over PBMs, while the Minnesota Department of Health provides analysis and approval of network adequacy reporting. The new authority and reporting requirements will give the State the ability to understand the relationship between PBMs and insurance companies, as well as the associated costs and could help inform policy solutions to address unaffordable drug costs…

…As of January 1, 2020, 40 PBMs are now licensed in the State of Minnesota to do business. The Department of Commerce is in the rulemaking process to implement the law, including the transparency reporting requirements. Commerce staff are soliciting comments from stakeholders and are finalizing the formation of an advisory committee to provide input on draft rules. The committee is anticipated to hold its first meeting in January with a public meeting to follow…


January 9, 2020: Cal Matters posted an article titled: “Gov. Gavin Newsom to propose that California manufacture its own generic drugs”. From the article:

In a bold strategy to drive down prescription drug prices, Gov. Gavin Newsom is proposing that California become the first state in the nation to develop its own generic drug label, making those medications available at an affordable price to the state’s 40 million residents.

The proposal, part of the new state budget Newsom is expected to send to the Legislature on Friday, would authorize the state to negotiate contracts with drugmakers to manufacture selected prescriptions on behalf of California. Such a disruption of the pharmaceutical industry, proponents say, would leverage the state’s massive market to increase competition and lower generic drug prices nationally.

The strategy is one of several the Democratic governor plans to recommend to lower the cost of health care for Californian’s. The administration released only a summary of the proposal on Thursday without the projected price tag, but indicated it’s part of a multi-prong effort that includes strengthening the state’s public option for health insurance and increasing drug pricing transparency.

Newsom will also continue last year’s push to establish a single market for drug pricing, direct the state to ask for more rebates from drug manufacturers, and open a new health care affordability office sometime this spring…

A copy of the brief is available here.

January 9, 2020: Cal Matters posted an article titled: “Gov. Gavin Newsom to propose that California manufacture its own generic drugs”. From the article:

In a bold strategy to drive down prescription drug prices, Gov. Gavin Newsom is proposing that California become the first state in the nation to establish its own generic drug label, making those medications available at an affordable price to the state’s 40 million residents.

The proposal, part of the new state budget Newsom is expected to send to the Legislature on Friday, would authorize the state to negotiate contracts with drugmakers to manufacture selected prescriptions on behalf of California. Such a disruption of the pharmaceutical industry, proponents say, would leverage the state’s massive market to increase competition and lower generic drug prices nationally.

The strategy is one of several the Democratic governor plans to recommend to lower the cost of health care for Californians. The administration released only a summary of the proposal on Thursday without the projected price tag, but indicated that it’s part of a multi-prong effort that includes strenghtening the state’s public option for health insurance and increasing drug pricing transparency.

Newsom will also continue last year’s push to establish a single drug market for drug pricing, direct the state to ask for more rebates from drug manufacturers, and open a new health care affordability office sometime this spring…

January 9, 2020: NBC News posted an article titled: “Kansas governor, top Republican reach deal to expand Medicaid”. It was written by Phil McCausland. From the article:

Kansas Gov. Laura Kelly, a Democrat, and Sen. Jim Denning, the state’s top Senate Republican, announced Thursday that they had come to an agreement on Medicaid expansion, which would provide the state’s working poor access to health care coverage.

Though the announcement was not a bill signing, Kelly said that Denning, the senate majority leader, had endorsed her plan to expand Medicaid to provide health care coverage to more than 100,000 people in the state.

The state legislature will still have to pass the bill, which is highly likely now with Denning’s endorsement. Kelly said the intention is for the legislation to be passed over the next year, so that Kansans can take advantage of the program by Jan. 1, 2021.

“Today, I am proud to stand with Sen. Denning to announce we have taken a crucial bipartisan step toward making Kansas the 37th state to expand Medicaid,” Kelly said…

…Kelly’s plan increases Kansans’ Medicaid eligibility to 138 percent of the federal poverty level, works to defray costs through a surcharge on hospitals, and includes a work training and placement program that is less stringent than the work requirements that many Republicans desired.

It also will create an easy escape hatch for Kansas in case the federal government chooses to no longer provide 90 percent of the funding for Medicaid expansion and also moves forward with a program to help insurance programs provide cheaper health care on the federal exchange…

…Approximately 130,000 Kansans are expected to enroll when the expanded Medicaid program becomes available, according to an estimate by the Kansas Health Institute, at a net cost of $520 million over 10 years.

Advocates for expansion have pointed out that there is a need for the program…

January 9, 2020: Senator Cory Booker posted a press release titled: “Booker, Merkley, Murkowski, Duckworth Introduce Bipartisan Legislation to Expand Breastfeeding Protections At Work”. From the press release:

U.S. Senator Cory Booker (D-NJ), along with Senators Jeff Merkley (D-OR), Lisa Murkowski (R-AK), and Tammy Duckworth (D-IL) today announced the introduction of bipartisan legislation to provide salaried employees in traditional office environments—a group of approximately 13.5 million executive, administrative, and professional women—with reasonable break time and a private place to pump breastmilk. Their bill, the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act, would expand a 2010 law authored by Merkley and Rep. Carolyn Maloney (D-NY-12), which provides space and time for hourly employees who are nursing. 

Additionally, the legislation for the first time includes an anti-retaliation enforcement provision to grant women whose workplaces flout the law with pathways to fight for fair compensation and enforcement of the law…

…Inadequate time and space to pump in the workplace subjects countless women to harassment, reduced wages, and job loss, while others are forced to stop breastfeeding—which can create serious health consequences for their own health and the health of their children. According to the Surgeon General, breastfeeding can help protect babies from illnesses like ear, skin, and respiratory infections, diarrhea, and vomiting, as well as longer-term conditions such as obesity, type 1 and type 2 diabetes, and asthma. It also lowers mothers’ risk of breast cancer, heart disease, and other ailments…

…The PUMP for Nursing Mothers Act is endorsed by the NEA, the USBC, A Better Balance, and American Civil Liberties Union.


January 10, 2020: Sacramento Bee posted an article titled: “From housing to health care: Here’s what’s in Gavin Newsom’s $222 billion California state budget”. It was written by Sophia Bollag. For the purpose of this blog post, I am only including the parts of the budget that are related to health care.

..Newsom is also calling for a “once-in-a-generation” revamp of Medi-Cal to increase preventative health services, boost assistance for homeless people and improve mental health care.

His plan would also steer nearly $700 million in addition money to the program.

His budget would allow undocumented people over the age of 65 to enroll in Medi-Cal, provided they meet the program’s income requirements. That proposal builds on the current budget’s Medi-Cal expansion to undocumented young adults.

The budget proposal also contains ambitious plans to cut prescription drug costs, including creating a state-owned generic drug label and a single drug purchasing market in California…

January 10, 2020: Human Rights Watch posted an article titled: “US: Unalienable Rights’ Commission Risks Rights Protections.” From the article:

The United States State Department’s Commission on Unalienable Rights risks calling for a dangerous downgrading of international human rights protections. On January 10, 2020, the Human Rights Watch executive diretor, Kenneth Roth, testified at the commission’s fourth open session.

While the fundamental rights set out in the human rights treaties are clear, the Trump administration has taken issue with the rights they uphold, such as reproductive freedom, or the rights of LGBT people not to face discrimination. Human Rights Watch expressed concern that the commission’s exercise in identifying “unalienable” rights is the administration’s unilateral attempt to rewrite international law basd on its own beliefs.

“The US Government’s voice is needed on human rights, but it should be a voice that upholds the principled defense of all rights, not a pick-and-choose approach,” Roth said. “Repressive governments frequently justify their human rights violations by claiming that some rights are more important than others. If the Trump administration adopts its own selective approach to human rights, it will only facilitate this classic excuse to evade the requirements of international rights law.”

Secretary of State Mike Pompeo announced the formation of the commission in July 2019 to advice on the promotion of human rights in foreign policy. The commission has yet to announce the form of its final product or the role that open session testimony will have in shaping that final product. Though the commission’s meetings are open to the public, it has not provided any publicly available record or transcript of testimony.

The commission’s first step should be changing President Donald Trump’s own approach to foreign policy and human rights, Human Rights Watch said.

“As long as the president embraces autocrats and dictators, expressing envy of their ability to silence or compromise the democratically essential checks and balances on their authority, the US government will have little credibility on human rights,” Roth said.

January 10, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Sununu and HN Insurance Department Announce Plan to Reduce Premium Rates, Improve Individual Health Insurance Market”. From the press release:

Today, Governor Chris Sununu is announcing that the New Hampshire Insurance Department intends to file a Section 1332 State Relief and Empowerment Waiver application with the federal government to promote stability in the state’s individual health insurance market with an expectation that plan year 2021 premiums will be reduced by approximately 15% over what they would havebeen otherwise.

“Preserving and stabilizing New Hampshire’s individual health insurance market has been a key priority for our administration. Our previous efforts have kept our state’s three current insurance companies in the market and have lowered premiums for two consecutive years,” said Governor Chris Sununu. “However, continued dysfunction and lack of reform in Washington is likely to produce increased prices next year that could put healthcare out of reach for too many Granite Staters. Thanks to good financial management and the reforms my administration made to our state’s Medicaid Expansion program, this waiver, unlike previous proposals, makes sense and could reduce prices for individuals by 15%. This is a win for New Hampshire and I want to thank the team at the Department of Insurance for their efforts.”

As required by HB 4, which passed last September, the Insurance Department is seeking a waiver to create a state-based reinsurance program. The waiver would allow New Hampshire to receive what is known as federal “pass-through” funding — the equivalent of what the federal government is estimated to save in premium subsidy payments to New Hampshire residents as a result of the program.

An initial analysis prepared for the Insurance Department estimates the plan will save the federal government $31.1 million in Advance Premium Tax Credits for 2021. In combination with the state share of $13.5 million, initial estimates indicate that the program could provide $44.6 million in reinsurance dollars to individual market companies to cover high cost claims. This would enable these companies to lower their premium rates and limit their exposure to high cost claims.

Payments will be allocated to the companies providing coverage in the individual market based on the number and magnitude of high cost claims that they incur. The waiver application will include a provision to allow the state to adjust the program on a year-to-year basis as market conditions may require, or to terminate the program at the end of any plan year…

…About a dozen states were granted or are in the process of applying for Section 1332 Waivers to support their individual markets.  In 2018, the Trump Administration announced additional Section 1332 Waiver options for states to promote pursuit of the waivers. Most states began their 1332 Waivers in 2019 and have estimated double-digit premium savings.

In order to receive the federal funding, the Department seeks to waive a very limited portion of the federal health care law in order to allow New Hampshire to receive the pass-through savings. The waiver request is related to the structure of the risk pool, and will not affect consumer protections or essential health benefits. The state share funding will be raised through an assessment of health insurance companies that is authorized by a state law that has been in place since 1998. This law has been used to fund individual market subsidy mechanisms in the past.

Obtaining public input is an important part of the plan for stabilizing the market. The Insurance Department will hold two public hearings this spring on the proposed risk-sharing plan and application for federal funding. The dates and locations for the hearings will be announced once the venues are confirmed.


January 13, 2020: The U.S. House of Representatives Ways and Means Committee posted a press release titled: “Neal, Larson, and Davis Slam Harmful Draft Social Security Rule. From the press release:

Today, Ways and Means Committee Chairman Richard E. Neal (D-MA), Social Security Subcommittee Chairman John B. Larson (D-CT), and Worker & Family Support Subcommittee Chairman Danny K. Davis (D-IL) released the following statement regarding reports of a draft Social Security Administration (SSA) rule that would narrow the eligibility criteria for Social Security and Supplemental Security Income (SSI) disability benefits:

“Yet again, the Trump Administration is going out of its way to make life more challenging for the most vulnerable people in our country. The United States government has extremely stringent disability standards. In fact, fewer than four in 10 applicants are found eligible for Social Security disability benefits, even after all levels of appeal. This rule would further restrict eligibility, making it even harder for disabled people to access the essential income they’re qualified to recieve. We are particularly alarmed that news of this latest proposal comes on top of the Administration’s recent efforts to cut off benefits for severely disabled people whom the agency already found eligible.

“Instead of working to strip disability benefits from people who qualify, the SSA should focus on its truly pressing problems. Resources should go toward cutting lengthy wait times on the phone and at field offices, eliminating benefit backlogs, and hiring personnel to improve the agency’s lacing services.

“We strongly urge the Trump Administration to reject this curel proposed rule and reassess SSA’s priorities.”

January 13, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “AG James Stops Public Charge Rule From Taking Effect”. From the press release:

New York Attorney General Letitia James issued the following statement after the United States Court of Appeals for the Second Circuit denied the Trump Administration’s efforts to immediately reverse a nationwide preliminary injunction on the president’s Public Charge Rule:

“Today is a victory for the millions of immigrants in our state and in this country that have been sidelined, disrespected, and demeaned by the Trump Administration. Generations have come to this country with nothing more than a dream in their pockets, but the president’s Public Charge Rule is an egregious attempt to infringe upon the values of our nation. The court’s decision to enforce the preliminary injunction and block the president from expediting his plan to discriminate against communities of color is welcome news to millions across New York and this country. We remain committed to fighting against this misguided rule and will continue to pursue every legal took available to permanently stop it.”

In August 2019, Attorney General James and a coalition that includes the attorneys general of Connecticut and Vermont, as well as the City of New York, filed a lawsuit challenging the Trump Administration’s Public Charge Rule, which aims to deny green cards to immigrants that use or have used government assistance programs. The program specifically targets immigrants of color, while putting these communities at risk, and would have short and long-term impacts on public health and the economy.

In September, Attorney General James and the coalition filed a motion for a preliminary injunction to stop the rule from going into effect. After the court order the preliminary injunction, President Trump and his Administration filed to stay the order but were denied in their efforts today.

The overall health and wellbeing of New York’s immigrant communities that use vital public benefit programs would be negatively impacted by the Public Charge Rule. Additionally, with the anticipated decline in Medicaid enrollment, individuals who would have otherwise had access to healthcare are at risk of living with undiagnosed and untreated conditions. Economically, impacted communities can be expected to experience increased poverty rates, housing instability, a reduced workforce, and an overall decrease in total economic productivity.

January 13, 2020: Speaker Pelosi tweeted: “130 million Americans live every day with pre-existing conditions. They depend on knowing their health care, secured by protections in the ACA, is there when they need it. #ProtectOurCare”

January 13, 2020: Senator Sherrod Brown tweeted: “The Affordable Care Act’s Medicaid expansion is our number one took to get Ohioans the addiction treatment they need – and President Trump wants to take it away. We must #ProtectOurCare.” The tweet included a link to a Washington Post article titled “Medicaid expansion may have saved thousands from overdose deaths”.

January 13, 2020: Representative Vicente Gonzalez tweeted: “Our government should be fighting to ensure Americans have access to quality, affordable health care without facing discrimination based on their pre-existing conditions – not working to take it away from millions! #ProtectOurCare”

January 13, 2020: Representative Bill Foster tweeted: “If @realDonaldTrump gets his way, families across the country will see their costs go up as they lose pre-existing condition protections. I’m fighting to #ProtectOurCare for the 314,000 residents of my district who live with pre-existing conditions.

January 13, 2020: Representative Zoe Lofgren tweeted: “I’m fighting for people living with pre-existing conditions in CA-19 & all around the country. If the GOP’s Texas v US lawsuit strikes down the Affordable Care Act, millions of Americans will lose vital protections & access to care. We must #ProtectOurCare!”

January 13, 2020: Representative Ted Lieu tweeted: “If Trump gets his way, families in #CA33 and across the country will see their health care costs go up as they lose pre-existing condition protections. We can’t let it happen. #ProtectOurCare”.

Here are a few tweets from President Trump:

January 13, 2020: President Trump tweeted: “Mini Mike Bloomberg is spending a lot of money on False Advertising. I was the person who saved Pre-Existing Conditions in your Healthcare, you have it now, while at the same time winning the fight to rid you of the very unpopular Individual Mandate…

January 13, 2020: President Trump tweeted: “…and if Republicans win in court and take back the House of Representatives, your healthcare, that I have now brought to the best place in many years, will become the best ever, by far. I will always protect your Pre-Existing Conditions, the Dems will not!

January 13, 2020: President Trump tweeted: “I stand stronger than anyone in protecting your Healthcare with Pre-Existing Conditions. I am honored to have terminated the very unfair, costly and unpopular individual mandate for you!”

In the above tweets, President Trump is spouting propaganda. His words do not match his actions in the previous years regarding American’s health care. (For more details, read my previous blogs about the ways Republicans and Trump have been trying to take away American’s health care.)


January 14, 2020: Senator Bob Casey tweeted: “If the ACA is overturned: Women lose protections against discrimination in health care settings. Insurance companies will be able to charge women more than men. Women lose essential protections for breastfeeding including vital workplace standards. #ProtectOurCare.”

January 14, 2020: Senator Doug Jones tweeted: “Folks, I know there’s a lot going on right now, but we can’t forget about the nearly 1M Alabamians living with pre-existing conditions whose health coverage is under attack right now. We need to stand up to #ProtectOurCare.”

January 14, 2020: Human Rights Watch posted: “Letter to Urge Florida Senate to Reject Forced Parental Consent for Abortion”. The letter was sent to Senator David Simmons, Chair of the Committee on Judiciary. From the post:

Dear Chair Simmons and Members of the Judiciary Committee,

We write to you on behalf of Human Rights Watch to urge you to vote against Senate Bill (SB) 404, which would force adolescent girls to obtain parental consent for abortion. We appreciate Florida legislators’ interests in protecting the health and well-being of adolescent girls and supporting healthy family communication. However, by changing Florida law from its current requirement that girls notify a parent or guardian before an abortion to requiring them to obtain parental consent, SB 404 will undermine those goals. Florida legislators committed to protecting the rights and dignity of adolescent girls should reject SB 404.

Human Rights Watch is a global human rights organization with offices throughout the world, including in Miami, Florida. We have extensively documented how laws and policies that restrict access to abortion threaten women’s and girls’ health and lives and drive abortion underground, making it less safe.[1]

We have examined the effects of laws requiring adolescent girls to obtain parental authorization for abortion in several US states, including Florida. In Florida, we sought to understand the human rights impacts of Florida Statutes §390.01114 (the Parental Notice of Abortion Act), requiring girls to notify a parent or legal guardian prior to an abortion, or obtain a judicial waiver.

We conducted in-depth phone interviews with three Florida-based medical professionals providing adolescent sexual and reproductive health care, and six attorneys with experience representing adolescent girls seeking judicial waivers for Florida’s parental notification requirement.[2] We also analyzed state, national, and international laws and policies and conducted a review of secondary sources, including public health studies, case law, reports by the American Academy of Pediatrics and other health professional associations, and other sources.

Our findings indicate that changing Florida state law to mandate parental consent for abortion is unnecessary given the state’s existing parental notification requirement, and could seriously threaten the health and human rights of Florida’s adolescent girls.

Mandating Parental Involvement Can Hurt Adolescent Girls

Attentive and loving parents typically provide important guidance to their teenage children. Studies have shown that most adolescent girls voluntarily involve a parent or another trusted adult in their abortion decisions, whether or not the law requires parental authorization.[3] In particular, close and supportive family relationships facilitate parental involvement in adolescent girls’ abortion decisions.[4] A Florida counselor who has conducted reproductive health counseling with adolescent patients for 19 years told Human Rights Watch that the vast majority of adolescent girls seeking abortion care at the Florida clinic where she works involve a parent in their decision before learning about Florida’s parental notification requirement.[5] The counselors we interviewed said they consistently encourage girls to seek advice and support from their parents when they can do so safely.[6]

Florida attorneys and medical providers told Human Rights Watch that when girls are unable to involve a parent in their abortion decision, it is often because they fear violence, being kicked out of the home or alienated from their families, or being forced to continue a pregnancy against their wishes, or because their parents are not part of their lives. In some cases, girls are unable to involve a parent because they are pregnant from rape or incest and/or have been removed from their homes. Mandating parental consent under these circumstances would place girls at serious risk of harm…

Fear of Being Forced to Continue an Unwanted Pregnancy

Another attorney told Human Rights Watch that in her career she had represented about 50 adolescent girls seeking judicial waivers. While some feared being kicked out of the home or isolated financially, she said the majority sought judicial waivers because they feared that their parents would force them to continue an unwanted pregnancy against their wishes. “Almost all of them say, ‘[If I tell my parents], they’ll make me have the baby.’ And they don’t want to have the baby wherever they are in life.”[13]

A juvenile law attorney said that many clients she represented believed that their parents “would never permit them to have an abortion, disagree completely with their child’s decision to do that. And girls know they can’t raise this baby.”[14]

Stevenson of the ACLU of Florida said that clients told him that, “When they have a child, they want to be in a place where they can be the good mother they want to be.”[15]

Several attorneys said they represented adolescent girls who hoped to pursue a college education and felt that continuing a pregnancy and giving birth against their wishes would require them to alter their educational and career goals significantly.[16]

Parents Who are Not Involved in a Girl’s Life

Bernard Perlmutter with the Children and Youth Law Clinic at the University of Miami School of Law estimated that he has represented 15 girls seeking judicial waivers since Florida’s Parental Notice of Abortion Act took effect, most of them in foster care. Perlmutter explained that Florida’s Department of Children and Families cannot act as a parent or legal guardian to satisfy the parental notification for abortion requirement, so if girls in foster care feel unable to notify their legal parent or guardian, or if the biological parents’ parental rights have been terminated, they must seek judicial waivers.[20]

Perlmutter said,

Not a single one of the foster care teenagers [I’ve represented for judicial waivers] had an ongoing healthy relationship with her parents. They come into the foster care system very traumatized. Some are victims of severe neglect. Some of them are victims of sexual predation, or victims of sex trafficking at one point or another. Their relationships with their [biological] parents are not wholesome and strong. That’s why they are in state custody.[21]

Consequences for Survivors of Sexual Violence

Notifying a parent before an abortion can be particularly difficult for girls pregnant from rape or incest. Two attorneys said they had represented girls who were pregnant from rape or incest and sought judicial waivers because they had been removed from their parents’ care and were under the care of the state Department of Children and Families. Even in these circumstances, the state is unable to act as a parent or legal guardian to satisfy the parental notification for abortion requirement, so girls are forced to seek judicial waivers.[22]

The Legal Aid Society of Palm Beach County[23] has represented girls in the delinquency or dependency system who sought judicial waivers for Florida’s parental notification for abortion requirement, including a 10-year-old survivor of human trafficking who was pregnant from rape. Kristen Flynn, an attorney with the organization’s Juvenile Advocacy Project, has represented girls who were pregnant from rape or incest and removed from their parents’ care. She said forcing girls in these situations to appear before a judge to seek a judicial waiver of the state’s parental notification requirement can be retraumatizing. She said that any child who has been removed from the home and placed in state care has a high risk of experiencing trauma-related psychological and emotional consequences, such as anxiety disorders. When a girl has been removed from the home due to a pregnancy from sexual violence, appearing in court to answer questions about why they cannot notify their parents can be extremely distressing. “For anyone who is a victim of assault, one of the most difficult things is to relive those moments [of violence],” Flynn said. “You take a child living through such strong trauma and expect them to answer questions [about abortion in front of a judge], … it’s adding insult to injury. We’re continually asking kids to relive the trauma.”[24]

Limits of the Judicial Bypass Process

…To initiate the judicial bypass process, girls typically have to go in person to the office of their county’s Clerk of Court, find their way to the appropriate division handling these cases, request a court-appointed attorney if they do not already have one, and demonstrate to a judge that they are sufficiently mature to make the decision to terminate an unwanted pregnancy without involving their parents, or that involving their parents is not in their best interest.[27] (In some circumstances, girls are able to find an attorney before approaching the clerk’s office, but attorneys interviewed by Human Rights Watch suggested this was rare.) When girls fear that parental involvement could trigger violence or alienation from their families, they have to find ways to initiate the process without their parents finding out, including securing transportation or arranging time away from school.[28]

…While the overwhelming majority of petitions by minors seeking abortions are granted, according to data from the Office of the State Courts Administrator,[33] adolescent girls may still find the process frightening and be deterred from going through it. The process of appearing before a judge to seek a judicial waiver can be intimidating for an adolescent girl, regardless of the professionalism and sensitivity of Florida’s judges, attorneys, clerks, and court staff. One attorney described the emotional state of her clients as “very anxious. Their overriding fear is that the judge is going to deny it [their petition].”[34]

The process can require adolescent girls to answer intimate and personal questions about their health and lives. “It’s a lot for anyone to be able to do, much less a child,” said Kristen Flynn of the Legal Aid Society of Palm Beach County.[35] Other attorneys said that they believed their clients experienced stress, anxiety, or trauma around the judicial bypass process.[36]

Consequences of Mandating Parental Involvement

Public health research in the United States has shown that mandated parental involvement, whether through notification or consent, can push adolescents to delay accessing abortion care, leading to riskier or more complicated abortions. Delays in care can be especially harmful to adolescent girls, as they often suspect pregnancy later than adult women, and take longer to confirm a suspected pregnancy.[38] The problems accessing the current judicial bypass process, and the psychological and emotional impacts that process inflicts on adolescent girls, suggest that a judicial bypass system does not mitigate the harms caused by mandated parental involvement.

A recent study of the effects of a Massachusetts parental consent for abortion law found that girls who obtained parental consent had an abortion an average of 8.6 days after first calling to schedule an abortion, while girls who obtained judicial waivers had an abortion an average of 14.8 days after initial contact. Though legal induced abortion is very safe – and much safer than childbirth[39] – delaying abortion to later gestational stages can increase the risk of complications.[40] The study found “minors with judicial bypass also had higher odds of becoming ineligible for medication abortion between the day of first call and the day of procedure,” meaning their reproductive healthcare options were limited.[41] Many women and girls may prefer medication abortion, as it is noninvasive and can allow patients more flexibility and privacy.[42]

Analysis of statewide data in Texas before and after a parental notification law took effect in 2000 found that some girls required to obtain consent would, if possible, wait until they had turned 18 to have an abortion to avoid the requirement, even though later abortions are more complicated and often more expensive and difficult to access. The study found a 6 percent increase in abortions obtained at age 18 by adolescents who became pregnant at 17 years and 8 months, and a 13 percent increase in abortions obtained at 18 by those who became pregnant at 17 years and 9 months. The rate of second-trimester abortion in these groups increased by 21 percent, while there was no increase in second-trimester abortion among younger adolescents who would not have been able to delay abortion until age 18. The study concluded, “Some minors postpone abortion until the second or even third trimester of pregnancy to circumvent parental notification requirements.”[43]

…We respectfully urge you to consider the cases and evidence described above and the complicated and often dire circumstances that leave some adolescent girls unable to involve their parents in abortion decisions, and to vote “no” on SB 404. Given the onerous parental notification requirement already in effect in Florida, and the evidence that mandating parental involvement can be a serious barrier to timely health care, we urge you to reject forced parental consent and focus instead on enacting policies to facilitate greater access to comprehensive sexual and reproductive health information and services for adolescents.

Voting against SB 404 will affirm the rights and dignity of Florida’s adolescent girls.

We request that this statement be included in the record of the committee’s proceedings.

Sincerely,
Zama Neff
Executive Director
Children’s Rights Division
Human Rights Watch

Carine Chehab
Miami Director
Human Rights Watch


January 15, 2020: The Star Tribune Editorial Board posted an Editorial titled: “Waiting game on the Affordable Care Act isn’t healthy”. From the editorial:

Patients, seniors, doctors, hospitals, state lawmakers and voters are owed a swift answer from the U.S. Supreme Court about whether the Affordable Care Act (ACA) will survive the latest challenge to its existence. The court needs to remove the uncertainty hovering ominously over this landmark measure, one whose sprawling web of assistance programs consumers, hospitals and states have come to rely on for quality, accessible care.

That the fate of the 2010 law is dependent on the courts for the third time in a decade is exasperating. Twice already, battles over the ACA’s constitutionality have been fought all the way to the Supreme Court. Twice, justices have upheld the law. Now, a third challenge, one that’s essentially a vanity project led by a headline-seeking Texas attorney general, is gaining ill-deserved momentum.

The legal argument in this dubious Texas lawsuit is the flip side of the original 2012 Supreme Court challenge to the law. Back then, the ACA’s earliest opponents argued that the law was unconstitutional because it required people to buy insurance. The Texas AG now argues that the law is unconstitutional because Congress essentially gutted the purchase requirement in 2017 during an end-of-the year tax bill…

…The implications are enormous. Millions of Americans depend on the financial aid the law provides to buy private insurance. In Minnesota, the average household that applied for help through MNsure received $5,244 to buy coverage in 2020. That aid could be gone next year or in the future. The fate of the Medicare “doughnut hole” is equally uncertain, leaving seniors with frightening questions about how they’ll be able to afford medications…

January 15, 2020: Senator Sheldon Whitehouse tweeted: “If Trump and the GOP succeed in overturning the Affordable Care Act, millions of Americans will lose coverage and access to life-saving prescription drugs. This is a fight for basic human rights. #ProtectOurCare”.

January 15, 2020: America’s Health Insurance Plans posted a statement on their website titled: “AHIP Issues Statement Upon Filing an Amicus Brief with the Supreme Court Requesting Certiorari in TX v US”. From the statement:

Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), issued this statement as the association filed an amicus brief with the Supreme Court requesting certiorari in TX vs US and timely consideration of the validity of the Affordable Care Act (ACA):

“Every American deserves affordable coverage and high-quality care. This has been – and always will be – our commitment.

“The district court’s original decision to invalidate the entire ACA was misguided and wrong. We urge the Supreme Court to grant certioari and remove the overhanging legal uncertainty that undermines the stability of coverage for nearly 300 million Americans, and that inhibits greater and faster progress to improve coverage and care for everyone.

“As we indicated in our brief, returning this case to the district court on remand only delays what Congress has unmistakably indicated through its actions: that the ACA should continue in operation despite its zeroring out of the mandate. We are confident that the Supreme Court will ultimately recognize that zeroing out the mandate was never intended to wreak havoc across the entire American health care system.

“As we continue to engage in the legal process, health insurance providers remain committed to serving all of their members, and to strengthening affordability, access, and choices for every American.”


January 16, 2020: U.S. Department of Health and Human Services posted a press release titled: “HHS Announces Proposed Rule Regarding Equal Treatment of Faith-Based Organizations in HHS-Supported Social Service Programs”. From the press release:

Today, January 16, 2020, the U.S. Department of Health and Human Services (HHS) is proposing a rule – PDF that implements President Trump’s Executive Order No. 13831 (May 3, 2018), removes regulatory burdens on religious organizations, and ensures that religious and non-religious organizations are treated equally in HHS-supported programs.  The proposed rule ensures that HHS-supported social service programs are implemented in a manner consistent with the Constitution and other applicable federal law. 

“President Trump’s administration is taking historic action to protect religious social service providers from discrimination in federal regulations,” said HHS Secretary Alex Azar. “Americans of faith play an essential role in providing healthcare and human services to so many vulnerable people and communities, and President Trump is dedicated to removing every unfair barrier that stands in the way of this important work. Americans from every walk of life deserve to be treated with dignity and respect. Our Constitution and civil rights laws ensure equal treatment and today’s action makes clear that the federal government cannot discriminate against people and institutions based on how they live out the dictates of their faith.”

Under current regulations that govern HHS-supported programs, religious providers of social services—but not other providers of social services—must make referrals under certain circumstances to alternative service providers and must post notices regarding this referral procedure.  These regulatory burdens had been required by then-President Obama’s Executive Order No. 13559 (Nov. 17, 2010).   Consistent with President Trump’s Executive Order No. 13831 (May 3, 2018), HHS’s proposed rule would eliminate these requirements from department regulations.  As HHS’s proposed rule observes, these burdens were not required by any applicable law, and because they were imposed only on religious social service providers, they are in tension with recent Supreme Court precedent regarding nondiscrimination against religious organizations.  The proposed rule also will foreclose other unequal treatment of religious organizations by ensuring that they are not required to provide assurances or notices that are not required of secular organizations. 

By compelling religious organizations, but not secular organizations, to post special notices and make referrals, the alternative-provider requirements placed burdens unequally on religious organizations and cast unwarranted suspicion on them.  By singling out religious organizations for unique regulatory burdens, the requirements infringed the organizations’ religious liberty rights.

In addition, the proposed rule will clarify that religious organizations may apply for awards on the same basis as any other organization and that when HHS selects award recipients, HHS will not discriminate based on an organization’s religious character. The proposed rule also clarifies that religious organizations participating in HHS-supported programs retain their independence from the government and may continue to carry out their missions consistent with religious freedom protections in federal law, including the Free Speech and Free Exercise Clauses of the First Amendment…

January 16, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Condemns Proposed Rules that Would Grant Recipients License to Discriminate”. From the press release:

Today, as part of a series of similar rules released across several federal agencies, the Trump-Pence administration’s Department of Health and Human Services (HHS) and U.S. Agency for International Development (USAID) proposed religious refusal rules that would strip away critical protections from people rely on federally funded health and social services programs both domestically and abroad. The rules also make it substantially easier for faith-based organizations to receive tax-payer funding while simultaneously promoting their religion. They would eliminate protections that require faith-based organizations to notify people that they are serving about their rights, and refer them to other services providers if desired.

This is the latest in a long line of dangerous policies that could impact peoples’ abilities to access HIV and STI prevention programs, reproductive health services and other vital health care; youth homelessness services; and foster care and adoption services. They represent a concerted effort by the Trump-Pence administration across the federal government to attack access to sexual and reproductive health care and other services by taking funds from qualified providers and give them to religious entities that may not provide comprehensive services…

…Discrimination in health care already prevents too many LGBTQ people from accessing care. According to the 2015 U.S. Transgender Survey, 33 percent of respondents who sought health care in the last year experienced mistreatment, including violence, because they were transgender – and nearly one-quarter avoided seeking health care service when they needed them out of fear of discrimination. Nearly one-third of transgender people surveyed said a doctor or health care provider refused to treat them due to their gender identity.

When women are denied access to the full range of reproductive services, rates of unintended pregnancy, maternal mortality, mental health conditions, and sexually transmitted infections increase. Access to contraception also impacts women’s educational attainment, participation in the workforce, and economic growth.

January 16, 2020: The American Civil Liberties Union (ACLU) posted a news article titled: “Arkansas Legislators’ Attack on Abortion is Unconstitutional.” It was written by Michele Goodwin and David S. Cohen. From the article:

The U.S. Supreme Court has ruled time and time again that reproductive privacy is “central to personal dignity and autonomy, [which] are central to the liberty protected by” the Constitution. The Court has made eminently clear that under the Constitution, the right of a pregnant person to terminate a pregnancy prior to viability is a right so essential to our freedom that our government cannot ban or impose an undue burden on its exercise. But despite long-standing clarity of this principle, reproductive health and rights continue to come under blistering, unrelenting attack…

…Enough is enough. That’s why we, along with our colleagues and fellow scholars in constitutional law, filed a friend of the court brief in the 8th Circuit last week, speaking up against Arkansas’s recent attempts to interfere with the right to reproductive autonomy. Right now, Arkansas is asking the 8th Circuit to overturn a lower court order that blocked a set of abortion bans and restrictions the state passed last year from taking effect. These laws include: a ban on doctors performing abortions prior to viability if the abortion is sought after 18 weeks (18-weeks ban); a ban on doctors performing abortions prior to viability if the doctor has “knowledge” that the abortion is sought “solely” due to a belief that the fetus may have Down syndrome (reason ban); and a medically unnecessary restriction on the types of physicians who can perform abortion in the state, which would prohibit all qualified providers who are not board-certified or board-eligible in obstetrics and gynecology from continuing to provide the safe, compassionate abortion care they have been providing in Arkansas for years (OBGYN requirement).

Arkansas insists that its two bans on pre-viability abortion are not actually bans but merely “regulations.” This is nothing but Orwellian subterfuge. We know a ban when we see one and so do people looking to terminate their pregnancies. Regulations are laws that control how a right can be exercised. Bans prohibit a right from being exercised at all. And that is exactly what the 18-week ban and reason ban would do if permitted to take effect…

…Thankfully, a district court saw through Arkansas’s sophistry and phony justifications and preliminary enjoined the state’s two bans on abortion prior to viability and OBGYN requirement, with a decision rooted in long-standing precedent and bedrock precedent of justice. Let’s hope the Eight Circuit Court of Appeals follows our brief and heeds the wisdom of the lower court, preserving not only that decision but also the civil rights and civil liberties of all people who want to terminate a pregnancy.

January 16, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Multiple Groups Join Attorney General James in Urging Supreme Court To Take Up ACA Case”. From the press release:

New York Attorney General Letitia James today announced that a diverse group of bipartisan patient groups, hospitals, health care providers, insurance companies, economists, and others filed multiple amicus briefs supporting a multistate effort to defend the Affordable Care Act (ACA). The amici urge the U.S. Supreme Court to grant expedited review of the coalition’s case and argue that such review is necessary to protect America’s health care system and the well-being of Americans across the nation.

“Despite what the president may tweet, all he wants to do is strip health care away from 133 million Americans with pre-existing conditions, make it harder for children and young people to obtain coverage, and charge Americans more for health care,” said Attorney General James. “Obamacare has been the law of the land for a decade, but President Trump and his Administration continue to look for ways to chip away all the protections of the health care reform law. A wide-ranging and diverse group of organizations is joining our fight today to protect the ACA because health care should be a right every American has access to, not a privilege for a select few.”

The amicus briefs filed today support the state coalition’s request for the Supreme Court to review a recent decision by the U.S. Court of Appeal for the Fifth Circuit that upheld a lower ruling finding the ACA’s individual mandate to be unconstitutional, and that simultaneously called into question whether the remaining provisions of the law could still stand. The state coalition has asked that the Supreme Court grant expedited review of this decision and decide the case before the court’s term ends in June – a resolution that is needed to alleviate the uncertainty created by this litigation.

The ACA – also known as Obamacare – contains hundreds of protections that countless Americans rely on for health care, including:

  • Prohibiting insurers from denying health insurance to the 133 million Americans with pre-existing conditions (like diabetes, cancer or pregnancy) or from charging individuals higher premiums because of their health status;
  • Allowing young people, up to the age of 26, to stay on their parents’ insurance;
  • Expanding Medicaid to provide health coverage to more than 12 million Americans, including young children and babies;
  • Providing tax credits and financial assistance to nine million low- and middle-income individuals and families, so they can access affordable health coverage through the ACA marketplace; and
  • Preventing insurance companies from imposing lifetime and yearly insurance limits, among other benefits.

Amicus briefs in support of the state coalition’s request for expedited review by the Supreme Court were filed by America’s Health Insurance Plans (AHIP), National Hospital Associations; Small Business Majority Foundation, American Cancer Society, et al, State Hospital Associations, AARP, et all, and Bipartisan Scholars.

Joining Attorney General James in defending the ACA are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky.

January 16, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Diverse, Bipartisan Coalition Supports Attorney General Becerra’s Defense of the ACA, Urges Supreme Court to Act”. From the press release:

California Attorney General Xavier Becerra today announced that a diverse group of bipartisan economists, patient groups, hospitals, healthcare providers, healthcare insurance companies, and others filed amicus briefs defending the Affordable Care Act. The diverse coalition of amici supports California’s state coalition in its fight to protect the Affordable Care Act. The amici urge the Supreme Court to grant review of California’s case and argue that it is necessary to protect America’s healthcare system and the well-being of Americans across the nation.

“For nearly a decade, the Affordable Care Act has been the backbone of our nation’s healthcare, paving the way toward better care with protections that keep our loved once healthy and covered,” said Attorney General Becerra. “Our healthcare should never be used as a political football – people’s health isn’t a game, it’s a matter of life and death. Today, a bipartisan coalition of legal experts, patient and physician advocates, economists, and public health experts agree: This repeal lawsuit will cause immense harm and uncertainty, so our fight to save affordable healthcare must go all the way to the Supreme Court.”…

January 16, 2020: The National Women’s Law Center posted a press release titled: “Federal Court Allows Challenge to Proceed Against Trump Administration and University of Notre Dame’s Back-Room Birth Control Agreement”. From the press release:

Today, the U.S. District Court from the Northern District of Indiana ruled to allow a lawsuit brought by the National Women’s Law Center (NWLC) Americans United for Separation of Church and State (Americans United), the Center for Reproductive Rights (CRR), and law firms Fried Frank and Macey Swanson to proceed against the Trump-Pence Administration and University of Notre Dame.

The lawsuit is brought on behalf of student group Irish 4 Reproductive Health and others on Notre Dame’s health plan and challenges the unlawful settlement agreement between the Administration and the University of Notre Dame that denies students and employees coverage of birth control guaranteed to them by the Affordable Care Act. It also challenges rules issued by the Trump-Pence Administration that allow virtually any employer or university to take birth control coverage away from employees and students. The court denied the Administration’s and University’s attempt to dismiss the lawsuit.

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

“Today’s ruling sends a clear message to the Trump-Pence Administration that it cannot deny birth control coverage by entering into backroom deals or issuing unlawful rules. The Administration is once again trying to circumvent the law, and it must end. This is a win not only for Notre Dame students, but for everyone seeking access to birth control. We will keep fighting until every person across the country has the birth control coverage guaranteed to them by law, no matter where they work or go to school.”

January 16, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “ACLU of South Dakota Opposes House Bill 1057”. From the press release:

The ACLU of South Dakota opposes House Bill 1057, a bill that would criminalize doctors for providing medically necessary care for transgender youth.

The bill, which was introduced Tuesday, would make it a felony for medical providers to treat youth consistent with evidence-based treatment protocols. HB 1057 continues the streak of bills that would codify discrimination against transgender youth that the South Dakota Legislature has attempted to pass over the last five years.

Like all health care, health care for transgender youth is individualized and based on the needs of each particular person. This bill would take away private health care choices around the provision of medical care consistent with prevailing medical and scientific standards. Such choices should be made between a doctor and a patient, not politicians…

…By blocking medical care supported by every major medical association, including the American Academy of Pediatrics and the American Medical Association, the legislature is compromising the health of trans youth is dangerous and potentially life-threatening ways. Research shows that transgender youth whose families affirm their gender identity have a 52 percent decrease in suicidal thoughts, a 48 percent decrease in suicide attempts and significant increases in self-esteem and general health.

No other state has passed a law like HB 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary…

January 16, 2020: Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Legislative Package Protecting the Affordable Care Act in New Jersey”. From the press release:

Governor Phil Murphy today signed a package of bills to safeguard the provisions of the Affordable Care Act (ACA) in New Jersey. The bills, which will codify into state law the basic protections for health care consumers that are part of the Affordable Care Act, include protections for no-cost preventative care and contraception, prohibt exclusions for pre-existing conditions, allow children to stay on their parents’ plan until age 26 and incorporate mental health and maternity care as part of essential benefits, among others. The Governor highlighted the importance of these bills during an armchair discussion with Hackensack Meridian Health Chief Executive Office Bob Garrett…

The Governor signed the following bills into laws:

  • A5500 Expands rate review process in DOBI for certain individual and small employer health plans.
  • AB5501 Requires continuation of health benefits dependent coverage until child turns 26 years of age.
  • A5503 Establishes open enrollment period under Individual Health Coverage Plans
  • A5504 Applies 85 percent loss ratio requirement to certain large group health benefits carriers
  • A5506 Repeals statute authorizing offering of “Basic and Essential” health benefits plans under individual health benefit plans and other statutes concering basic health plans; makes confirming amendments.
  • A5507 Requires health benefits coverage for preventative services.
  • A5508 Revises law requiring health benefits coverage for contraceptives
  • A5248 Preserves certain requirements that health insurance plans cover essential health benefits
  • S626 Clarifies prohibition on preexisting condition exclusion in health insurance policies.

As a clarification, A5508 is described as: “Federal changes to the Affordable Care Act aimed to jeopardize women’s access to safe, preventative care. This new law will remove those obstacles in New Jersey and preserve the benefits afforded to residents’ under the ACA. With this law, women will continue to have insurance that covers contraception without having to pay out of pocket.”

January 16, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “Lawmakers Playing Politics with Trans Kids’ Lives at the Start of the Decade”. It was written by Chase Strangio, Deputy Director for Transgender Justice. From the article:

We’re just days into the first state legislative sessions of 2020 and across the country, lawmakers are once again targeting transgender young people with a slate of proposed laws that would bring devastating harms to the transgender community.

In 2016, lawmakers fixated on where transgender people go to the bathroom. This year, lawmakers are zeroed in on transgender people playing sports and receiving life-saving medical care. It’s hard to imagine why state legislators have decided to prioritize barring transgender young people from sharing in the benefit of secondary school athletics or disrupting medical treatment consistent with prevailing standards of care. But here we are, the state of a session, a time to fight.

As has been the case since 2015, South Dakota is leading the way with legislation targeting transgender youth. On the first day of this legislative session, South Dakota lawmakers introduced HB 1057, a bill that would make it a felony for medical providers to affirm a transgender minor’s gender. This bill would not only compromise positive health outcomes for transgender youth, but it would lead to the arrest and imprisonment for doctors simply for treating patients consistent with prevailing medical standards…

…Denying best practice medical care and support to transgender youth can be life-threatening. It has been shown to contribute to depression, social isolation, self-hatred, risk of self-harm and suicidal behavior, and more. The “problem” this bill and other similar bills in Florida, South Carolina, and Missouri is supposed to be addressing? That medical providers are treating children in accordance with long-established standards of medical care and the Hippocratic oath they took to do no harm.

Lawmakers want to stop people from being transgender and they are willing to put doctors in jail and tell transgender youth that they shouldn’t receive health care in order to achieve their aims…

January 16, 2020: Secretary of U.S. Department of Health and Human Services (HHS) Alex Azar posted a press release titled: “Secretary Azar Hosts Foreign Officials to Reaffirm Trump Administration’s Support for Protecting Life in Global Health Policy”. From the press release:

Today, January 16, 2020, Secretary of Health and Human Services Alex Azar hosted ambassadors and high level officials from more than 30 countries representing more than 1.7 billion people at the Blair House for a meeting to further advance the Trump Administration’s work within global health policy to promote a positive vision for women’s health, protect the lives of the most vulnerable, defend the important role of the family, and encourage respect for national sovereignty. The meeting also served to further strengthen collaborative efforts among nations going forward in 2020.

During the meeting, Secretary Azar reaffirmed the Trump Administration’s support for an international right to life and opposition to efforts by organizations like the United Nations to use diplomatic channels and declarations to undermine the sovereignty of individual nations on these matters.

Counselor to the President Kellyanne Conway, Minister of State for Family and Youth Affairs Katalin Novák of Hungary, and the Deputy Chief of Mission Minister-Counselor Fernando Pimentel of Brazil also delivered remarks to the assembled officials.


January 17, 2020: Representative Hakeem Jeffries tweeted: “More than 100 million ppl have a preexisting condition. President Obama’s leadership provided healthcare protection for these Americans. Donald Trump is trying to strip it away. Those are the FACTS.”

January 17, 2020: Reuters posted an article titled: “Supreme Court to hear Trump appeal in Obamacare contraception fight”. It was written by Lawrence Hurley. From the article:

The U.S. Supreme Court on Friday took up an appeal by President Donald Trump’s administration seeking to enforce new federal rules allowing employers to obtain religious exemptions from an Obamacare requirement that health insurance that they provide to employees pays for women’s birth control.

At issue is a challenge by the states of Pennsylvania and New Jersey to the administration’s 2018 rule that permits broad religious moral exemptions to the Affordable Care Act’s contraception mandate and expands accommodations already allowed under the 2010 law dubbed Obamacare. The administration has asked the Supreme Court to reverse a nationwide injunction issued by a lower court blocking the rule from taking effect.

Arguments in the case before the high court, which has a 5-4 conservative majority including two justices appointed by Trump, are likely to be in April with a ruling due by the end of June…

…The legal question is whether Trump’s administration had legal authority to expand the exemption both under the Obamacare law itself and another federal law, the Religious Freedom restoration Act, which allows people to press religious claims against the federal government.

The Philadelphia-based 3rd U.S. Circuit Court of Appeals last year upheld a nationwide injunction issued by a district court judge in the lawsuit by New Jersey and Pennsylvania, blocking implementation of the rule. Separately, the San Francisco-based 9th U.S. Circuit Court of Appeals last year upheld a lower court’s injunction on blocking the rule in a group of 14 states…

January 17, 2020: Senator Bob Casey tweeted: “The ACA dramatically reduced racial disparities in health insurance coverage. In PA alone, the uninsured rate among Black and Hispanic adults each decreased by more then 11% from 2013 to 2018. This obscene Republican lawsuit threatens these gains. We must #ProtectOurCare”

January 17, 2020: CBS News posted an article titled: “Supreme Court to hear Obamacare birth control case”. From the article:

The Supreme Court will weigh in on contraceptive coverage under the nation’s health care law this term, agreeing to hear a case involving the Obamacare rule requiring large companies to help pay for their employees’ birth control. The high court will review whether the Trump adminisration was on solid ground when it gave religious employers and universities broader religious and moral exemptions to the Obamacare contraception mandate, which requires health care plans to offer free birth control.

This is another case involving the Little Sisters of the Poor, an order of Roman Catholic nuns that objected to the birth control mandate and prevailed in its request from the Supreme Court for a religious exemption in 2016.

Now the court will consider allowing the Trump adminisration to enforce rules that allow more employers to deny coverage for contraceptives to women.

The case is likely to be heard in April. The Supreme Court will review an appeals court ruling that blocked the Trump administration rules because it did not follow proper procedures. The new policy on contraception, issued by the Department of Health and Human Services (HHS), would allow more categories of employers, including publicly traded companies, to opt out of providing no-cost birth control to women by claiming religious objections.

The policy would also allow some employers, though not publically traded companies, to raise moral objections to covering contraceptives…

January 17, 2020: National Women’s Law Center posted a press release titled: “SCOTUS to Hear Case That Threatens Access to Birth Control, Says NWLC”. From the press release:

Today, the Supreme Court decided to hear a case – Trump v. Pennsylvania – that will determine whether employers and schools can deny insurance coverage of birth control to employees and students.

In November 2018, the Trump-Pence administration finalized rules to undermine Affordable Care Act’s birth control benefit by allowing virtually any employer or university to deny birth control coverage otherwise required by law. These rules were challenged in courts across the country including by the National Women’s Law Center. In a case brought by Pennsylvania and New Jersey, the 3rd Circuit Court of Appeals issued a nationwide injunction blocking the rules.

The following is a statement from Fatima Goss Graves, President and CEO of the National Women’s Law Center:

“Birth control should never be determined by where someone lives or goes to school. The Supreme Court should affirm the lower court’s decision that these rules are illegal and harmful. We won’t stop fighting until all people have access to birth control despite these vicious attacks by the Trump-Pence administration.”

January 17, 2020: Planned Parenthood posted a press release titled: “Supreme Court to Consider Trump Policy Allowing Employers and Universities to Deny Birth Control Coverage to Employees and Students”. From the press release:

Today, the Supreme Court announced it would consider the validity of the Trump-Pence administration’s rules that allow employers and universities to refuse to provide insurance coverage for all contraception to their employees or students. These rules are currently blocked by the courts.

This is the first time the Supreme Court will consider the issue of contraceptive coverage since Trump-appointed justices Neil Gorsuch and Brett Kavanaugh joined the Court…

…The Trump-Pence administration’s birth control rules allow employers, universities and any entity that provides health insurance to deny a person birth control coverage based on religious or moral objection. These harmful rules could have far-reaching implications for the Affordable Care Act’s requirement to guarantee birth control coverage which has benefited more than 62 million women, including 17 million Latina women and 15 million Black women.

Data shows that an overwhelming majority of Americans believe women should have birth control coverage, regardless of their employer’s personal objections. This rule puts the Trump-Pence administration in direct opposition to the overwhelming majority of voters.


January 18, 2020: SFGATE posted an article titled: “Louisiana Medicaid managed care contract awards thrown out”. It was written by Melinda Deslatte. From the article:

Multibillion-dollar Medicaid contracts awarded by Gov. John Bel Edwards’ administration have been scrapped by Louisiana’s chief procurement officer, who determined the health department mishandled the bid process for deals to provide health services to 1.5 million people.

Louisiana’s state procurement officer Paula Tregre said the health department failed to follow state law or its own evaluation and bid guidelines in determining which private companies should receive contracts to manage care for most of Louisiana’s Medicaid patients. In a decision issued late Friday, Tregre wrote the health department’s actions “resulted in a fatally flawed procurement process.”

In response to protests filed by two losing bidders, Tregre rescinded the three-year contract awards estimated to be worth about $21 billion. She said the health department will have to redo the bid process to choose the insurance companies that will oversee care for about 90% of Louisiana’s Medicaid enrollees – mostly adults covered by Medicaid expansion, pregnant women and children.

Tregre’s decision, which can be contested, won’t disrupt Medicaid health services to nearly one-third of Louisiana’s population. The Edwards administration signed emergency contracts to keep the state’s five current Medicaid managed care contractors in place this year because of the ongoing disputes about the contract awards and bid process…

January 18, 2020: Morning Call posted an article titled: “Pennsylvania Democrats prod Republicans over Obamacare’s fate this election year”. It was written by Ford Turner. From the article:

Pennsylvania House Democrats have dusted off a seldom-used legislative maneuver to push Republican action on health bills – including one on pre-existing conditions – that Democrats say will help if the Affordable Care Act gets nullified in the courts.

“Discharge resolutions” filed in the state House last week push four stalled bills that work as a package, according to Democrat spokesman Bill Patton…

…The move comes as Democrats nationwide, cognizant of election-year ramifications, take steps to draw attention to the Trump administration’s vow to end Obamacare. A special focus is being placed on the law’s widely popular guarantees of preexisting condition coverage and parental plan coverage of offspring up to age 26…

…Pennsylvania’s House Democrats, including Allentown’s Peter Schweyer, said the state must act. Schweyer is prime sponsor of a bill that would preserve access to insurance and doctors by people with preexisting conditions even if Obamacare is thrown out. New Jersey’s Democratic governor on Thursday signed into law a bill on the same topic.

Three other Pennsylvania bills mandate that insurance policies sold in Pennsylvania include coverages required by Obamacare, preserve coverage for adult children up to age 26, and ensure there are no “lifetime limits” on health care coverage…

…But the four have received no action in the House Insurance Committee despite being sent there more than 10 months ago. Republicans control the state House and Senate…


January 19, 2020: NJ.com posted an article titled: “Murphy enacts laws to protect Obamacare benefits in N.J. from Trump cuts”. It was written by Susan K. Livio. From the article:

Gov. Phil Murphy has signed a package of legislation that enshrines the tenets of the Affordable care Act into state law, giving New Jersey the authority to operate its own insurance marketplace and protect people with pre-existing conditions from losing coverage.

The laws are a guard against pending legal threats to the landmark health care law, which in New Jersey insured 500,000 low-income people through the Medicaid program and 255,000 others who found coverage through the public marketplace last year.

Murphy expects the state will operate its own Healthcare.gov marketplace later this year, enabling it to keep the $50 million it sends to the U.S. Centers for Medicare and Medicaid Services every year to handle that responsibility. The state would also be able to set a longer open enrollment period, which President Donald Trump’s administration cut in half to six weeks.

The nine bills Murphy, a Democrat, signed into law Thursday protects benefits, such as coverage for pre-existing conditions and adult children up to age 26, that may be at risk should the courts or Congress repeal or furthe weaken the Affordable Care Act, also known as Obamacare…

Here is a list of the bills Governor Phil Murphy signed:

  • S626 – prevents carriers from denying a policyholder coverage because of a pre-existing medical condition
  • A5248 – requires insurance companies to cover benefits deemed essential under Obamacare and protects older people and people with disabilities from discrimination
  • A5500 – creates a more rigorous review process for carriers seeking more than a 10 percent annual rate increase
  • A5501 – allows adult children to remain on their parents’ health coverage until they turn 26
  • A5503 – establishes an open enrollment period for the state’s existing Individual Health Coverage Program
  • A5504 – requires large insurance carriers to report their “medical loss ratio” to the state to prove they are spending at least 85 percent of premiums on medical-related expenses and keeping no more than 15 percent on administration, fees and profits. Policyholders would receive a credit if carriers keep too much money.
  • A5506 – repeals the law allowing insurance carriers to offer “basic and essential” plans that do not contain the 10 benefits required under the ACA, such as maternity care, substance abuse treatment and mental health treatment and prescription drugs
  • A5507 – provides free cancer and other preventative health screenings
  • A5508 – requires coverage for contraceptives

January 19, 2020: Senator Patty Murray tweeted: “Let me be clear: the Republicans’ partisan health care lawsuit would put them one step closer to getting the health care plan they’ve always wanted – one that kicks millions of people off their care & takes away protection they rely on. We must keep fighting to #ProtectOurCare”.

January 19, 2020: Herald-Tribune posted a Guest-Editorial titled: “Floridians are losing access to affordable health care.” It was written by Florida House of Representatives Margaret Good. From the Guest-Editorial:

The health of Florida families is in jeopardy. More than 2.5 million Floridians are not covered by health insurance and prescription drug costs continue to rise.

These are among the issues I hear about most from the people I serve. It is time for the Legislature to make real change to increase coverage and lower costs. This session, I filed House Bill 1293, which addresses access and costs.

While Florida already has one of the highest uninsured rates in the country, the stage is set for the crisis to worsen. More than 3.5 million Floridians with preexisting conditions may lose access to affordable care, depending on the outcome of a court case challenging parts of the Affordable Care Act. If the special interests behind this lawsuit are successful, insurers will be free to charge Floridians with preexisting conditions whatever they want, effectively pricing people with preexisting conditions out of the market.

This is especially concerning because of a bill that passed the Florida Legislature last session that allows insurers to sell short-term health insurance policies that avoid the pricing and term requirements of the ACA. Consumers who purchase these policies often believe they have comprehensive coverage, when, in fact, the short-term policy may exclude medically necessary treatment. This leaves Floridians, especially those with preexisting conditions, vulnerable…

…There are no federal or Florida regulations of the pharmaceutical industry’s pricing structure. House Bill 1293 holds pharmaceutical companies accountable by creating a Prescription Drug Affordability Commission, which would review increases in prescription drug prices, ensuring that companies cannot raise prices indiscriminately…

January 19, 2020: Senator Ron Wyden tweeted: “Thanks to Republicans’ lawsuit against the Affordable Care Act, health care coverage for Americans with pre-existing conditions is once again on the chopping block. One thing remains certain: @morethanmySLE and I are committed in the fight to #ProtectOurCare”

January 19, 2020: Axios posted an article titled: “Scoop: “Birth tourism” is Trump’s next immigration target”. It was written by Stef W. Knight and Jonathan Swan. From the article:

The Trump administration has a new target on the immigration front – pregnant women visiting from other countries – with plans as early as this week to roll out a new rule cracking down on “birth tourism,” three administration officials told Axios.

Why it matters: Trump has threatened to end birthright citizenship and railed against immigrant “anchor babies.” The new rule would be one of the first tangible steps to test how much legal authority the administration has to prevent foreigners from taking advantage of the 14th Amendment’s protection of citizenship for anyone born in the U.S…

…How the new regulations would work: It would alter the requirements for B visas (or visitor visas), giving State Department officials the authority to deny foreigners the short-term business and tourism visas if they believe the process is being used to facilitate automatic citizenship…

January 19, 2020: West Virginia Legislature Blog posted an article titled: “House Passes Insulin Cap Bill.” It was written by Juliet Thomas. From the article:

The House passed House Bill 4543 Wednesday, which would create a cap on the price of insulin.

House Bill 4543 aims to reduce the skyrocketing costs of insulin by capping the cost of a 30-day supply of insulin at $25 with insurance.

More than 240,000 West Virginians have diabetes, and it is estimated that over 65,000 people have the disease undiagnosed. Most of these people rely on daily doses of insulin to survive. The cost of insulin can exceed $600 per month even with insurance. One in four diabetics ratin their insulin due to the high costs. This causes orgin failure and even death.

Under this bill, health insurance policies and plans that are issued or renewed by July 1, 2020 must provides coverage for insulin that follows the guidelines of this bill.

Although this bill caps the cost of insulin at $25 per month, nothing stops insurance companies from making the price even lower. This bill covers those with private or PEIA insurance but does not cover those with Medicare or Medicaid.

Barbara Fleischauer, D- Monongalia, is one of the sponsors of this bill. During the floor session, she spoke in the words of the scientist who discovered insulin, “No one should profit from a lifesaving medication.”…


January 20, 2020: The Columbus Dispatch posted an article titled: “‘Business negotiations’ result in Ohio’s Medicaid network losing 272 pharmacies”. It was written by Marty Schladen. From the article:

Ohio Medicaid Director Maureen Corcoran says she was told that both CVS and Walgreens demanded last year that the other be excluded from the network of the state’s largest managed-care provider – a statement they both deny,

Despite months of questions about the matter, it was the first time the state’s Medicaid chief acknowledged that she had been told that both pharmacy giants had demanded cuts to the provider network as the price of doing business with the federal-state health-care program. She also said it was hearsay.

Meanwhile, CareSource, the Dayton-based company that, according to Corcoran, told her of the demands, continues its practice of not answering questions on the subject from The Dispatch.

CareSource receives almost $8 billion a year from Ohio taxpayers. It is the largest contractor and its biggest Medicaid managed-care organization. But Corcoran expresses a disinterest in negotiations that have slashed 272 pharmacies from a network that serves almost 3 million poor Ohioans…

…CareSource would not comment on whether the big chains demanded each others’ ouster…

…As it has since this past fall, Walgreens said it did not ask that CVS be eliminated…

…CVS also said it did not demand that Walgreens be dropped…

January 20, 2020: Senator Patty Murray tweeted: “Republicans are putting health care in our country on a completely avoidable, catastrophic crash course w/ their partisan lawsuit. I urge President Trump & Republicans to listen to patients & drop their partisan & deeply harmful attacks on families’ health care. #ProtectOurCare”

January 20, 2020: The Hill posted an article titled: “Trump scrambles to defend pre-existing conditions record amid ObamaCare lawsuit”. It was written by Peter Sullivan. From the article:

President Trump, who is backing a court challenge to the Affordable Care Act that would overturn the law and eliminate its protections for people with pre-existing conditions, is now tweeting about how he saved those protections.

In an election year where Democrats are vowing to focus on health care, Trump’s tweets suggest he is recognizing the political danger posed by his support for the GOP-led lawsuit.

Trump’s efforts have been undercut not only by the court challenge but also his repeated vows to repeal the 2010 law, including support for a House Republican bill in 2017 that would have allowed for weakening protection for pre-existing conditions…

January 20, 2020: Reuters posted an article titled: “Women rarely regret decision to get abortion”. It was written by Lisa Rapaport. From the article:

Five years after an abortion, most women still say it was the right decision even if they struggled with their choice at the time, a U.S. study suggests.

Researchers surveyed 667 women who had abortions in 21 states a week after they had the procedures and then once every six months for five years. By the end of that period, 84% of women had either positive or neutral feelings about their choice.

“We found no evidence of emergent negative emotions about the abortion over the five years,” said study leader Corinne Rocca of the University of California, San Francisco.

“In fact, of all the emotions we looked at, relief remained the most commonly reported one at all times, even five years out,” Rocca said by email.

Opponents of abortion have argued against legal access to these procedures in part because of concerns that abortion harms women by causing emotions and regret, researchers note in Science and Medicine. This idea has contributed to state laws and court decisions limiting abortion as well as state policies requiring women seeking abortions to be warned it might cause lasting emotional or mental harm, the study team notes…

January 20, 2020: Houston Chronicle posted an article titled: “Critics: consumers should be wary of short-term health plans”. It was written by Kelli Kennedy. From the article:

Consumers who bought short-term health insurance thinking they had found a better deal than “Obamacare” during the open enrollment season may be in for a shock when they show up at their doctor’s office this year.

The low-cost plans aren’t required to cover basics such as prescription drugs or maternity care.

The Trump administration rolled back restrictions on short-term plans in 2018. But critics quickly labeled them junk insurance, warning they come with gaps and don’t have to cover pre-existing medical conditions…

…With premiums about a third of the cost of comprehensive coverage, short term plans are significantly cheaper but don’t meet requirements under the Affordable Care Act. And while they cover major catastrophes such as a car accident, they don’t have to cover the law’s “essential benefits” – including mental health and substance abuse treatment and they won’t cover pre-existing conditions…

…Some short-term insurance companies are calling customers directly and repeatedly, said Islara Souto, a program director for Epilepsy Florida, which helps consumers secure health plans in Miami.

“These plans are being targeted to those consumers in Spanish with misleading facts,” said Souto, adding some try to appear they’re from the federal marketplace by calling themselves the “Coverage Department”…


January 21, 2020: CBS News posted an article titled: “Supreme Court declines to fast-track Obamacare case”. From the article:

The Supreme Court refused Tuesday to consider a fast-track review of a lawsuit that threatens the Obama-era health care law, making it highly unlikely that the justices would decide the case before the 2020 election. The decision comes hours before Chief Justice John Roberts will preside over the president’s impeachment trial.

The court denied a request by 20 mainly Democratic states and the Democratic-led House of Representatives to decide quickly on a lower-court ruling that declared part of the statute unconstitutional and cast a cloud over the rest…

…The justices did not comment on their order. They will consider the appeal on their normal timetable and could decide in the coming months whether to take up the case…

January 21, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James’ Statement On Supreme Court Decision to Not Expedite ACA Case”. From the press release:

New York Attorney General Letitia James today released the following statement after the U.S. Supreme Court announced that it was denying a motion to expedite review of a decision in litigation threatening the Affordable Care Act (ACA):

“While the Supreme Court has said it will not expedite its review, we are still urging the court to hear arguments next term. Day after day, President Trump makes false statements, sends misleading tweets, and spouts outright lies about Obamacare and the many protections the law has provided to millions across the country. Our coalition will never stop fighting against the president’s continued efforts to strip health coverage away from American families, including the 133 million Americans with pre-existing conditions.”

Earlier this month, Attorney General James and a coalition of attorneys general from around the nation filed a motion asking the Supreme Court to expedite its review of a recent decision by the U.S. Court of Appeals for the Fifth Circuit in Texas v. U.S. The decision affirmed a lower court’s ruling that the individual mandate of the Affordable Care Act (ACA) is unconstitutional, yet refused to rule on the validity of the rst of the ACA – calling into question whether the remaining provisions of the statute could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that many harm the health of millions of Americans – in addition to doctors, clinics, patients, and the healthcare market – Attorney General James and the coalition petitioned the Supreme Court to take up the case and resolve it before the end of the court’s current term in June.

While the Supreme Court did not expedite its review of the states’ petition, it is still reviewing the petition and has not yet determined whether it will grant review and hear arguments next term. Under the Fifth Circuit’s decision, the district court that originally ruled on the case will rehear and reconsider the validity of the rest of the health care reform law….

January 21, 2020: AARP posted information on its website titled: “Supreme Court Says No to Fast Review of ACA Ruling”. It was written by Dena Bunis. From the information:

The U.S. Supreme Court will not take up a federal court ruling that said a key provision of the Affordable Care Act (ACA) is unconstitutional. The high court’s refusal on Tuesday to fast-track a review means all the protections of the ACA remain in force but the long-term status of the law remains uncertain.

AARP and AARP Foundation joined two otehr nonprofit groups that fight for older Americans – Justice in Aging and the Center for Medicare Advocacy – in filing an amicus brief on Jan. 15 asking the high court to review a December 2019 rulng by the Court of Appeals for the 5th Circuit. That decision struck down the ACA’s individual mandate but left the fate of the rest of the law in the hands of a lower court judge who has already declared the entire law invalid. While the justices declined to fast-track an appeal, the Supreme Court could decide to hear the case at a later time…

January 21, 2020: California Health & Human Services Agency posted a press release titled: “Health and Human Services Agency Announces Formation of Governor Newsom’s Behavioral Health Task Force to Address Urgent Mental Health and Substance Use Disorder”. From the press release:

Following the unveiling of his budget proposal with its robust focus on improving behavioral health services, the California Health and Human Services Agency announced the formation today of Governor Gavin Newsom’s Behavioral Health Task Force to address the urgent mental health and substance use disorder needs across California. The panel will advise the Administration’s efforts to advance statewide behavioral health services, prevention, and early intervention to stabilize conditions before they become severe.

“Behavioral health services and wellness are essential to living a healthy, happy, and fulfilling life,” said Governor Newsom. “All Californians should be able to get the mental health and substance use disorder assistance they need when they need it. We must also prevent these conditions when possible, and intervene early to reduce their severity, particularly among younger Californians.”

The task force, chaired by Health and Human Services Agency Secretary Dr.Mark Ghaly, will consist of a broad range of stakeholders, including people living with behavioral health conditions – including mental health and substance use disorders, family members, adovocates, providers, health plans, counties, and state agency leaders…

…The mission of the task force is to develop recommendations for the Governor about ho California can best provide timely access to high-quality behavioral health care for all of its residents. The task force will include representatives from both the public and private sectors to align efforts to address behavioral health challenges from a public health perspective. What’s more, the task force will inform and bolster the state’s work to prevent mental health and substance use disorders and ensure that health and social service providers are able to intervene early to stabilize conditions before they become severe…

January 21, 2020: The Hill posted an article titled: “Trump health chief: “Not a Need” for ObamaCare replacement plan right now.” It was written by Peter Sullivan. From the article:

Secretary of Health and Human Services Alex Azar said Tuesday that “there’s really not a need” for the Trump administration to put forward an ObamaCare replacement plan at the moment.

Azar was asked where the administration’s replacement for the health law is in an interview on the “Kevin Wall Radio Show.” He replied that there is not a need for one until the Supreme Court issues a final ruling on a GOP-backed lawsuit seeking to overturn the law…

…He also added that the administration could need a replacement if Republicans win back the House in this year’s election but noted that the current Democratic-led House has no interest in repealing and replacing ObamaCare…

…Azar’s comments stand in contrast to what President Trump said in an interview with ABC News in June.

“We’ll be announcing that in about two months,” Trump said at the time when asked about an ObamaCare replacement plan…

January 21, 2020: Speaker Pelosi posted a press release on her official website titled: “Pelosi Statement on Supreme Court’s Decision to Delay Review of ACA Lawsuit”. From the article:

Speaker Nancy Pelosi issued this statement following the decision by the U.S. Supreme Court to not expedite review of Republicans’ Texas v. U.S. lawsuit, which, last month, the 5th Circuit Court of Appeals sided with the Republicans and instructed the District Court to redetermine how much of the Affordable Care Act to strike down:

“Today’s disappointing decision by the Supreme Court only prolongs and worsens the uncertainty and fear that Republicans’ anti-health care agenda is inflicting on American families. The longer this GOP lawsuit continues, the longer it will needlessly drive up costs and endanger life-saving protections for people with pre-existing conditions.

“The Trump Administration and its GOP allies have engaged in an outrageous sabotage campaign to systematicaly destroy protections for the millions of Americans with pre-existing conditions as well as every last benefit and protection provided by the Affordable Care Act. In the courts and in the Congress, the Democratic House Majority will continue to fight relentlessly to defend Americans’ health care as we work to preserve protections for people with pre-existing conditions and deliver lower health costs and prescription drug prices for all Americans.”

January 21, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Chris Sununu Testifies Before Senate Commerce Committee”. From the press release:

Today, Governor Chris Sununu testified before the Senate Commerce Committee in support of Senate Bill 685, establishing a wholesale prescription drug importation program, as well as Senate Bill 687 and Senate Bill 690. A copy of Governor Sununu’s remarks as prepared are below:

I am pleased to join you today in support of three common sense measures that will help to provide prescription drug price relief to thousands of Granite Staters.
 
Skyrocketing drug prices are harming the health and well-being of Granite State families, especially our seniors who are on fixed incomes and can least afford spikes in costs.
 
More than 500,000 people over age 50 live in New Hampshire. The average older American takes 4.5 prescription drugs daily on a chronic basis. The average annual cost of prescription drug treatment increased 57.8% between 2012 and 2017 in New Hampshire.
 
The bills before you this afternoon will help to bend that curve. In some cases it will come with increased competition, in others greater oversight in pricing and in others with greater transparency.

  • SB 685: Drug Affordability, will allow us to import lower-cost prescription drugs from Canada. The federal government is already experimenting with a pilot program in Florida with this concept and I am eager for New Hampshire to be able to take advantage of importation down the road. I have spoken directly with the Trump Administration about allowing New Hampshire to be part of the program.
  • SB 690: Is a common sense measure with an eye toward drug accessibility. It will prevent insurance companies from changing drug coverage in the middle of a plan year.
  • SB 687: Drug Price Transparency, will create a drug affordability board in New Hampshire to monitor changes in the cost of prescription drugs to keep the industry honest and to keep an eye on prices to prevent price spikes.

Often, many of the challenges in health care can start to be addressed through greater transparency in pricing. That transparency brings scrutiny and accountability as to why the cost of a particular drug is high or higher than similar drugs in the same class.

In 2017, 22% of New Hampshire residents stopped taking medication as prescribed due to cost. That is wrong.

These bills will help bring relief on the cost of prescription drugs and I ask that you pass these bills and get them to my desk as quickly as possible.

January 21, 2020: New Jersey Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Prescription Drug Bill to Limit Out-Of-Pocket Prescription Drug Expenses for New Jersey Families”. From the press release:

Governor Phil Murphy today signed legislation (A2431) to help limit out-of-pocket prescription drug expenses for New Jersey families. The bill, which requires health insurers to provide plans that limit patient cost-sharing concerning prescription drug coverage, will improve affordability and access for thsoe who require necessary medication.

“Few issues have a greater financial impact on New Jersey families than the unpredictable and ever-increasing cost of preventative drugs,” said Governor Murphy. “Cost-sharing too often presents a barrier to a patient’s ability to access medically-necessary treatments. This legislation will improve the affordability of medical care for many residents who unfortunately must make sacrifices in order to pay for their required medications.”…

January 21, 2020: Center for Reproductive Rights posted a statement titled: “Statement from Nancy Northup, CEO of the Center for Reproductive Rights, on the 47th Anniversary of Roe v. Wade:” From the statement:

“This week marks 47 years since the U.S. Supreme Court affirmed our constitutional guarantee to reproductive freedom in Roe v. Wade. But that guarantee has been whittled away in the decades since. Today’s reality is that accessing abortion care in many states is extremely challenging, rendering Roe meaningless for some women. States have figured out how to shut down clinics and create endless barriers and delays for women. 

Right now, six states have just one abortion clinic left; 30 states require doctors to give patients biased and medically inaccurate information about abortion; 31 states force patients to wait one to three days before they can get abortion care after first meeting with a provider. Last year alone, 18 states enacted 46 laws that prohibit or restrict abortion.

Disappointingly, we find ourselves back at the Supreme Court this term challenging a Louisiana law designed to shut down clinics. The law would leave just one doctor to serve all the women seeking abortion care in the state. Just four years ago, the Court found an identical law in Texas to be unconstitutional, ruling that states can’t use underhanded medical regulations to shut down clinics. But Louisiana is openly defying that ruling.

It is high time for Congress to act to protect women’s access to abortion services. We need Congress to pass protections like the Women’s Health Protection Act, which would put an end to these state laws that shut down clinics and curb access. Also critical is the EACH Woman Act, which would make this care more affordable. Together, these bills have the power to transform abortion access across the country. This kind of protection has never been needed more.

The Constitution demands that our fundamental rights not vary from state to state. For more than 25 years, the Center for Reproductive Rights has defended these constitutional rights and will continue to do so in the battles to come.”…

January 21, 2010: New Jersey Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Legislation to Improve Hospital Transparency and Expand Reporting Requirements.” From the press release:

Governor Phil Murphy today signed legislation (A5916 and A5918) to improve hospital transparency and expand reporting requirements. The bills, which will provide more financial and operational insight into New Jersey’s hospitals, will ensure that these facilities will not abruptly discontinue services and leave communities without access to care. Today’s signings build upon Governor Murphy’s signing of A5917 last week, which increased the Department of Health’s oversight of hospital finances.

“New Jersey is home to some of the nation’s leading hospitals, health care facilities, and treatment centers,” said Governor Murphy. “By requiring these institutions to disclose financial distress and expand their reporting obligations, we will enhance operational transparency and ensure that our communities have access to high-quality, affordable health care.:

Governor Murphy signed the following bills:

  • A5916 – Authorizes DOH to notify elected officials of financial distress of certain hospitals
  • A5918 – Expands hospital reporting requirements

January 22, 2020: Texas Observer posted an article titled: “In Texas, Thousands of Kids Lose Medicaid Coverage Each Month”. It was written by Sophie Novak. From the article:

…Texas has made it extremely difficult for kids to stay on Medicaid. While many states check children’s eligibility yearly, Texas moved in 2014 to a system of income checks multiple times per year, burdening families with heaps of paperwork. According to Adriana Kohler, policy director at Texans Care for Children, families have just 10 says – starting from when the when the state puts papers in the mail – to recieve the forms, gather necessary documentation, fill them out, and send them back. This caused thousands of eligible kids to lose Medicaid coverage each month. State lawmakers have repeatedly declined to pass bills to move to 12-month continuous coverage.

There are other causes too: Attacks on the ACA from Trump and GOP lawmakers have reduced enrollment outreach and confused families. Anti-immigrant policies – particularly Trump’s “public charge” rule, which would make it harder to get a green card if applicants might need public assistance – have led families to pull kids out of benefit programs for fear that they could negatively affect the parents’ immigration status. The rule is currently blocked by the courts, but the “horrible” policy is already “having the desired effect,” according to Jason Terk, a Keller pediatrician and the former head of the Texas Pediatric Society.

Missed vaccinations are one tangible effect of these coverage lapses, and they’re riskier than ever. Vaccine exemptions for kids have skyrocketed from about 2,300 in 2003 to 64,176 in 2018, and there were 21 confirmed measles cases in Texas this year…

January 22, 2020: Planned Parenthood posted a press release titled: “On the 47th Anniversary of Roe v. Wade, Trump Administration Allows Texas To Bar Care at Planned Parenthood.” From the press release:

Today, the Trump administration rewarded Texas’s long-standing effort to cut off people’s access to health care. The administration approved Texas’ request to implement a Medicaid family planning program that bars patients from accessing care at Planned Parenthood and other sexual and reproductive health providers that also provide abortion. This is the first time the federal government has allowed a state to explicitly waive Medicaid’s free choice of provider for family planning provision. This move upends longstanding federal law and sets a dangerous precedent for other states to pursue similar state-level measures, with grim consequences for health care access nationwide.

By approving Texas’ request, the Trump administration puts federal funding behind a failed program that was designed to limit people’s access to health care and directly resulted in people losing health care. Because federal law safeguards the right of Medicaid patients to access reproductive health care at the qualified provider of their choice, six years ago, Texas rejected federal funding for its state family planning program and launched a fully state-funded program in order to bar access to care at Planned Parenthood. Prior ot this, and draconian family planning cuts in 2011, Planned Parenthood affiliates served more than 40 percent of patients in the program…

…Planned Parenthood provides important preventative health care including lifesaving cancer screenings, birth control, and STI testing and treatment. Nationally, 75 percent of Planned Parenthood patients have incomes at or below 150 percent of the federal poverty level (FPL), and at least 60 percent of Planned Parenthood patients access care through the Medicaid program. These approved waivers take away rights and freedoms from people who already face unequal and unfair treatment, including LGBTQ people, people of color, people with disabilities, and women. These groups are more likely to have lower income and rely on programs like Medicaid. Blocking access to Planned Parenthood and other providers can make it impossible to get the care they need.

January 22, 2020: American College of Obstetricians and Gynecologists (ACOG) posted news titled: “ACOG Opposes CMS Decision Excluding Qualified Medicaid Providers”. From the news:

Maureen Phipps, MD, MPH, FACOG, chief executive officer of the American College of Obstetricians and Gynecologists (ACOG), issued the following statement regarding the decision by the U.S. Centers for Medicare and Medicaid Services to approve Texas’ request to receive federal Medicaid funding that excludes physicians and other clinicians who provide abortion care:

“CMS’s decision sets a troubling precedent that threatens women’s access to quality health care, including well-woman exams, breast and cervical cancer screenings, HIV testing, and family planning. This action violates well-settled law that requires states to include ‘any willing provider’ in Medicaid programs as a condition of receiving federal dollars. No state should be allowed to discriminate against physicians and other medical professionals qualified to deliver care.

“Every day, obstetrician-gynecologists see the harmful impact that restricted access to health care has on women and communities. Policymakers need to prioritize the health of women over political ideology. The Administration should reverse its decision.

“ACOG, the nation’s leading organization of physicians dedicated to the health of women, has always been committed to fighting political interference and restrictions on access to health care. ACOG opposes any effort to exclude qualified providers, including Planned Parenthood health centers, from participating in Medicaid and other federal health programs.”

January 22, 2020: Speaker Pelosi posted a press release on her official website titled: “Pelosi Statement on the Anniversary of Roe v. Wade”. From the press release:

Speaker Nancy Pelosi released the following statement marking the 47the anniversary of the Roe v. Wade decision today:

“For 47 years, the Supreme Court’s decision in Roe v. Wade has stood as the law of the land, ensuring that a woman’s reproductive health decisions are her own – in consultation with her family, her physician and her faith. This fundamental principle is rooted in our founding values of liberty and equality for all, and it must be fiercely safeguarded from brazen attempts to roll back women’s constitutional rights.

“Women’s freedom of choice is currently under unprecedented threat from this Administration, and from Republicans in Congress and in state capitols across the country who are determined to insert themselves into women’s private health care decisions. For millions of women and their families, this relentless GOP assault continues to jeopardize their future and threatens to undo decades of progress towards women’s equality.

“Yet, American women are fearlessly standing up and speaking out to demand an end to Republican’s outrageous efforts to undermine the landmark Roe v. Wade decision. Together, with these tireless women, House Democrats are committed to ending the attack on Roe v. Wade. We will not rest until all women have access to the comprehensive health care they need and are treated equally under the law.”

January 22, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “47 Years Later, We’re Fighting to Make Roe a Reality Everywhere”. it was written by Jessica Arons, Senior Advocacy and Policy Counsel for Reproductive Freedom. From the article:

…This Spring, the Supreme Court will hear arguments in June Medical Services v. Gee and could uphold state abortion restrictions identical to ones it struck down only four years ago, thereby allowing states to continue shutting down abortion clinics with no medical justification. Unsatisfied, 207 abortion opponents in Congress have asked the Court to overturn Roe entirely and pave the way for states to ban abortion outright.

But while this high-stakes showdown plays out at the Supreme Court, we cannot take our eyes off the states. In 2019, seven states throughout the South and Midwest tried to ban abortion (all have been blocked so far) while seven other states passed eight affirmative measures to protect and expand access to abortion. This year will include new threats, as well as new opportunities to build on recent victories.

…Already in 2020, bills that would ban abortion from the earliest days of pregnancy – like those passed in Georgia and Alabama last year – have been introduced in 13 states, with more likely to be filed in the coming days and weeks. Not all will advance, but there is a genuine risk that at least five more abortion bans could be enacted this year.

Less aggressive but equally harmful and extreame measures are also being considered: a Florida bill that would force young people to obtain parental consent for an abortion, which would increase risks to vulnerable youth; bans on the standard of care for abortion after 14 weeks in Michigan and Nebraska; and an Ohio measure that promotes the dangerous and unproven theory that an abortion with pills can be “reversed”. Additionally, abortion opponents are taking steps to eliminate abortion protections or pass new restrictions via ballot measures in Colorado, Kansas, Kentucky, Louisiana, and elsewhere.

But it’s not all bad news…

…Massachusetts is working to pass the ROE Act, which would, among other things, improve youth access to abortion and ensure coverage for abortion regardless of income or immigration status. In the wake of an historic election in Virginia, legislators are lining up to show their support with a bevy of proactive bills. And New Jersey Gov. Phil Murphy recently called for efforts to codify reproductive rights into state law.

The reality is, however, that we will never break free from the relentless cycle of harmful state laws and court battles without federal action by Congress – which is why we are joining calls for Congress to pass the Women’s Health Protection Act. Already supported by more than 200 co-sponsors in the House and 42 in the Senate, WHPA would prohibit states from shutting down abortion clinics and banning abortion outright….

January 22, 2020: EMILY’s List posted a statement titled: “EMILY’s List Statement Honoring The Anniversary Of Roe V. Wade”. From the statement:

Today, EMILY’s List, the nation’s largest resource for women in politics, honored the anniversary of Roe v. Wade, the Supreme Court decision that constitutionally protects women’s right to safe and legal abortion in the United States. In response, Stephanie Schriock, president of EMILY’s List, released the following statement:

“For nearly 50 years, women have had a constitutional right to make their own health care decisions. Yet, Trump and the Republican party have put that right more at risk than ever. Just weeks ago, we saw an attempt by over 200 anti-choice members of Congress urging the Supreme Court to reconsider or overturn the Roe v. Wade and Planned Parenthood v. Casey, decisions that have solidified women’s reproductive freedom for decades. In 2019 alone, hundreds of dangerous and unconstitutional bills to gut abortion access were introduced in states across the country, and with legislatures beginning their 2020 sessions, we know that there are more to come.”

“In 2020, women’s rights are undoubtedly on the ballot and we know the public and the momentum is on our side. Republican efforts to spread cruel lies and strip away women’s reproductive freedom is drastically out of touch with the seven in 10 Americans that believe Roe v. Wade should stand. In fact, both the 2018 midterms and 2019 elections in Virginia have shown that voters overwhelmingly support pro-choice Democratic women who will fight for women’s access to reproductive health care. EMILY’s List is proud to have fought alongside these women and we look forward to electing a record number of pro-choice champions in 2020.”

January 22, 2020: ABC News posted an article titled: “Trump suggests he may be open to entitlement cuts in future”. It was written by Ricardo Alonso-Zalidvar and Aamer Madhani. From the article:

President Donald Trump appeared to suggest in a television interview Wednesday that he’s willing to consider entitlement cuts in the future, a move that would mark a tectonic shift from his stance during his 2016 run for the White House.

Trump suggested he was open to a cut in social safety net benefits, such as Medicare and Social Security, in comments during a CNBC interview on the sidelines of the World Economic Forum in Davos, Switzerland…

…Asked if entitlement cuts would ever be on his agenda, Trump responded, “At some point they will be.”…

…In the CNBC interview, Trump called tackling entitlement spending “the easiest of all things” and suggested higher economic growth would make it easier to reduce spending on the programs…


January 23, 2020: Center for Reproductive Rights posted a press release titled: “Trump Administration ‘Defunds’ Reproductive Health Services Providers in Texas”. From the press release:

Yesterday, on the 47th anniversary of Roe v. Wade, the U.S. Department of Health and Human Services (HHS) approved a previously-denied waiver request by the state of Texas for federal Medicaid funding to administer a family planning that discriminated against reproductive health care providers. The approval upends a longstanding Medicaid requirement that enrollees be able to receive services from the qualified provider of their choice – including Planned Parenthood and other providers who also provide abortion services.

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

“The Trump administration just gave the green light for states to deprive low-income people access to reproductive health care. The administration’s approval of the Texas waiver has opened a back-door pathway to “defund” Planned Parenthood and other providers. The federal government’s complicity in setting this precedent is equal parts dangerous and wrong, and like other decisions from this administration, will be acutely felt by low income individuals and people of color.  

“In 2011, the Obama Administration rejected this Texas plan because the proposal violated Medicaid’s requirement that people covered by Medicaid be able to obtain family planning services from their choice of qualified provider and it was unlikely to promote the objectives of the Medicaid Act.

“In a complete reversal in prior agency policy, the Trump administration has now paved the way for state Medicaid programs to restrict enrollees’ ability to receive services from the qualified provider of their choice and discriminate against such providers.  From the very beginning, the Trump administration set its sights on weakening the Medicaid program and threatening access to reproductive health care for the underserved and vulnerable populations that this program serves.  By approving this illegal waiver, the Trump administration has imperiled the public safety net for reproductive health care.”

January 23, 2020: Politico posted an article titled: “Trump administration finalizing Medicaid block grant plan targeting Obamacare”. It was written by Dan Diamond. From the article:

The Trump Administration is finalizing a plan to let states convert a chunk of Medicaid funding to block grants, even as officials remain divided over how to sell the controversial change to the safety net health program…

…Capping Medicaid spending, even among just Obamacare’s expansion population, would be a major transformation of how the federal government finances the safety net health care program that has grown to cover about 1 in 5 Americans. The plan is guaranteed to enrage critics and invite attacks from Democrats in an election year.

Republicans have long argued that states should recieve defined funding for Medicaid, instead of the current open-ended structure in which the federal government matches state spending. Democrats, along with many hospital and physican groups, have fiercely opposed the idea, warning that strict funding constraints would result in cuts to enrollment and health care services.

Democratic lawmakers have promised to fight the administration on block grants, contending CMS doesn’t have the authority to restructure the program’s financing without congressional approval…

…Congress has not been supportive of the idea. Lawmakers during the failed Obamacare replacement effort in 2017, rejected a similar plan to cap spending on Medicaid expansion and private health insurance subsidies, which would have resulted in millions losing coverage.

The Trump administration is seeking to bypass congressional opposition by using existing Medicaid authority to test states’ health care ideas under what’s known as demonstration waivers.

Several Republican-led states are pursuing plans to convert their Medicaid programs into block-grant funding. Tennessee, which has not expanded Medicaid, in November became the first state to submit a block grant plan to the Trump administration. That plan remains under review…

January 23, 2020: New Hampshire Governor Chris Sununu sent a letter to the New Hampshire State Senate Education and Workforce Development Committee. From the letter:

Dear Chairman Khan and Members of the Senate Education Committee,

I write to you today in support of Senate Bill (SB) 684, an important piece of bipartisan legislation to address issues regarding New Hampshire’s Medicaid to Schools program.

As you know, I am a strong supported of this important program and am encouraged by the bipartisan steps we have taken, in coordination with the New Hampshire Department of Health and Human Services and the Legislature, to ensure that students are able to recieve the critical services they need.

It is important to review the history of the situation to understand why we find ourselves in the position that we are in today. As you recall, on July 1, 2019, the Centers for Medicare and Medicaid Services (“CMS”) issued guidance in partnership with the Substance Abuse and Mental Health Services Administration. That guidance document is attached. While CMS focused on how schools may expand mental health and SUD related treatment services in the publication, it also highlighted Medicaid requirements specific to the unique nature of providing medical services in a school setting.

One of those requirements is that, for services to be reimbursable under a state’s Medicaid program, a medical service must be provided through a Medicaid-particpating provider that meets federal and/or state provider qualification requirements. Qualifications of providers must “minimally be the same as those providers who furnish services in other settings in the community”.

Under state law, there are certain qualified practitioners authorized to provide health-related services in the school setting without licensure by a health-related licensing boards. However, given CMS’s guidance, it was clear that schools would not be able to claim federal matching dollars through the Medicaid to Schools Program for services performed by these practitioners, unless the appropriate medical board also licenses them…

…SB 684 is part of our effort to work with districts and successfully navigate around the federal guidance, while ensuring that districts are provided the support that they need…

…The draft legislation, as it currently stands:

  • Ensures that DHHS has authority to promulgate administrative rules that maximize the availability of federal financial participation to schools as a setting under New Hampshire’s Medicaid program;
  • Provides an efficient pathway to allow qualified professionals certified and credentialed by the Department of Education who are currently providing medical services in public schools to be licensed by the related medical and health care boards.
  • Facilitates the provision of medical services in the school setting to students that are enrolled in participating public schools and Medicaid, thereby furthering the education and health of New Hampshire’s students…

January 23, 2020: American Academy of Pediatrics (AAP) posted news titled: “Study: Blocking puberty in transgender teens linked to lower likelihood of suicidal thoughts”. It was written by Melissa Jenco. From the news:

Transgender teens who were able to receive treatments to supress puberty were less likely to ever consider suicide, researchers found.

High levels of anxiety and depression are common among transgender youths, and studies have found as many as 40% of transgender adults have ever attempted suicide, according to “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation,” (Turban JL, et al. Pediatrics. Jan. 23, 2000)…

…The AAP, Endocrine Society and World Professional Association for Transgender Health support providing transgender adolescents gender-affirming care. This includes gonadotrophin-releasing hormone analogs that temporarily block puberty by stopping the production of testosterone and estrogen.

Researchers analyzed data from the National Center for Transgender Equality’s 2015 U.S. Transgender Survey to look more closely at the impact of such therapy on the mental health of people who are transgender.

Among 20,619 transgender adults, 17% reported wanting pubertal suppression. Of those, 2.5% recieved it, according to the study.

Those getting the treatment were more likely to be younger, assigned male sex at birth, heterosexual, have a higher household income and hae greater family support compared to those who wanted it but did not recieve it. They also were less likely to have suicidal ideation.

“Given that suicidal ideation alone is a known predictor of future science attempts and deaths from suicide, the current results warrant particular concern,” authors wrote.

The study may not have had enough people to detect differences in suicide attempts and did not include data on suicides.

Authors said pubertal suppression therapy offers teans a course of action that is not permanent.

“Some have also theorized that gender-affirming medical care may have mental health benefits separate from their physical effects,” they wrote, “because it provides implied affirmation for gender identity from clinicians, which may in turn buffer against minority stress.”


January 24, 2020: U.S. Department of Health and Human Services (HHS) posted a press release titled: “HHS Issues Notice of Violation to California for its Abortion Coverage Mandate”. From the press release:

Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced an action to protect human life and the conscience rights of all Americans.

OCR is issuing a Notice of Violation to the state of California, formally notifying California that it cannot impose universal abortion coverage mandates on health insurance plans and issuers in violation of federal conscience laws.  California has deprived over 28,000 people of plans that did not cover elective abortion, but now must cover abortion due to California’s mandate.  

OCR’s investigation arose from two complaints alleging that California engaged in unlawful discrimination when California’s Department of Managed Health Care (DMHC) ordered, in August 2014, that all health plan issuers under its jurisdiction must offer coverage for elective abortion in every plan they offer.  The two complainants are the Missionary Guadalupanas of the Holy Spirit, a Catholic order of religious sisters, and Skyline Wesleyan Church, a non-profit Christian church—organizations whose religious beliefs preclude them, in good conscience, from helping to pay for insurance coverage for elective abortions.

Pursuant to 45 CFR Part 88 (effective March 2011), OCR has completed the investigation of the complaints and determined that California violated the Weldon Amendment by mandating that California health care plan issuers cover elective abortion in each plan product, and continues to violate federal law by continuing to require objecting health care entities protected by the Weldon Amendment to cover elective abortion.  With this Notice, OCR requests that California inform OCR, within thirty days, whether California will continue to enforce its requirement that all health plans cover elective abortions, or whether it will agree to take corrective action and remedy the effect of its discriminatory conduct.

If, after 30 days, OCR does not receive sufficient assurance that California will come into compliance with federal law, OCR will forward the Notice of Violation and the evidence supporting OCR’s findings in this matter to the HHS funding components from which California receives funding for appropriate action under applicable grants and contracts regulations.  This action may ultimately result in limitations on continued receipt of certain HHS funds.

This is not the first time OCR has found California to be in violation of federal conscience statutes. In January 2019, OCR found that California violated the Weldon and Coats-Snowe Amendments when it subjected pregnancy resource centers in the state to potential fines and discrimination for refusing to post notices referring for free or low-cost abortions…

January 24, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Asks Court to Protect California’s Title X Family Planning Program”. From the press release:

California Attorney General Xavier Becerra asked the Northern District of California court to rule on its complaint that alleges the federal government illegally promulgated a Final Rule (Gag Rule) to undermine the Title X program, the nation’s only federal family planning program. The Trump-Pence Administration’s Gag Rule attacks Title X by limiting access to preventative healthcare including access to birth control, restricting healthcare providers’ ability to provide comprehensive information to patients, and prohibiting referrals for abortion. California and other plaintiffs are still waiting for a ruling from the Ninth Circuit Court of Appeals regarding the federal government’s appeal of the district court’s earlier grant of a preliminary injunction halting the implementation of the Gag Rule.

“The Title X program is a critical tool that helps low-income women and families access essential healthcare in California and across the nation,” said Attorney General Becerra. “This is yet another attack on women and their reproductive rights by the President and Vice President who circumvented the law and the public by jamming this Gag Rule through the process. That’s unacceptable. California won’t watch struggling families go without basic healthcare.”

California’s renewed push against the Title X regulation is based on the physical separation requirement of the Title X Final Rule which will take effect on March 4, causing further devastating consequences for California’s Title X network. The physical separation requirement would require both physical and financial separation between any Title X program participant and any faculty that provides abortion services. This means a provide must have, at minimum, separate examination and waiting rooms, office entrances and exits, phone numbers, email addresses, educational services, websites, staff and personnel, electronic or paper-based health care records, and workstations. The financial and administrative burdens this requirement would impose on Title X providers would only increase the exodus of providers from the program. California has already experienced significant loss of Title X providers since the Gag Rule took effect. Without relief before the March 4 deadline, California may no longer have a Title X network, causing untold harm to thousands of women and families across the state. California seeks to resolve its Administrative Procedures Act (APA) claims before the physical separation deadline to mitigate this harm.

In the brief, California argues that the Trump Administration’s final rule is in violation of the APA because it is arbitrary and capricious as well as contrary to federal statutes that require non-directive counseling and that forbid the federal government from creating unreasonable barriers to appropriate medical care.

A copy of the the motion is available here.

January 24, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Issues Response to Trump Administration’s Baseless Allegations of Weldon Violation”. From the press release:

Attorney General Becerra today issued a statement in response to a letter from the Trump Administration’s Office for Religious Consciousness that alleges California law violates the Weldon Amendment, a federal appropriations rider that restricts abortion.

“Women’s health should never be dangled as bait for the sake of political grandstanding. Today, Donald Trump is using the official levers of government to advance his political agenda. Sound familiar? In California, we will continue to protect our families’ access to healthcare, including women’s constitutional right to abortion. Nothing changes.”..

January 24, 2020: California Governor Gavin Newsom posted a tweet on his personal account: “Trump is threatening to take away ALL OF OUR HEALTHCARE FUNDING. TENS OF BILLION of dollars. 10 MILLION PEOPLE who are: poor, sick, kids, seniors, families, will LOSE their healthcare. And yet you call yourself “pro-life” @realDonaldTrump?? You sicken me.” The tweet included a link to the following Politico article.

January 24, 2020: Politico posted an article titled: “Trump threatens to cut California funding over abortion coverage.” It was written by Alice Miranda Ollstein. From the article:

The Trump administration on Friday threatened to cut off some federal funds to California unless it drops a state requirement that private health insurers cover abortion.

The administration says the policy violates a federal ban on discriminating against health care entities that refuse to cover abortion services or refer patients for the procedure when taxpayer dollars are involved. HHS is giving the state 30 days to comply or face the loss of unspecified funds…

…Five other states – Illinois, Maine, New York, Oregon, and Washington – have similar laws on teh books. But HHS is, for now, only singling out California.

California Gov. Gavin Newsom indicated the state won’t change the policy.

“The Trump administration would rather rile up its base to score cheap political points and risk access to care for millions than to do what’s right,” he said. “California will continue to protect a woman’s right to choose, and we won’t back down from defending reproductive freedom for everybody – full stop.”

California’s Attorney General Xavier Becerra tweeted: “California won’t be deterred. We will fight this by any means necessary.”

The move is in line with other Trump administration actions targeting the progressive state over issues including environmental standards, immigration policies and homelessness. It was also timed to coiencide with the March for Life on the National Mall, where President Donald Trump will become the first president to address the anti-abortion demonstration in person as he works to shore up support from social conservatives…

…While public insurance programs like Medicaid have long been barred from covering abortion services, Friday’s announcement also marks the escalation of the administration’s efforts to extend the prohibition to private coverage. In December, HHS unveiled a rule requiring private insurers on Obamacare markets to send patients separate monthly bills to separate the portion of the premium that goes toward abortion coverage. The added administrative burden could prompt some insurers to drop abortion care altogether…

January 24, 2020: EMILY’s List posted a press release titled: “EMILY’s List Statement On The Trump Admin’s Threat To Restrict Californians’ Access To Abortion”. From the press release:

Today, the Trump administration threatened to restrict federal funds to California if the state continues to require health insurance plans to provide coverage for abortion. In response, EMILY’s List President Stephanie Schirock issued the following statement:

“In yet another despicable move, the Trump administration has proved how little they value women’s health care. Denying California federal funds for insisting women have access to reproductive care not only hurts women and their families, but also sets a dangerous precedent and jeopardizes entire communities that depend on federal resources. We’re proud to have so many pro-choice Democratic women at every level of office in California who will stand up against Republican attempts to chip away at women’s health care and reproductive freedom.”

January 24, 2020: California Attorney General Xavier Becerra posted a press release titled: “Broad Coalition of Healthcare Providers, Historians, Policy Leaders, Legal Experts, Members of Congress, and More Join Effort to Fight Harmful Public Charge Rule”

California Attorney General Xavier Becerra today announced that a broad coalition of healthcare providers, historians, policy leaders, legal experts, members of Congress, and more filed amicus briefs in support of the state’s efforts to stop the Trump Administration’s harmful public charge rule. The rule unnecessarily targets working immigrants and their families by turning the use of critical health, nutrition, and housing programs that supplement their modest incomes into barriers to lawful admission to the United States. The amicus briefs filed with the U.S. Court of Appeals for the Ninth Circuit raise a wide range of concerns with the rule and highlight why implementation should be halted.

“This public charge rule is a cruel attempt to coerce hardworking families to go without basic necessities,” said Attorney General Becerra. “Access to critical food and housing programs should never be used as a bargaining chip. It goes against everything California stands for. This broad coalition of medical professionals, legal experts, members of Congress, and more, are standing with us to say this is unacceptable. Together, we’ll continue to fight for the rights of those aspiring to the American Dream.”

Public benefit programs are designed to help working families make ends meet and ensure strong, healthy families in California. Long-standing guidance by the federal government defined a public charge as a person who is primarily dependent on either public cash assistance for income maintenance or institutional long-term care at the government’s expense. The new rule declares that use of additional federally funded government programs, including nutrition and food support through CalFresh (California’s Supplemental Nutrition Assistance Program), healthcare through Medi-Cal (California’s Medicaid program), and housing for families through Section 8 housing assistance, may now constitute grounds for a public charge determination. These changes would discourage many eligible immigrants and mixed immigration-status families, who are not otherwise subject to the rule, from accessing benefits to which they are entitled. The rule could have an outsized impact on California, where one in four people are immigrants and one in two children have an immigrant parent. It will also make it harder for hard-working, low- and moderate-income immigrants to be admitted into the United States or to get green cards. The new standards are so high that if they were applied to citizens across the country, a substantial portion would likely be considered a ‘public charge.’ 

In 20 filings with the court, the diverse coalition raises a number of concerns with the federal government’s public charge rule. For instance, the rule:

  • Runs Contrary to Congressional Intent: The U.S. House of Representatives asserts that the rule fundamentally deviates from Congressional intent and runs counter to longstanding judicial and administrative understanding of the term public charge;
  • Threatens Older Adults: A coalition representing the interests of older adults across the country notes that the rule threatens the well-being of hundreds of thousands of caregivers who help supply critical aid to millions of people who need assistance with dressing, bathing, eating, and other daily tasks both at home and in nursing facilities;
  • Burdens Hospitals: The American Hospital Association points to estimates that the Trump Administration’s rule puts hospitals at risk of spending as much as $17 billion every year in additional uncompensated care costs as the result of immigrants and their families disenrolling from Medicaid;
  • Harms Local Governments: Dozens of counties and local governments, which are responsible for the public health, housing, and nutrition of their residents, argue that the rule will force localities to fill funding gaps left by the federal government and grapple with the compounding consequences of the rule;
  • Increases Housing Instability: Non-profit and labor organizations highlight the impossible bar set by the rule by noting that, in 90 percent of U.S. counties, a person working full-time and earning the average renter’s wage cannot afford a modest two-bedroom rental home;
  • Undermines Economic Growth: A coalition of 105 business and organizations highlights estimates that the rule could result in over $80 billion in losses to the American economy; and
  • Creates an Unworkable Definition of “Medical Condition”: The American Academy of Pediatrics expresses concern that the vague definition of “medical condition” is overbroad and unworkable with no explicit requirement that such claims must be documented by a medical professional, exposing children, individuals with disabilities, pregnant women, and other vulnerable groups to harm under the rule.

Amicus briefs in support of the states’ lawsuit were filed by numerous non-profits, municipalities, and professional associations, including: 105 Business and Organizations; American Civil Liberties Union; American Academy of Pediatrics; American Hospital Association; Asian Americans Advancing Justice; Association of Counties; Center for Reproductive Rights; Congressional Tri-Caucus; Education Legal Alliance; Fiscal Policy Institute; U.S. House of Representatives; Immigration Law Professors; Institute for Policy Integrity; Justice in Aging; Legal Historians; National Consumer Law Center; National Housing Law Project; Non-Profit Anti-Domestic Violence and Sexual Assault Organizations; Public Health Deans; and Public Justice Center.

Attorney General Becerra has fought against the Trump Administration’s public charge rule every step of the way. In 2018, Attorney General Becerra called on the U.S. Department of Homeland Security to withdraw its initial public charge proposal. In 2019, Attorney General Becerra detailed how the rule will negatively impact California’s public health, social services, housing, educational programs, and economy. Shortly afterward, the Attorney General filed a lawsuit asserting the rule will have a chilling effect that will discourage many other immigrants, who are not otherwise subject to the rule, from accessing benefits that they need. The Attorney General also filed a motion for a preliminary injunction to halt the rule’s implementation. There is currently a nationwide injunction in place out of New York, blocking the rule from being implemented.

Attorney General Becerra is joined in the lawsuit by the attorneys general of Maine, Oregon, Pennsylvania, and the District of Columbia.

Copies of the amicus briefs can be found in the online version of this release here.

January 24, 2020: The Hill posted an article titled: “Trump administration threatens to cut health funding for California over abortion insurance law”. It was written by Jessie Hellmann. From the article:

The Trump administration is threatening to withhold federal funds from California over the state’s requirement that all insruance plans cover abortion.

Officials with the Department of Health and Human Services (HHS) argued the insurance requirement forces people to pay for other people’s abortions and is a violation of federal law.

The state will have 30 days to come into compliance with federal law or risk losing some of the health funding it gets from HHS…

…The decision by HHS also serves as a warning to the five other states that mandate abortion coverage in insurance plans, including Maine, Illinois and New York.

California passed a state law in 2014 requiring all insurance plans, including those offered by employers, to cover abortion. Religious organizations argued the requirement is illegal because it violates their religious rights…

…The announcement from HHS came on the same day as the March for Life, the annual march against abortion in Washington, D.C.

President Trump will become the first sitting president to speak at the march as he seeks to galvanize his conservative base ahead of the November election…

…The Supreme Court will hear a case this year challenging a Trump rule that allows employers with religious objections to contraception to opt-out of covering it in their insurance plans.

Another rule issued by the Administration that was blocked in court would have penalized organizations that require employees to participate in abortions or other procedures that violate their consciences…

January 24, 2020: National Women’s Law Center posted a press release titled: “Trump Administration Attempts to Take Away Comprehensive Health Coverage for Californians, says NWCL”. From the press release:

Today, the Department of Health and Human Services’ (HHS) Office of Civil Rights has taken the extraordinary action of threatening to withhold critical funding to California – just because the state protects its residents by requiring all health insurance plans to cover the full range of reproductive services, including abortion. The Trump Administration is claiming that these plans violate the Weldon Amendment – one of several federal laws that allow various health care providers to refuse to provide care to a person seeking an abortion. This decision comes on the same day as the annual March for Life, an anti-abortion rally where Trump is proudly touting his record of limiting women’s rights.

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

“It is no mistake that on the same day of the extremist anti-abortion March, the Trump Administration is trying to deny millions access to comprehensive health insurance that includes abortion. They claim they are ‘pro-women’ and ‘pro-life’, yet this action proves cruelty is the point for this administration. The very people they claim to be marching for are those who will be hurt by this decision. This is an illegal attempt to bully and punish the state of California for ensuring its residents have comprehensive health coverage that includes abortion. All health insurance plans should cover all basic health services and the full range of pregnancy-related care.”

January 24, 2020: Planned Parenthood posted a press release titled: “Trump’s Travel Ban Targets and Discriminates Against Pregnant Women of Color”. From the press release:

The Trump-Pence administration will allow the State Department to deny temporary visas to pregnant women. The new rule is expected to take effect today and will give discretion to consular officers to reject women they believe are traveling to the United States and its territories to give birth, making their children U.S. citizens. This policy will include visas issued for pleasure, medical treatment, or to see friends and family. The rule will primarily affect travelers from Africa, Asia, and Latin America, because it will not apply to countries in the Visa Waiver Program. Thirty one of the 39 countries in this protected program are from Europe.

This rule is part of a long line of attacks on immigrants by the administration, including ending temporary protected status for several countries; the physical separation of children form their parents at the U.S.-Mexico border; the rollback of parental rights as part of immigration proceedings; and increased enforcement of detention and deportation…

…This isn’t the first time the administration has used visas as a tool for its extreme anti-immigrant ideology. Within months of taking office, Trump announced a travel ban against Muslims. The relentless attacks on immigrants by the administration have contributed to a culture of fear in immigrant communities, and often keep far too many from seeking the lifesaving care they need.

January 24, 2020: U.S Department of Health and Human Services posted a press release titled: “Trump Administrations Actions to Protect Life and Conscience”.

It includes a laundry list of ways the Trump Administration planned on doing in order to hurt people who have uteruses, people who need abortion, people who want insurance coverage for abortion, people who currently qualified for Medicaid, and more.

It also planned to take away people who are LGBTQ’s right to access health care – any kind of health care – simply because they are LGBTQ and someone at the health clinic was a homophone or transphobe.

The Trump Administration also pretty much declared that Christianity was the national religion (which is against the Constitution) by listing all the ways that the Trump Administration would change things by putting the rights of Christians OVER the rights of all other people in the United States.

January 24, 2020: Illinois Governor JB Pritzker posted a news release titled: “Gov.Pritzker Signs Law Capping Insulin Costs at $100/Month for 1.3 Million Illinoisans”. From the news release:

Gov. JB Pritzker signed SB 667 into law today, capping out of pocket insulin costs at $100 for a 30-day supply. The new law is an important step forward in lowering healthcare costs for working families making Illinois a leader in ensuring healthcare is a right, not a privilege. The 1.3 million Illinoisans who rely on insulin will no longer face soaring prescription drug prices that force them to make tough decisions.

“Health care is a right for all, not a privilege and that’s why I am so proud tha we created an insulin price cap that successfully puts patients above profits,” said Governor Pritzker. “As we work to address the high cost of prescription drug prices that are burdening millions of all our our state, this new law is an essential step in fulfilling our promise to put state government back on the side of working families.”

Diabetes affects approximately 1,300,00 adults in Illinois. All people with Type 1 diabetes and some with Type 2 diabetes need insulin, but regular price hikes make insulin difficult to afford for the uninsured and those whose coverage requires significant cost sharing.

Many patients either forgo insulin or they ration their prescribed insulin dose to stretch it until they can afford the next prescription. One if four Type 1 diabetics have reported insulin underuse due to the high cost of insulin…


January 25, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General Secures Victory for Women Seeking Abortions in Rochester”. From the press release:

New York Attorney General Letitia James today released the following statement after the Honorable David Larimer of the Western District of New York issued a decision authorizing the City of Rochester to continue to enforce a 2005 order establishing a sidewalk “buffer zone” outside a local Planned Parenthood facility:

“In the nearly 50 years since Roe v. Wade, anti-choice activists have attempted to inflict their will on women’s bodies, but this decision is another confirmation by the courts that no one has the right to interfere with women’s reproductive choices. Despite their denials, these anti-abortion activists attempted to harass, threaten, and block women from entering a local Planned Parenthood and strip them of the right to make a deeply personal choice to use every legal tool at its disposal to prioritize the reproductive rights of women. We thank the court for its decision and for ensuring Roe v. Wade is enforced in Rochester without interruption.”

Deborah McDell-Hernandez, Senior Director of Public and Community Affairs of Planned Parenthood of Rochester added, “Planned Parenthood is very appreciative of the attention that the New York Attorney General’s Office offered to this case. This positive outcome will help ensure that we are able to continue to provide a welcoming and safe environment to patients and staff. Accessibility to quality, affordable health care is our priority.”

In 1989, the Office of the New York Attorney General won a decision – in New York ex rel. Spitzer v. Operation Rescue Nat’l – establishing a buffer zone prohibiting protests, picketing and the blocking of the entry within 15 feet of “entrances and driveways of facilities that perform abortions in the Western District of New York,” including Planned Parenthood of Rochester.

Despite this ruling, two years ago, anti-abortion activist Jim Havens and his group ROC Love Will End Abortion, began protesting women who were entering the Planned Parenthood of Rochester facility. When they were prohibited from continuing their protests within 15 feet of the facility, Havens and his group filed a lawshit against both the State of New York and the City of Rochester, asserting that they were being improperly prevented from conducting their protests.

Under Attorney General James’ leadership, the Office of the New York Attorney General opposed the motion for a preliminary injunction and moved to dismiss the lawsuit, stating that Havens and his group were indisputably acting “in active concert or participation” with the original defendants to the state lawsuit.

Yesterday afternoon, Judge Larimer denied the motion for a preliminary injunction and dismissed the lawsuit in its entirety, stating that Havens and his group were indisputably acting “in active concert or participation” with the original defendants of the state lawsuit. The court took particular note of Havens’ and the original defendants named ‘ shared common goal of deterring ‘abortion-minded’ women from seeking services at PPR,” and further held that Havens’ legal arguments were based on “wishful thinking on [their] part,” concluding, “Any suggestion that plaintiffs acted ‘independent’ from these Named Defendants… is not only disingenuous, but is also belied by plaintiffs’ own allegations.”…

January 25, 2020: MSN posted an article titled: “Kansas lawmakers begin debate on Medicaid expansion”. From the article:

While a bipartisan plan in Topeka seeks to end years of gridlock on the issue, Kansas Governor Laura Kelly says there is a long way to go before declaring victory.

Supporters of Medicaid expansion in Kansas say the time is now for this to happen as the state senate’s public health and welfare committees start to debate the issue…

…Republican Senate Majority Leader Jim Denning and Democratic Governor Laura Kelly hammered out a compromise from previous proposals. That compromise calls for Medicaid expanding to Kansans who fall within 138 percent of the poverty line.

It includes work requirements where applying for Medicaid will have to fill out a form showing they are looking for work or show why they are not able to work. Enrollees would pay monthly premiums of up to $25 per month, or $100 for a family of four, as proposed in the proposed bill. A hardship provision is also included.

The plan also includes a re-insurance program to support Kansans who buy health insurance through the exchange. That program would go into effect no later than January 1, 2022…


January 26, 2020: Cleveland.com posted an opinion piece titled: “DeWine administration deserves Ohioans’ thanks for uncovering – and vowing to fix – state Medicaid mess”. It was written by The Editorial Board of Cleveland.com and The Plain Dealer. From the opinion piece:

Kudos to Republican Gov. Mike DeWine’s administration for its candor in exposing big flaws in a computer system, called Ohio Benefits, that’s supposed to help the state manage its part of the Medicaid, Temporary Assistance for Needy Families and food stamp (SNAP) programs.

Instead, a system into which the state has already sunk more than a billion dollars — yes, nine zeros — is so flawed that it’s wrongly thrown an unknown number of Ohioans off Medicaid by erasing their eligibilty histories, failing to handle renewals correctly, or simply causing applicants to disappear from the system. It’s also violated recipients’ privacy by sending paperwork to the wrong address and, in one case, linked a baby to an 11-year-old who wasn’t the child’s parent…

…The state has already spent $1.2 billion on Ohio Benefits [State Medicaid Director Maureen] Corcoran said. And it likely will have to spend more to fix it…

..In effect, the state is all but yoked to the vendor. And all told, Ohio Benefits has nearly 1,100 defects, cleveland.com’s Laura Hancock reports, citing Corcoran’s findings.

The state adopted the benefits system six years ago when Kasich was governor, to help manage Ohio’s benefits systems, starting with Medicaid…


January 27, 2020: Representative Debbie Dingell tweeted: “4,110,300 people in Michigan have a pre-existing condition. Because of the Affordable Care Act, insurance companies cannot deny their coverage. We must #ProtectOurCare.”

January 27, 2020: The Supreme Court of the United States released a ruling on Department of Homeland Security, Et. Al. v. New York, Et. Al. on an application for a stay on the Trump administration’s Public Charge rule. It starts with:

The application for stay presented to Justice Ginsburg and by her referred to the Court is granted, and the District Court’s October 11, 2019 orders granting a preliminary injunction are stayed pending disposition of the Government’s appeal in the United States Court of Appeals for the Second Circuit and disposition of the Government’s petition for a writ of certiorari, if such writ is timely sought. Should the ptetition for a writ of certiorari be denied, this stay shall terminate automatically. In the event the petition for a writ of certiorari is granted, the stay shall terminate upon the sending down of the judgement of this Court.

Justice Ginsburg, Justice Breyer, Justice Sotomayor, and Justice Kagan would deny the application.

Justice Gorsuch, with whom Justice Thomas joins, concurring in the grant of stay…

It should be noted that the reason Chief Justice John Roberts is not mentioned in the ruling could be because he was presiding over President Trump’s impeachment trial in the U.S. Senate.

January 27, 2020: CNBC posted an article titled: “Supreme Court allows Trump’s ‘public charge’ immigration rule to take effect.” It was written by Tucker Higgins. From the article:

The Supreme Court said Monday that it will allow the Trump administration “public charge” rule to take effect after the immigration policy had been blocked by lower courts.

The 5-4 vote was divided along partisan lines, with the court’s four Democratic appointees indicating that they would not have allowed the policy to be enforced.

The rule, which was proposed in August, will make it more difficult for immigrants to obtain permanent residency, or green cards, if they are likely to use public benefits like food stamps and Medicaid.

Under previous federal rules, a more narrow universe of public benefits, such as cash assistance and long-term hospitalization, were considered in determining whether an immigrant was likely to become a “public charge”.

Civil rights groups criticized the rule, arguing that it would penalize poor immigrants and disproportionately affect non-white immigrants…

January 27, 2020: California Governor Gavin Newsom posted a press release titled: “Governor Newsom Statement on Supreme Court’s Decision on Trump Administration’s Public Charge Rule”. From the press release:

Governor Gavin Newsom issued the following statement after today’s decision by the Supreme Court of the United States regarding the public charge rule that targets low-income immigrant families:

“The effects of today’s Supreme Court decision on the “public charge” rule will be devastating. Because of the “public charge” rule, families are already going hungry and people are avoiding needed medical care.”

“California is actively reviewing the decision to determine next steps and provide further guidance to impacted Californians. California will continue to fight against these efforts to terrorize immigrant families.

“Anyone concerned about this ruling should seek qualified immigration advice.”

The Governor’s 2020-2021 state budget proposal includes a total of $75 million to ongoing qualified nonprofit organizations that provide a broad array of qualified immigration services…

January 27, 2020: Senator Patty Murray tweeted: “Just stepped out of the impeachment trial to news that the Trump Administration can begin implementing its cruel public charge rule that will threaten the lives & livelihoods of so many hardworking families in WA & across the country. This is just so wrong.

January 27, 2020: The American Civil Liberties Union (ACLU) tweeted: “The “Public Charge” rule enshrines the false stereotype that people with disabilities do not contribute to our society. Congress has repeatedly declared that disability discrimination violates federal law. This rule must be stopped.”

The tweet included a screenshot of a statement by the ACLU that said:

In a 5-4 ruling, the Supreme Court, allowed the Trump administration’s “public charge” rule to temporarily take effect. The rule imposes new restrictions on green cards and visas, and particularly affects individuals with disabilities as well as low-income families. The American Civil Liberties Union opposes the rule.

Claudia Center, senior staff attorney with the ACLU’s Disability Rights Program, had this reaction to the Supreme Court’s action:

“This policy is yet another way for the Trump administration to hurt immigrants. It enshrines the false stereotype that that people with disabilities do not contribute to our society. Families will suffer. Congress has repeatedly declared that disability discrimination violates federal law. This rule must be stopped.”

January 27, 2020: Representative Alexandria Ocasio-Cortez tweeted: “This is shameful. America shouldn’t have a wealth test for admission. It’s a place where millions of people are descendants of immigrants who came w noting & made a life. The American Dream isn’t a private club with a cover charge – it’s the possibility of remaking your future.”

Representative Alexandria Ocasio-Cortez was responding to a tweet from Greg Stoher, a Supreme Court reporter for Bloomberg News, who tweeted: “BREAKING: On 5-4 vote, Supreme Court lets Trump administration start enforcing new immigrant wealth test, designed to screen out green card applicants seen as at risk of becoming “public charges.”

January 27, 2020: Women’s Law Project posted statement titled: “WLP Statement on Trump’s Cruel “Public Charge” Rule”. From the statement:

Today, in a 5-4 vote along ideological lines, the U.S. Supreme Court Justices said they would let the controversial immigration rules go forward even as lower courts wrestle with multiple legal challenges against them.

“Today is another sad day for immigrants and a shameful one for our country. We have shut the golden door on the poor and huddled masses. Trump’s public charge rule effectively creates an immigration system that favors wealth over hard-working individuals and families,” says Women’s Law Project staff attorney Christine Castro, who authored WLP’s comments on the rule. “These radical proposed changes will undermine they health and safety of immigrant families, especially immigrant mothers.”

Under current policy, immigration officials can deny certain immigrants a visa or a green card if the official finds the immigrant would be a “public charge,” meaning someone deemed likely to become “primarily dependent” on current or past receipt of cash assistance programs like Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF) when predicting whether someone will become a “public charge”. (Only 3 percent of noncitizens use these programs.)

Trump’s new rule expands the list of factors to be counted against a person to include safety-net programs like SNAP (“food stamps”), Section 8, Medicaid, earning a low income, English proficience, age (specifically, being over 60 or under 18 years old), having a low credit score, having a large family, and having a medical condition.

“The rule’s preference for immigrants who speak English would codify the Trump Administration’s xenophobic rhetoric into actual policy and clearly targets people of color who are less likely to already speak English,” says Castro.

Under the new rule, legal immigrants could be denied green cards or visas if they’ve ever used or are suspected of having used Medicaid, SNAP, or other safety-net programs. Currently, one in seven Americans rely on Medicaid, including two out of every five children, five in eight nursing home residents, and one in three people with disabilities…

January 27, 2020: Southern Poverty Law Center posted a short thread that started with this tweet: “Today’s ruling allows yet another discriminatory and xenophobic Trump administration policy aimed at low-income Black and brown immigrants.” – SPLC’s Samuel Brooke”. The tweet included a link to the CBS News article (posted earlier in this blog post).

Southern Poverty Law Center also tweeted: “The @DHSgov’s ‘public charge’ rule only hurts families struggling to make ends meet. It effectively cuts essential aid that helps ensure immigrants’ basic human right to housing, food and health care” – SLPC’s Samuel Brooke.”

January 27, 2020: Senator Bernie Sanders tweeted: “In 2017, 10,000 people died waiting for Social Security Disability Insurance. Instead of addressing this crisis, Trump wants to make it harder for people with disabilities to get the help they need to get by. We will defeat him and undo this cruelty.” The tweet included a link to the following article from USA Today.

January 27, 2020: USA Today posted an opinion piece titled: “Trump administration cuts to Social Security disability benefits among the cruelest.” It was written by Rebecca Vallas. From the article:

Hardly a day goes by without the Trump administration finding a new way to slash the safety net.

But its latest proposal – which would cut Social Security disability benefits by $2.6 billion over 10 years – is one of the cruelest. It would require millions of beneficiaries to re-prove their disability – and navigate a complex web of red tape and paperwork – every two years. Hundreds of thousands of people could lose benefits even though their condition has not changed…

…Proving eligibility for benefits is an ardurous process that can take months if not years, and hundreds, if not thousands of pages in medical evidence. America has among the strictest eligibility standards in the world. Over 60% of applicants are denied, and tens of thousands of people die each year waiting for benefits.

While vital, benefits are so modest – averaging roughly $1,200 per month for Social Security Disability Insurance and $536 for Supplemental Security Income – that many beneficiaries live in poverty. Unspeakable hardship will result if this proposal takes effect..

January 27, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra: “We’ll Keep Fighting to Stop the Trump Administration’s Harmful Public Charge Rule”. From the press release:

California Attorney General Becerra today issued a statement following the U.S. Supreme Court’s decision to stay the nationwide injunction on the public charge rule. As a result of the ruling, the Trump Administration will be allowed to restart its efforts to implement its harmful public charge rule while litigation is ongoing. The rule unnecessarily targets working immigrants and their families by turning the use of critical health, nutrition, and housing programs that supplement their modest incomes into barriers to lawful admission to the United States.

“This rule harms our children and families in communities across the country. It hurts our economy and the healthcare of so many Californians,” said Attorney General Becerra. “We are a nation of immigrants, so we will lean forward in the face of heartless attacks on working families. Together, we’ll continue our fight to stand up for the rights of each and every person who calls the United States their home.”

Attorney General Becerra has fought against the Trump Administration’s public charge rule every step of the way. In 2018, Attorney General Becerra called on the U.S. Department of Homeland Security to withdraw its initial public charge proposal. In 2019, Attorney General Becerra detailed how the rule will negatively impact California’s public health, social services, housing, educational programs, and economy. Shortly afterward, the Attorney General filed a lawsuit asserting the rule will have a chilling effect that will discourage many other immigrants, who are not otherwise subject to the rule, from accessing benefits that they need. The Attorney General also filed a motion for a preliminary injunction to halt the rule’s implementation. Today’s decision was on the nationwide injunction in a separate public charge case out of the U.S. Court of Appeals for the Second Circuit. California’s case is currently before the U.S. Court of Appeals for the Ninth Circuit.

Individuals who are concerned about the impacts of this decision on their immigration status should consult with an immigration attorney. Each case is different and a range of factors must be considered.

A copy of the decision is available here.

January 27, 2020: Human Rights Watch posted an article titled: “Reject the Bill to Block Critical healthcare for Transgender Youth”. It was written by Jacqulyn Kantack. From the article:

Some of South Dakota’s most vulnerable teenagers could be denied critical health care if the legislature passes a proposed law.

State lawmakers are considering a bill that would make it a criminal offense for doctors, physician assistants, or nurse practitioners to provide gender-affirming health care to transgender youth under age 16. House Bill 1057, misleadingly titled the “Vulnerable Child Protection Act,” makes it a misdemeanor to prescribe puberty blockers or hormone replacement therapy, as well as prohibiting any gender-affirming surgery.

Far from protecting vulnerable teenagers, this bill could put them in danger…

…HB 1057 is just the latest iteration of more than a dozen anti-LGBT bills introduced in the state in recent years. Prominent examples include the “Bathroom Bill” passed by the legislature but vetoed by then-Governor Dennis Daugaard in 2016, and legislation signed into law in 2017 allowing adoption agencies receiving state funding to discriminate against same-sex couples.

HB 1057 is the latest attack on trans kids in the state and poses a serious threat to their health and rights.

The decision to undergo puberty-blocking treatment and other forms of gender-affirming health care is not a decision taken lightly. Youth and their parents make this decision in close consultation with their doctors. Medical professionals should not be forced to choose between turning young patients away and providing necessary, sometimes life-saving treatment, risking up to a year in jail.   

The bill passed out of committee on January 22 and will come to the House floor on January 27. South Dakota legislators who believe in promoting equality, preventing discrimination, and upholding the rights to health and life should reject this bill and other anti-transgender legislation. In doing so, our legislators will take a vital step toward defending the rights of trans youth and making South Dakota a place where the dignity of all people is protected.  


January 28, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Denounces Supreme Court’s “Public Charge” Ruling”. From the press release:

The Supreme Court furthered the Trump-Pence administration’s discriminatory and cruel attacks against immigrants yesterday by allowing its final “public charge” rule to go into effect. Under the rule, people may be denied entry into the U.S. or an adjustment in their immigration status (i.e. obtaining a green card), simply because they have received certain public benefits in the past – including health care, nutrition assistance, and public housing – or are judged likely to use benefits in the future. It is designed to keep families separated, and to scare immigrants already in the U.S. from accessing health care and other basic care and benefits, to which they are legally entitled, out of fear of retaliation from the administration…

…The Supreme Court’s 5-4 decision comes on the heels of other attacks on immigrants by this administration, such as banning pregnant women from entering the U.S.; ripping millions of families apart by rescinding DACA (Deferred Action for Childhood Arrivals) and ending TPS (temporary protected status) for several countries; the physical separation of children from their parents at the U.S.-Mexico border; the rollback of parental rights for parents involved in immigration proceedings; and increased enforcement of detention and deportation.

January 28, 2020: A group of U.S. Senators sent a letter to Commissioner Andrew M. Saul of the Social Security Administration opposing the cuts to Social Security. From the letter:

…We write to oppose the Social Security Administration’s (SSA) proposed regulations altering when and how often SSA conducts continuing disability reviews (CDR), published in the Federal Register on November 18, 2019. The proposed rule would dramatically increase the number of CDRs the agency conducts every year and burden millions of Americans with disabilities with more frequent, unjustified reviews of their eligibility for Social Security Disability Insurance (SSDI) benefits. At a time when leadership from SSA is sorely needed to further reduce unacceptably long disability application wait times and eliminate the disability hearing backlog, it is alarming that the agency appears more concerned with devoting limited resources toward making it harder for people with disabilities to receive essential benefits. This proposal appears to be yet another attempt by the Trump Administration to make it more difficult for Americans to access essential supports.

Specifically, we oppose SSA’s proposal to create a new medical diary category with a two-year CDR review period, to change the criteria used to assign cases into each medical diary category and to change the frequency with which the agency performs CDRs for cases in one existing medical diary. In its Notice of Proposed Rulemaking (NPRM), SSA fails to justify the need for this rule. Specifically, SSA fails to clearly establish a need for these changes, fails to justify the specific procedural changes proposed, fails to fully evaluate the effects these changes will have on beneficiaries and fails to provide an adequate cost-benefit analysis. SSA does not even provide a cursory estimate of the number of people who will lose access to benefits earlier than they would have had otherwise as a result of this rule…

Failure to Justify Proposed Procedural Changes

Throughout the NPRM, SSA repeatedly fails to justify the specific changes it is proposing to make. For example, in explaining what cases will be included in the new MIL diary category, SSA provides no ratinale for including step 5 allowances, which are cases in which beneficiaries were determined eligible for disability benefits at the last step of the five-step disability claims process. SSA never explains why this arbitrary administrative distinction, and not medical evidence, should dictate that these individuals have their cases reviewed every two years. Furher, SSA provides no medical or administrative rationale for assigning children approaching ages 6 and 12 to the new MIL diary category other than stating tha these are ages at which many children transition into formal education or transition into adolescence. SSA provides no explanation for how such transitions relate to a child’s underlying medical condition of likelihood of experiencing MI nor does SSA explain why such beneficiaries would require more frequent review of ongoing eligibility.

The proposed changes to the Medical Improvement Not Expected (MINE) diary category similarly lack justification. For example, SSA states that step 5 allowances based only on 17 specific impairments or conditions will continue to be included in the MINE diary category, but provides no explanation of the criteria used to distinguish these impairments and conditions from all others. In proposing to change the CDR review period for cases in the MINE diary category from between 5 and 7 years to every 6 years, SSA does not provide any explanation of why a 6-year review period is more appropriate than a 7-year period and provides no data on current MINE case review periods to justify the proposed change. In addition, SSA does not explain why, despite the agency repeatedly citing the need for greater flexibility as among the primary reasons it has issued this proposed rule, the agency is proposing to significantly curtail its flexibility to schedule CDRs for the wide variety of cases included in the MINE category.

Failure to Fully Evaluate Effects on Beneficiaries

SSA also fails to fully evaluate the effects the proposed rule would have on beneficiaries. The only aspect of beneficiary welfare that SSA provides any analysis of is the proposed rule’s potential impact on beneficiary employment outcomes, and that analysis is entirely insufficient. On the issue of beneficiaries’ potential return to employment, SSA selectively references only intersection SSDI and SSI benefit receipt and employment outcomes. SSA also interprets the findings of these few studies – which seemingly show that the majority of people who lose their SSDI benefits are not able to consistently earn significant income in the years after losing access – as somehow being supportive of the agency’s position that the proposed rule will improve overall beneficiary outcomes. The only additional evidence SSA cites to support its assertions are numbers the agency produced itself looking at the relationship between time spent out of the labor force and future earnings. SSA, however, then admits that its numbers provide no evidence of a casual relationship between the factors examined, rendering the agency’s findings completely immaterial to its analysis of the proposed rules’ effects.

SSA provides no analysis of how the proposed rule will impact beneficiaries’ financial security, health or any other measure of individual wellbeing. These exclusions are not explained in the NPRM. SSA’s contention that this rule could have positive effects on for beneficiaries cannot be considered complete if the agency arbitrarily selects which aspects of beneficiary welfare it analyzes. Employment is not the only outcome of importance to the welfare of beneficiaries.

Perhaps the most egregious omission from SSA’s analysis of effects on beneficiaries is that the agency provides no estimate of the number of children, yought and adults who will lose acces to benefits more quickly than they would have otherwise as a result of the proposed rule. This includes losing access to SSDI and SSI cast benefits, but also Medicare and Medicaid coverage that are frequently tied to a person’s eligibility for SSDI and SSI. SSA should be capable of producing such estimates with available data, and the fact that SSA already presents estimates of the proposed rule’s effects on SSDI and SSI benefit expenditures in the NPRM suggests that SSA has already produced an estimate. Without an estimate of the number of children, youth and adults who would lose access to their cash and health care benefits sooner than under current rules, the public cannot evaluate the effects of the proposed rule…

Here are the Senators who signed the letter (by state):

  • California: Kamala Harris. Diane Feinstein
  • Colorado: Michael F. Bennet
  • Connecticut: Richard Blumenthal
  • Delaware: Christopher A. Coons, Thomas R. Carper
  • Illinois: Tammy Duckworth, Richard J. Durbin
  • Hawaii: Mazie Hirono, Brian Schatz
  • Maine: Angus S. King, Jr.
  • Maryland: Benjaman L. Cardin, Chris Van Hollen
  • Massachusetts: Edward J. Markey, Elizabeth Warren
  • Michigan: Debbie Stabenow, Gary C. Peters
  • Minnesota: Amy Klobuchar, Tina Smith,
  • Nevada: Catherine Cortez Masto, Jackie Rosen
  • New Hampshire: Margaret Wood Hassan, Jeanne Shaheen
  • New Mexico: Tom Udall, Martin Heinrich
  • New Jersey: Cory A. Booker, Robert Menendez
  • New York: Kristen Gillibrand, Charles E. Schumer
  • Ohio: Sherrod Brown
  • Oregon: Ron Wyden, Jeff Merkley
  • Pennsylvania: Robert P. Casey
  • Rhode Island: Jack Reed, Sheldon Whitehouse
  • Virginia: Tim Kaine
  • Vermont: Bernard Sanders, Patrick Leahy
  • Washington: Maria Cantwell, Patty Murray
  • Wisconsin: Tammy Baldwin

January 28, 2020: Reuters posted an article titled: “Trump Administration urges Supreme Court not to expedite Obamacare hearing”. It was written by Antonita Madonna. From the article:

The Trump administration has asked the U.S. Supreme Court to deny the Democrats’ request to expedite its review of a lower court’s decision on the validity of the Affordable Care Act.

Attorneys general in Democrat-led states had appealed to the Supreme Court to review a ruling of the Fifth Circuit Court of Appeals on Dec. 18 that one component of the ACA – the soc called “individual mandate” – was unconstitutional but sidestepped a decision on the validity of the entire law by sending it back to a federal judge in a lower court for further analysis…

…Attorneys general in 20 states and the District of Columbia asked the Supreme Court to expedite its decision on the matter, citing the impact of the decision on the health care of millions of Americans and the health insurance market, at large.

The Trump administration, however, argued in its filing last week that the appeals court’s decision has no “imminent consequences,” as the individual mandate it ruled unconstitutional was already repealed as part of the tax overhaul in 2017 in which the tax penalty associated with it was removed…

…Attorneys General in 11 Republican states, led by Texas also asked the Supreme Court to deny the Democrats petition…

The Trump administration’s request is here.

The request made by 11 Attoneys General of Republican states is here.

January 28, 2020: Hawaii Attorney General Clare E. Connors posted a news release titled: “Hawaii Attorney General Joins a Multistate Brief Challenging Restrictive Abortion Laws”. From the news release:

Hawaii Attorney General Clare E. Connors today joined a multistate coalition led by California and Illinois in filing an amicus brief in the Eighth Circuit Court of Appeals in Reproductive Health Services v. Planned Parenthood of St. Louis challenging the constitutionality of several recently enacted abortion bans in Missouri. Planned Parenthood of St. Louis, the only remaining abotion clinic in Missouri, and its Chief Medical Officer Dr. Colleen McNicholas, are seeking to overturn two state laws that would significantly curtail women’s rights and creates barriers to safe and legal abortion. The multistate coalition argues that these laws are unconstitutional restrictions on women’s right to choose.

“The law is planly unconstitutional and would put the health and wellbeing of women at risk by denying access to healthcare,” said Attorney General Connors. “Because any attack on reproductive freedom is dangerous, we are committed to protecting women’s rights throughout the country”…

…Joining Attorney General Connors in today’s filing are the attorneys general of California, Illinois, Colorado, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

January 28, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Fights Missouri’s Restrictive Abortion Laws”. From the press release:

New York Attorney General Letitia James today continued her fight to protect a woman’s right to choose, pushing back against obstructive laws passed in the State of Missouri that impose unconstituional restrictions on a woman’s right to have an abortion. In a multistate amicus brief filed in support of the defendants in Reproductive Health Services v. Planned Parenthood of St. Louis, Attorney General James, part of a coalition of 20 attorneys general from around the nation challenged the constitutionality of several recently enacted abortion bans in Missouri. Planned Parenthood of St. Louis – the only remaining abortion clinic in Missouri – and its Chief Medical Officer, Dr. Colleen McNicholas, are seeking to overturn several state restrictions that would significantly curtail women’s rights and create barriers to have safe, legal abortions.

“Nearly 50 years ago, the courts ruled that women across the country have the right to control their own bodies, but nearly every day since anti-choice legislators have tried to impost their personal beliefs on the wills of millions of women nationwide,” said Attorney General James. “These laws simply aim to control our bodies, control our choices, and control our freedom, which is why we will never stop fighting. We will not allow Missouri, nor any other state to undo all the progress we have made by restricting access to safe, legal, abortions.”

Missouri recently enacted several anti-choice laws meant to deny women access to abortion care in the state. Included in those laws are several “Gestational Age Bans” that make it a felony for physicians to perform abortions before the stage of viability recognized by the Supreme Court and, in some cases, before women would even know they were pregnant. In particular, the bans prohibit abortion after 14, 18, and 20 weeks so that if the court strikes down the eight-week ban, for example, the 14-week ban woudl still be in effect. Also included in the Missouri laws is a “Reason Ban” that prohibits a doctor from performing a pre-viability abortion if the doctor “knows” that a patient is seeking an aborton “solely because” of a prenatal diagnosis of Down syndrome.

In August 2019, Planned Parenthood of St. Louis secured a preliminary injunction in the U.S. District Court for the Western District of Missouri against the enforcement of the Gestational Age Bans. The district court subsequently issued an addition order prohibiting the state from enforcing the “Reason Ban.” Missouri appealed both decisions. Attorney General James and the coalition of attorneys general are today arguing that the challenged laws are unconstitutional, do not promote women’s healthcare, and deny women access to safe, legal abortions. As the coalition explains, states can advance their interests in support of women’s health while simultaneously protecting the rights of persons with Down syndrom without infringing on women’s reproductive rights.

Today’s brief is just the latest victory in a long list of measures Attorney General James has taken to protect women’s reproductive freedom. Last week, Attorney Genral James secured a victory for women in Rochester seeking to have an abortion without being harassed, threatened, or blocked before entering a clinic when a district court judge dismissed a lawsuit by anti-abortion activists seeking to bypass a 15-foot “buffer zone” outside a local Planned Parenthood clinic…

…Joining Attorney General James in filing today’s brief are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia

January 28, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Multistate Brief Challenging Restrictive Abortion Laws”. From the press release:

California Attorney General Xavier Becerra and Illinois Attorney General Kwame Raoul today led a multistate coalition in filing an amicus brief in the Eight Circuit Court of Appeals challenging the constiutionality of several recently enacted abortion bans in Missouri in Reproductive Health Services v. Planned Parenthood of St. Louis. Planned Parenthood of St. Louis, which provides the only remaining abortion services in Missouri, and its chief Medical Officer Dr. Colleen McNicholas, are seeking to overturn two start laws that would significantly curtail women’s rights and create barriers to safe and legal abortion. The multistate coalition argues that these laws are unconstitutional restrictions on women’s right to choose.

“No government, state or federal, has the right to make personal decisions for a woman about her body or her healthcare,” said Attorney General Becerra. “Missouri’s anti-choice laws are blatently unconstitutional and leave women in Missouri with no option within the state for safe, legal abortion care. We will continue to stand with women and the Constitution to protect their access to comprehensive healthcare.”.

Missouri recently enacted a number of anti-choice laws meant to deny women access to abortion care in the state. These unconstitutional measures include a so-called “Reason Ban” and several “Gestational Age Bans” that make it a felony for physicians to perform abortions at or after 8, 14, 18, and 20 weeks—before the stage of viability recognized by the Supreme Court and in some cases before women would even know they were pregnant. The passage of these laws sparked outrage as they are blatant attempts to undermine Roe v. Wade.

In August 2019, Planned Parenthood of St. Louis secured a preliminary injunction in the district court halting Missouri’s attempt to criminalize performing abortions. After the State of Missouri appealed the decision to the Eighth Circuit Court of Appeals, the district court issued an additional order prohibiting the state from enforcing the so-called “Reason Ban,” which was later appealed by Missouri. The California-Illinois-led coalition argues that the law is unconstitutional, does not promote women’s healthcare, and denies women access to safe, legal abortions.  

A copy of the complaint is here,

January 28, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Court’s Decision on Public Charge Rule Jeopardizes Health Care for Immigrants”. This statement is attributable to Robert McLean, MD, MACP, President of American Collge of Physicians. From the press release:

The American College of Physicians (ACP) is deeply disappointed that the Supreme Court decided to allow the Administration’s “public charge” rule to take effect in most of the United States while legal challenges play out. ACP is greatly concerned that this decision will jeopardize the health of children, their families, and create barriers to care for legal immigrants.

As a physician, I fear that with the changes to the public charge rule in place patients will forgo necessary care rather than face the threat of deportation or family separation, putting their own health and the health of their communities at risk. I worry that patients who are legal immigrants will opt out of health care services for themselves and their children – avoiding critical preventative services and leaving urgent medical conditions untreated.

ACP has been on record opposing the changes to greatly expand the scope of the public charge rule. When the changes were first proposted, the ACP wrote to the Department of Homeland Security to say that the changes “would undermine the physician-patient relationship and disrupt care continuity, and it is anthetical to the College’s mission to ensure meaningful access to health care for our patients. The rule will have negative impacts that will reverberate across populations, including U.S. citizens and legal residents.” That is why just last week ACP and other major physician groups filed an amicus brief in the Supreme Court case, opposing the new rule and outlining the harms that it would cause if it went into effect.

ACP asserts that immigration policy should not interfere with patient-physician relationship, and that health policy should not foster discrimination against any patient, regardless of immigration status. We will continue to urge the courts to issue a final ruling tha the public charge is unlawful and unconstitutional. At the same time, we also urge Congress to act to block its implementation.


January 29, 2020: The Hill posted an article titled: “Appeals court reufses to reconsider ruling striking down ObamaCare mandate”. It was written by Harper Neidig. From the article:

A federal appeals court voted against rehearing a legal challenge to ObamaCare after a three-judge panel struck down the health care law’s individual mandate.

The 5th Circuit Court of Appeals voted 8-6, mostly along ideological lines, against rehearing the case, after one of the judges asked for a vote.

Neither party in the lawsuit had asked the circuit court to rehear the case. A coalition of blue states has already appealed to the Supreme Court , which is currently deciding whether to take up the law….

January 29, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “We’re Back in Court this Week Defending Access to Safe Abortion in Kentucky”. It was written by Amber Duke, Communications Director. From the article:

The ACLU is back in court today once again to stop Kentucky’s attempt to block access to abortion. We’ve been here before. Over the past three years, the Kentucky General Assembly has passed bill after bill that limits – and even bans – a person’s ability to get an abortion. And time after time, we’ve gone to court to protect people’s rights to get the care they need.

At issue this week is a law that makes it a crime for doctors at Kentucky’s last remaining abortion clinic to perform an abortion procedure that is the standard of care. In reality, the law is nothing more than a backdoor abortion ban: It would bar the only procedure available in the state after about 15 weeks of pregnancy.

Following a trial last year, a federal district court blocked the law, finding that it imposed “a substantial obstacle to a woman’s right to an abortion” – as other courts around the country similarly found. But the Commonwealth of Kentucky appealed, and we are arguing the appeal in the U.S. Court of Appeals for the Sixth Circuit today.

The commonwealth’s opposition to this type of procedure is blatently political, not medical. Leading medical expets such as the American Medical Association and the American College of Obstetricians and Gynecologists oppose these bans, saying they interfere with a doctor’s ability to provide the best possible care for their patient….

…today Kentucky has only one clinic left in the entire state. And the state is trying to force that last clinic to close its doors, leaving Kentuckians with no abortion provider at all. It’s only because we went with the clinic, EMW Women’s Surgical Center, to get a court order that the doors are still open; this case is on appeal…

January 29, 2020: Politico posted an article titled: “‘Block grants’ no more: Trump’s Medicaid overhaus has a new name, same goals”. It was written by Dan Diamond and Rachel Roubein. From the article:

The Trump administration will rebrand its Medicaid block grant program and look to safeguard the policy against an expected wave of legal challenges from patient advocates, according to two officials with knowledge of the plan set for release Thursday.

The forthcoming block grant program comes with a new name – “Healthy Adult Opportunity” – but retains the original mission long sought by conservatives: allowing states to cap a portion of their spending on Medicaid, a radical change in how the safety net health program is financed.

The block grant plan, which invites states to request capped funding for poor adults covered by Obamacare’s Medicaid expansion, also would let states limit health benefits and drugs avaialble to some patients…

…Aware of criticism that any cap on Medicaid funding would target vulnerable patients, [Seema] Verma will stress during Thursday’s announcement that her plan, by focusing just on the Obamacare expansion, will not affect the poorest or disabled patients. Verma has long argued Medicaid expansion is siphoning away resources from the most vulnerable patient covered by the program CMS will frame the block grant as a way to reinvest any savings into care improvements for Medicaid beneficiaries.

States will be required to report their performance in real time, such as whether Medicaid patients see declines in access to providers or health outcomes, which one official said would allow the administration to gague whether the block grant was truly working to make adults healthier. One official said this could help CMS guard the program against legal challenges as advocates who say the administration doesn’t have the authority to cap Medicaid…

…The Trump administration also will allow participating states to limit the drugs offered by their Medicaid programs, a sticking point for states frustrated by the requirements that the safety net program include an expansive list of medications. Patients with behavorial health needs of HIV would be protected under the Trump administration plan, said one official…

January 29, 2020: Several U.S. Representatives signed a letter to U.S. Department of Health and Human Services Alex M. Azar, II and Administrator of Centers for Medicare and Medicaid Services regarding the Trump administration’s approval of Medicald block grant waivers. From the letter:

…We write to express our strong concerns regarding your intent to approve Medicaid block grant waivers. Previous statements from those in the Administration make it clear that the goal of these block grants is to cut benefits and further limit access to publicly funded health care. Additionally, the approval of such waivers would directly oppose federal statutes, which describe how the agency must make matching funds available to state Medicaid programs.

Medicaid was created in 1965 for the purpose of expanding access to healthcare to low-income children, families, people with disabilities, seniors and other adults. Section 1115 explicitly permits waivers of specific sections of the Social Security act, but does not allow waivers for Section 1903, the section that directs federal matching funds to states. Therefore, the Centers for Medicare and Medicaid Services (CMS) is required to match state’s spending as the statute prescribes and is powerless in determining alternative state payments, including capping the Medicaid funds it disburses. The power and responsibility to change these payments lies solely with Congress. The intent of the current structure and the federal match is to help states provide adequate medical support for their poorest residents.

By contrast, the purpose of block grant waivers is to overhaul the state’s Medicaid program by capping federal funding. In turn, states would be given a lump sum of federal money, freed from federal oversight or accountability measures; measures which encourage baseline benefits and quality of care to be available to all enrollees. These waivers would give states the ability to remove enrollees or cut certain health care benefits and rates, if they believe they are too costly or unnecessary.

Permitting waivers to allow for less spending in return for limited oversight directly contradicts Congress’s intent when establishing Medicaid; a safety-net health program. Medicaid block grants necessitate cost-cutting measures like restricting enrollment, decreasing provider reimbursement, and limiting eligibility and benefits through managed care. These actions endanger the lives of the most vulnerable patients, the population Medicaid was created to protect.

Not only do Medicaid block grants directly oppose Congress’s intent for the Medicaid program, but they are illegal under Section 1115.

Earlier this month, House Energy and Committee Chairman Frank Pallone, Jr. and Senate Finance Ranking Member Ron Wyden sent a letter to the Office of Inspector General in the Department of Health and Human Services citing the illegality of Medicaid block grants. Chairman Pallone and Ranking Member Wyden are both members of the two Committees with jurisdiction over Medicaid; the agency should heed their concern over the lack of program integrity should these waivers be approved.

Guidance providing states a roadmap to obtain Medicaid block grant waivers not only defies Congress and the federal Medicaid statute but if implemented, will threaten health care for millions of individuals, hurting them whne they are the most vulnerable. The Administration should not issue any guidance encouraging block grant waivers, should reject these waviers and the concept of block grants, and urge any state that is considering this misguided policy to commit its energy to implementing Medicaid as Congress intends.

Here are the Representatives who signed this letter (by state):

  • Alabama: Terri A. Sewell
  • Arizona: Ann Kirkpatrick, Donald S. Beyer Jr.
  • California: Ro Khanna, Grace Napolitano
  • Colorado: Jason Crow
  • Connecticut: Rosa L. DeLauro
  • Florida: Darren Soto, Cathy Castor, Debbie Mucarsel-Powell, Val B. Demmings
  • Iowa: Abby Finkenauer
  • Kansas: Sharice L. Davis
  • Maine: Chellie Pingree
  • Massachusetts: Joseph P. Kennedy, III, Ayanna Pressley
  • Michigan: Debbie Dingell, Daniel Kildee
  • Minnesota: Angie Craig, Ilhan Omar
  • New Hampshire: Chris Pappas
  • New York: Thomas R. Suozzi, José E. Serrano, Eliot Engel, Adriano Espaillat, Nydia M. Velázquez
  • North Carolina: G.K. Butterfield
  • Ohio: Marcia L. Fudge
  • Pennsylvania: Susan Wild, Mike Doyle
  • Tennessee: Jim Cooper, Steve Cohen
  • Texas: Eddie Bernice Johnson
  • Vermont: Peter Welch
  • Virginia: Jennifer Wexton
  • Wisconsin: Gwen Moore

January 29, 2020: WiscNews posted an article titled: “Wisconsin further delays Medicaid work requirments for childless adults.” It was written by David Wahlberg. From the article:

Wisconsin’s work requirement for childless adults on Medicaid, initially schedulled to begin Nov. 1 and delayed until Thursday, has been postponed again – with a new requested start date of April 29.

Premiums and some other stipulations adopted by former Republican Gov. Scott Walker and approved by President Donald Trump’s administrtion are set to begin Saturday…

…Wisconsin plans to limit Medicaid coverage to four years for poor adults without dependent children unless they work, train for a job, or particiapte in certain other activities.

Gov. Tony Evers, a Democrat who took office last year, tried to block the work requirment, but the Republican-controlled Legislature kept it. Evers’ administartion has said it would implement it.

January 29, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU of South Dakota Urges Lawmakers to Stop Hurting Transgender Youth”. From the press release:

Ahead of today’s full chamber vote on House Bill 1057, legislation that would criminalize doctors for providing medically necessary care for transgender youth, some South Dakota legislators continue their attempts to codify discrimination against trans kids.

The ACLU of South Dakota opposes Senate Bill 88 and Senate Bill 93.

Senate Bill 88 would mandate that school counselors, school psychologists or social workers disclose to a parent any young person’s identification as transgender, exploration of gender identity or reference to potential symptoms of gender dysphoria. This bill could result in forced disclosure of someone’s trans or questioning status to a non-affirming parent which could result in the young person becoming homeless or physically harmed.

“When transgender youth face discrimination and victimization at school, it can often lead to serious negative health and mental health consequences,” said Libby Skarin, policy director for the ACLU of South Dakota. “Senate Bill 88 infringes on the rights of privacy of youth and deters young people from seeking support from trusted adults in positions to consel them.”

Senate Bill 93 would give a parent the right to refuse to consent to a range of health care treatment options, including mental health treatment, for transgender young people. Parents, however, already have broad constitutional and common law powers to make decisions about medical treatment for minor children in their care and custody that cannot be limited by legislation.

“Transgender yough are among society’s most at-risk populations,” Skarin said. “Senate Bill 93 just amounts to a proclamation of government disapproval of transgender young people and contributes to the already dangerous rates of family rejection for transgender youth.”

Like House Bill 1057, Senate Bill 88 and Senate Bill 93 would hurt transgender youth, violate federal law and expose South Dakota to legal liability. The ACLU of South Dakota is committed to ensuring that transgender South Dakotans can live openly without discrimination remains strong and urges South Dakota lawmakers to stop hurting transgender youth…

January 29, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “NH Hospital Wait Times Drastically Decrease”. From the press release:

Today, Governor Chris Sununu and the New Hampshire Department of Health and Human Services (DHHS) have released new data highlighting New Hampshire Hospital’s successful efforts to decrease the wait time for a bed and reduce the number of staff injuries.

According to new trend data, the total average number of days patients spent in hospital emergency departments (ED) decreased by 60% in the last two years, from 1,500 total ED boarding days spent by individuals in September 2017 to 755 total days spent by individuals in November 2019. During that same period, the average length of time an individual patient waited for admission to NHH or a Designated Receiving Facility has decreased from 6.2 days to 3.8 days, a 40% decline….

…NHH has effectively overseen daily management of the waitlist, made policy changes to expedite referrals to community-based treatment settings, implemented guidelines to prevent most patients from waiting more than 15 days for admission, and facilitated the development of new protocols that expedite the admissions process by instituting an interdisciplinary review of referrals.

NHH leadership has also focused on reducing staff injuries to improve safety for staff, patients and visitors. Since 2018, staff injuries have decreased by 48%, resulting in a safer workplace, less time lost from work, and a savings of more than $350,000 in workers compensation claims…

January 29, 2020: The Buffalo News posted an article titled: “Lawmakers push back against Cuomo Medicaid deficit reduction ideas”. It wa written by Tom Precious. From the article:

…Before Health Commissioner Dr. Howard Zucker and Medicaid Director Donna Frescatore departed a legislative hearing room Wednesday, they were told by lawmakers in no uncertain terms that: fiscal books are somehow being cooked; facts are being withheld; painful service cuts are aimed at elderly, poor and disabled New Yorkers; and county taxpayers are going to be harmed by cost shifts proposed by Cuomo…

…[State Senator Gustavo] Rivera, and others were frustrated by a lack of specifics, the blocking of information to legislative staff experts and a plan by Cuomo to create a private, outside panel to come up with $2.5 billion in Medicaid savings that won’t report its findings until sometime shortly before a state budget is due March 31…

…Officials in New York City, which accounts for about half of Medicaid costs in the state, said Cuomo’s cost shift plan could, based on recent insurance cost levels, hit the city with a $1.1 billion tab in the coming year. [Cuomo officials later said the city’s $1.1 billion claim was vastly overstated by at least $880 million.]…

…Last week, Erie County Executive Mark Poloncarz said Medicaid costs would have been about $8 million higher in each of 2017 and 2018 had Cuomo’s new cost-sharing plan been in effect. How muchcould it be in 2020 is anyone’s guess at this point.

The state is facing a $6.1 billion deficit in the coming fiscal year, with two-thirds of that generated by Medicaid red ink. High costs for providers meeting the state’s new minimum wage requirements and rising long-term care costs for seniors and disabled people are among the big expense drivers. The Cuomo administration has solved part of the problem by rolling over – or delaying – payments to providers from one fiscal year to the next.

Cuomo has two other ideas now: incentivize counties to help find Medicaid savings by raising state costs onto them if those savings aren’t realized, and, create a panel – called the Medicaid Redsign Team (MRT) – to find $2.5 billion in savings. With budget talks already underway, Cuomo has yet to appoint the panel, except its two co-chairs: a longtime health care union leader and the New York head of a hospital system that is the state’s largest. One lawmaker Wednesday pondered out loud about potential conflicts of interest inherent in having a hospital boss decide winners and losers in Medicaid cuts…

January 29, 2020: Senator Ron Wyden (Democrat – Oregon) posted a press release on his website titled: “Wyden, Merkley Demand Trump Publicy Commit To Protecting Social Security, Medicare, Medicaid”. From the press release:

…Oregon’s U.S. Senators Ron Wyden and Jeff Merkley this week joined their Democratic colleagues in demanding Donald Trump retract the alarming threats he made last week concerning cutting earned benefits like Medicare or Social Security to pay for his tax scam, which has been a handout to corporations at the expense of workers.

“As a presidential candidate, you promised the American people that you would not cut Social Security, Medicare, or Medicaid. In fact, you criticized your opponents for failing to make the same promise. Not only have you broken that promise, you have waged an all-out assault on Medicaid,” the senators wrote. “Attempting to make up the trillion-dollar deficit created by your tax law on the backs of hard-working Americans would be a betrayal to all who consider these programs a lifeline. American workers who for decades have paid into Social Security and Medicare should not be forced to relinquish their health and retirement security to pay for your tax cuts for the wealthiest Americans and largest corporations.”

Despite Republican claims that their scam bill was a tax cut for working people, it has proven to be nothing more than a giveaway for corporations and the wealthy. It has also exploded the deficit – which Republicans have planned all along to use as their justificationt for cutting the benefits hard-working Americans have earned. Wyden, Merkley, and their colleagues are demanding Trump publicly commit to protecting Social Security, Medicare and Medicaid for the remained of his presidency.

Joining Wyden and Merkley in sending the letter are U.S. Sens. Sherrod Brown, D-Ohio, Tammy Baldwin, D-Wisc., Michael Bennet, D-Colo., Richard Blumenthal, D-Conn., Cory Booker, D-N.J., Maria Cantwell, D-Wash., Ben Cardin, D-Md., Bob Casey, D-Pa., Chris Coons, D-Del., Catherine Cortez Masto, D-Nev., Tammy Duckworth, D-Ill., Richard Durbin, D-Ill., Dianne Feinstein, D-Calif., Kirsten Gillibrand, D-N.Y., Kamala Harris, D-Calif., Maggie Hassan, D-N.H., Martin Heinrich, D-N.M., Mazie Hirono, D-Hawaii, Tim Kaine, D-Va., Amy Klobuchar, D-Minn., Patrick Leahy, D-Vt., Edward Markey, D-Mass., Bob Menendez, D-N.J., Patty Murray, D-Wash., Gary Peters, D-Mich., Jack Reed, D-R.I., Jacky Rosen, D-Nev., Bernie Sanders, D-Vt., Chuck Schumer, D-N.Y., Jeanne Shaheen, D-N.H., Tina Smith, D-Minn., Debbie Stabenow, D-Mich., Tom Udall, D-N.M., Chris Van Hollen, D-Md., Elizabeth Warren, D-Mass., and Sheldon Whitehouse, D-R.I.


January 30, 2020: The Guardian posted an article titled: “South Dakota lawmakers vote to jail doctors for treating trans teens”. It was written by Guardian staff and agency. From the article:

South Dakota lawmakers voted in favor of a law that would see doctors jailed for giving puberty-blocking drugs to transgender children, the latest in a slew of such bills sweeping the United States.

The bill, which cleared the South Dakota house of representatives on Wednesday but still has to clear the state’s senate, would bar doctors in the state from providing anyone under 16 with the drugs, which can temporarily stop the body from producing the hormones that lead to puberty, a reversable process.

Critics of the proposed ban say the drugs play a crucial role in allowing trans children struggling with the onset of puberty to hit pause.

“One of the biggest problems for these kids is… their sense of who they are isn’t matching their body,” Anne Dilenschneider, a South Dakota psychologist, told the Thomson Reuters Foundation.

“They’ve got a body developing in a way that is causing a huge crisis. And they want it to stop,” said Dilenschneider, warning that this could make young people suicidal.

Studies have found that young trans people have a much higher suicide rate than their peers…

…The bill follows the introduction in South Carolina of measures that could see the licenses of doctors who treat trans children revoked, one of a series of such measures in conservative US states…

…Experts and parents of trans children warn such restrictions could harm young people already struggling with the challenges of adolescence and gender dysphoria…

…The ban passed with 46 votes to 23 in the state’s Republican-controlled house of representatives. It will still have to clear the senate, where it may face greater opposition. The state’s govenor will have the final say.

January 30, 2020: The American Academy of Pediatrics (AAP) posted news titled: “AAP opposes new Medicaid guidance on block grants, per capita caps”. It was written by Trish Korioth. From the news:

Sweeping new federal guidance on Medicaid issued by the Centers for Medicare & Medicaid Services (CMS) would be detrimental to children and families, according to the AAP, five other major medical organizations and several health groups.

The guidance announced by CMS Thursday allows caps on federal funding and offers states the option to use block grants and per capita caps for low-income adult populations, including parents with young children.

“The American Academy of Pediatrics urges CMS to immediately rescind this guidance and instead pursue policis that strengthen Medicaid. CMS must instead work to revers the troubling trend of rising child uninsurance rates due to children losing Medicaid and CHIP (Children’s Health Insurance Program) coverage,” AAP President Sara “Sally” H. Goza, M.D., FAAP, said in a statement.

Medicaid enrolls 37 million children nationwide. When parents lose coverage, their children are more likely to lose coverage as well. However, the full impact of the guidance on children remains unknown. The AAP and health groups isued a joint statement “united in opposition to any threat to Medicaid that would dismantle a pillar program millions of families rely on.”

The block grant or per capita financing mechanism for Medicaid also violates joint principles on Medicaid waivers supported by the six major medical organizations that represent more than a half-million U.S. physicians.

Children, including those with special health care needs and those from low-income families, make up the single largest group of people who rely on Medicaid.

Following the release last September of the U.S. Census Bureau data showing 425,000 fewer childrne had health insurance coverage in 2018, the groups called for immediate action by Congress and the Trump administration to protect and improve health coverage for all children…

…The Medicaid program guarantees specific benefits designed for children, known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT). As a result, children on Medicaid are more likely to get checkups, miss less school, graduate and enter the workforce than their uninsured peers. But under the new guidance, states also will be allowed to opt out of providing EPSDT to some populations.

“We urge CMS to immediately rescind the guidance and keep Medicaid strong,” Dr. Goza said. “Simply put: Medicaid works.”

The letter from six major medical organizations is here. It includes the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, American Osteopathic Association, and American Psychiatric Association.

January 30, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Sues Trump Administration For Attempting To Raise Costs Of Abortion Services Under ACA”. From the press release:

New York Attorney General Letitia James today co-led a coalition of seven attorneys general in suing the Trump Administration for making it more difficult for women in New York and across the nation to access abortion services under the Affordable Care Act (ACA). In late December 2019, the U.S. Department of Health and Human Services (HHS) issued a final rule that unlawfully reinterpreted Section 1303 of the ACA by requiring qualified health plans that particupate in the state exchanges – like the New York State of Health – to send separate bills and collect separate payments of at least one dollar for abortion services. In their lawsuit, Attorney General James and the colaition argue that HHS’s new onerous and confusing requirement threatens women’s access to abortion. The lawsuit also highlights that the new rule is incompatible with the ACA’s requirement of equitable access to health care and disproportionately affects states – like New York, California, Maine, Oregon, and Vermont – that are committed to ensuring access to comprehensive reproductive health care by requiring health plans to provide abortion coverage.

“Every day, the Trump Administration and anti-choice activists look for new ways to undermine Roe v. Wade and impose burdensome restrictions on women’s reproductive freedoms,” said Attorney General James. “This new rule is just another attempt to control women’s bodies and make it harder for those struggling financially to exert their constitutional right to an abortion. New York will not sit idly by as this Administration continues its assault on women. We will never stop fighting to ensure every woman is able to make her own reproductive choices.”

Under New York law, all private health plans regulated by the state are required to offer abortion coverage as part of their basic health care services, but the new federal rule requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage. The rule also requires consumers to make a separate payment of at least one dollar for these services or risk losing all of their health care coverage. HHS itself has conceeded that requiring separate bills and separate payments will inevitably lead to confusion for the more than 260,000 New Yorkers that have already enrolled in a qualified health plan this year. The rule will also burden states with unnecessary administrative costs and harm consumers who will face higher insurance premiums as a result to increased cost to carriers. For example, initial compliance is expected to cost all impacted insurance companies nearly $400 million, with another $100 million in estimated annual costs to maintain the separate systems. These excessive costs put pressure on insurers to remove abortion coverage from their plans and punish those companies that do business in states, like New York, where abortion coverage is required.

In the lawsuit filed today – led by Attorney General James and California Attorney General Xavier Becerra – the coalition aruges that the new rule is unlawful because it:

Imposes onerous and unnecessary regulatory barriers aimed at restricting women’s constitutionally-protected right to access abortion care;

Seeks to frustrate state sovereignty by coercing states to change their policies relating to the protection of abortion care;

Violates section 1554 of the ACA, which prohibits the prmulgation of any regulation that creates unreasonable barriers to the ability of individuals to obtain appropriate medical care; and

Exceeds HHS’s statutory authority under Section 1303 of the ACA..

…Joining Attorney General James and Attorney Genearl Becerra in filing today’s lawsuit were the attorneys general of Maine, Maryland, Oregon, Vermont, and the District of Columbia.

A copy of the brief is here.

January 30, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorneys General Becerra and James File Lawsuit Challenging Trump Administrtion Attack on Healthcare Access and Reprodcuctive Rights”. From the press release:

California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of six states and the District of Columbia, today sued the U.S. Department of Health and Human Services (HHS) for its unlawful reinterpretation of Section 1303 of the Affordable Care Act (ACA). On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to send separate bills and collect separate payments of at least one dollar for abortion coverage. This onerous and confusing requirement threatens women’s access to abortion and puts millions at risk of accidentally losing critical health insurance coverage. The lawsuit highlights that the new rule is incompatible with the ACA’s requirement of equitable access to healthcare and disproportionatelly affects states that are committed to ensuring reproductive healthcare.

“This new rule is just another Trump Administration attack on women and reproductive rights,” said Attorney General Becerra. “We have a long history of protecting women’s access to comprehensive reproductive healthcare, including abortion. We won’t let an unlawful administrative rule change that. And we will defend California’s ability to enact and enforce laws that promote the health of its residents.”

Under California law, all health plans regulated by the state are required to offer abortion coverage as part of their basic healthcare services. The new federal law requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage. The rule also requires consumers to make a separate payment of at least one dollar for these services or risk losing all of their healthcre coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion, putting more than 1.4 million enrolles in California alone at risk of losing coverage if they inadvernently fail to make full premium payments on time. The rule will also burden carriers. For example, initial compliance is expected to cost all impacted insurance companies nearly $400 million, with another $100 million in estimated annual costs to maintain the separate systems. These excessive costs put pressure on insurers to remove abortion coverage from their plans and punish those companies that do business in states like California where abortion coverage is required…

…Attorney General Becerra was joined in filing today’s lawsuit by the attorneys general of New York, Maryland, Maine, Oregon, Vermont and the District of Columbia.

January 30, 2020: The Department of Health and Human Services Centers for Medicare and Medicaid Services sent a letter to state Medicaid directors about “Healthy Adult Opportunity”. From the letter:

Dear State Medicaid Director:

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new opportunity for states to potentially achieve new levels of flexibility in the administration and design of their Medicaid programs while providing federal taxpayers with greater budget certainty. The Healthy Adult Opportunity (HAO) initiative will allow states to carry out demonstrations under section 1115 (a)(2) of the Social Security Act (the Act) to provide cost-effective coverage using flexible benefit designs under either an agressive or per-capita financing model for certain populations without being required to comply with a list of Medicaid provisions identified by CMS.

CMS recognizes that states, as administrators of the program, are in the best position to assess the needs of their respective Medicaid-eligible populations to drive reforms that result in better health outcomes. States that agree to implement demonstrations under either of these financing models and to increased transparancy and accountaiblity for effective administration of their programs, quality and access to care, which in the judgement of CMS, are likley to assist in promoting the objectives of the Medicaid program, will be granted extensive flexibility to test alternative approaches to implementing their Medicaid programs, including the ability to make many ongoing program adjustments without the need for demonstration or state plan amendments that require prior approval. The list of Medicaid provisions with respect to which we will consider providing flexibility for states participating in demonstrations approved under the HAO initiative is provided in Appendex A. This includes flexibility on provisions such as retroactive coverage, cost-sharing limits, presumptive eligibility, and other requirements that CMS historically has waived under section 1115 of the Act.

Through the HAO initiative, CMS is inviting states to design demonstrations for consideration by CMS that will promote the objectives of the Medicaid program, including the furnishing of medical assistance in a manner that promotes the sustainability of government health care spending through the use of an annual budget neutrality limit, calculated in the aggregate or on a per capita basis. While federal funding will be capped, federal financial participation (FFP) will continue to flow to states as it does today; nothing in this letter changes the need for states to submit claims reflecting actual expenditures to obtain federal matching funds for the Medicaid program. Demonstrations approved utilizing this approach will ofeer states far greater flexibility and discretion than is available under ordinarily-applicable Medicaid rules without the need for complex amendments or advance federal approval of certain changes…

…The HAO initiative encourages states to apply for all flexibilities that been previously approved in other demonstrations where such flexibilities would be likely to promote the objectives of the Medicaid program, such as…

  • The ability to cover adults who qualify for Medicaid on a basis other than disability or need for long-term care services and supports and who are not covered under the state plan, including covering all individuals… that would apply if they were covered under the state plan;
  • Providing populations covered under an HAO demonstration with coverage more consistant with insurance benefits provided the the Exchanges, rather than the traditional Medicaid benefit package;
  • The ability to pay for services that cannot be funded by Medicaid, including those deisgned to address certain health determinants, such as enhnaced case management services that link individuals to housing or other supports;
  • Design of flexible premium and cost sharing structures that are not required to comply with the terms of section 1916(f) of the Act;
  • The ability to impose additional conditions of eligibility, such as community engagement requirements for non-elderly, non-pregnant Medicaid beneficiaries who are eligibile for Medicaid on a basis other than disability;
  • The ability to make certain changes in benefits, premiums, and co-payments during the course of the demonstration without the need for state plan or demonstration amendments and further approval by CMS;
  • The ability to change eligibility and enrollment processes, such as eliminating retroactive eligibility.

Additionally, the HAO initiative potentially offers states new opportunities, including:

  • The ability to make certain administrative changes during the course of the demonstration, such as certain changes in provider payment rates and application of claims review prior to making payment, without amendments or further approval by CMS;
  • The ability to adopt a closed forumulary in line with Essential Health Benefit (EHB) requirements (with special protections for individuals with HIB and behaviorial health conditions);
  • The ability to include coverage of services provided by a federally qualified health center as part of the state’s value-based payment reform option;
  • The opportunity to propose alternate approaches to compliance with statutory managed care provisions that differ from those set forth in regulations;
  • The opportunity for states implementing an aggregate cap demonstration to be elibible for shared savings when actual FFP is less than FFP allotment under the aggregate cap, provided a state meets certain performance criteria.

…States will have the opportunity to impose conditions of eligibility on coverage under an HAO demonstration that do not generally apply to Medicaid coverage under state plans, such as community engagement requirements, … and consistent with other applicable laws, including title VI of the Civil Rights Act of 1964, section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age of Discrimination Act of 1975, and section 1557 of the Patient Protection and Affordable Care Act (PPACA). CMS, in consultation and coordination with the Department of Health and Human Services (HHS) Office for Civil Rights, is available to assist states in designing projects that comply with the civil rights laws…

…States choosing to participate in the HAO initiative also will ahve the opportunity to set the income standard for eligibility for coverage under an HAO demonstration, as well as to change the standard over the course of the demonstration, and/or to limit coverage to a defined subset of individuals, such as individuals with severe mental illness, individuals needing treatment for substance use disorder, or individuals with HIV/AIDS. States may also propose to require an asset test for individuals seeking coverage under an HAO demonstration. Under the HAO initiative, and in other demonstration projects covering the adult group under section 1115(a)(2) authority, increased FMAP will be availble in accordance iwth sections 1905(y) and 1905(z) of the Act, provided that demonstration includes a standard for eligibility based on a household income standard of at least 133 percent of the federal poverty level (FPL), no asset test for those with income at or below 133 percent FPL, and eligibility for all individuals described in the adult group, even when benefits are not provided in accordance with section 137 of the Act…

…For populations covered under an HAO demonstration, CMS will not require compliance with the effective date of eligibility prescribed under 42 CFR 435.914. Instead, states may propose to not to provide retroactive eligibility, as well as to establish a prosptective effective date of coverage – for example, to coincide with enrollment in a managed care plan or a Qualified Health Plan (QHP). States could also propose to conduct an individual’s first regularly-scheduled renewal of eligibility prior to the end of the 12-month renewal called for in 42 CFR… in order to align with the open enrollment period for Exchange coverage. In addition, many states may propose to not comply with the requirment to operate Hospital Presumptive Eligibility (HPE), … although states implementing an HAO demonstration can elect to offer such coverage to individuals covered under an HAO demonstration…

…States may propose under an HAO demonstration may propose to noe be required to comply with restrictions on premiums and cost-sharing imposed under sections 1916 and 1916A of the Act… Instead, states will have broad flexibility to propose alternative premiums and cost sharing structures. We would expect states to adhere to two overarching limitations:

(1) Aggregate out-of-pocket costs incurred by beneficiaries covered under the demonstration would not exceed 5 percent of the beneficiary’s household income, meaured on a monthly or quartly basis.

(2) Premiums and cost-sharing charges for tribal beneficiaries as well as individuals needing treatment for substance use disorder and individuals living with HIV, as well as cost-sharing charges for prescription drugs needed to treat mental health conditions, would not exceed amounts permitted under the statute and implementing regulations. States similarly would not be permitted to suspend enrollment for such individuals for failure to pay premiums or cost-sharing, even if authorized for other individuals under the demonstration…

…While nothing in this letter represents final approval of any program or is binding on any state or any Medicaid recipient, CMS hppes this information is helpful and looks forward to continuing to work with states to consider and implement innovative solutions to improve their Medicaid programs. CMS is available to provide technical assistance to states, as well as to preview states’ draft section 1115 proposals to help ensure states have the best chance possible of meeting federal requirements…

January 30, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Changes to Medicaid Program Will Put Health Care at Risk for Vulnerable Patients”. This statement is attributable to Robert McLean, MD, MACP, President of American College of Physicians. From the press release:

The American College of Physicians (ACP) is greatly concerned that the new Healthy Adult Opportinity Plan announced by the administration today will put access to health care at risk for Medicaid beneficiaries. ACP strongly opposes transforming Medicaid’s existing financial structure into a block grant approach because it will increase the nimer of people without health insurance coverage for essential health care services. Likewise, the per-capita cap option will restrict crucial health care funding.

The Medicaid program is meant to provide a safety net for those most in need. For states that apply for the new demonstration project there would be a cap on the federal funding provided to cover adults under age 65 who are primarily eligible for Medicaid through Medicaid expansion, giving those states only a fixed amount of money no matter the need in the state. Just as troubling, they would also no longer need to ensure that their program is providing those beneficiaries with the same benefits and coverage. Fewer patients will be covered, and those who remain covered will have less access to health care services.

We are concerned that enacting a cap on Medicaid funding leaves states unprepared to respond quickly to potential public health crises. In the event of an economic downturn, states would be unable to quickly accomodate people who might be unexpectedly and suddenly dealing with a loss of insurance and employment. States will have more ability to impose premiums and cost-sharing on adult Medicaid beneficiaries under these changes. We know that imposing cost-sharing dissuades low-income beneficiaries from seeking needed care.

We are also concerned that this may encourage states, in a cost-saving effort, to cut prescription drug benefits. They also will be permitted to cut non-emergency transporation benefits tha could be vital to those seeking necessary care in rural or remote locations.

Further, by restricting federal funding available to states, they may reduce payments to physicians under Medicaid. Currently, many state Medicaid programs reimburse at much lower rates than Medicare and commercial payers. Encouraging states to further reduce payments to physicians will have a particularly adverse impact on primary care physicians, making i more difficult for them to continue seeing Medicaid beneficiaries.

As a physician, I worry abotu what will happen to my patients who depend on Medicaid for their health care. Medicaid programs across the country are vital in the effort to ensure that our nation’s most vulnerable population has access to health coverage. ACP calls on the Centers for Medicare and Medicaid Services to reverse this guidance that would drastically weaken coverage under the Medicaid program for low-income adults and instead focus on policies that would strenghten it.

Our current healthcare system with problems of accessiblity and affordability already leaves too many patients behind. ACP is greatly concerned this Medicaid change will exacerbate these problems. Our patients deserve better.

January 30, 2020: American College of Obstetricians and Gynecologists (ACOG) posted news titled: “Administration’s Attempt to Restructure Financing of the Medicaid Program is Concerning”. From the news:

Ted L. Anderson, MD, PhD, president of the American College of Obstetricians and Gynecologists (ACOG), issued the following statement regarding the Administration’s letter to state Medicaid directors that encourages states to transition their Medicaid programs to a “block grant” funding mechanism: 

“The American College of Obstetricians and Gynecologists (ACOG) opposes the Administration’s attempt to encourage states to block grant Medicaid funding for certain populations. Block grants are fixed amounts of money given to the states from the federal government instead of funding based on the needs of each the state. This alternative financing mechanism would permit the federal government to cap its investment in Medicaid, reducing federal funding for the country’s most vulnerable, low-income individuals.

“As the nation’s leading group of physicians providing health care for women, ACOG is concerned by the limitations of capped federal financing in Medicaid. Medicaid was created to help pregnant women, children, people with disabilities, and other vulnerable populations access vital health care coverage. Limits on the federal contribution to the Medicaid program would negatively impact patients by forcing states to reduce the number of people who are eligible for Medicaid coverage, eliminate covered services, and increase beneficiary cost-sharing. ACOG is also concerned that this block grant opportunity could lower physician reimbursement for certain services, forcing providers out of the program and jeopardizing patients’ ability to access health care services. Given our nation’s stark rates of maternal mortality and severe maternal morbidity, we are alarmed by the Administration’s willingness to weaken physician payment in Medicaid.

“Medicaid is a women’s health success story. This invitation from the Centers for Medicare and Medicaid Services (CMS) to states to transform their Medicaid programs into block grants or other capped funding arrangements threatens millions of Americans with loss of coverage and will lead to adverse health outcomes for women and families. ACOG urges CMS to reconsider its willingness to approve state waiver requests that would alter the long-standing funding structure of our nation’s health care safety net.”

January 30, 2020: Planned Parenthood posted a press release titled: “Trump Administration Greenlights Massive Cuts to Medicaid”. From the press release:

Today, the Trump administration announced what could lead to a major overhaul to Medicaid, paving the way for states to slash Medicaid funding and jeopardize health care coverage for people with low incomes, including reproductive and sexual health care…

…The Trump administration’s move to allow states to overhaul Medicaid into a block grant system would result in drastic cuts to funding, and could cause women with low incomes across the country to lose access to their health care. About one in five women of reproductive age rely on Medicaid for their health care, and women account for over half of all adult Medicaid enrollees. Medicaid covers more women’s health services than any other payer. Medicaid is also the largest payer of reproductive health care coverage, paying for nearly half of all births in the United States and 75 percent of family planning services.

The attack on Medicaid comes barely a week after the Trump administration granted Texas federal funding for their state program that blocks patients in the program from accessing care at Planned Parenthood health centers, setting a dangerous precedent for other states that may follow suit. After Texas barred Planned Parenthood from providing care through the program in 2013, there was a sharp decline in access to women’s health services, resulting in nearly 45,000 fewer women accessing health care services through the Texas program…

January 30, 2020: Meals on Wheels America posted a press release titled: “Congress Reaches Bipartisan Compromise to Reauthorize the Older Americans Act”. From the press release:

Meals on Wheels America President and CEO Ellie Hollander today issued the following statement in response to a compromise Older Americans Act (OAA) reauthorization bill that was reached between the U.S. Senate and House of Representatives – Supporting Older Americans Act of 2020:

Meals on Wheels America commends the Senate Health, Education, Labor and Pension Committee, Senate Aging Committee and House Education and Labor Committee -Senate Chairmen Lamar Alexander and Susan Collins and Ranking Members Patty Murray and Bob Casey, and House Chairman Bobby Scott, Subcommittee Chairwoman Suzanne Bonamici, Ranking Member Virginia Foxx and Subcommittee Ranking Member James Comer – for reaching a bipartisan, bicameral agreement to reauthorize the Older Americans Act (OAA) for five years. The Supporting Older Americans Act of 2020 would amend the House-passed Dignity in Aging Act and reconciles bills introduced in the Senate to arrive at strong, comprehensive legislation that recognizes the extraordinary impact of the vital services provided through the Act, like Meals on Wheels, on the lives of millions of seniors nationwide. We urge swift and unanimous passage.

The Supporting Older Americans Act of 2020 includes a number of key priorities to strengthen the senior nutrition network overall and help enhance essential services on which so many individuals rely. Notably, we applaud the 6% increase in authorized appropriations funds for OAA programs; the focus on addressing the negative impacts of social isolation and malnutrition; and the initiatives to capture data around unmet need, including waiting lists for senior nutrition programs. Nearly half of Meals on Wheels America’s members – local senior nutrition providers – have a documented waiting list for meals, and the resources and attention granted by this legislation will improve the network’s ability to close service gaps while continuing to meet the evolving needs of a rapidly growing older adult population….

January 30, 2020: New Hampshire Governor Chris Sununu posted a press release titled “Governor Sununu Statement on Medicaid to Schools”. From the press release:

Today, Governor Chris Sununu issued the following statement after the Senate voted to pass Medicaid to Schools legislation, SB 684, out of the Senate. The legislation now goes to the full House of Representatives.

“I applaud the State Senate for passing our Medicaid to Schools legislation,” said Governor Chris Sununu. “The newly enacted federal rules put our system in jeopardy but this bill can help NH get back on track and ensure critical services to our students. I urge the House to act quickly to ensure schools are able to recoup their lost funds.”

January 30, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Trump Administration’s Illegal Medicaid Block Grant Scheme”. From the press release:

Speaker Nancy Pelosi issued this statement after the Trump Administration announced its so-called “Healthy Adult Opportunity” guideance, a plan to cap and slash Medicaid through block grants and new limits on treatment:

“The Trump Administration’s Medicaid block grant guidance is the latest example of President Trump’s obsession with taking away Americans’ health care by any and all means. After being stopped in the Congress from repealing the health care law and destroying the lifeline of Medicaid, the Trump Administration has decided to ignore the law and steal lifesaving health care from seniors and families anyway.

“The Trump Administration’s plan for states to cap and slash Medicaid will have ruinous consequences for rural hospitals, for families seeking opioid addiction treatments for their loved ones and for middle-class seniors with long-term care needs. The Trump Administration would invite states to push Medicaid recipients off lifesaving medicines, impose unaffordable premiums to maintain coverage and leave more vulnerable families exposed to catastrophic medical bills.

“At every turn, the Trump Administration is working to undermine protections for people with pre-existing conditions and to steal the promise of affordable, dependable health care. In the Congress and in the courts, Democrats will fight back against the Trump Administration’s illegal block grant scheme to dismantle the health care of seniors and families.”

January 30, 2020: Minnesota Governor Tim Walz posted a press release titled: “Governor Walz, Lt. Governor Flanagan, DFL Legislators Introduce Compromise Bill to Improve Access to Affordable Insulin.” From the press release:

After weeks of discussions between bipartisan members of the Insulin Work Group with no agreement, Governor Tim Walz, Lieutenant Governor Peggy Flanagan, and DFL legislators today pre-filed compromise legislation to improve access to affordable insulin in Minnesota. This commonsense legislation includes provisions Republicans put forward during negotiations and is ready to begin implementing immediately.

“The cost of insulin has tripled in the last ten years—raking in the cash for pharmaceutical companies while Minnesotans with diabetes are left scrambling to afford the drug they need to survive,” Governor Walz said. “ We have a solution to this crisis. Taking the best from both Democrat and Republican proposals, this compromise bill would increase access to affordable insulin, hold Big Pharma accountable, and is ready to be implemented. There’s no reason not to support it. ”

The legislation pre-filed today, the Alec Smith Insulin Affordability Act, ensures that Minnesotans facing an emergency — those most in danger of rationing their insulin due to the high cost of the drug — have access to an immediate refill at their pharmacy. It builds upon the bill introduced last session by including a provision initially proposed by Republicans that creates a long-term program to provide eligible Minnesotans access to free insulin…

…“It’s been 673 days since House Democrats introduced the Alec Smith Emergency Insulin Act, and Republicans are still prioritizing pharmaceutical companies over Minnesotans who need insulin,” said Speaker Melissa Hortman. “We remain committed to finishing this work as soon as possible. We have a proposal that provides emergency access, long-term affordability, and is ready to implement right now. It’s time for Republicans to agree to move ahead with this plan to ensure that no more Minnesotans lose their lives because they can’t afford the insulin they need to survive.”

While progress was made during the closed-door negotiations, there was one area where Republicans would not budge: holding pharmaceutical companies accountable. Three insulin manufacturers control over 90 percent of the insulin market in the United States. In the last twelve months, those three companies have reported $84.1 billion in revenue and $18.5 billion in profits. This legislation would place a small tax on insulin manufacturers to create an insulin affordability program and make pharmaceutical companies part of the solution for the crisis they created…


January 31, 2020: Senator Jeff Merkley (Democrat – Oregon) sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma regarding a proposed Medicaid rule change. From the letter:

Dear Administrator Verma,

I write to expres significant concern with the Centers for Medicare and Medicaid Services’ (CMS) proposed rule, Medicaid Fiscal Accountability Regulation (MFAR), that woudl affect Oregon’s Medicaid Program, the Oregon Health Plan (OHP), a critical safety net. CMS’ proposed changes would put health benefits at risk for the one in five Oregonians who are covered by Medicaid and rely on it for care.

OHP provides comprehensive coverage to nearly one million Oregonians including more than 300,000 individuals who gained coverage through the Affordable Care Act’s Medicaid expansion. In addition to federally mandated coverage for emergency services and hospital care, Oregon provides vital heath benefits through OHP such as prescription drugs, mental services, and dental care. This proposed rule would jeopardize access to these and more services.

CMS has proposed changes to how states pay their share of Medicaid costs including prohibiting states from using established CMS-approved funding agreements, such as Oregon’s voter-approved provider taxes, and adding new limitations to inter-governmental transfers from Oregon’s teaching hospital to the Oregon health Authority (OHA), which help fund OHP. Based on OHA’s analysis, this proposed rule could cut approximately 60 percent of state and federal financing for Oregon’s Medicaid system. In order to maintain current funding with CMS’ proposed changes , Oregon would need to generate $1.3 billion per year in general fund dollars through increased sales tax.

The complexity of the changes have made it difficult for stakeholders, beneficiaries, and advocates to fully understand the proposed rules’ potential impact. CMS’ regulatory impact analysis also states that the fiscal impact on Medicaid is “unknown”. I am concered that CMS is moving forward with the proposed changes without fully understanding what effects the changes will have on Medicaid beneficiaries. If finalized, this proposed rule would significantly undermine Oregon’s ability to finance its Medicaid program, further sabotaging health care for Oregonians and vulnerable communities. Accordingly, I request that this proposed rule be withdrawn in its entirety.

January 31, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi, Hoyer Announce Vote on Trump Administration’s Medicaid Block Grant Plan Next Week”. From the press release:

Speaker Nancy Pelosi and House Majority Leader Steny H. Hoyer released the following joint statement announcing a voite on a resolution to disapprove of the Trump Administration’s proposed Medicaid block grant plan next Thursday, February 6:

“On Thursday, the House will consider a resolution to disapprove of President Trump’s proposed cuts to Medicaid services through his new illegal block-grant scheme. Congress has a responsibility to protect Medicaid beneficiaries from the harm that would be caused by this new guidance. The goal of this new waiver is clear: reduce access to health care for millions of low-income Americans, including access to affordable prescription drugs. The Democratic-led House will not allow this challenge to health care access in our country to go unanswered.”

January 31, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Strong Enrollment by Last Day of ACA Open Enrollment in California”. From the press release:

Speaker Nancy Pelosi issued this statement on the last day of open enrollment for the Affordable Care Act marketplace in California as Covered California announced more than 364,000 new consumers have already signed up for coverage this year, a 20 oercent increase above last year’s total of 295,000:

“The Affordable Care Act stands as a pillar of health and economic security for millions of Californians and Americans across the country. Since it began, the ACA has lowered the uninsured rate in California by over 50 percent, giving millions of families health security, and freedom from the fear that an unexpected medical expense will lead to financial ruin.

“California is a shining example of the lower health costs and increased coverage that are possible when leaders are committed to health care progress instead of health care sabotage. Millions of Americans are needlessly suffering because of their state’s sensless refusal to expand Medicaid, and the Trump Administration’s cruel efforts to push affordable, dependable health coverage out of their grasp.

“Whether signing up for a new plan or making changes to existing coverage, Californian’s should use this last remaining day of open enrollment to ensure they have the benefits and protections they and their families need to stay healthy and thrive. House Democrats will continue to oppose Republicans’ outrageous health care sabotage as we fight For The People to lower the cost of health care and the price of prescription drugs, protect people with pre-existing conditions and advance progress for all Americans.”

February 2020

February 1, 2020: The Gainesville Sun posted an article titled: “State House Speaker seeks health care reform”. It was written by John Kennedy. From the article:

Backed by a scorched earth attack on Big Pharma and the “health care industrial complex”, House Speaker Jose Oliva is promoting wide ranging changes to the state’s medical landscape that may cause a possible side effect.

Republicans hope they help at the ballot box in the nation’s biggest presidential swing state.

With polls showing health care access and cost among the top issues for voters, Oliva is among a chorus of Florida Republicans getting behind President Donald Trump’s promise last spring to make the GOP “the party of health care.”

But in a state when Republican leaders’ opposition to the Affordable Care Act also has left it among the few not to expand Medicaid coverage for lower-income residents, some think the Miami Republican is more interested in the optics and political messaging of reform…

…Indeed, the issue has fallen out of discussions among lawmakers even as 36 states have embraced Medicaid expansion, which is 90 percent financed by the federal government.

About 2.8 million Floridians are uninsured, or 14 percent of the state’s population, a survey by the Centers for Disease Control shows…


February 4, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice Iowa Speaks Out Against Proposed Constitutional Amendment Seeking to Ban Abortion in the State”. From the press release:

Iowa Republicans in the House are today debating a proposed constitutional amendment (HSB577), which would roll back the right to access abortion in the state. Republicans are trying to sneak through discussion of the amendment by scheduling the hearing the morning after the biggest day in Iowa politics, the presidential caucus. This extreme measure is dramatically out of step with Iowans’ values and beliefs that decisions about pregnancy should be made by a woman, not politicians.

NARAL Pro-Choice America National Communications Director Kristin Ford released the following statement:

“Anti-choice Republicans in Iowa are trying to steamroll Iowans with their extreme agenda, attempting to roll back access to abortion by changing the state constitution. Every Iowan must be able to decide if, how, and when to grow a family. Iowans overwhelmingly support protecting the right to access abortion and believe that politicians have no place interfering in personal decisions best left up to a woman with the support of those she loves and trusts. Iowa is ground zero in the fight for reproductive freedom, and NARAL Iowa members will continue to take politicians to taks for attacking our fundamental freedoms.”

SJR2001, the corresponding Senate version of the bill which passed out of the Senate State Government committee earlier this year, proposes an amendment to the Constitution of Iowa tha would declare that there is “no right to an abortion” in the state…

…It’s clear that abortion is a critical issue to caucus-goers and voters in Iowa. Abortion and reproductive freedom remain a top issue for Iowa caucus-goers. When researching presidential candidates, “abortion” was among the top two most-searched issues in Iowa over the past week, according to Google Trends. Similarly, 8 out of 10 likely Democratic caucus-goers call support for abortion rights a “must have” for any candidate they would support, according to a recent CNN poll. 

Americans are aligned in their support for reproductive freedom and Roe v. Wade is more popular than ever. The vast majority of Americans (including Republicans!) support the landmark Supreme Court ruling, and there is no state in the country where banning abortion is popular.


February 5, 2020: Kaiser Family Foundation posted an issue brief titled: “Implications of CMS’s New “Health Adult Opportunity” Demonstrations for Medicaid”. It was written by Robin Rudowitz, MaryBeth Musumeci, Rachael Garfield, and Elizabeth Hinton. From the issue brief:

On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal funding financing in the form of per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap.

HAO demonstrations differ from other Medicaid demonstrations already granted by this Administration in several ways, including the scope and flexibility offered to states and the capped federal funding…

…Background…

…Today, states operate their Medicaid programs within federal minimum standards and a wide range of state options in exchange for federal matching funds that are available with no limit. The matching structure provides states with resources that automatically adjust for demographic and economic shifts, health care costs, public emergencies, natural disasters and the changing program’s role in covering a low-income population with limited resouces and often complex health needs. Over time, states have transformed tand updated their Medicaid programs to adopt new service deliver models, payment strategies, and quality initiatives.

Capped financing can present challenges for health programs. Unlike Medicaid in the states, the U.S. territories operate Medicaid under a federal cap, which has been set too low to meet enrollees’ needs and inflexible when responses to emerging health issues and natural disasters are required. Anotehr capped entitlement, the Children’s Health Insurance Program (CHIP), has been successful mainly becaise most states administer CHIP in conjunction with Medicaid (which is not capped), and the federal funding caps for CHIP have been set at levels that have not required states to make substantial program cuts. However, requirements to reauthorize federal CHIP funding and failure of Congress to act timely resulted in state budget issues and confusion for some enrollees…

…The Trump administration has used Section 1115 authority to implement substantial policy changes to the Medicaid program. Previous administrations have also used 1115 authority to advance policy priorities, but the Trump administration marked a new direction for Medicaid demonstrations beginning with the release of revised demonstration approval criteria in November 2017 that no longer included expanding coverage among stated objectives. Section 1115 demonstrations issued under the Trump administration to date hve included state programs to condition Medicaid eligibility on fullfillment of work and reporting requirements; use of premiums, copayments, and benefit restrictions not otherwise allowed under federal law; and behavioral health programs to use Medicaid funds for inpatient psychiatric hospital payments, among others… The HAO demonstrations also will use Section 1115 (a) (2) expenditure authority, which CMS maintains enables the Secretary to permit states to “not apply” federal Medicaid requirements to expenditures for individuals covered under the HAO demonsrations…. In using Section 1115 (a) (2), this Administration is inviting states to choose from a “menu” of provisions included in other approved demonstrations to date, and it is offering states the opportunity to modify or eliminate some program rules not previously granted.

Key Provisions of HAO Demonstrations

Financing

  • The HAO demonstrations will be subject to an annual spending cap.
  • The HAO spending caps differ from current methods used to determine budget neutrality for demonstrations
  • In exchange for greater risk, states choosing an aggregate cap can obtain 25 to 50% of federal savings if spending is below the cap and performance benchmarks are met.
  • States would be able to propose adjustments to an approved cap to account for changes in projected expenditures or enrollment due to unforseen circumstances outside the state’s control such as a public health crisis or major economic event.

Eligibility

States could include in HAO demonstrations ACA expansion adults and other adults under age 65 that do not qualify on the basis of disability. These adult groups include low-income parents and pregnant women covered at the state option and other populations currently covered under Section 1115 demonstration authority. All children, mandatory pregnane women (those with incomes up to 138% FPL), manditory low-income parents (those up to the state’s 1996 cash assistance levels), and adults eligible based on a disability or long-term care need are excluded from the new demonstrations. Still, some people included in HAO demonstrations may have functional or other disabilities, as a large share of Medicaid adults have such disabilities even though they do not qualify on the basis of a disability. The guidance also notes that CMS may consider state requests to include other adult populations who are not covered under the state plan, which may open these demonsrations up to additional adult populations. States could use HAO demonstrations to extend coverage to groups not already covered. States could also terminate current state plan authority for optional groups and move that coverage to an HAO demonstration with additional restrictions.

States could limit eligibility for certain adults under HAO demonstrations. States could set an income limit for expansion adults below 138% FPL and apply an asset test to limit eligibility for any demonstration enrollees. However, states can only recieve enhanced matching funds for ACA expansion adults if they cover the full population (alll adults with incomes under 138% FPL) without an asset test. Under the ACA, asset tests are not allowed for low-income parents, pregnant women, and expansion adults. States also can use HAO demonstrations to cover a subset of ACA expansion adults (at the regular matching rate), using other (non-financial) criteria, such as establishing geographic limits or restricting coverage to people with specific illnesss, such as behavoral health diagnoses.

Under the HAO demonstrations, states could limit Medicaid eligibility in other ways not allowed by current law…

…Benefits and Cost Sharing

  • The HAO demonstrations would allow staets to limit covered benefits compared to current law. States would not have to provide the full Medicaid alternative (formerly known as benchmark) benefit packate to demonstration enrollees.. …States could recieve enhanced ACA matching funds for expansion adults without provideing the full benchmark benefits package as required by current law…
  • States could establish closed prescription drug formularies, a change from current Medicaid rules that generally require states to include all FDA-approved drugs from manuracturers with Medicaid rembate agreements.
  • States would have broader authority to impose cost-sharing on enrollees…

February 6, 2020: Planned Parenthood posted a press release titled: “House of Representatives Oppose Trump-Pence Attacks on Medicaid”. From the press release:

Today, the House of Representatives voted to oppose the Trump-Pence administration’s invitation to states to cut Medicad funding, and jeopardize health care coverage for people with low incomes, including reproductive and sexual health care…

…The Trump-Pence administration’s move to allow states to shrink Medicaid into a block grant system would result in drastic cuts to funding, and could cause people with low incomes across the country to lose access to their health care or provider. Half of the people seeking care at Planned Parenthood health centers across the country use Medicaid. About one in five women of reproductive age rely on Medicaid for their health care, and women account for over half or all adult Medicaid enrollees. Medicaid covers more women’s health services than any other payer. Medicaid is also the largest payer of reproductive health care coverage, paying for nearly half of all births in the United States and 75 percent of family planning services.

February 6, 2020: The U.S. House of Representatives voted on H.Res 826. It is titled: “Expressing disapproval of the Trump administration’s harmful actions towards Medicaid.” It is a resolution, which means it does not have the force of law. Here is the text of the resolution:

Whereas Medicaid and the Children’s Health Insurance Program (CHIP) provide comprehensive, quality health care to 71 million Americans and children;

Whereas Medicaid expansion has provided coverage to millions of adults and reduced the uninsured rate for both adults and children;

Whereas Medicaid is a lifeline for some of our most vulnerable populations, including children with complex medical needs, people living with disabilities, low-income seniors, and individuals with mental illness and substance use disorders;

Whereas Medicaid expansion has improved access to diagnoses and treatment for people with life-threatening conditions, including heart disease, and substance use disorder;

Whereas Medicaid expansion improves and saves lives;

Whereas research shows that Medicaid expansion saved at least 19,000 lives since 2014;

Whereas Medicaid is the larges payer of behavioral health services in the country;

Whereas Medicaid is the largest payer of long-term services and supports, including those provided in community-based settings;

Whereas the opioid epidemic has claimed hundreds of thousands of lives, and Medicaid provides access to evidence-based treatment for individuals with opioid use disorder;

Whereas researchers found that Medicaid expansion is linked to a 6-percent reduction in the opioid death rate, an 11-percent lower death rate for heroin, and a 10-percent lower death rate for fentanyl;

Whereas Medicaid and CHIP play a key role in maternity services, pay for nearly half of all births in the United States, and provide access to prenatal and postpartum care;

Whereas nearly all States and the District of Columbia provide Medicaid coverage to pregnant women with incomes higher than the minimum Federal standards;

Whereas maternal mortality rates have risen nationally and disproportionately affect women of color;

Whereas access to health care can prevent, detect, and treat conditions that put women at increased risk of pregnancy-related complications;

Whereas research shows that Medicaid expansion improves postpartum care for women, reduces maternal and infant death, and reduces the likelihood a woman will experience a gap in coverage;

Whereas research shows that Medicaid expansion improves postpartum care for women, reduces maternal and infant death, and reduces the likelihood a woman will experience a gap in coverage;

Whereas rural hospitals are closing at an alarming rate, jeopardizing access to care for the 20 percent of Americans who live in rural areas, including 13,000,000 children, and research has found that States that expanded Medicaid had fewer rural hospital closures, and that rural hospitals in those States experienced improved financial peformance;

Whereas Medicaid expansion reduces medical debt for individuals receiving coverage, which improves their individual and family financial security;

Whereas once in office, President Trumo has gone further than any President in the history of the proram to make life harder for working families who rely on Medicaid for their health and well-being;

Whereas the President has waged an unrelenting war on Medicaid, making it easier for States to take coverage away and create barriers for reenrollment;

Whereas on President Trump’s watch, the number of uninsured children has increased, reversing years of declines, largely as a result of substantial losses in Medicaid coverage for children – many of whom remain eligible;

Whereas under President Trump, over 1,000,000 children have lost Medicaid and CHIP coverage and over 750,000 adults have lost Medicaid coverage; and

Whereas, despite President Trump’s campaign promise that he would “save Medicaid”, his administration has –

(1) issued guidance to allow States to cap their Medicaid funding through a block grant, putting the financial viability if the States’ programs at risk and taking coverage and access to health care away from our citizens;

(2) proposed regulations to roll back access standards put in place to ensure beneficiares recieve the care they need;

(3) issued guidance to allow State Medicaid programs to restrict access to prescription drugs by adopting closed formularies;

(4) proposed massive, annually componding cuts in Federal funding to the program in direct contradiction to an explicit campaign promise; and

(5) allowed States to institute policies that have resulted in people improperly losing Medicaid coverage; Now, therefore be it

That it is the sense of the House of Representatives that –

(1) the illegal actions taken by the Trump administration to undermine the Medicaid program, including the beneficiary protections, are a cruel attack on a program that provides for the health and well-being for some of our most vulnerable citizens;

(2) the Trump administration should immediately withdraw its illegal block grant guidance and cease its campaign to undermine and weaken Medicaid; and

(3) the Trump administration should uphold its responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid.

Here are the Representatives who voted YES on H.Res 826 (by state):

  • Alabama: Terri Sewell (Democrat – district 7)
  • Arizona: Tom O’Halleran (Democrat – district-1), Raúl Grijalva (Democrat – district 3), Ruben Gallego (Democrat – district 7), Greg Stanton (Democrat – district 9)
  • California: Jared Huffman (Democrat – district 2), John Garamendi (Democrat – district 3), Mike Thompson (Democrat, district 5), Doris Matsui (Democrat, district 6), Ami Bera (Democrat, district 7), Jerry McNerrey (Democrat, district 9), Josh Harder (Democrat, district 10), Mark DeSaulnier (Democrat, district 11), Barbara Lee (Democrat, district 13), Jackie Speier (Democrat, district 14), Eric Swalwell (Democrat, district 15), Jim Costa (Democrat, district 16), Ro Khanna (Democrat, district 17), Anna Eshoo (Democrat, district 18), Zoe Lofgren (Democrat, district 19), Jimmy Panetta (Democrat, district 20), TJ Cox (Democrat, district 21), Salud Carbajal (Democrat, district 24), Julia Brownley (Democrat, district 26), Judy Chu (Democrat, district 27), Adam Schiff (Democrat, district 28), Tony Cárdenas (Democrat, district 29), Brad Sherman (Democrat, district 30), Pete Aguilar (Democrat, district 31), Grace Napolitano (Democrat, district 32), Ted Lieu (Democrat, district 33), Jimmy Gomez (Democrat, district 34), Norma Torres (Democrat, district 35), Raul Ruiz (Democrat, district 36), Karen Bass (Democrat, district 37), Linda Sánchez, (Democrat, district 38), Gilbert Cisneros (Democrat, district 39), Lucille Roubal-Allard (Democrat, district 40), Mark Takano, (Democrat, district 41), Maxine Waters (Democrat, district 43), Nanette Barragán (Democrat, district 43), Katie Porter (Democrat, district 45), Alan Lowenthal (Democrat, district 47), Harley Rouda (Democrat, district 48), Mike Levin (Democrat, district 49), Juan Vargas (Democrat, district 51), Scott Peters (Democrat, district 52), Susan Davis (Democrat, district 53)
  • Colorado: Diana DeGette (Democrat, district 1), Joe Neguse (Democrat, district 2), Jason Crow (Democrat, district 6), Ed Perlmutter (Democrat, district 7)
  • Connecticut: John Larson (Democrat, district 1), Joe Courtney (Democrat, district 2), Rosa DeLauro, (Democrat, district 3), James Himes (Democrat, district 4), Jahana Hayes (Democrat, district 5)
  • Delaware: Lisa Blunt Rochester (Democrat – at large)
  • Florida: Al Lawson (Democrat – district 5), Stephanie Murphy (Democrat, district 7), Darren Soto (Democrat, district 9), Val Demmings (Democrat, district 10), Charlie Crist (Democrat, district 13), Kathy Castor (Democrat, district 14), Alcee Hastings (Democrat, district 20), Lois Frankel (Democrat, district, 21), Theodore Deutch (Democrat, district 22), Debbie Wasserman Schultz (Democrat, district 23), Frederica Wilson (Democrat, district 24), Debbie Mucarsel-Powell (Democrat, district 25), Donna Shalala (Democrat, district 27)
  • Georgia: Sanford Bishop (Democrat, district 2), Hank Johnson (Democrat, district 4), Lucy McBath (Democrat, district 6), David Scott, (Democrat, district 14)
  • Hawaii: Ed Case (Democrat, district 1)
  • Illinois: Bobby Rush (Democrat, district 1), Robin Kelly (Democrat, district 2), Daniel Lipinski (Democrat, district 3) Jesús Garcia (Democrat, district 4) Mike Quigley (Democrat, district 5), Sean Casten (Democrat, district 6), Danny Davis (Democrat, district 7), Raja Krishnamoorthi (Democrat, district 8), Jan Schakowsky (Democrat, district 9), Bradley Schneider (Democrat, district 10), Bill Foster (Democrat, district 11), Lauren Underwood (Democrat, district 11), Cheri Bustos (Democrat, district 17)
  • Indiana: Peter Visclosky (Democrat, district 1), André Carson (Democrat, district 7)
  • Iowa: Abby Finkenauer (Democrat, district 1), David Lobesack (Democrat, district 2), Cynthia Axne (Democrat, district 3)
  • Kansas: Sharice Davids (Democrat, district 3)
  • Kentucky: John Yarmuth (Democrat, district 3)
  • Louisiana: Cedric Richmond (Democrat, district 2)
  • Maine: Chellie Pingree (Democrat, district 1), Jared Golden (Democrat, district 2)
  • Maryland: Dutch A. Ruppersburger (Democrat, district 2), John Sarbanes (Democrat, district 3), Anthony Brown (Democrat, district 4), Steny Hoyer (Democrat, district 5), David Trone (Democrat, district 6), Jamie Raskin (Democrat, district 8)
  • Massachusettes: Richard Neal (Democrat, district 1), Jim McGovern (Democrat, district 2), Lori Trahan (Democrat, district 3), Joseph Kennedy (Democrat, district 4), Katherine Clark (Democrat, district 5), Seth Moulton (Democrat, district 6), Ayanna Pressley (Democrat, district 7), Stephen Lynch (Democrat, district 8), William Keating (Democrat, district 9)
  • Michigan: Daniel Kildee (Democrat – district 5), Elissa Slotkin (Democrat – district 8), Andy Levin (Democrat – district 9), Haley Stevens (Democrat – district 11), Debbie Dingell (Democrat, district 12), Rashida Tlaib (Democrat – district 13), Brenda Lawrence (Democrat, district 14)
  • Minnesota: Angie Craig (Democrat, district 2), Dean Phillips (Democrat, district 3), Betty McCollum (Democrat, district 4), Ilhan Omar (Democrat, district 5), Collin Peterson (Democrat, district 7)
  • Mississippi: Bennie Thompson (Democrat, district 2)
  • Missouri: Clay Lacy (Democrat, district 1)
  • Nevada: Dina Titus (Democrat, district 1), Susie Lee (Democrat, district 3), Steven Horsford (Democrat, district 4)
  • New Hampshire: Chris Pappas (Democrat, district 1), Ann Kuster (Democrat, district 2)
  • New Jersey: Andy Kim (Democrat, district 3), Josh Gottheimer (Democrat, district 5), Frank Pallone (Democrat, district 6), Tom Malinowski (Democrat, district 7), Albio Sires (Democrat, district 8), Bill Pascrell (Democrat, district 9), Donald Payne (Democrat, district 10), Mikie Sherrill (Democrat, district 11), Bonnie Watson Coleman (Democrat, district 12)
  • New Mexico: Debra Haaland (Democrat, district 1), Xochitl Torres Small (Democrat, district 2), Ben Luján (Democrat, district 3)
  • New York: Thomas Suozzi (Democrat, district 3), Kathleen Rice (Democrat, district 4), Gregory Meeks (Democrat, district 5), Grace Meng (Democrat, district 6), Nydia Velázquez (Democrat, district 7), Yvette Clarke (Democrat, district 8), Jerrold Nadler (Democrat, district 9), Max Rose (Democrat, district 11), Carolyn Maloney (Democrat, district 12), Adriano Espaillat (Democrat, district 13), Alexandria Ocasio-Cortez (Democrat, district 14), José Seranno (Democrat, district 15), Eliot Engel (Democrat, district 16), Nita Lowey (Democrat, district 17), Sean Mahoney (Democrat, district 18), Antonio Delgado (Democrat, district 19), Paul Tonko (Democrat, district 20), Anthony Brindisi (Democrat, district 22), Brian Higgins (Democrat, district 26)
  • North Carolina: G.K. Butterfield (Democrat, district 1), David Price (Democrat, district 4), Alma Adams (Democrat, district 12)
  • Ohio: Joyce Beatty (Democrat, district 3), Marcy Kaptur (Democrat, district 9), Marcia Fudge (Democrat, district 11), Tim Ryan (Democrat, district 13)
  • Oklahoma: Kendra Horn (Democrat, district 5)
  • Oregon: Suzanne Bonamici (Democrat, district 1), Earl Blumenauer (Democrat, district 3), Peter DeFazio (Democrat, district 4)
  • Pennsylvania: Brendan Boyle (Democrat, district 2), Dwight Evans (Democrat, district 3), Madeleine Dean (Democrat, district 4), Mary Scanlon (Democrat, district 5), Chrissy Houlahan (Democrat, district 6), Susan Wild (Democrat, district 7), Matthew Cartwright (Democrat district 7), Connor Lamb (Democrat, district 17), Mike Doyle (Democrat, district 18)
  • Rhode Island: David Cicilline (Democrat, district 1), Jim Langevin (Democrat, district 2)
  • South Carolina: Joe Cunningham (Democrat, district 1), Jim Clyburn (Democratic, district 6)
  • Tennessee: Jim Cooper (Democrat, district 5), Steve Cohen (Democrat, district 9)
  • Texas: Lizzie Fletcher (Democratic, district 7), Al Green (Democrat, district 9), Vicente Gonzalez (Democrat, district 15), Veronica Escobar (Democrat, district 16), Shelia Jackson Lee (Democrat, district 18), Joaquin Castro (Democrat, district 20), Henry Cuellar (Democrat, district 28), Sylvia Garcia (Democrat, district 29), Eddie Johnson (Democrat, dsstrict 30), Colin Allred (Democrat, district 32), Marc Veasey (Democrat, district 33), Filemon Vela (Democrat, district 34), Lloyd Doggett (Democrat, district 35)
  • Utah: Ben McAdams (District 4)
  • Vermont: Peter Welch (Democrat at large)
  • Virginia: Elaine Luria (Democrat, district 2), Bobby Scott (Democrat, district 3), Donald McEachin (Democrat, district 4), Abigail Spanberger (Democrat, district 7), Donald Beyer (Democrat, district 8), Jennifer Wexton (Democrat, district 10), Gerald Connolly (Democrat, district 11)
  • Washington: Suzan DelBene (Democrat, district 1), Rick Larsen (Democratic, district 2), Derek Kilmer (Democrat, district 6), Pramila Jayapal, (Democrat, district 7), Kim Schrier (Democrat, district 8), Adam Smith (Democrat, district 9), Denny Heck (Democrat, district 10)
  • Wisconsin: Mark Pocan (Democrat, district 2), Ron Kind (Democrat, district 3), Gwen Moore (Democrat, district 4)

The vote was 223 YES (54%) to 190 NO (46%).

February 6, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on the Passage of Disapproval Resolution Against President Trump’s Attack on Medicaid.” From the press release:

Speaker Nancy Pelosi issued this statement after the House passed H. Res. 826, a resolution expressing disapproval of the Trump Administration’s harmful actions toward Medicaid in response to the Administration’s illegal Medicaid block grant plan to cap and slash Medicaid.

“President Trump’s illegal Medicaid Block Grant scheme is a direct assault on a critical lifeline for millions of families. The Administration must not move forward to push Medicaid recipients off of lifesaving medicines, impose unaffordable premiums or leave vulnerable families exposed to catastrophic medical bills.

“In the courts and in Congress, House Democrats are fighting to protect the right of every American to access quality, affordable health care. While the President continues his all-out attack on Americans’ health care, Democrats are working to lower health care costs and the price of prescription drugs, protect individuals with pre-existing conditions and strenghten the pillars of health and financial security for every American.”

February 6, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Condemns Trump Administration’s Unlawful Healthcare Requirements Restricting Legal Immigration”. From the press release:

California Attorney General Xavier Becerra today announced that he is co-leading two separate amicus briefs in support of lawsuits challenging the Trump Administration’s revised public charge guidelines and unlawful proclamation imposing new healthcare requirements for most visa applicants. Together, these federal actions would require consular officers to deny entry to prospective immigrants who might, at any point in the future, make minor and temporary use of public programs, and to assess whether prospective immigrants have qualifying health coverage or the ability to pay for their reasonably foreseeable medical care. The first amicus brief was filed with the U.S. Court of Appeals for the Ninth Circuit in Doe v. Trump and the second was filed with the U.S. District Court for the Southern District of New York in Make the Road New York v. Pompeo.

“President Trump is so fixated with pursuing anti-immigrant policies that he is blind to the effects they’ll have on the health of our nation and our economy,” said Attorney General Becerra. “Punishing hardworking immigrant families will hurt not only them, but everyone in the communities and states they call home. There’s no place for this type of arbitrary rule in a nation built by immigrants. We’ll continue to fight against these callous efforts every step of the way.”

By vastly expanding the criteria for barring immigrants on the grounds that they are likely to become a “public charge” and imposing new health insurance requirements, the Trump Administration is attempting to unlawfully prevent up to hundreds of thousands of people from obtaining visas each year. In both amicus briefs, the coalitions argue that the Trump Administration’s actions contradict Congress’ longstanding policy of keeping families together. Estimates indicate that as many as 65 percent of recently arrived green card holders would not have been granted a visa under the healthcare proclamation. Many of those individuals would have been eligible for entry as immediate relatives of U.S. citizens, such as spouses, children, and parents.

The amicus briefs also assert that the Trump Administration’s actions undermine federal law and healthcare access. For instance, the healthcare proclamation runs counter to Congressional intent in providing affordable and comprehensive healthcare access to immigrants. By directing immigrants toward health coverage that does not comply with the Affordable Care Act, the Trump Administration could drive up healthcare premiums for people across the country. As a result, uninsured rates could go up and states could be stuck with the bill when their residents are unable to pay for their healthcare.

Attorney General Becerra is committed to defending the healthcare and rights of hardworking families in California and across the country. Last year, the Attorney General helped block the President’s healthcare proclamation from going into effect nationwide by leading an amicus brief at an earlier stage of Doe v. Trump. In a separate lawsuit, Attorney General Becerra is leading a multistate coalition against the Trump Administration’s harmful public charge rule that discourages hardworking immigrants and their families from accessing critical health, nutrition, and housing programs. Attorney General Becerra is also leading the defense of the Affordable Care Act, recently petitioning the U.S. Supreme Court for review, to help keep healthcare affordable and protect those with preexisting conditions from the Trump administration’s efforts to invalidate the entire law.

A copy of the amicus brief filed with the U.S. Court of Appeals for the Ninth Circuit is available here. Co-led by California and Oregon, the coalition includes the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia, as well as Santa Clara County, CA and the cities of Baltimore, MD; Carrboro, NC; Chicago, IL; Los Angeles, CA; New York, NY; Oakland, CA; Philadelphia, PA; San Francisco, CA; Seattle, WA; and Union City, NJ.

A copy of the amicus brief filed with the U.S. District Court for the Southern District of New York is available here. Co-led by California and New York, the coalition includes the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as Santa Clara County, CA and the cities of Chicago, IL; Los Angeles, CA; New York, NY; Oakland, CA; Philadelphia, PA; and Seattle, WA.

February 6, 2020: The American Civil Liberties Union (ACLU) of Oklahoma posted a press release titled: “ACLU of Oklahoma Statement on HB 1182”. From the press release:

In response to today’s scheduled floor hearing of HB 1182, a bill equal to an abortion ban, the ACLU of Oklahoma released the following statement:

The following is attributable to Nicole McAfee, Director of Policy and Advocacy:

“Less than five days after members of the Oklahoma Legislature cheered the Governor’s commitment to reducing wasted taxpayer dollars, the first major piece of legislation to be considered this session on the House floor is HB 1182, an unconstitutional measure which undermines reproductive autonomy and inserts the government in private healthcare decisions by punishing abortion care providers. Yet another legal fight over yeat another unconstitutional bill is an unfortunate misuse of power that our state cannot afford.

Across the country, politicians have created a web of medically unnecessary, politically-motivated restrictions that push aboriton care out of reach for many, but particularly for low-income people, young people, and people of color. And while this pandering attack is business as usual for the Oklahoma legislature, it is disappointing to see the body so quickly into session use their power to try and push this thinly veiled attempt at an abortion ban.

As we turn our eyes to the House floor for this scheduled vote, we call on leadership and legislatuors from across the aisle and across the state to stop this dangerous and stigmatizing attempt to score partisan political points. This session provides real opportunity for change, and instead of continuing to violate fundamental rights and liberties protected by the Constitution, the legislature should prioritize being good stewards of Oklahoma taxpayer dollars by focusing on issues like healthcare access, education funding, and criminal justice reform that reqire their urgent attention.”

February 6, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “South Dakota Lawmakers Need to Focus on Real Issues, Not Discriminatory Bills”. From the press release:

Issues that matter most to South Dakotans are being ignored as some South Dakota legislators continue their attack the LGBTQ and Two Spirit community and erode their rights with bills that stoke fear and hatred amid discriminatory rheortic.

Bills like House Bill 1057, which will be heard in the Senate Health and Human Services Committee on Monday, House Bill 1215 and Senate Bill 109 detract from the state’s real problems.

  • House Bill 1057 would criminalize life-saving medical treatment for transgender youth. No other state has passed a law like HB 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary.
  • House Bill 1215 would prohibit the state from endorsing or enforcing certain policies regarding same-sex marriage. Marriage equality is the law of the land in South Dakota and the entire nation. South Dakota lawmakers cannot defy the U.S. Supreme Court based on their extreme personal views.
  • Senate Bill 109: would allow health care providers, medical institutions, and health insurance providers to refuse to care for a patient on religious, moral, ethical, or philosphical grounds. This means a public school counselor could refuse to care for a young LGBTQ person in distress or an EMT could refuse care to a gay man in an emergency situation.

“With serious and complex issues like the lack of adequate education funding for teacher salary increases to access drug addiction treatment in the rural areas of our state, it’s disturbing that legislators have spent so much time attacking vulnerable transgender youth and the LGBTQ and Two Spirit community as a whole,” said Libby Skarin, ACLU of South Dakota policy director. “Bill after bill seems fixated on the incorrect notion that some of our friends and neighbors are not entitled to the same dignity and respect as others. Our committment to ensuring that LGBTQ and Two Spirit South Dakotans can live openly without discrimination remains strong. We urge South Dakota lawmakers to focus in the issues that really matter.”

South Dakotans agree.

On behalf of the Human Rights Campaign, Change Research polled 720 likely voters in South Dakota between Jan. 28-30 and found 69% say that “legislators are too focused on divisive issues and should be focusing on pressing issues that will actually have an impact on South Dakotans, like growing the economy.” Additionally, nearly two-shirts of voters say “we need to stop stigmatizing transgender people as a society.”

February 6, 2020: Planned Parenthood posted a press release titled: “House of Representatives Oppose Trump-Pence Attacks on Medicaid”. From the press release:

Today, the House of Representatives voted to oppose the Trump-Pense administration’s invitation to states to cut Medicaid funding, and jeopardize health care coverage for people with low incomes, including reproductive and sexual health care.

Statement from Jacqueline Ayers, Vice President, Government Relations & Public Policy, Planned Parenthood Federation of America:

“People want more access to health care, not less. But the Trump-Pence administration’s attempts to take Medicaid apart puts people with low incomes, and particularly women, at risk of losing their health insurance or their provider. We thank the champions in the House of Representatives who are standing up to this cruel policy and reaffirming their commitment to protecting Medicaid and the millions of people it serves. Senators must now decide if they’ll stand with the administration, or with their constituents whose health care is on the line.”

The Trump-Pence administration’s move to allow states to shrink Medicaid into a block grant system would result in drastic cuts to funding, and could cause people with low incomes across the country to lose access to their health care or their provider. Half of people seeking care at Planned Parenthood health centers across the country use Medicaid. About one in five women of reproductive age rely on Medicaid for their health care, and women account for over half of all adult Medicaid enrollees. Medicaid covers more women’s health services than any other payer. Medicaid is also the largest payer of reproductive health care coverage, paying for nearly half of all births in the United States and 75 percent of family planning services.


February 7, 2020: Representative Jan Shakowsky (D-Illinois) posted a press release on her official website titled: “Schakowsky Votes to Protect Medicaid from Caps and Cuts”. From the press release:

This week, Congresswoman Jan Schakowsky, Senior Chief Deputy Whio and Chair of the Energy and Commerce Consumer Protection and Commerce Subcommittee, voted YES on H.Res. 826, a resolution expressing disapproval of the Trump Administration’s harmful actions towards Medicaid. Last week, the Trump Administration unveiled its illegal Medicaid block grant plan, inviting states to cap and slash Medicaid. The plan would essentially allow states to recieve a waiver to block grant their Medicaid programs for certain low-income Medicaid recipients.

The Administration’s Medicaid block grant plan undermines crucial protections of the Medicaid program and gives states broad authority to scale back important beneficiary protections, restrict eligibility standards and limit access to prescription drugs. The effect would be to push Medicaid recipients off lifesaving medicines, impose unaffordable premiums to maintain coverage and leave more vulnerable families exposed to catastrophic medical bills – with ruinous and even fatal consequences for the most vulnerable in our communities.

The Resolution of Disapproval affirms the sense of the House of Representatives that:

The illegal actions taken by the Trump Administration to undermine the Medicaid program, including beneficiary protections, are a cruel attack on a program that provides for the health and well-being for some of our most vulnerable citizens;

The Trump Administration should immediately withdraw its illegal block grant guidance and cease its campaign to undermine and weaken Medicaid; and

The Trump Administration should uphold its responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid…


February 9, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Trump Budget Summary”. From the press release:

Speaker Nancy Pelosi issued this statement on President Trump’s FY2021 budget summary:

“The budget is a statement of values and once again the President is showing just how little he values good health, financial security and well-being of hard-working American families.

“Year after year, President Trump’s budgets have sought to inflict devastating cuts to critical lifelines that millions of Americans rely on. Less than a week after promising to protect families’ health care in his State of the Union address, the President is now brazenly inflicting savage multi-billion-dollar cuts to Medicare and Medicaid – at the same time that he is fighting in federal court to destroy protections for people with pre-existing conditions and dismantle every other protection and benefit of the Affordable Care Act.

“Americans’ quality, affordable health care will never be safe with President Trump. The American people sent a Democratic House Majority to Washington to fight For The People to lower their health care costs, and that is exactly what we will continue to do.


February 10, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “ACLU of South Dakota Commends Decision to Kill House Bill 1057”. From the press release:

Today, in a 5-2 vote, the Senate Health and Human Services Committee voted to kill amended legislation that would prohibit doctors for providing medically unnecessary care to transgender youth and take away parents’ rights to make decisions about their children’s care.

The ACLU of South Dakota opposed House Bill 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary.

“Though supporters claimed House Bill 1057 was aimed at protecting vulnerable youth, it was clearly fueled by a fear and misunderstanding of transgender South Dakotans,” said Libby Skarin, policy director for the ACLU of South Dakota. “It’s time we stop these attacks and the very real harm they cause to transgender youth across our state. Let this be a signal to the South Dakota Legislature that discrimination against a marginalized group is a distraction from the needs of the state and hurts us all.

In addition to the ACLU of South Dakota, companies and organizations like the Sanford Health, the South Dakota Chapter of the American College of Obstetricians and Gynecologists, the South Dakota Pharmacists Association, the South Dakota Chamber of Commerce and Industry, the South Dakota State Medical Association, the South Dakota Retailers Association, the Sioux Falls Area Chamber of Commerce, LEAD South Dakota and the Human Rights Campaign also opposed House Bill 1057.

February 10, 2020: Senator Jeff Merkley (Democrat – Oregon) posted a press release titled: “Merkley Blasts Trump Budget As Completely Ignoring Concerns of Oregonians”. From the article:

Oregon’s U.S. Senator Jeff Merkey issued the following statement after President Donald Trump released his proposed fiscal year 2021 budget:

“At Donald Trump’s events, he talks and talks and talks but never listens. If he did a town hall in every county in Oregon every year, like I do, and actually listened to people, maybe his budget wouldn’t make life worse for people in all the ways they’re most worried about.

“When I talk to folks, I hear concerns about the cost of health care and pharmaceutical drugs. This budget would cause millions of people to lose health care coverage, with massive cuts to Medicare, Medicaid, and the Children’s Health Insurance Program—all while Americans are suffering from ever-increasing drug and health care costs. Just as perplexing: In the midst of the global coronavirus outbreak, the president wants to cut the Centers for Disease Control budget. 

“In rural communities, the economy is still pretty precarious. Yet just as rural communities are beginning to be connected with broadband internet—vital for growing opportunity in rural education and economies—the president wants to eliminate $50 million from the program. In another gut-punch to rural economies, his budget eliminates the $46 million Rural Business Program grants.

“Millions of Oregonians are paying more than they can afford for housing and people are sleeping under overpasses and on medians. But the president wants to decrease affordable housing funding by more than 15 percent and slash support for rural housing by $92 million. He would eliminate housing programs that are critically important to Oregon communities—including the rental assistance, low-income housing construction, and Community Development Block Grants that I fought to increase in the 2020 budget.

“Not even hungry children were spared: The president proposes eliminating the programs that make sure kids get fed during the summer months and get breakfast during the school year, and further cuts food assistance for families by $181 billion over 10 years.

“Somehow, this president who fancies himself a billionaire and has spent nearly a third of his presidency hanging around with rich people at country clubs could find enough money to give the super-rich and giant corporations a trillion dollars in tax breaks. But working families across Oregon, and especially in rural communities, are hanging on by the fingertips, and President Trump, instead of giving a hand up, is stomping on their fingers. 

“Budgets are a statement of values. Our job in government should be making sure every person who works hard can get ahead. Instead, this budget does the opposite, turning a blind eye to the real issues that real Oregonians and Americans are facing. The rich and powerful are doing just fine; the last thing we should be doing is stacking the deck even more in their favor. I will do everything I can to fight the president’s reckless proposal and make sure we’re investing in our people, our communities, and our future.”

February 10, 2020: The New York Times posted an article titled: “Trump Opens Door to Medicare and Other Entitlement Programs”. It was written by Alan Rappeport and Maggie Haberman”. The article was originally posted on January 22, 2020, and was updated on February 10, 2020. From the article:

President Trump suggested on Wednesday that he would be willing to consider cuts to social safety-net programs like Medicare to reduce the federal deficit if he wins a second term, an apparent shift from his 2016 campaign promise to protect funding for such entitlements…

…Asked in an interview with CNBC if cuts to entitlement would ever be on his plate, Mr. Trump answered yes.

“At some point they will be,” Mr. Trump said, before pointing to United States economic growth. “At the right time, we will take a look at that.”

Mr. Trump suggested that curbing spending on Medicare, the government health care program for the elderly, was a possibility.

February 10, 2020: The White House released the President’s Budget for fiscal year 2021. For the purpose of this blog post, I will focus on the things that are related to health care that the Trump administration wants to eliminate.

  • Agency for Healthcare Research and Quality (AHRQ): The 2020 budget funded AHRQ 338 million dollars. The Trump budget reduces that funding for 2021 to zero.

The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions.

Some of AHRQ’S areas of focus include:

Project ECHO (Extention for Community Healthcare Outcomes) for training and supporting primary care clinicians in rural communities to provide specialized care for patients.

Re-Engineered Discharge (RED) is a structured protocol and suite of implementation tools that helps hospitals rework their discharge processes to reduce readmissions by determining patients’ needs and carefully designing and communicating discharge plans.

Comprehensive Unit-based Safety Program (CUSP) is a highly effective method of preventing healthcare-associated infections.

Consumer Assesment of Healthcare Providers and Systems survey, which provide valid assessments of patients’ experience of care in hospitalss, nursing homes, and doctor’s offices.

Medical Expenditure Panel Survey data helped the Medicaid and CHIP Payment and Access Commission develop estimates of eligibility for Medicaid and the Children’s Health Insurance Program.

  • CDC Chronic Disease Activities: The 2020 budget funded it with $1,240 million. The Trump budget is going to reduce that amount by $427 million in 2021.

Part of the CDC includes the National Center for Chronic Disease Prevention and Health Promotion. Its website points out that six in ten adults in the US have a chronic disease and four in ten adults have two or more.

Chronic disease includes, but is not limited to, the following: heart disease or stroke; cancer; diabetes.

Here is what the National Center for Chronic Disease Prevention and Health Promotion does:

Works to reduce the risk factors for chronic diseases, especially for goups affected by health disparities which are differences in health across different geographic, racial, ethnic and socioeconomic groups.

Finds out how chronic diseases affect populations in the United States.

Studies interventions to find out what works best to prevent and control chronic diseases.

Funds and guides states, territories, cities, and tribes to use interventions that work.

Shares information to help Americans understand risk factors for chronic diseases and how to reduce them.

  • Health Workforce Programs: In 2020, it was funded $734 million. The Trump budget reduces that by $484 million for 2021.

The Health Workforce website says that it is part of the Health Resources & Services Administration (HRSA). It improves the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need.

HSRA programs provide health care to people who are geographically isolated, economically or medically vulnerable. This includes people living with HIV/AIDS, pregnant women, mothers and their families, and those otherwise unable to access high quality health care. HRSA also supports access to health care in rural areas, the training of health professionals, the distribution of providers to areas where they are needed most, and improvements in health care delivery.

  • Low Income Home Energy Assistance Program: In 2020, this program was funded $3,740. The Trump Budget will reduce that funding to zero.

The Low Income Home Energy Assistance Program (LIHEAP) helps keep families safe and healthy through initiatives that assist families with energy costs. It is part of the Office of Commiunity Services.

The Purpose of LIHEAP is: to assist households with low incomes, particularly those with the lowest incomes that pay a high proportion of household income for home energy, primarily in meeting their immediate home energy needs.

  • National Institute for Occupational Safety and Health: In 2020, it was funded $343 million. The Trump Budget reduces that by 153 million in 2021.

The National Institute for Occupational Safety and Health (NIOSH) is part of the Centers for Disease Control and Prevention. Its vision is: safer, healthier workers.

Its mission is: To develop new knowledge in the field of occupational safety and health and to transfer that knowledge into practice.

NIOSH mission goals include:

Goal 1: Conduct research to reduce worker illness and injury, and to advance worker well-being.

Goal 2: Promote safe and healthy workers through interventions, recommendations and capacity building.

Goal 3: Enhance worker safety and health through global collaborations.

  • Federal Emergency Management Agency State and Local Grants/Training was funded $2,052 million in 2020. The Trump budget reduces it by 535 million in 2021.

Federal Emergency Management Agency (FEMA) supports citizens and emergency personnel to build, sustain, and improve the nation’s capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards.

It is responsible for disaster assistance, the national flood insurance program, and U.S. fire adminisration. The national flood insurance program is government-run, and is the only one allowed to sell flood insurance. This type of insurance covers your home and the things inside it, and helps people to cope with the costs of flood damage.

  • The Trump Budget also reduces Flood Hazard Mapping and Risk Analysis Program from the $263 million it was funded in 2020 by 163 million for 2021.

The National Flood Insurance Program Flood Hazard Mapping program is also part of FEMA. This program identifies flood hazards, assesses flood risks, and partners with states and communities to provide accurate flood hazard and risk datat to guide them to mitigation actions.

Flood hazard mapping is an important part of the National flood Insurance Program (NFIP), as it is the basis of the NFIP regulations and flood insurance requirements. FEMA mantains and updates data throigh Flood Insruance Rate Maps (FIRMs) and risk assessments. FIRMs incude statistical information such as data for river flow, storm tides, hydrolic/hydraulic analyses and rainfall and topographical surveys.

In addition, the Trump Budget has a list of things that it wants to “reform”. Here are the things that directly relate to health:

  • Federal Disability Programs

…The Budget would introduce new reforms that remove barriers to work for people with disabilities and improves access to services to help them return to work…

The changes will impose the following upon people who have disabilities:

Test New Approaches to Increase Labor Force Participation: Allows the administration to test new program rules and requires manditory participation by program applicants and beneficiaries. This proposal calls on Congress to establish an expert panel that will identify specific changes to program rules that increase LFP and reduce participation on disability programs based on the results of successful demonstrations of other evidence. The panel would be responsible for making recommendationg to reduce participation levels that would be directly tied to reaching a five percent reduction in Disability Insurance (DI) and Supplemental Security Income (SSI) projected outlays by 2032.

SSI Youth Transition to Work: Institutes initial disability reviews at age 6 and age 12. Disregards all earned income and elminiated income reporting requirements through age 20. Improves access to vocational rehabilitition services for SSI transition-aged youth by allowing the Social Security Administration to make referrals to these services.

Replaces that Ticket To Work (TWW) program: It will replace this program with block grants to the states.

Create a Sliding Scale for Multi-Recipient SSI Families: “Currently, multi-recipient SSI families are eligible to recieve an equal full benefit amount for each SSI child recipient. However, economies of scale in some types of consumption such as housing reduce per capita living expenses so that two children generally do not need twice the income of one child….”

Eliminate Workers’ Compensation (WC) and Temporary Disability Reverse Offset

Allow State Hearing Officers to Hold Disability Hearings: This proposal would allow State disabilitiy hearing officers to conduct hearings resulting from disabiity cessation determinations issued by a Federal component. This would allow additional flexibility for SSA to manage workloads at a national level, while preserving the individual’s right to an evidentiary hearing.

Modernize the Commissioner’s Collection of Medical Evidence: This proposal would allow SSA to more quickly recieve the medical evidence it needs to determine initial and continuing entitlement to disability benefits by allowing custodians to release medical records to SSA without the signed authorization of the person applying for or recieving disability benefits.


What follows is the Trump Budget’s proposed changes to Medicare:

This section of the Trump Budget is titled: “Medicare: Address Wasteful Spending, Fraud, and Abuse”.

…The budget includes two proposals aimed at reforming how the Federal Government reimburses hospitals for certain “add-on” payments that are not directly tied to Medicare beneficiary care. These reforms improve the sustainability of the Medicare Trust Fund and ensure that Medicare funds are spent on meeting the health needs of the Nation’s seniors. In addition, thes proposals better align the Medicare program with private sector health insurance business practices.

Medicare currently makes payments to hospitals related to uncompensated care for non-Medicare beneficiaries. The Budget proposes to reform uncompensated care payments by removing the payment from the Medicare payment system, moderating the rate of growth of spending, and establishin a new process to distribute uncompensated care amounts to hospitals based on their share of chairty care and non-Medicare bad debt…

… The Budget includes several additional proposals aimed at eliminating wasteful spending in Medicaire.

Establish a unified payment system for post-acute care providers: …The budget would transition payment for post-acute care to site-neutral payments over five years. It would reduce the growth rate of post-acute care payment during the transition period. The proposed value-based payment system is based on the anticipated clinical needs and risk factors of the patient, rather than the site of services. All types of facilities would remain available, and patients with their doctors would determine the right site of care.

Pay all hospital-owned physician offices located off-camous at the physician office rate:…The Budget would equalize Medicare payment for all physician practices and off-campus facilities, regardless of whether they are hospital-owned or when established, lowering out-of-pocket costs for seniors receiving services at those facilities.

Pay on-campus hospital outpatient departments at the physician office rate for certain services: …The Budget proposes to make site-netural payments between on-campus hospital outpatients departments and physician offices for certain servics to include imaging tests, clinic visits, and drug administration.

Authorize long-term care hospital (LTCH) site neutral exceptions criteria: The Budget proposes to better align payments to LTCHs based on patient need by modifying the criteria for payment… Researchers, including the nonpartisan Medicare Payment Advisory Commission (MedPAC), have suggested that the current criterion of at least three days in the intensive care unit (ICU) may be too low, and that a higher number of days may more accurately identify patients who require the intensity of care provided at an LTCH. The Budget proposes to extend the criterion to at least an eight-day stay in an ICU, as recommended by MedPAC, to better identify chronically ill patients who would more likely benefit from an LTCH.

Reduce Medicare coverage of bad debts: The budget would reduce the amount Medicare pays to certain institutional providers to cover copayments or deductibles that beneficiaries fail to pay. Medicare currently reimburses certain providers at 65 percent of bad debt. Private insurance companies do not typically cover any portion of uncollected cost-sharing, which is the responsibility of the beneficiary. The Budget would bring Medicare more in line with the private sector by gradually reducing reimbursement to 25 percent of bad debt over three years.

Reform and expand durable medical equipment competitive bidding: The Budget proposes to implement a more rational approach for setting payment rates in competitively bid areas by eliminating the single payment amount, and paying winning durable medical suppliers at their bid amounts…

Expand basis for benefiary assignment for Accountable Care Orgnizations (ACOs): …ACOs are designed to help reduce wasteful Medicare spending and improve quality by coordinating patient care and preventing unnecessary duplication of services. The Budget proposes to provide additional flexibilities to increase providers, including nurse practitioners, physician assistants, and clinical nurse specialists, moving more beneficiaries from fee-for-service Medicare to value-based care, without affecting beneficiaries access to providers or the care they recieve.

Modify payment for hospital care provided to beneficiaries in skilled nursing facilities: Currently, Medicare pays hospices the same rate for care provided in skilled nursing and nursing facilities as it does for care provided in other settings, such as the home. This results in overpayment to hospice providers since nursing facilities are staffed with professional caregivers and are often paid separately under Medicare and Medicaid. Therefore, the Budget proposes to reduce hospice reimbursement by $10 per day to account for separate Medicare and Medicaid payments already provided for personal care services delivered to beneficiaries who elect hospice in skilled nursing and nursing facilities.

Remove the cap on Medicare Advantage benchmarks and remove the doubling of quality bonus payments in qualifying counties: The Budget proposes to remove two Medicare Advantage payment mechanisms put in place by the Affordable Care Act. Removing the benchmark caps will allow Medicare Advantage organizations to fully realize their quality bonus payments by removing caps set by spending patterns that are over 10 years old. Removing double bonus payments will eliminate inequitable payments made to plans based on their geographic location that are not tied to quality. Taken together these two proposals result in a streamlined Medicare Advantage payment methodology that also produces net savings to Medicare….

February 10, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Trump FY2021 Budget”. From the press release:

Speaker Nancy Pelosi released this statement on President Trump’s full Budget Request for fiscal year 2021:

“President Trump’s latest budget continues his relentless attacks on the health and economic security of hard-working Americans. It is a complete reversal of the promises he made in the campaign and a contradiction of the statements he made at the State of the Union.

  • Cutting Medicare, Medicaid and Social Security, President Trump has broken his promises to seniors and families by slashing half a trillion dollars from Medicare, taking $900 billion from the lifeline of Medicaid, and cutting Social Security Disability Insurance;
  • Hurting students, the Trump Budget cuts federal student loan initiatives by $170 billion, eliminates the Public Service Loan Forgiveness initiative, and harms choldren in our public schools by cutting billions from the Department of Education;
  • Abandoning farmers and hungry families; while American farmers declare bankruptcy at record rates, the Trump Budget slashes nearly $80 billion from the farmer safety net and steals more than $180 billion in nutrition assistance from families struggling to keep food on the table;
  • Cutting investments in jobs and the future of communities; the Trump Budget breaks the bipartisan budget agreement last year by slashing a total of $1.6 trillion dollars in the health, education, safety, and global security of the American people;
  • Contributing to the national debt, by extending the GOP Tax Scam for the rich.

“The federal budget is supposed to be a statement of national values. Once again, the President is showing just how little he values the good health, financial security and well-being of hard-working American families. The President’s budget is anti-growth, does not create good-paying jobs and increases the national debt.”


February 11, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Remarks at Press Conference on Trump FY2021 Budget”. From the press release:

…The budget, our federal budget, should be a statement of national values. What is important to us as a nation should be reflected in how we allocate our resources. The budget, in terms of our legislative work, is the heart of the matter. It is where it all begins. And this is a heartless budget. Its a heartless budget in some of the ways that the distinguised Leader spelled out, and I think it does bear repeating what he is doing.

Slashing half a trillion dollars for Medicare, after he stood in front of the House and said, ‘I am protecting Medicare and Social Security.’ A half a trillion dollars out of Medicare. And from Medicaid, $900 billion. So if you’re sitting at home at your kitchen table and you’re a senior or there is a senior in your family on Medicare, you’re getting cut. And if there is long-term care in your family’s budget, you are getting cut.

Two-thirds of long-term care, two-thirds of long-term care is payed for by Medicaid. This is a middle class benefit. Those cuts endanger the health of seniors in long-term care needs for them and their families. And these Medicaid cuts also hurt rural hospitals, people seeking opioid addiction treatment, veterans and their families, more than one million veterans are on Medicaid; $900 billion cut from Medicaid. At the same time, the President is in court fighting to overturn the Affordable Care Act which has, as you mentioned, the pre-existing condition benefit; so important to all of those families.

But in this budget, what could possibly be his motivation to cut all that money from the CDC, that you mentioned, at the time of the Coronavirus and the threat that that is? Cutting members – money from CDC – the Centers for Disease Control, using the full title, the prevention element of the good health of the American people. What could possibly – what could he be thinking? Maybe I’m using that term loosely.

The President said he would fight for farmers. We all want to fight for farmers.  But at a time when farmers are declaring bankruptcy at record rates, the President, in this budget, wants to slash the safety net by nearly $60 billion and ransack the U.S. Department of Agriculture. 

His budget also takes food off the table of hungry families in both rural and urban communities by cutting more than $180 billion from the SNAP program. SNAP program – some farmers, when I visit farmers in the Midwest, they say we are farmers and we are on food stamps.  It’s such a sad thing.  Their economies depend – that’s why Senator Dole and Senator McGovern even began all of this, was to help people meet their food security but also to help farmers have their economic security as well…

…And the National Committee to Preserve Social Security and Medicare writes, ‘This budget would leave seniors and other vulnerable seniors – citizens hungrier, sicker and poorer. It reveals the President’s cruel priorities heading into the 2020 elections.’ …

…This budget is an insult to the hopes and dreams and aspirations of America’s working families.  It increases the national debt.  It must be rejected.

And, by the way, it is in a complete abandonment of the budget agreement that we had with the domestic and defense priorities.  Clearly, this Administration cannot be trusted. 

February 11, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say President’s Budget Would Harm the Health of Americans”. The statement is attributed to Robert McLean, MD, MACP, President of American College of Physicians. From the press release:

The American College of Physicians (ACP) is extremely disappointed in the proposed fiscal year 2021 budget proposal released by President Trump. The drastic cuts to key government health programs would harm the health and healthcare of Americans.

The budget proposes deep cuts in funding for both Medicare and Medicaid, hurting the programs that our elderly and vulnerable depend on to access necessary health care services. Medicare would be cut by $756 billion over ten year. These cuts would include drawing down payments for uncompensated care, expanding costlier Medicare Advantage plans at the expense of traditional Medicare, and promoting high deductable health plans for seniors. Medicaid would be cut by $920 billion over ten years by limiting eligibility, imposing work requirements, and offering states waivers to curtail Medicaid spending. All of thes changes would hurt access to coverage and care for Medicaid beneficiaries.

The proposal would cut funding for the Department of Health and Human Services by 9 percent or almost $10 billion in FY2021. This would include $2.6 billion in cuts to the National Institutes of Health (NIH) threatening the U.S. standing as a world leader in medical and biomedical research. Nearly $700 million is cut from the Centers for Disease Control and Prevention, harming public health at a critical time. The proposal moves or consolodates the Agency for Healthcare Research and Quality (AHRQ) into NIH without specific details about ow that change would be structured, while providing nearly $100 million less for the agency to meet its mission.

The budget proposal also includes cutes to many of the programs that support our health care workforce. For instance, over $50 billion would be cut for vital payments to the Graduate Medical Education program, by which graduated medical students become competent physicians in a particular field of medicine and add to the nation’s physician supply. The proposal would also eliminate a large portion of Title VII health professions funding including $49 million of Section 747 training in Primary Care Medicine, the only federal program dedicated to funding and improving training of primary-care physicians. Budget cuts that harm support for training physicians and other health care professionals would reverberate for years to come.

Congress should set aside this flawed plan. Instead, Congress should enact a budget that woudl support the health and well-being of all Americans.

February 11, 2020: California State Senator Lena A. Gonzalez (Democrat – district 33) posted a press release on her official website titled: “Equal Insurance HIV Act announced to end discrimination against HIV-positive Californians for life and disability income insurance”. From the press release:

Today, Senator Lena Gonzalez (D- Long Beach), Insurance Commissioner Ricardo Lara, and Equality California announced the Equal Insurance HIV Act to stop insurance companies from denying life and disability income insurance coverage based solely on HIV status. This bill proposal would enact anti-discrimination to ensure they have equal access to the coverage they deserve.

“Everyone deserves access to life and disability income insurance, regardless of preexisting conditions,” said Senator Lena Gonzalez. “I am so proud that my first bill introduced in the legislature will ensure access to these critical resources for residents who are HIV-positive. It is time that we end the practice of insurance companies refusing to provide services to those who need it most.”

This proposed bill overturns a law passed in 1989 when treatment for someone who tested HIV-positive was extremely limited. Therapies were ineffective, and came with severe side effects causing many individuals who were HIV-positive to bypass treatment. Today, with access to health care, advancement in HIV testing, and more effective treatment, a person who is HIV positive and undergoes and remains on treatment can live a long healthy life. HIV status is treated by medical professionals like any other treatable chronic condition…

…With HIV-positive people living longer healthier lives, their need for life and disability income insurance is imperative to protect themselves and their families. Current California law allows insurers to deny coverage for life or disability income insurance to HIV-positive individuals based on positive results of an ELISA test followed by a positive Western Blog Assay performed by or at the direction of the insurer – tests that are no longer commonly used today…

…A person’s HIV positive status should be treated in the same way as any other chronic condition in the writing of life and disability income insruance. This bill will ensure that life and disability insurance companies can no longer use outdated and discriminatory insurance underwriting law that allows insurers to refuse life and disability income insurance applications for HIV-positive individuals based solely on a positive HIV test…

February 11, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU, Planned Parenthood, And Consumers Challenge Trump Administration Rule That Threatens Insurance Coverage For Abortion”. From the press release:

The Rule Imposes More Than $1 Billion In Unnecessary Costs In An Effort To Coerce Insurance Companies to Stop Offering Coverage For Abortion, Affecting More Than 3 Million Consumers.

Planned Parenthood of Maryland, Inc. and several consumers around the country filed a lawsuit today challenging the Trump administration’s new rule designed to make insurance companies stop offering coverage for abortion. They are represented by attorneys with the American Civil Liberties Union (ACLU), Planned Parenthood Federation of America, Inc., and Brown Goldstein & Levy, LLP.

In December 2019, the Department of Health and Human Service (HHS) and the U.S. Centers for Medicare and Medicaid Services (CMS) released a new rule that, if implemented, would force insurance companies that sell plans in the Affordable Care Act individual marketplaces to send two separate bills to customers – onefor the coverage of abortion care, and another for coverage of other health care. Insurers will also have to instruct their customers to pay the bills using two checks, two money orders, or two electronic transactions every month.

As the adminsitration acknowledged in finalizing the rule, the extensive administrative burdens will lead to higher premiums for consumers and will cause some insurers to drop insurance coverage for abortion altogether. As the administration also acknoweledged, confusion about these new requirements will lead some people to miss payments and risk losing their health insurance coverage entirely.

“If this rule takes effect, I face the terrifying risk of losing not only my insurance coverage for abortion, but my insurance coverage entirely, which would be devistating for me given my pre-existing condition,” said Rebecca, a resident of Washington, D.C., and plaintiff in the case. “That’s why I’m joining the ACLU and Planned Parenthood to fight back. It is curel and unacceptable that the Trump administration is interfering in my health care and trying to interfere with how health insurance companies do business, just because they want to make it more difficult for me to access my right to abortion.”..

…More than 3 million consumer would be affected by the rule’s onerous restrictions, including the individual plaintiffs in the lawsuit from Maryland, the District of Columbia, New Jersey, and Maine. The rule would also affect one-third of the individual market exchange plans nationwide, including every individual plan offered on the marketplaces in Maryland. A fact sheet on the impact can be found here

…The lawsuit was filed in the U.S. District Court for the District of Maryland.

February 11, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood, ACLU, and Consumers Challenge Trump Administration Rule That Threatens Insurance Coverage for Abortion”. From the press release:

Planned Parenthood of Maryland, Inc., and several consumers around the country filed a lawsuit today challenging the Trump administration’s new rule designed to make insurance companies stop offering coverage for abortion. They are represented by attorneys with the Planned Parenthood Federation of America, Inc., American Civil Liberties Union (ACLU), and Brown, Goldstein & Levy, LLP.

In December 2019, the Department of Health and Human Services (HHS) and the U.S. Centers for Medicare and Medicaid Services (CMS) released a new rule that, if implemented, would force insurance companies that sell plans in the Affordable Care Act individual marketplaces to send two separate bills to customers — one for the coverage of abortion care, and another for coverage of other health care. Insurers will also have to instruct their customers to pay the bills using two checks, two money orders, or two electronic transactions every month.

As the administration acknowledged in finalizing the rule, the extensive administrative burdens will lead to higher premiums for consumers and will cause some insurers to drop insurance coverage for abortion altogether. As the administration also acknowledged, confusion about these new requirements will lead some people to miss payments and risk losing their health insurance coverage entirely…

…More than 3 million consumers would be affected by the rule’s onerous restrictions, including the individual plaintiffs in the lawsuit from Maryland, the District of Columbia, New Jersey, and Maine. The rule would also affect one-third of the individual-market exchange plans nationwide, including every individual plan offered on the marketplaces in Maryland…

February 11, 2020: Senator Kamala Harris posted a press release titled: “In Judiciary Hearing, Harris Speaks Out Against Misleading and Punitive Bill Targeted at Pregnant Women”. From the press release:

U.S. Senator Kamala D. Harris (D-CA) on Tuesday raised serious concerns about the punative nature of a bill that traffics in misinformation about abortion and seeks to criminalize physicians during a hearing of the Senate Judiciary Committee. In her question to Fatima Goss Graves, president and CEO of the National Women’s Law Center, she expressed her belief that the bill attempts to put the priorities of politicians ahead of the best medical judgement of health providers and professionals…

…Full transcript is below:

HARRIS: Thank you. Ms. Goss Graves, good morning. I do believe and I think many of us believe that this bill attempts to put the priorities of politicians ahead of the priorities of medical health providers and professionals as evidence by the fact that even this morning the American College of Obstetricians and Gynecologists oppose this bill. I’m asking you then, is there any evidence that this bill would improve health outcomes for women and their families?

GOSS GRAVES: Certainly not. And if we wanted to actually improve health outcomes for women, health outcoem for babies, there’s a long list of things we could do – whether it is actually investing in rather than cutting Medicaid. There’s a bill that’s moving through the House called the Pregnant Workers Fairness Act that supports pregnant workers who need accomodation while on the job. There is food assistance, housing, transportation. Those are things that have all been proven to actually improve pregnancy outcomes, but this bill is not one of them.

HARRIS: And it appears that this bill is therefore – the nature of it is punative as opposed to supportive of the desires and needs of women as it relates to their healthcare and the healthcare that they need and require during the course of their pregnancy. So I ask you does this bill increase the likelihood that women with complicated and potentially dangerous pregnancies will be forced to delay recovery and receiving necessary medical care? Is there a dis-incentive for certain populations of women created by this bill top recieve the care they need?

GOSS GRAVES: Well that’s my real worry: The disinformation and misinformation and the stigma that is wrapped around this bill is precicely the type of thing that would prevent someone from actually getting the care they need when they need it.

HARRIS:

HARRIS: And one of the issues that I’ve focused on in improving outcomes for women and their families and particularly women of color, is based on many factors including that the United States is 1 of only 13 countries where the health outcomes for pregnant women are worse today- worse today than 25 years ago. Black women are disproportionally affected. They are twice as likely as white women to suffer life-threatening complications during pregnancy and as we all know Black women are 3-4 more times more likely to die in connection with childbirth than other women. This is due in part to the implicit bias that is undoubtedly in our health care delivery system. And that’s why we proposed the maternal care act to establish implicit bias training for medical health professionals. So obviously, we need to address the racial disparities both in terms of the outcomes but also the implicit and sometimes the explicit bias that is real in the health care delivery system and we obviously need to address these issues and eliminate the barriers to comprehensive high quality care for all women. So my question is how do restrictions on access to abortion such as this bill exacerbate the health disparities that women of color face in America today?

GOSS GRAVES: One of the things that we know is that the restrictions in places like Texas and Louisiana and other states that also have very high maternal mortality rates—especially for Black women—those things are not disconnected. It’s the same states that are shutting down access to care, shutting down clinics, making it harder to get care that also have these extraordinarily high rates. It’s the same states that haven’t taken the Medicaid expansion and so Medicaid is harder to come by. And now we have this new effort to have a block grant which is only going to lead to even more cuts. About half of births are Medicaid. And so when I look ahead and think about what this is going to look like for Black women in particular, who have this extraordinarily high maternal mortality rate—which is really an outrage for this country—it’s not just that this bill will do nothing, this bill is among a continuum that is actually harming women and their families.

HARRIS: So if the United States Senate really wanted to address the health and well-being of pregnant women, do you think there are smarter ways to go about achieving that goal that I believe we all have be us, Democrats, Republicans or whatever are party affiliation or where we live, what would you propose we do to actually achieve the outcomes this bill reports to have as its goal? 

GOSS GRAVES: I mean you can start by addressing the bias that pregnant patients are facing in healthcare. For Black women, indigenous women in particular you would invest more in Medicaid that would be a huge thing. But you would also deal with the other factors like the pregnant workers fairness act. You’d have things like paid family medical leave so that people actually take of time from work when they’re experiencing pregnancy complications. And you would things like a meaningful investment in housing and food assistance so that people are able to eat healthily during their pregnancies. There are things that could make a difference around pregnancy outcomes.

HARRIS: Thank you.

February 11, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Statement on House Markup of DC Statehood Bill”. From the press release:

Today, the House Committee on Oversight and Reform voted to pass the Washington D.C. Admissions Act, a bill intended to give statehood to Washington, D.C., and its 700,000 residents who are currently being taxed without representation. During the markup, anti-reproductive health members of Congress also failed to restrict reproductive health care access even further…

…During the markup, a dangerous amendment was proposed to limit reproductive health care options and interfere with the doctor-patient relationship in the new state of Washington, D.C. by seeking to restrict abortions later in pregnancy. This amendment is part of a broader agenda against access to health care, accurate information, and bodily autonomy. The new state of Washington, D.C., shouldn’t be subjected to any laws passed by Congress that other states aren’t also subject to. The amendment failed a full committee vote 16-21.

More than 700,000 people make their lives in D.C., which is more than the populations of Wyoming and Vermont and almost as many as Alaska, North and South Dakota. Yet, D.C. residents do not have federal representation, despite having paid more taxes than 22 states, and paying more to the federal government than they recieve in benefis. In addition, Congress has unfairly prohibited D.C. from using its own local tax dollars to cover abortion care throug Medicaid, impacting 55,000 women of reproductive age enrolled in Medicaid, disproportionately impacting women of color. The only way to guarantee D.C. residents equal representation in Congress as well as full control of the laws and budgets passed by their locally elected officials is to pass the Washington D.C. Administration Act and admit the District of Columbia as the 51st State.

February 11, 2020: Senator Kamala Harris (Democrat – California) posted a press release titled: “Harris, Colleagues Introduce Bill to Counter Safety Net Cuts Pushed by Trump Administration”. From the press release:

U.S. Senator Kamala D. Harris (D-CA) joined Senators Chris Coons (D-DE) and Sherrod Brown (D-OH) and 8 of their colleagues in introducing the Allowing Steady Savings by Eliminating Tests, or ASSET, Act to eliminate asset limits as a means of eligibility for three vital public assistance programs and raise asset limits for a fourth program.

The bill presents an alternative vision for vital public assistance programs. Rather than shredding the safety net by imposing new bureaucratic hurdles for families, as proposed by President Trump in his budget released this week, the ASSET Act would increase the financial security of low-income families by helping them save for the future and move towards self-sufficiency.

The Temporary Assistance for Needy Families (TANF) program, the Supplemental Nutrition Assistance Program (SNAP), and the Low-Income Home Energy Assistance Program (LIHEAP) help low-income families, particularly those with children, meet basic needs like food and heating. However, currently, these public assistance programs limit eligibility for benefits on the basis of not only income, but the assets of a family, such as savings and other resources. Asset limits for savings are outdated and often set as low as $1,000 or $2,000, limiting a family’s preparedness for a medical emergency or unanticipated expense. The ASSET Act would eliminate these savings penalties, reducing administrative costs and resulting in a consistent policy across the country.

The Supplemental Security Income (SSI) program reduces extreme poverty among the elderly and people with disabilities. While asset limits are part of the SSI program design, limits have not been raised or even adjusted for inflation since 1989. The ASSET Act raises SSI asset limits from $2,000 to $10,000 for an individual and $3,000 to $20,000 for a couple, and indexes those thresholds to inflation.

“Let’s be clear– safety net programs should not punish people for saving money for unexpected expenses and medical emergencies,” said Senator Harris. “I’m proud to join my colleagues in introducing legislation that helps lift working families out of poverty by eliminating outdated restrictions. We should be doing everything we can to ensure Americans have access to these vital programs that help them thrive.”

In addition to Senators Harris, Coons, and Brown, the ASSET Act is cosponsored by Senators Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Tim Kaine (D-VA), Patrick Leahy (D-VT), Dick Durbin (D-IL), Chris Van Hollen (D-MD), Bernie Sanders (I-VT), and Bob Casey (D-PA).

The bill is endorsed by Alliance to End Hunger, Bread for the World, Center for Law and Social Policy (CLASP), Children’s HealthWatch, Coalition on Human Needs, Delaware Community Legal Aid Society, Delaware Community Reinvestment Action Council, Food Bank of Delaware, Food Research and Action Center (FRAC), First Focus Campaign for Children, National Low Income Housing Coalition, National Women’s Law Center, Prosperity Now, REACH Riverside, United Way of Delaware, and UnidosUS. Quotes from endorsers available HERE.

The bill text is available HERE.

The one-pager is available HERE.


February 12, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on House Brief Seeking Supreme Court Ruling on GOP’s Anti-ACA Lawsuit”. From the press release:

Speaker Nancy Pelosi released the following statement as the House of Representatives filed a reply brief in Republicans’ Texas v. U.S. lawsuit, asking the Supreme Court to act swiftly to hear the case and deliver a ruling this term. In December, the 5th Circuit Court of Appeals had sided with Republicans and given instructions to the District Court to redetermine how much of the law to strike down, almost certainly delaying a final ruling into 2021 or later.

“Every day that the Republicans’ anti-health care lawsuit is allowed to endure is a day that American families will be forced to live in uncertainty and fear. The longer this GOP lawsuit continues, the longer it will needlessly drive up families’ costs and endanger life-saving protections for people with pre-existing conditions – as well as destroy all the other benefits and protections of the Affordable Care Act.

“The Trump Administration and its GOP allies want to delay judgement on the disaster they have sought – and continue to seek – to unleash on the health care of the American people, but there is no legal or practical justification for doing so.

“To protect the American people, the Supreme Court should hear this case now. In the courts and in Congress, House Democrats will continue to fight the Administration’s dangerous assault on Americans’ health care.”

February 12, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Files Reply Brief in Supreme Court, Asks to Resove the ACA Repeal Lawsuit”. From the press release:

Attorney General Becerra today led a coalition of 20 states and D.C. in filing a reply brief in the U.S. Supreme Court in California v. Texas. In the brief, the attorneys general reiterate the harms this ACA Repeal Case is causing our healthcare system and Americans’ healthcare. The brief also opposes arguments by the Trump Administration and the Texas coalition that the case should be sent back to the district court, and urges the Supreme Court to take up teh case to resolve uncertainty in the healthcare market.

“Today, our coalition made clear that we must end the uncertainty and harm in our healthcare system caused by the Trump Administration and Texas coalition’s Repeal Lawsuit,” said Attorney General Becerra. “We are hopeful that the Supreme Court agrees with hospitals, bipartisan economists, public health experts, patients groups, businesses and others, and swiftly resolves this lawsuit.”

A copy of the brief is here.

February 12, 2020: Center for Reproductive Rights posted a press release titled: “In Congressional Testimony, Center for Reproductive Rights Urges Congress to Pass Historic Abortion Rights Legislation that Answers Calls to ‘Codify Roe;”. From the press release:

Today, Nancy Northup, President and CEO of the Center for Reproductive Rights, testified in the U.S. House of Representatives on the Women’s Health Protection Act (H.R. 2975/S. 1645), federal legislation that answers the recent calls to ‘codify Roe’ by safeguarding the right to access abortion care for all people in the United States.

In her testimony, Nancy Northup described the growing crisis in abortion care across the United States and urged Congress to take action on the landmark legislaton:

“Our Constitution protects the right of each of us to chart our own life path and to make the deeply personal decisions that impact our lives, our families, and our health, including whether and when to become a parent. One in four women in the United States will make the decision to have an abortion in the course of her life. Yet in large parts of the United States, obtaining abortion care is difficult – and in some cases, impossible – due to a coordinated, nationwide strategy to eliminate access to abortion care.

The Women’s Health Protection Act would ensure the right to abortion recognized nearly fifty years ago in Roe v. Wade is a day-to-day reality for people in the United States, no matter what state they live in … We need this law now – because the crisis is now.”

Read Nancy Northup’s testimony here.

The Women’s Health Protection Act establishes a statutory right for health care providers to provide, and their patients to recieve, abortion care free from medically unnecessary restrictions and bans.

The hearing took palce in the House Energy and Commerce Subcommittee on Health, chaired by Representative Anna Eshoo (D-CA.). The Women’s Health Protection Act was introduced in the House of Representatives by Judy Chu (D-CA.), Lois Frankel (D-FL.), and Marcia Fudge (D-OH), on May 23, 2019. The bill has earned the support of over 210 cosponsors in the House, nore than in any previous Congress. Senators Richard Blumenthal (D-CT) and Tammy Baldwin (D-WI) introduced an identical bill in the Senate with 42 cosponsors…

February 12, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Applauds Historic Women’s Health Protection Act”. From the press release:

Today, the U.S. House Committee on Energy and Commerce, Subcommittee on Health will hold a historic hearing on the Women’s Health Protection Act (WHPA).

WHPA is a critical piece of legislation that would protect against medically unnecessary abortion restrictions being pushed foward by politicians. Reproductive health champions Rep. Judy Chu (D-CA-27) and 215 co-sponsors in the House of Representatives, and Sen. Richard Blumenthal (D-CT) and 42 co-sponsors in the Senate, are pushing the legislation forward…

…During the 2019 state legislative sessions alone, 58 new restrictions on abortion were enacted into law. All in all, in 2019, a record 25 abortion bans were enacted in 12 states.

At the bottom of the above press release, Planned Parenthood linked to a Fact Sheet about the Women’s Health Protection Act. From the Fact Sheet:

Roe v Wade recognized the constitutional right to abortion. But for many people in the United States, accessing abortion is difficult and, in some places, nearly impossible. We need a federal law to assure that the right to access abortion first recognized in Roe v. Wade is a reality in every state. The Women’s Health Protection Act is that law.

There is a coordinated, nationwide strategy to eliminate abortion access

In 2016, the U.S. Supreme Court reaffirmed the right to access abortion care without undue burden. Yet anti-abortion lawmakers have escalated their attacks, pushing through over 170 harmful laws since them, and nearly 450 since 2011.

These laws:

  • Delay and obstruct access
  • Lower the quality of care that is delivered
  • Are designed to shame those seeking abortion
  • Require providers to preform medically unnecessary procedures and tell patients factually incorrect information
  • Increase costs and risks of reproductive health care services
  • Create gross inequities in access to health care

These restrictions do nothing to protect health or safety of patients and can have long-lasting socioeconomic consequences for people and their families. The harms these barriers create are deeply unequal, falling most heavily on underserved people and commmunities, including people living in poverty, people of color, young people, LGBTQ people, and people living in rural or medically underserved areas.

How does the Women’s Health Protection Act work?

The Women’s Health Protection Act (WHPA) creates a nationwide safeguard against bans and medically unnecessary restrictions that single out abortion care, and protects the long-held constitutional right to access abortion. WHPA works by establishing a statutory right for health care providers to provide, and for their patients to receive, abortion care free from medically unnecessary limitations and bans.

February 12, 2020: The House Committee on Energy & Commerce held a hearing titled: “Protecting Women’s Access to Reproductive Health Care”. The statements of some Committee members and the testimony of some of the participants will be included in this blog post.

Opening Statement Chairman Frank Pallone, Jr.

Today’s hearing is on legislation to protect women’s access to abortion care.

This legislation is necessary today because states have passed an onslaught of ideological bans and restrictions intended to interfere with women’s personal medical decision-making and to severely limit women’s access to abortion care.

Since 2011 alone, anti-abortion state lawmakers have passed nearly 450 restrictive laws with the sole purpose of making it more difficult for women to access this care. They’ve passed mandatory that waiting periods, requirements for multiple in-person visits, and requirements that doctors provide their patients with medically inaccurate information about the potential risks of the procedure. They have also passed rediculous and unnecessary building requirements for abortion providers tha are intended solely to shut down clinics that provide abortion services.

The result of these increasingly restrictive laws is that women all across the country are having a harder time accessing abortion care, which they have a constitutional right to obtain. Comprehensive health care means having access to affordable abortion care, which is a safe medical procedure with far fewer risks than many routine medical procedures. Repeated studies have confirmed the safety of abortion, including comprehensive findings by the National Academics of Science, Engineering, and Medicine. It is a safe and legal procedure, but ideological state legislators continue to put up roadblocks for women and providers.

Today, nearly 90 percent of American counties are without a single abortion provider, and six states only have one abortion clinic in the entire state. The unfortunate reality in America is that your constitutionally guaranteed health care rights are now dependent upon where you live, and that is wrong.

Sadly, we know that anti-abortion restrictions fall hardest on those who already face significant barriers to health care: low-income women, women of color, LGBTQ people, young people, and people living in rural communities. At a time when we should all be working together to reduce health care disparities, we are watching states across the country actively pass legislation that increases those disparities, we are watching states across the country actively pass legislation that increases those disparities. Their actionsare putting access to care further out of reach. One particularly alarming study from the Center for Reproductive Rights and Ibis Reproductive Health found that states with more anti-abortion lawas have poorer health outcomes generally for both women and children than states that have fewer restrictions. This should be alarming to all of use especially as we are faced with an increasingly dire national maternal health crisis that we also know disproportionately impacts women of color.

It is for all these reasons that we are holding this important and timely hearing on the Women’s Health Protection Act. This legislation simply ensures that patients can access, and health care providers can provide, abortion services. It prevents medically unnecessary and burdensome restrictions that single out abortion providers and deny women access to care. It is long past time that we affirm women’s health care rights by ensuring that they can actually utilize those rights. The Women’s Health Protection Act would do just that by ensuring the constitutional right to have an abortion is a reality for all people, no matter where they live…

The full text of H.R. 2975 The Women’s Health Protection Act is here.

Opening Statement Chairwoman Anna G. Eshoo

Nearly 50 years ago, the Supreme Court affirmed the right of every woman to make decisions about her own life, body, and future.

Now that right is under threat by state laws restricting and banning reproductive healthcare and abortion care.

Since 2011 states have passed more than 450 medically unnecessary restrictions on reproductive care.

For example, Alaska, Kansas, Oklahoma, and Texas force doctors to lie to their patients by having them inaccurately link abortion and breast cancer in theri patient counseling.

Louisiana, Texas, and Wisconsin require providers to perform medically unnecesssary ultrasounds and show and describe the images to women who have already decided to have an abortion.

Eighteen states have specific requirements for procedure rooms and corridors, as well as requiring facilities to be near and have relationships with local hospitals. These requirement do not improve patient care but set expensive standards that make it difficult for clinics to stay open.

Today, 90 percent of counties in our country are without a single abortion provider, and six states have only one abortion clinic.

So, why is this a problem that the Subcommittee should address?

First, these restrictions deny women access to safe health care. Restricting abortion doesn’t stop abortion. It makes it less safe.

A nonpartisan study by the National Academies of Sciences found that the biggest threats to the quality and safety of abortion care are state regulation that create barriers to trained abortion providers.

When abortion is accessible and legal, it is extremely safe. The rate of serious complications in first-trimester abortions is less than 0.05 percent, making abortion 40 times safer than a colonoscopy.

But when abortion care is restricted, women face devistating consequences.

The landmark Turnaway Study, a five-year longitudional study by reserachers at UCSF, followed 1,000 women who sought, but did not always obtain, abortion care.

The researches found that the women who were denied health care consistently fared worse outcomes than those who recieved it.

The women forced to carry a pregnancy were more likely to experience eclampsia and were more likely to stay with abusive partners. They were four times more likely to be living below the poverty level. Two women who were denied abortion care died of pregnancy-related causes.

The Women’s Health Protection Act makes sure that every Americanhas equal access to comprehensive reproductive health care, no matter where they live.

This legislation follows in the tradition of the Voting Rights Act of 1965 where Congress safeguarded a constitutionally-protected right. That’s because states don’t get to pick and choose what part of the Constitution to follow…

Holly Alvarado – advocate – provided testimony in support of H.R. 2975: The Women’s Health Protection Act. From her testimony:

In her testimony, Holly Alvarado stated that she served in the United States Air Force from 2006 to 2011 as a law enforcement officer. In 2009, she was given orders for deployment with a 10 person team. Two weeks before her deployment, she wsa gathering supplies, packing, and moving her apartment into a storage unit, she realized she could be pregnant.

….I knew immediately that I did not want to continue this pregnancy. I knew me. 22 year old me knew that what now 33 year old me wanted out of life and this pregnancy was not part of my plan. Even though this was an immediate feeling, I took time to think about how I was not financially or emotionally in a state of my life where I was ready to continue a pregnancy and raise a child. While serving in the military, I saw the many challenges facing servicewomen with children… I made a deeply ethical and moral decision by myself and was resolute on what I needed to do…

…I called Planned Parenthood of North Dakota and learned that the closest facility that could perform abortions was in Fargo, ND, approximately 2 hours away. North Dakota only has one abortion clinic. which means longer wait times for an appointment. They did not have any appointments in the next two week and were unable to help me. I was encouraged to call St. Paul, MN’s Planned Parenthood office, 4 hours away. I called and scheduled my first and second appointment…

…My first appointment was needed to verify my pregnancy with an ultrasound and urinalysis, they would give me information, and an ultrasound picture. I needed to book a second appointment for the procdure itself. This was not due to any medical reason and it was certainly not my preference. Minnesota law mandates a 24 hour waiting period between the first appointment and the day of the procedure. And because of the wait times for an appointment at the clinic I would have to wait 3 days between appointments. I would spend a total of 4 days in Minnesota without resources. The day before my appointment I would have to wait for a mandatory phone call. I was told to wait by my cell phone and be somewhere with good service because I would need to answer and couldn’t miss the call. If I had missed the call they would have to cancel my appointment for the next day and I would have to start the process all over again. If that had happened I would have missed my deployment deadline, I would have been financially unable to repeat this process, and close to the gestitational limit of having an abortion. In that phone call I would be told I have options like adoption or continuing the pregnancy, that I am eligbile to receive child support and WIC, that my procedure could be dangerous and prevent me from having children in the future, and then I would need to confirm my appointment for the next day if I did not want to continue the pregnancy…

…I confirmed my appointment the next morning. The state laws, the biased counseling, the waiting period, the protesters in front of Planned Parenthood, all felt like a slap in the face…

…I chose the surgical abortion because it was a one day procedure with no follow up. If I took the medication abortion, I would need to have a follow up appointment after a week of taking the medication to make sure the pregnancy had ended. I would not be able to do that because I would be in training for deployment on an isolated base, so the only option was a surgical abortion…. The appointment was long as I would need another pregnancy test, an RH test, another ultrasound, and counseling with an RN.

…When the procedure was complete I felt relief…

..Because of a federal ban on abortion coverage I was unable to use TRICARE as my healthcare insurance and was unsure what I would do if there had been any complications… ….Regardless, the abortion was a saf procedure and I had zero complications, I returned to duty within 12 hours of having my procedure.

The procedure for an abortion was approximately 500 dollars, coupled with preperation in purchasing gear for deployment, needs for gas, and food and the 4 hour, 600 mile roundtrip journey to get the healthcare I needed. I had 16 dollars to my name the day I drove back to North Dakota and pay day was 1 week and a half away…

Nancy Northup, President and CEO of the Center for Reproductive Rights, provided testimony in support of the Women’s Health Protection Act. From her testimony:

…Our Constitution protects the right of each of us to chart our own life path and to make the deeply personal decisions that impact our lives, our families, and our health, including whether and when to become a parent. One in four women in the United States will make the decision to have an abortion in the course of her life. Yet in large parts of the United States, obtaining abortion care is difficult – and in some cases, impossible – due to a coordinated, nationwide strategy to eliminate access to abortion care.

Anti-abortion rights lawmakers in state legislatures are doing whatever they can to ensure that patients face insurmountable barriers to care and that clinics are forced to close – effectively banning abortion without ever havin to touch Roe v.Wade. Since 2011, nearly 450 laws restricting and banning abortion care have been pushed through state legislatures. These laws close clinics, increase health care costs, exacerbate ineqhalities, and harm women and their families.

In 1992, the year that Planned Parenthood v. Casey was decided, there were 2,380 clinics in the United States. In 2017, there were 1,587 – a decrease of one third. Already six states are down to one abortion clinic, and nearly 90 percent of American counties are without a single abortion provider. The harms caused by the decimation of abortion access are deeply unequal, falling most heavily on marginalized and underserved people and communities who already experience stignificant structural and systemic barriers to accessing quality health care including abortion. These communities include low-income people, people of color, immigrants, young people, and people living in rural and other medically underserved areas.

The Women’s Health Protection Act would ensure that the right to abortion first recognized nearly 50 years ago in Roe v. Wade is a day-to-day reality for people in the United States, no matter what state they happen to live in. This bill would create a federal statutory right for providers to provide abortion services, and a corresponding right for their patients to receive abortion services, free from medically unnecessary restrictions and bans that single out abortion and impede access to care.

Congress has the authority under the Commerce Clause to regulate health care as interstate commece, and the authority under Section 5 of the Fourteenth Amendment to protect against the abridgement of constitutionally protected rights. It must exercise this authority now and protect the right to access abortion care first recognized in Roe by passing the Women’s Health Protection Act…

Yashica Robinson, MD, who is a board certified obstetrician-gynecologist, provided testimony. She serves on the board of directors of Physicians for Reproductive Health and is the medical director of Alabama Women’s Center. From her testimony.

…I came to this work because of my passion for young people, one that is deeply connected to my personal experience with teen pregnancy. Prior to finishing high school, I learned I was pregnant. As a result of fear and lack of resources, by the time I confided in my mother and grandmother, I had no choice – I was going to be a mother. Becoming a mother as a teenage came with many harsh realities. I love ny children with all my heart, but I know that everyone should be able to make the decision to parent for themselves. I have been in the shoes of many of the young people I see in my clinic, and it’s important for them to know that regardless of their decision, that I am here to support them.

I support the Women’s Health Protection Act becasue it would help ensure tha access to care does not look differently depending on your zip code. In states like California or Maryland, today a patient can access abortion care without the state forcing medically inaccurate information on them, or making them endure a medically unnecessary waiting period. This is what care should look like. Unfortunately, today that is not the case for my patients in Alabama.

Providing abortion care in Alabama is challenging. Just last year, the legislature passed a near total ban on abortion. Under that ban a physician could be sent to prison for 99 years for performing an abortion. This law, should it ever go into effect, it would threaten doctors like myselfwith prison for providing ethical, medically appropriate care. There is no other area of medicinewhere politicians threaten physicians with prosecution for doing their jobs. Represented by the ACLU, I and other abortion providers in the state filed suit to prevent this bill from going into effect. Thankfully, the ban was blocked, and abortion remains legal in Alabama, as it is in every other state.

…It is not unusual for patents to travel up to eight hours, or from as far away as Louisiana and Florida – because so many other providers have been forced to shut their doors. Then they are required to wait an additional 48 hours before I can provide the care they need due to a state-imposed waiting period. I know people who have slept in their cars as a result of this manditory delay period because they had no other options.

The state also requires that my patients recieve outdated materials as part of so-called “counseling” that are filed with misinformation that I then need to correct. We are required to do ultrasound examinations, even when they are unnecessary and provide no medical value. These restrictions only add costs and delays. Their effects on my patients are painful for me to see.

Alabama also bans abortion after 20 weeks post-fertilization. Patients needing care after that point have to travel out of state, making care even more expensive. And young people in Alabama have to navigate an onerous, time-intensive process to have an abortion if they cannot involve a parent. I have cared for a 12-year-old victim of incest who faced many delays before finally getting judicial approval for the abortion she needed. Even though I met her in her first trimester of pregnancy, she was nearing Alabama’s legal limit by the time she navigated all of these hurdles…

…in 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a comprehensive study affirming that abortion is extremely safe and the biggest threat to patient safety is the litany of medically unnecessary regulations that raise costs and delay procedures, ultimately putting women’s health at risk. They confirmed what we already know: that access to safe abortion care all too often depends on where you live and how much money you have…

…The bottom line is this: Abortion is healthcare! The Women’s Health Protection Act would bring needed federal protections for my patients and safeguard their right to abortion care. Protecting abortion care will also protect access to pregnancy care because they are interconnected. Health care in any speciality should be patient-centered, and medical decisions should remain between the patient and her physician, without political interference.

There were also two anti-choice people who provided testimony. Their words do not belong in my blog post.


February 13, 2020: New York Attorney General Letitia James posted a press release titled: “AG James Voices Support for Legalization of Surrogacy In New York”. From the press release:

Attorney General Letitia James released the following statement in support of legalizing gestational surrogacy in New York.

“Our antiquated surrogacy ban makes it prohibitively expensive and burdensome for many New Yorkers to become parents. Countless families, particularly members of the LGBTQ community and those with fertility issues, have been unable to have a child through surrogacy because of this outdates law. The current proposal has been well-researched, well-written, and will not only support families, but provide critical legal and medical protections to surrogates, parents, and children. I respect the legislative process and look forward to meeting with members of the legislature to address their concerns so we can move forward to adopt this proposal.”

“New York is one of the most progressive states in the nation and a leader in LGBTQ and women’s rights, and yet we are only one of three states that does not allow LGBTQ individuals and people struggling with fertility to conceive a child and start a family through gestational surrogacy,” said Governor Andrew M. Cuomo. “We need to right that wrong, and with the support of the Attorney General and our broad coalition of advocates, this year we will get it done and complete marriage and family equality”…


February 14, 2020: EMILY’s List posted a press release titled: “EMILY’s List Announces Top 2020 State-Level Targets in $20 Million Campaign”. From the press release:

Today, EMILY’s List, the nation’s largest resource for women in politics, announced its strategic state targets for the 2020 election cycle. In addition to targeting several states where state legislatures control redistricting, EMILY’s List is focused on legislative chambers where Republicans have consistently pushed appallingly anti-woman, anti-family agendas. EMILY’s List will be working to flip the following chambers from red to blue by electing pro-choice Democratic women: the Arizona House and Senate, the Florida Senate, the Iowa House, the Minnesota Senate, the Michigan House, the North Carolina House and Senate, the Pennsylavania House and Senate, and the Texas House.

In addition to flipping these 11 critical chambers in eight states, EMILY’s List will be working with Democratic majorities in chambers in Colorado, Minnesota, Nevada, and New Hampshire, and expand the number of pro-choice Democratic women serving in state legislatures in states like California, Georgia, Maine, New Mexico, Ohio, Washington, and Wisconsin.

“We have a once in a decade opportunity to replace right-wing partisans with candidates who will not only put an end to extremism, but draw maps that give voters a fair shot at the ballot box,” said EMILY’s List President Stephanie Schriock. “EMILY’s List is working hard to recruit and elect pro-choice Democratic women across the country who will stand with working families and permanently oust hundreds of out-of-touch state legislators. Republicans in our priority states have thwarted progress at every turn, championed draconian laws attacking women and families, and rigged the map to make themselves unbeatable. There is simply too much at stake to allow them to manipulate elections for years to come at the expense of working people.”

Last summer, EMILY’s List announced an unprecedented $20 million investment in state and local elections for the 2019-2020 cycle targeting more 500 state legislative races. In addition to focusing on redistricting, the effort prioritizes states where there is great opportunity due to changing demographics, where a woman’s right to choose is under attack, and where there are rising women leaders pushing for change across the board.

In the 2018 cycle, the organization targeted more than 1,600 races in more than 20 states, increasing the number of women in statewide offices, state legislative seats, and municiple seats. We flipped seven chambers and laid the groundwork for future victories by gaining seats in more than 10 chambers that could potentially flip in 2020. In 2019, through our $20 million campaign, EMILY’s List-endorsed women who also helped flip the Virginia Assembly from red to blue and have since passed progressive legislation to ratify the Equal Rights Amendment and expand non-discrimination protections for LGBTQ Virginians.

February 14, 2020: NBC News posted an article titled: “Federal court strikes down Trump administration’s Medicaid work requirements”. It was written by Phil McCausland. From the article:

A federal appeals court rejected a Trump administration rule that allowed Arkansas and other states to impose work requirements on its low-income residents who received Medicaid benefits, further blocking a marquee issue for the president.

The U.S. Court of Appeals for the District of Columbia Circuit ruled Friday that the White House had acted unlawfully and that Health Secretary Alex Azar’s approval of the program, known as Arkansas Works, was “arbitrary and capricious.”

Judge David Sentelle referred to the original Medicaid statute in his opinion, which he wrote “identifies its primary purpose rather than a laundry list” of secondary goals and only aims “to provide health-care coverage to populations that otherwise could not afford it.”

The decision was unanimous and upheld the one originally made by U.S. District Judge James E. Boasberg in March 2019

…The appeals court opinion criticized Azar for only considering positive secondary outcomes that did not deal with the central objective of the law and for ignoring Congress’s direction within the law itself, noting that “when Congress wants to pursue additional objectives within a social welfare program, it says so in the text.”

In his original approval letter to Arkansas, Azar said that the program would “encourage beneficiaries to obtain and maintain employment or undertake other community engagement activities that research has shown to be correlated with improved health and wellness.”…

…Critics argue that work requirement programs do not work and only lead to people losing coverage…

February 14, 2020: KCUR.83 NPR in Kansas City posted an article titled: “Kansas Medicaid Expansion Blocked, Supporters Frustrated And Lawmakers Considering ‘Nuclear Option'”. It was written by Stephen Koranda. From the article:

The Kansas legislative session began with what seemed like a done deal for expanding Medicaid. Gov. Laura Kelly and a top Republican senator had forged a compromise to offer health coverage for up to 130,000 low-income Kansans.

About a month later, the deal has ground to a halt — and even the state budget could be held up — because of abortion politics. 

Medicaid supporters are irritated. Moderate Republicans and Democrats are ready to fight back with delays. And abortion opponents haven’t budged…

…The Senate already passed the proposed constitutional amendment on abortion, which would overturn a court ruling that said the state constitution gurantees women a right to the procedure. But the House narrowly rejected it on Feb. 7.

That led the influential anti-abortion group Kansans for Life to call for blocking Medicaid expansion until the amendment is on a ballot, something Republican Senate President Susan Wagle has promised will happen.

Abortion opponents say the delay is necessary, fearing that the court ruling on abortion rights could lead to state money being used for abortions through an expanded Medicaid program….

…Senate Majority Leader Jim Denning, the Republican who helped draft the Medicaid compromise, is pushing back, saying state funding would not go to abortion due to federal law.

Last year, Democrats and moderate Republicans tried holding up the budget in the House to get Medicaid expansion, but ultimately didn’t have enough votes. The top Democrat in the House said expansion is such a high priority this year that they’re willing to try again if needed.

“We will keep discussing it with them to get that leverage,” House Minority Leader Tom Sawyer said.

Since Republicans hold strong majorities in both chambers, Democrats would need to attract a healthy number of Republicans like Hardy if they hope to successfully block any bills.

Meanwhile, Medicaid supporters held a rally last week, shouting their disapproval of the whole situation inside the Statehouse…


February 18, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “There is a Coordinated Attack Agains Trans Youth in State Legislatures”. It was written by Rose Saxe. From the article:

Less than a month and a half into 2020, this state legisative session has seen unprecedented attacks on LGBTQ people, and an alarming focus on bills that would harm trans youth…

…Right now, bills are pending in 10 states that would criminalize life-saving, best practice medical care for trans youth, putting govenrment in the way of decisions that should be left up to the young person, their parents, and their medical providers. Proponents of these bills repeat similar lies about medical care, but these bills are opposed by all major medical associations that just want to be sure all kids can get the health care they need.

At the same time, 16 states currently are considerin bills that would ban young trans athletes from participating in athletic activities consistent with their gender (bills in Missouri and Idaho have hearings this week.) Some of the bills only exclude girls who are trans, echoing language tha was once used to keep cisgender women out of sports. Others also require boys who are trans to participate solely on girls’ teams. Statewide scholastic sports organizations typically regulate the terms of participation in sports to ensure all youth can participate fairly. These bills would instead authorize invasive medical examination of young athletes, and would substitute a categorical exlcusion from school sports that doesn’t match up even with the most strignent regulations governing elite competition like the Olympics.

And still, other bills would allow all health care providers to refuse care based on religious objections to trans people, or make it harder for schools to support trans youth.

These bills – and dozens of other anti-LGBTQ measures – are pending in states across the country from Alaska to Florida. That’s not a coincidence. These efforts are part of an orchestrated national campaign led by groups like Heritage Foundation, Alliance Defending Freedom, – who last week filed a lawsuit attacking trans student athlethes – and the Family Policy Alliance, to demonize trans youth and drive a wedge among supporters of LGBTQ equality. We can’t let them succeed…

February 18, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Condems Federal Proposal To Roll Back Critical Anti-Discrimination Protections For Patients and Students”. From the press release:

New York Attorney General Letitia James today sent two multistate comment letters to the Trump Administration, opposing federal proposals that roll back critical anti-discrimination protections for patients and students. Both proposals stem from President Trump’s Executive Order that allows faith-based organizations to deny services to various groups. In the first proposal, the U.S. Department of Health and Human Services (HHS) would eliminate transparency requirements for faith-based providers that help patients to understand their rights and access referrals to care from alternative providers. In the second, the U.S. Department of Education is vastly expanding the definition used to claim a religious exemption under Title IX of the Education Amendments Act of 1972. This would allow schools to discriminate on the basis of sex against students or faculty based on the moral beliefs and practices of administrators, even if those practices have no connection with a religion. Together, these federal proposals are part of the Trump Administration’s ongoing assault on the rights of women, survivors of sexual harassment and violence, and LGBTQ+ individuals.

“The president’s Executive Order is nothing more than a veiled attempt to discriminate against our nation’s patients, students, and those who are most vulnerable,” said Attorney General James. “Religion should never be used as weapon, yet the Trump Administration has repeatedly worked to pit Americans against each other by using faith as a wedge between us. Our coalition is fighting the president’s attempts to divide Americans along religious lines, and will continue to do everything in our power to protect women, LGBTQ+ individuals, and those who need these vulnerable protections.”

In the first comment letter, the coalition of 23 attorneys general contends that HHS’ proposal fails to safeguard the rights of women and LGBTQ+ individuals – both groups which already disproportionately face barriers to care. particularlu when it comes to obtaining accurate information about theri health care and referrals. The reciept of accurate and impartial information from providers is vital to a patient’s health and could mean the difference between the life and death. Under the proposal, faith-based providers will no longer be required to notify patients of their rights, including the right to a referral. For instance, removing notice and referral requirements will adversely impact a woman’s ability to access critical reproductive care, including an abortion. In fact, religiously-affiliated crisis pregnancy centers – which have seen an uptick in federal funding under the Trump Administration – have been known to offer patients misleading information in an attempt to discourage them from obtaining an abortion or accessing contraception. In the comment letter, the coalition maintains that HHS’ proposal is arbitrary and capricious because it failes to consider evidence or adequately justify the proposed changes.

In the second comment letter, the coalition of 20 attorneys general highlights how the Department of Education’s proposal to expand religious expemptions under Title IX could give schools free rein to discriminate against students or faculty on the basis of sex – significantly harming people who have suffered discrimination, including sexual harassment and violence. Currently, Title IX contains a narrow religious exemption for educational institutions controlled by a religious organization. The proposal would allow more schools to discriminate on the basis of sex by broadening the criteria for institutions to claim a religious exemption, such that even schools with a tenuous relationsip with religion could claim exemption from Title IX requirements. As a result, under the proposal, a student could unlawfully face discrimination – for using birth control, being pregnant or parenting a child out of marriage, or for being LGBTQ+ – simply because of the moral beliefs or practices of school administators. Sexual harassment and violence survivors could also be denied the protections of Title IX by schools claiming to be exempt under the proposed rule. This kind of discrimination can needlessly and seriously disrupt a student’s academic trajectory and career and could have a detrimental long-term effect on their mental health. The coalition also notes that the proposal is arbitrary and capricious because the federal government failed to provide any substantive reasoning that would justify this dramatic departure in policy, which is contrary to the goals of Title IX.

Joining Attorney General James in sending the first letter to HHS are the attorneys general of California, Connecticut, Delaware, Hawai’i, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia.

Joining Attorney General James in sending the second letter to HHS are the attorneys general of California, Colorado, Connecticut, Delaware, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Vermont, and the District of Columbia.

February 18, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Condemns Federal Proposals to Roll Back Critical Anti-Discrimination Protections for Patients and Students”. From the press release:

California Attorney General Xavier Becerra today filed two multistate comment letters in opposition to federal proposals that roll back critical anti-discrimination protections for patients and students. Both of these proposals stem from President Trump’s Executive Order that allows faith-based organizations to deny services. In the first proposal, the U.S. Department of Health and Human Services (HHS) would eliminate transparency requirements for faith-based providers that help patients to understand their rights and access referrals to care from alternative providers. In the second, the U.S. Department of Education (ED) is vastly expanding the definition used to claim a religious exemption under Title IX of the Education Amendments Act of 1972 (Title IX). This would allow schools to discriminate on the basis of sex against students or faculty based on the moral beliefs and practices of administrators, even if those practices have no connection with a religion. Together, these federal proposals are part of the Trump Administration’s ongoing assault on the rights of women, survivors of sexual harassment and violence, and LGBTQ individuals.

“There’s no excuse for discrimination against patients or students, including denying lifesaving referrals or educational programs that help students thrive,” said Attorney General Becerra. “Sadly, these new proposals are just the latest example of the Trump Administration’s obsession with trampling on our nation’s anti-discrimination protections. California is prepared to step up to protect the rights of the people of our state.”

In the first comment letter, the coalition contends that HHS’ proposal fails to safeguard the rights of women and LGBTQ individuals, who already disproportionately face barriers to care, particularly when it comes to obtaining accurate information about their healthcare and referrals. The receipt of accurate and impartial information from providers is vital to a patient’s health, and could mean the difference between life and death. Under the proposal, faith-based providers will no longer be required to notify patients of their rights, including the right to a referral. For instance, removing notice and referral requirements will adversely impact women’s ability to access critical reproductive care, including abortion. In fact, religiously-affiliated crisis pregnancy centers, which have seen an uptick in federal funding, have been known to offer patients misleading information in an attempt to discourage them from obtaining an abortion or accessing contraception. In the comment letter, the coalition maintains that HHS’ proposal is arbitrary and capricious because it fails to consider the evidence or adequately justify the proposed changes.

In the second comment letter, the coalition highlights how ED’s proposal to expand religious exemptions under Title IX could give schools free rein to discriminate against students or faculty on the basis of sex, significantly harming people who have suffered discrimination, including sexual harassment and violence. Currently, Title IX contains a narrow religious exemption for educational institutions controlled by a religious organization. The proposal would allow more schools to discriminate on the basis of sex by broadening the criteria for institutions to claim a religious exemption such that even schools with a tenuous relationship with religion could claim exemption from Title IX requirements. As a result, under the proposal, a student could unlawfully face discrimination for using birth control, being pregnant or parenting a child out of marriage, or for being LGBTQ, simply because of the moral beliefs or practices of school administrators. Sexual harassment and violence survivors could also be denied the protections of Title IX by schools claiming to be exempt under the proposed rule. This kind of discrimination can needlessly and seriously disrupt students’ academic trajectories and careers and has a detrimental long-term effect on the mental and physical health of students. The coalition also notes that the proposal is arbitrary and capricious because the federal government failed to provide any substantive reasoning that would justify this dramatic departure in policy, which is contrary to the goals of Title IX…

…A copy of the HHS comment letter is available here. In filing the letter, Attorney General Becerra is joined by the attorneys general of Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia.

A copy of the ED comment letter is available here. In filing the letter, Attorney General Becerra is joined by the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Vermont, Virginia, and the District of Columbia.

February 18, 2020: American Academy of Pediatrics (AAP) posted news titled: “State bills seek to place limits on transgender care, ‘punish’ physicians”. From the news:

Pediatricians in some states are facing battles in their ability to care for transgender and gender-diverse (TGD) patients, as legislators propose bills that aim to limit treatment — often based on misinformation — and would even punish physicians who deliver care.

A recent bill in South Dakota would have criminalized medical providers who prescribe puberty blockers, hormone treatment or gender-confirmation surgeries on minors. Pediatricians could have been fined up to $2,000 and jailed for one year for providing such care to youths under age 16 years. The bill passed in the House but was defeated in the Senate on Feb. 11.

That outcome is providing encouragement to those opposed to similar bills under consideration in at least 13 states. While language in the bills varies, all seek to make forms of transgender care illegal.

South Dakota Chapter speaks out

AAP South Dakota Chapter President Michelle Schimelpfenig, D.O., M.P.H., FAAP, and chapter officers marshalled more than 20 pediatricians and pediatric residents to advocate against their state’s current bill on transgender issues. Coincidentally, the chapter planned its first advocacy day at the capital when the bill originally was presented to a House health committee.

Dr. Schimelpfenig testified against the bill — her first such experience — along with Alaa Al Nofal, M.D., a pediatric endocrinologist from Sioux Falls, S.D.

The bill’s defeat is a significant victory both in the state as well as for AAP efforts across the country. The experience also convinced Dr. Schimelpfenig of the importance of pediatrician involvement in legislation.

“I don’t think you go into pediatrics thinking that ‘someday I’m going to testify at our state capital,’” she said. “But I truly feel it’s part of the job when we care for children and want to advocate for children.”

A major reason Dr. Schimelpfenig opposed the bill was because she said it “criminalized” medicine, with physicians facing fines and jail time if they defied the law.

“… Physicians want to take care of their patients. They don’t want the government in their clinic or hospital telling them what they can and can’t do,” she said.

In the end, Dr. Schimelpfenig found the most impactful testimony came from families and children who are living with transgender issues…

AAP policy reflects standard  

The Academy opposes stigmatization and marginalization of transgender youths, who have higher rates of depression, anxiety, substance use, self-harm and suicidality, and frequently face harassment and victimization.

The 2018 policy recommends that youths who identify as TGD have access to comprehensive, gender-affirming and developmentally appropriate health care. It asserts that variations in gender identity and expression are normal aspects of human diversity.

A lot of decision-making goes into gender care and supporting identity formation, Dr. Rafferty said. “You look at (these state) policies that are trying to regulate that process. It takes away from the value of the patient-family-provider connection that is so important to navigating individual care.”

The American Academy of Pediatrics stands by pediatricians who are delivering care to transgender youth, said AAP CEO/Executive Vice President Mark Del Monte, J.D.

“We share their alarm at legislative efforts aimed at undermining their expertise and compromising care for this vulnerable population of patients,” Del Monte said. “Our policy is clear, our chapters are engaged and our pediatrician members are leading the way. We will continue to support their work and advocate for policies that allow them to continue to provide gender-affirming, developmentally appropriate care to their patients.”

February 18, 2020: EMILY’s List posted a statement titled: “EMILY’s List Statement On The Anniversary Of The Introduction of Nevada’s Trust Women Act”. From the statement:

Today, EMILY’s List, the nation’s largest resource for women in politics, celebrated the one year anniversary of the introduction of the Trust Women Act in Nevada. This crucial legislation repealed antiquated and unnecessary consent laws regarding abortion in Nevada and repealed criminal penalties associated with the procedure. Stephanie Schriock, president of EMILY’s List, released the following statement:

“As several states seek to tighten restrictions on a woman’s right to choose, Nevada stands out as a leader in the fight to expand critical access to reproductive care. Our government works better when it looks like the people it represents, and for 35 years, EMILY’s List has worked to do just that by increasing the number of women serving in elected office and creating a pipeline for higher office. With the passage of laws like the Trust Women Act, the country’s first-ever majority-women legislature is proof that pro-choice Democratic women are more effective leaders and will fight for policies that support working families when they have a seat at the table. We hope the Nevada state legislature’s accomplishments can be an example to states across the country of the power of women’s leadership and we look forward to seeing what else they can accomplish.”


February 19, 2020: EMILY’s List posted a press release titled: “EMILY’s List Statement on Mariannette Miller-Meeks’ Vote in Support of a Constitutional Amendment to Ban Abortion”. From the press release:

Today, EMILY’s List President Stephanie Schriock issued the following statement regarding Mariannette Miller-Meeks’ vote in support of an amendment to the Iowa constitution that would effectively ban abortion in the state.

“Iowa women deserve to make their own decisions about their bodies and their futures, without the interference of the government. By voting to effectively ban abortion in Iowa, Miller-Meeks is telling women she doesn’t trust them those decisions. Iowans will remember this when it is time to choose their next representative from Iowa’s 2nd Congressional District.”


February 20, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU, Center for Reproductive Rights, Planned Parenthood File Motion For Summary Judgement In Georgia Abortion Ban Lawsuit”. From the press release:

Today, the American Civil Liberties Union, the ACLU of Georgia, the Center for Reproductive Rights, and Planned Parenthood filed a motion for summary judgement in their lawsuit challenging Georgia’s abortion ban, SisterSong v. Kemp. The motion asks the court to block the ban permanently from taking effect.

The lawsuit, which was filed in June 2019, challenges Georgia’s abortion ban which was set to take effect on January 1, 2020. The law would ban abortion care from the earliest weeks of pregnancy, before many women even know they are pregnant.

According to the lawsuit, Georgia’s abortion ban is in clear violation of Roe v. Wade and nearly a half century of Supreme Court precedent reaffirming Roe’s central holding. Writing for the court in 1992, U.S. Supreme Cout Justice Sandra Day O’Connor wrote, “The ability for women to participate equally in the economic and social life of the Nation has been facilitated by their ability to control their reproductive lives.”

On October 1, 2019, the federal district court granted the plaintiffs motion for preliminary injunctive relief and temporarily blocked the ban from taking effect while the lawsuit is pending. The preliminary injunction will remain in place until the court explicitly says otherwise.

If plaintiffs’ motion for summary judgement is granted, the abortion ban will be permanently blocked unless an appeals court says otherwise.

“As a reproductive justice organization based in Georgia for over 20 years, SisterSong is committed to centering and amplyfying the needs of those communities historically pushed to the margins. Georgia’s maternal mortality rate is the second highest in the nation and Black women in our state are dying at six times the national average. SisterSong is bringing this lawsuit to protect maternal health and reproductive rights so that every person – especially persons of color – can thrive in their families and communities as well as maintain their reproductive lives,” said Monica Simpson, executive director of SisterSong…

…According to a 2019 Atlanta Journal-Constitution poll, 70 percent of Georgians support Roe v. Wade, the landmark U.S. Supreme Court case that guaranteed the right to an abortion…

…The organizations bringing forward the lawsuit are SisterSong Women of Color Reproductive Justice Collective, Feminist Women’s Health Center, Planned Parenthood Southeast, Inc., Atlanta Comprehensive Wellness Clinic, Atlanta Women’s Medical Center, FemHealth USA d/b/a carafem, Columbus Women’s Health Organization, P.C., Summit Medical Associates, P.C., Carrie Cwiak, M.D., MPH., Lisa Haddad, M.D., M.S., M.P.H., and Eva Lathrop M.D., M.P.H.

The defendants in the case are Georgia Governor Brian Kemp, Attorney General Christopher M. Carr, Commissioner for the Department of Public Helath Kathleen Toomey, the Executive Director and Members of the Georgia Composite Medical Board, and the District Attorneys for the counties where the plaintiffs provide medical care – all sued in their official capacities…

A copy of the lawsuit can be found here.

February 20, 2020: Center for Reproductive Rights posted a press release titled: “Appeals Court Blocks Mississippi’s Six-Week Abortion Ban”. From the press release:

Today, the Fifth Circuit Court of Appeals temporarily blocked Mississippi’s six-week abortion ban, upholding a lower court’s decision from May 2019. The case was brought by the Center for Reproductive Rights, civil right attorney Robert B. McDuff, of Jackson, Miss., Paul, Weiss Rifkind, Wharton & Garrison, and the Mississippi Center for Justice on behalf of Jackson Women’s Health Organization (JWHO) – the last remaining abortion clinic in Mississippi. On December 13th of last year, the Fifth Circuit struck down a 15-week ban passed by Mississippi.

In today’s decision, a three-judge panel of the Fifth Circuit wrote, “[A]ll agree that cardiac activity can be detected well before the fetus is viable. That dooms the law. If a ban on abortion after 15 weeks is unconstitutional, then it follows that a ban on abortion at an earlier stage of pregnancy is also unconstitutional.”

“This is now the second time in two months the Fifth Circuit has told Mississippi that it cannot ban abortion,” said Hillary Schneller, senior staff attorney at the Center for Reproductive Rights. “Despite the relentless attempts of Mississippi and other states, the right to legal abortion remains the law of the land.”

The six week abortion ban was signed into law in March 2019 and blocked in May by District Judge Carlton W. Reeves. In his decision, he wrote, “Here we go again: Mississippi has passed another law banning abortions prior to viability.” He went on to say that, [This law] prevents a woman’s free choice, which is central to personal dignity and autonomy.”

“A ban at six weeks of pregnancy means many of our patients would lose their right to have an abortion before they even know they’re pregnant,” said Shannor Brewer, director of Jackson Women’s Health Organization. “Most of our patients are past that point. Some have spent weeks saving money for the procedure and have driven hundreds of miles to reach us. Keeping thsi law blocked means abortion remains legal in Mississippi and gives those women a chance to access it.”

The ban violates Supreme Court precedent dating back to Roe v Wade affirming that a state may not ban abortion prior to viability, meaning the point at which a fetus can survive for a sustained period outside the womb…

February 20, 2020: California Attorney General posted a press release titled: “Attorney General Becerra Urges Court to Uphold Preliminary Injunction against Unconstitutional Ohio Abortion Law”. From the press release:

California Attorney General Xavier Becerra, leading a coalition of 21 attorneys general, filed an amicus brief in support of a woman’s right to safe, legal abortion care in Preterm-Cleveland, et al. v. Himes. The case involves an Ohio law that criminalizes abortion before viability based on a woman’s reason for seeking abortion, running in direct conflict with the Supreme Court precedent set in Roe v. Wade. The amicus brief reaffirms the coalition’s previous support for Preterm-Cleveland and argues that the preliminary injunction issued by the Sixth Circuit Court should again be upheld by the en banc panel.

“This year marks the 100th anniversary of women gaining the right to vote, and nearly 50 years since the Supreme Court affirmed women’s autonomy over their healthcare decisions in Roe v. Wade,” said Attorney General Becerra.Ohio’s law takes our nation backwards and could erase decades of hard-fought victories. We stand with women across America in this fight to protect their constitutional right to reproductive freedom.”

In December 2017, Ohio passed a law to criminalize abortion in certain cases, at all stages of pregnancy, making it inconsistent with the Supreme Court’s decades-long legal standard put forward in Roe v. Wade. Preterm-Cleveland, a medical facility, challenged the constitutionality of the law and successfully blocked its enforcement, which was set to go into effect in March 2018. The decision was then appealed by Ohio to the U.S. Court of Appeals for the Sixth Circuit, which upheld the District Court’s preliminary injunction. Ohio sought further review of the decision, petitioning the Sixth Circuit to hear the appeal en banc. In the brief submitted today, the coalition restates its support for the injunction and argues that Ohio’s law is incompatible with the law and Supreme Court precedent…

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

A copy of the brief is available here.

February 20, 2020: New Hampshire Governor Chris Sununu sent a letter to the New Hampshire State Senate Judiciary Committee. From the letter:

Dear Chairwoman Hennessy and Members of the State Judiciary Committee,

I write today in support of Senate Bill 679.

As governor, my administration has worked to combat sexual violence and support survivors. On our college campuses today, too many young people are impacted by rape and sexual assault. In fact, it is estimated that college students are more than four times as likely be assaulted than any other age group.

In New Hampshire, we know that 1 in 4 women and 1 in 10 men will be sexually assaulted in college. of these victims, only 12% will report the assault to schools or police. We know from survivors that the fear of being blamed, and the fear of not being believed, are among the top reason why they do not come forward to report their experiences. We also know that many survivors do not receive the supports they need to feel safe on campus, which is why more than a third of survivors drop out of college without completing their degree.

Although New Hampshire leads the nation in terms of its efforts to end sexual violence, our state still has no specific laws in place regarding campus sexual violence. We are falling behind in the area of sexual violence prevention for our students, and we must strengthen our laws to provide survivors with the supports they need and to reduce the prevalence of sexual violence on college camuses. SB 679 represents a critical step forward in the fight against campus sexual assualt by ensuring survivors have increased access to medical care and counseling, developing partnerships between universities and domestic and sexual violence crisis centers, expanding prevention education efforts, and gathering more transparent data on sexual violence.

I urge this Committee, followed by the full Senate and the House of Representatives, to pass this legislation in its strongest possible form, thereby ensuring that students across New Hampshire will have access to the same set of basic protections and services regardless of where they happen to attend school.

I look forward to signing into law a bill that strengthens protections against sexual violence on campus, and sends a strong message that all young people have the right to pursue their education free of fear from rape and sexual assault…


February 21, 2020: California Attorney General Xavier Becerra posted a press release titled: “California Attorney General Becerra and Governor Gavin Newsom: California Law Protecting Women’s Reproductive Healthcare Does Not Violate Weldon Amendment”. From the press release:

California Attorney General Xavier Becerra and California Governor Gavin Newsom today sent a letter on behalf of the State of California responding to the January 24 Notice of Violation (Notice) issued by the Trump Administration’s Office for Civil Rights (OCR). The Notice alleged that California law, which requires health plans in the state to offer abortion coverage, violates the Weldon Amendment, a federal appropriations rider that is intended to restrict abortion. In their response, the state leaders defend California law and highlight that not only is it legal, OCR itself previously determined that the state law does not violate the Weldon Amendment.

“California has the sovereign right to protect women’s reproductive rights. Political grandstanding should never interfere with that,” said Attorney General Becerra. “The Trump Administration’s threats not only put women’s health on the line, but illegally threaten crucial public health funding that Californians rely on. In California, we will continue to protect our families’ access to healthcare, including women’s constitutional right to abortion. We fully understand and respect the law. We’ll hold the Trump Administration to the same standard.” 

“It’s remarkable that the President is threatening to take away funding that provides healthcare for almost half of the people who Congressman McCarthy represents in Congress – not to mention one in four Californians,” said Governor Newsom. “This is extreme presidential overreach and would, if carried out, jeopardize lives of Californians. We will not allow it.” 

In the letter, Attorney General Becerra and Governor Newsom assert that California law works in harmony with both state and federal law, including the Weldon Amendment. Both California Supreme Court precedent and the California Constitution protect women’s right to privacy and reproductive freedom. Furthermore, California’s Knox-Keene Act requires health plans to provide subscribers and enrollees with “all of the basic health care services,” which includes abortion services. While the Weldon Amendment provides for certain exemptions, California has satisfied its obligations under the Weldon Amendment by granting, in 2015, the only religious exemption request it has ever received. In 2016, OCR itself concluded that California law does not violate the Weldon Amendment when it closed three complaints and found in favor of California.

California’s response letter also argues that OCR’s Notice illegally attempts to expand the Weldon Amendment and improperly threatens state health funding used to support crucial programs including emergency preparedness, infectious disease prevention, and child welfare programs. OCR’s Notice suggests that the federal Weldon Amendment requires California to exempt “abortion-free plans as a class” including plans that exclude coverage for abortions in all circumstances, even in cases of rape or incest. OCR further suggests the Weldon Amendment requires the Department of Managed Health Care to locate a private, licensed health plan that will provide healthcare coverage consistent with a complainant’s religious beliefs. The Weldon Amendment requires neither of these actions and the State argues that this exceeds OCR’s legal and enforcement authority in that it:

  • Dramatically reinterprets the Weldon Amendment in a manner that is unconstitutional and not in accordance with federal law;
  • Contradicts its own 2016 determination that California law did not violate the Weldon Amendment; and
  • Threatens California’s sovereign and quasi-sovereign interests, including its regulation of healthcare and California-licensed entities.

Finally, the OCR Notice threatens California’s federal health funding unless the state takes “corrective action,” yet OCR never defines what sort of corrective action is required nor the process by which such action would be reviewed. If there is a risk to California’s federal funding, then the state must be provided with an opportunity to dispute allegations. California is entitled to a fair and due process, which demands that California be permitted to review all documents and to dispute all claims. To that end, California is submitting a Freedom of Information Act request for OCR records and communications.

A copy of the letter is available here. A copy of the FOIA request is available here.  


February 24, 2020: The American Civil Liberties Union (ACLU) of Wyoming posted an article titled: “ACLU of Wyoming Supports Funding Mental Health, Substance Use Diversion Programs”. From the article:

Mental health and substance use diversion programs are an effective way to redirect people out of the criminal legal system and into supportive community treatment. Current diversion efforts in Wyoming, however, have proven ineffective because of a lack of adequate upfront funding.

That’s why ACLU of Wyoming supports House Bill 31, legislation that would require the Department of Health and the Department of Corrections to collaborate to reduce criminal offender recidivism by improving mental health and substance use programming and funding. House lawmakers passed House Bill 31 last week. The ACLU of Wyoming urges the Senate to take up consideration of the bill as soon as possible…

…Although House Bill 31 comes with a price tag – the Legislative Service Office estimates it would cost $648,760 to fund – diversion programs like this are cheaper and more effective than incarceration…

…Expanding the use of mental health and substance use diversion programs is among the proposed reforms in the ACLU of Wyoming’s Blueprint for Smart Jusice report. The report includes an overview of Wyoming’s incarcerated populations, including analysis on who is being sent to jail and prison and the racial disparities that are present, what drives people into the system, how long people spend behind bars and why people are imprisioned for so long. It also offers a calculation on the impact of certain reforms by 2025 on racial disparities in the prision population, fiscal costs and progress toward a 50 percent decarceration goal.

February 24, 2020: Planned Parenthood posted a press release titled: “Court Denies Relief for Title X Patients”. From the press release:

Today, an en banc panel of the U.S. Court of Appeals for the 9th Circuit voted 7-4 to uphold the Trump administration’s unethical and dangerous gag rule on Title X, the nation’s program for affordable birth control and reproductive health care. Planned Parenthood sued the Trump administration in March to block to tell patients how or where to access abortion, and imposes cost-prohibitive and unnecessary “physical separation” restrictions on health centers that provide abortion. These moves were obvious and ultimately successful tactics to push Planned Parenthood health centers and other reproductive health care providers out of Title X.

In “strongly” dissenting, Judge Paez, joined by three other judges, wrote, “In vacating the preliminary injunctions, the majority blesses an executive agency’s disregard of the clear limits placed on it by Congress. The consequences will be borne by the millions of women who turn to Title-X funded clinics for lifesaving care and the very contraceptive services that have caused unintended pregnancy – and abortion – to plummet.”…

February 24, 2020: California Atorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Issues Statement on Ninth Circuit Decision in Title X”. From the press release:

Attorney General Xavier Becerra today issued the following decision in response to the Ninth Circuit decision in California’s Title X case.

“Today’s court ruling on the Trump Administration’s Gag Rule is troubling. The Gag Rule interferes with healthcare decisions that should remain between women and their healthcare providers,” said Attorney General Xavier Becerra. “This reckless rule is just another attempt by the Trump-Pence Administration to roll back women’s access to reproductive healthcare. The rule targets the Title X program — which serves low income women, LGBTQ individuals, young people, and families — and obstructs access to care by gagging medical professionals from discussing all available options with their patients. Leaving women in the dark about their healthcare and restricting doctors from providing candid advice is simply not in the best interest of public health. In California, we will continue to fight for comprehensive reproductive healthcare, including safe and legal abortion.”

A copy of the decision can be found here.

February 24, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “ACLU Response to Ninth Circuit Ruling on Title X Family Planning Program”. From the article:

The U.S. Ninth Circuit of Appeals upheld a Trump administration policy that is destroying the Title X family planning program.

The rule prohibits family planning clinics – which previously served as the source of health care for more than four million low-income people every year – from providing Title X patients with referrals for abortion care and imposes other onerous requirements that have resulted in the widespread loss of critical Title X providers.

The Eastern District of Washington blocked the Trump administration’s rules, but the Ninth Circuit overturned that decision and issued a ruling on the merits.

“We are deeply disappointed that today’s decsion allows the Trump administration to once again make it harder and harder for people to get the health care they need, including family planning care,” said Ruth Harlow, senior staff attorney at the ACLU Reproductive Freedom Project, who argued the case before the Ninth Circuit. “We are looking at any further options to rescue the Title X program and to restore the critical care it has provided to marginalized patients for almost five decades.”

The ACLU’s lawsuit was brought on behalf of the National Family Planning & Reproductive Health Association and Cedar River Clinics.

February 24, 2020: The American Medical Association posted an article titled: “U.S. appeals court upholds Title X gag rule on physicians”. It was written by Senior News Writer, American Medical Association, Andis Robeznieks. From the article:

…The Trump administration gag rule that violates the AMA Code of Medical Ethics by mandating that physicians serve as government mouthpieces in discussions with patients in the Title X program will be allowed to take effect. The 9th U.S. Circuit Court of Appeals, in a 7-4 decision, vacated orders previously entered by federal district courts in California, Oregon, and Washington.

“The AMA is disappointed by – and strongly disagrees with – the reasoning behind a federal appeals court’s decision to allow the Trump administration to enforce a gag rule on physicians,” said AMA President Patrice A. Harris, MD, MA.

The ruling upholds the decision made last June by a three-judge panel from the same court that lifted a nationwide injunction issued by the district court. The AMA appealed that decision in the case, AMA v. Azar, and asked for it to be heard by a larger, “en banc” panel from the 9th Circuit.

A brief filed by the AMA and its co-plaintiffs included arguments against the gag rule and noted that the Health and Human Services Department (HHA) “cannot point to one instance where Title X funds have been misapplied.”

The court dismissed the arguments….

…Dissenting Judge Richard A. Paez cited the decision from last April by U.S. District Judge Michael McShane. That judge blocked the rule’s implementation arguing that the gag rule contradicted the Code of Medical Ethics’ prohibition on withholding information from patients and that it instructed doctors “to intentionally mislead patients.”

“The majority would return us to an older world, one in which a government bureaucrat could restrict a medical profession from informing patients of the full range of health care options available to her,” Paez wrote…

…Unless it is appealed to the Supreme Court, the ruling ends proceedings regarding injunctions on the gag rule and other new HHS regulations. The decision also hands the case back to the district court “for further proceedings consistent with this opinion.”

In the immediate future, however, Paez predicted it will be patients who will feel the biggest impact.

“In vacating the preliminary injunctions, the majority blesses an executive agency’s disregard of the clear limits placed on it by Congress,” he wrote. “The consequences will be borne by the millions of women who turn to the Title X-funded clinics for lifesaving care and the very contraceptive services that have caused rates of unintended pregnancy – and abortion – to plummet.”

Dr. Harris said the AMA will continue to oppose gag rules on physicians…


February 25: 2020: New York State website posted news titled: “Governor Cuomo Releases List of Healthcare Networks That Will Be Impacted by Trump Administration’s $8 Billion in Cuts to New York State Healthcare System”. From the news:

Govenor Andrew M. Cuomo today released a list of healthcare networks that will be impacted by the federal government’s $8 billion cut to New York’s healthcare system. Yesterday, the Governor delivered remarks addressing these planned cuts for New York State – The Trump Administration’s latest assault on the state.

“This past Friday we learned of the Trump administration’s latest assault on the state of New York – $8 billion in cuts to our healthcare system. Healthcare should be beyond politics and it is unconscionable that the federal administration is politicizing the lives of New Yorkers – primarily senior citizens,” Governor Cuomo said. “The healthcare networks on this list will bear the brunt of these short-sighted cuts, and as a result some of the most vulnerable New Yorkers will suffer. Make no mistake: New York will marshal all our allies, including our congressional delegation, to fight these cuts tooth and nail until New York receives the full funding we deserve.”

Below is a list of healthcare networks, known as Performing Provider Systems, that will be impacted by the federal cuts in healthcare:

NYC PPS

  • Bronx-Lebanon Hospital Center – $8,545,132
  • St. Barnabas PPS, St. Barnabas Hospital dba SBH Health System, Bronx Partners for Healthy Comminities – $19,990,806
  • New York Hospital Medical Center of Queens PPS (Presbyterian) – $1,324,033
  • Richmond University Medical Center & Staten Island Univeristy, Staten Island PPS – $24,561,822
  • Maimonides Medical Center – $25,767,912
  • Mount Siani PPS – $16,314,209
  • NYU Lutheran PPS, Lutheran Medical Center; Brooklyn Bridges PPS – $8,127,391
  • New York City Health & Hospitals Corporation, NYC, HHC, NYC Health + Hospitals – $137,493,647
  • Advocate Community Providers Inc., ACP (SOMOS) – $39,853,315
  • Nassau University Medical Center, NUMC, Nassau-Queens PPS, LLC. – $52,577,847
  • NYC TOTAL: $340,427,439

REST OF STATE PPS

  • AHI – $20,930,831
  • iHANY, Ellis Hospital, AFBHC -$27,865,422
  • Albany Medical Center Hosptial (AMCH) PPS – $15,748,286
  • Southern Tier Rural Integrated Performing Provider System, Inc (STRIPPS), United Health Services Hospitals, Inc. (UHS) – $25,110,123
  • SUNY Upstate; CNY DSRIP Performing Provider System, Inc. – $18,619,630
  • Sisters of Charity Hospital of Buffalo, New York, Catholic Medical Partners, Community Partners of WNY – $5,100,833
  • Finger Lakes PPS, FLPPS – $62,754,287
  • Mohawk Valley PPS; Mary Imogene Bassett Hospital; Bassett Medical Center – $7,921,320
  • Erie County Medical Center, ECMC – $22,505,689
  • NCL, Samaritan Medical Center – $8,677,143
  • Refuah Health Center, Inc., – $2,525,538
  • State University of New York at Stny Brook University Hospital, Stony Brook University Hospital – $21,289,481
  • Montefiore Medical Center; Hudson Valley Collaborative PPS – $14,469,921
  • Westchester Medical Center, WCMC – $31,054,057
  • ROS TOTAL: $283,572,561
  • NYS TOTAL: $625,000,000

February 25, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Senate Republicans’ Latest Attack on the Health and Freedom of American Women”. From the press release:

Speaker Nancy Pelosi issued this statement after Senate Republicans failed to pass two anti-choice, anti-women bills designed to deny women the right to make their own personal health care decisions:

“Instead of voting on any of the 275 bipartisan, House-passed pieces of legislation sitting on Leader McConnell’s desk, Senate Republicans have once again attacked the freedom of women to make their own health decisions in consulation with their families, their physicians and their faith. This latest outrageous attempt to gut Roe v. Wade’s fundamental protections is purpose-built to misinform, shame and deny women their fundamental rights, undermining our Constitution and the health and well-being of America’s women and families.

“At every opportunity, Republicans in Congress, this Administration and in state capitols acoss the country have shown the utter disrespect for women’s most private health decisions. These Republicans have worked relentlessly to allow politicians and employers to interfere in women’s personal decisions, and to roll back a generation of progress achieved by countless fearless women who spoke up, marched and voted to secure their rights and their freedom.

“While the Senate prioritzes dangerous, politically-motivated bills designed to hurt women and families, House Democrats will continue to stand with the millions of Americans demanding action to protect a woman’s right to choose, and strengthen access to the health care that all families need to grow and thrive.”

February 25, 2020: American Academy of Pediatrics (AAP) posted news titled: “Supreme Court to hear key child health cases”. It was written by Devin Miller. From the news:

The U.S. Supreme Court has a full agenda this spring, including several cases with child health implications. Key decisions are expected near the end of the session in late June.

Judicial advocacy plays a critical part in how the Academy speaks up for children at the federal level. If a rule finalized through the regulatory process or a new law is challenged in the courts, weighing in with the judicial branch offers another option for advocacy — whether that means supporting or opposing a policy.

The Academy has weighed in and is following numerous cases at the Supreme Court level as well as in lower courts across the country on issues ranging from immigrant child health to tobacco to environmental health.

Following is a look at a few of the cases before the Supreme Court that the AAP is tracking.

Department of Homeland Security v. Regents of the University of California

This case considers whether the Trump administration can end the Deferred Action for Childhood Arrivals (DACA) program by declaring it unlawful. The program, which was created in 2012 under the Obama administration, granted temporary protection from deportation for about 800,000 immigrants who were brought to the United States as children. Many of these children are now adults and have children of their own.

The Academy led an amicus (“friend of the court”) brief with other child advocacy organizations. Amicus briefs provide an opportunity for outside parties to offer information or expertise on the issues being discussed in the case. The brief outlined how rescinding the program would impact the children of DACA recipients, exacerbating the fear and anxiety that immigrant families face and its long-lasting consequences for children’s health.

The Supreme Court heard oral arguments in November, which is when the justices can ask questions and the attorneys for both parties can outline their main arguments. A decision is expected by June.

June Medical Services LLC v. Gee

The main issue is whether a Louisiana requirement that abortion providers have admitting privileges at nearby hospitals constitutes an undue burden on the right to abortion. The Supreme Court will hear oral arguments on March 4.

The AAP joined an amicus brief with women’s health and medical organizations, outlining how the requirement is medically unnecessary and limits access to care for patients.

“Laws regulating abortion should be evidence-based and supported by a valid medical justification,” the groups stated in the brief. “Because laws requiring clinicians who provide abortions to have local admitting privileges are neither, this Court should not allow them to stand, regardless of the state from which they originate.”

The Supreme Court found a similar provision of a Texas law unconstitutional in 2016. The 5-3 ruling in Whole Woman’s Health v. Hellerstedt held that the admitting privileges requirement posed an undue burden on access to abortion. Since then, the court’s composition has changed, and the current panel of judges will determine the fate of the Louisiana restrictions.

Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania

This case centers on a religious exemption to an Affordable Care Act (ACA) requirement that employers provide contraceptive coverage with no cost-sharing to employees through employer-sponsored health plans. A 2017 Trump administration rule dramatically expanded the ability of employers to opt out of this requirement for religious or moral reasons and therefore threatens access to contraception for women.

This issue has been posed to the Supreme Court twice. In 2014, the court ruled to allow closely held for-profit companies with religious objections to opt out of offering contraceptives to their employees and their families. In 2016, the court examined an Obama-era accommodation for certain religious organizations that would have ensured employees of objecting organizations received seamless access to no-cost contraception through the insurer, but it sent the case back to a lower court and declined to make a final ruling.

Beyond contraceptive coverage, a broad ruling in this case could set a precedent for companies to refuse to pay for other doctor-recommended health services, such as vaccines, due to personal objection.

At press time, no date had been set for oral arguments…


February 26, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Court Decision to Uphold Title X Changes Will Harm Patient-Physician Relationship”. The statement is attributable to Robert McLean, MD, MACP, President, American College of Physicians. From the press release:

The American College of Physicians (ACP) is disappointed in the federal appeals court decision to allow the Trump administration’s restrictions on the Title X program to go into effect. The changes will interfer in the patient-physician relationship, restricting the counsel that physicians can provide to their patients.

Restricting the program will jeopardize access to health care for vulnerable, often working, low-income patients who may have limited to no access to health insurance. They rely on the clinics who depend on Title X funding to provide preventative car and contraception services.

ACP opposes any restrictions that interfere with the patient-physician relationship. We will continue to fight against this or any other regulations that would prevent the physician from using sound medical judgement to counsel patients.

February 26, 2020: American Civil Liberties Union (ACLU) posted an article titled: “Stopping the Anti-Abortion Ordinances of East Texas”. It was written by Anjali Salvador. From the article:

Waskon. Naples. Joaquin. Tenaha. Rusk. Gary. Wells. These names might sound unfamiliar now, but you’ll be hearing more about the soon enough.

They are seven cities in East Texas that, within the last several months, each passed so-called “sanctuary city for the unborn” ordinances – moves that are blatently unconstitutional.

Waskom, Texas, was the first municipality to pass such an ordinance in July 2019. Soon after, other east Texas cities followed suit. The ordinances attempt to ban abortion within the cities if Roe v. Wade is overturned and some of them even try to ban emergency contraception.

The ordinances also declare organizations working to protect the right to abortion, including our clients Lilith Fund and Texas Equal Access Fund (TEA Fund), as “criminal organizations,” even though they have done absolutely nothing wrong. The ordinances function to silence abortion advocates, preventing them from operating and even speaking about abortion within the city limits.

These ordinances constitute an outright attack on abortion and free speech, which is why today we filed a lawsuit against these seven cities…

…Under these local laws, our clients cannot speak up about abortion rights, recruit volunteers to help them do their important work, or congegate to share informational materials in these cities without worrying about getting sued. The laws intentionally and unconstitutionally obstruct our plaintiffs’ ability to do their jobs, impeding the advocacy work that is intregral to their mission.

In contrast, anti-abortion organizations face no such restrictions, remaining free to undermine access to reproductive health care without legal ramifications. It’s this targeted and discriminatory suppression of speech and assembly that violates our clients’ First Amendment rights – and exactly what we are challenging in our lawsuit…


February 27, 2020: Openstates posted information about Georgia House Bill HB 1060, which is called “Vulnerable Child Protection Act; enact”. The purpose of the bill is to prevent doctors from providing gender-affirmative health care to minors – even if the minor’s parent believes it is the healthiest choice for their child. The Abstract says:

A BILL to be entitled an Act to amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to prohibit certain licensed, certified, or registered professionals from engaging in certain acts upon minors; to provide for a short title; to provide for definitions; to provide for exceptions; to provide for a penalty and private cause of action; to explicitly waive sovereign immunity, qualified immunit, and official immunity for such a private cause of action; to provide for related matters; to provide for an effective date and for applicability; to repeal conflicting laws; and for other purposes.

Here are some of the cruelest things in this bill:

This is the part where the bill denies minors recognition of their gender. It also prevents minors from accessing the gender-affirming health care they want.

…’Sex’ means the biological state of being female or male, based on sex organs, chromosomes, or endogenous hormone profiles…

…no health care professional shall engage in any of the following practices upon a minor, or cause such practices to be performed, for the purpose of attempting to affirm the minor’s perception of such minor’s sex, if that perception is inconsistent with such minor’s sex:

(1) Performing any surgery that sterilizes, including, but not limited to, castration, vasectomy, hysterectomy, oophorectomy, metoidioplasty, orchiectomy, penectomy, phalloplasty, or vaginoplasty;

(2) Performing a mastectomy;

(3) Removing any otherwise healthy or nondiseased body part or tissue; or

(4) Administering or supplying medications that induce transient or permanent infertility, including, but not limited to:

(A) Puberty-blocking medication to stop or delay normal puberty;

(B) Supraphysiologic doses of testosterone to females; or

(C) Supraphysiologuc doses of estrogen to males….

Here’s the part where the bill takes away parent’s rights to make decisions that would allow their minor child to recieve gender-affirming health care:

The chapter shall not apply to the medical decision of a parent or guardian of a minor born with one of the following medically verifiable genetic disorders of sex development:

(1) A minor with external biological sex characteristics that are irresolvably ambiguous, such as a minor born with 46 XX with virilization or 46 XY with undervirilization; or a minor with both ovarian and testicular tissue; or

(2) When a physician has otherwise diagnosed a sex development order, in which the physician has determined through genetic testing that the minor does not have the normal XY sex chromosome structure for a male or XX sex chromosome structure for a female.

Here’s the part that criminalizes health care professionals who provide gender-affirming health care to a minor who wants it and whose parent wants them to have it:

…(a) Any health care professional who violates this chapter shall be held guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not less than one nor more than ten years.

(b) Within ten days of a conviction, a health care professional who is convicted of violating this chapter shall notify in writing the applicable licensing board for his or her licensure, certification, registration, or other authorization to conduct such health care professional’s occupation. Upon being notified and notwithstanding any law, rule, or regulation to the contrary, the appropriate licensing board shall revoke the license, certification, registration, or other authorization to conduct such health care professional’s occupation…

February 27, 2020: Center for Reproductive Rights posted a press release titled: “Virginia Legislature Removes Medically Unnecessary Barriers to Abortion Access”.

Today, the Virginia General Assembly passed the Reproductive Health Protection Act, which will expand access to abortion care by repealing medically unnecessary restrictions that have made it more difficult for Virginians to access safe and legal abortion care for years.

The Act strikes down the following restrictions:

The Two-Trip Mandatory Delay Law: A law forcing pregnant people to undergo an unnecessary ultrasound, listen to state-mandated biased counseling, and then wait at least 24 hours before their procedure. This means pregnant people are unnecessarily delayed in accessing care because they must make at least two trips to the clinic, creating onerous burdens – especially for poor and low-income people – seeking care in the Commonwealth.

The Licensing Law: A law targeting abortion providers that subjects them to a burdensome, medically unnecessary regulatory scheme that applies to no other medical professionals and has no legitimate medical bias.

The Physicians Only Law: A law prohibiting trained and qualified advanced practice clinicians from providing first-timester abortion care…


February 28, 2020: EMILY’s List posted a statement titled: “EMILY’s List Statement On Rep. Lipinski Voting With Republicans On Anti-Choice Legislation”. From the statement:

Today, Rep. Dan Lipinski (IL-03) voted in favor of harmful, misleading anti-choice legislation, the “Born-Alive Abortion Survivors Protection Act”. Lipinski also recently joined Republicans urging the Supreme Court to overturn Roe v. Wade, Stephanie Schriock, president of EMILY’s List, the nation’s largest resource for women in politics, released the following statement:

“This legislation is a desparate attempt by Republicans to instill fear and spread misinformation about abortion, and it’s appalling that Representative Lipinski has happily joined them. Once again, Lipinski is telling women that he trusts Republican politicians more than he trusts women and their doctors. Families in Illinois’ 3rd Congressional District deserve a leader who will fight for their fundamental rights, and that’s why Marie Newman is going to defeat Dan Lipinski in the March 17 primary.”

UPDATE: March 17, 2020: BuzzFeed News reported that Marie Newman “a progressive, pro-choice abortion rights challenger to incumbent Democratic Rep. Dan Lipinski has won the Democratic primary in Illinois’s 3rd Congressional District.”


March

March 2, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Supreme Court Decision to hear ACA Lawsuit”. From the press release:

Speaker Nancy Pelosi released this statement after the Supreme Court announced that next session, it will step in and hear Republicans’ Texas v. U.S. lawsuit seeking to strike down protections for people with pre-existing conditions and the entirety of the Affordable Care Act. The Fifth Circuit had previously sent the case back to district court, which would have prolonged uncertainty over the law.

“The Affordable Care Act is an essential pillar of health and financial security for American families, and its protections are even more critical during a dangerous epidemic. But even in the middle of the coronavirus crisis, the Trump Administration continues to ask the court to destroy protections for people with pre-existing conditions and tear away health coverage from tens of millions of Americans.

“The sooner the GOP’s dangerous anti-health care lawsuit is ended, the better. Every day, the Affordable Care Act provides lifesaving protections and coverage for families across America. Democrats will continue to fight in the courts and the Congress to defend and strengthen the Affordable Care Act and lower health costs for all Americans.”

March 2, 2020: California Attorney General Xavier Becerra posted a press release titled: “Supreme Court Grants California Review of ACA Repeal Case”. From the press release:

California Attorney General Xavier Becerra, leading a coalition of 20 states and D.C., applauded the Supreme Court’s decision to review a case that seeks to repeal the entire Affordable Care Act (ACA) and put tens of millions of Americans’ healthcare at risk. The court agreed to review a recent Fifth Circuit decision that held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the law could still stand. Those important ACA provisions include coverage for the 133 million Americans with pre-existing conditions, subsidies that help working families afford healthcare, investments in public health programs to prevent and combat public health threats like the opioid epidemic, and support lab capacity and immunization infrastructure for threats like the novel coronavirus.

“Our health is the most precious resource we have—we should all be working to improve healthcare, instead of ripping coverage away from those most in need,” said Attorney General Becerra. “As Texas and the Trump Administration fight to disrupt our healthcare system and the coverage that millions rely upon, we look forward to making our case in defense of the ACA. American lives depend upon it.”   

Attorney General Becerra’s coalition petitioned the Supreme Court for review in order to protect Americans’ healthcare and resolve the uncertainty created by the Fifth Circuit decision, which threatens the health of millions of Americans, as well as doctors, clinics, and the healthcare market. 

California and its coalition will lead the defense of the ACA in order to protect the important advancements in healthcare access made under the law, including:

  • More than 12 million Americans receiving coverage through Medicaid expansion;
  • Nearly 9 million individuals nationwide receiving tax credits to help afford health insurance coverage through individual marketplaces;
  • Millions of working families relying on high-quality employer-sponsored insurance plans; 
  • Important protections prohibiting insurers from denying health insurance to the 133 million Americans with pre-existing conditions (like diabetes, cancer, or pregnancy) or from charging individuals higher premiums because of their health status; and
  • Nearly $1.3 trillion in federal funding being dedicated to keeping Americans healthy and covered, including Medicaid expansion and public health dollars.

Joining Attorney General Becerra in defending the ACA are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the Governor of Kentucky.

March 2, 2020: President of the American Federation of Teachers (AFT) Randi Weingarten, posted a press release titled: “AFT President Randi Weingarten on the U.S. Supreme Court Decision to Grant Cert on the Affordable Care Act”. From the press release:

Randi Weingarten, president of the American Federation of Teachers, whose 1.7 million members include nurses and healthcare professionals, issued the following statement after the Supreme Court’s decision today to accept review of another challenge to the Affordable Care Act:

“The fact that yet another challenge to the ACA has been brought by President Trump and Republican governors to the Supreme Court demonstrates their continued callous disregard to the healthcare needs of Americans. This is a ‘which side are you on?’ moment. The Republican Party wants to deny coverage for anyone with a pre-existing condition and then pretend they will not be pauperized because of their or a family member’s cancer, asthma, diabetes or any of the pre-existing conditions that millions of Americans have. Because the White House was unsuccessful in its attempt to repeal the ACA in Congress, it will use any means to destroy our country’s prevailing healthcare law.

“It is sad that the Republicans are not even honest about their strategy; they should at the very least have joined with Democrats in their motion to expedite having the case heard and decided before the 2020 election. Instead, the Republicans have lied about their intent in public, presumably because they, too, know the public is against them. But the decision by the Supreme Court to hear the case offers an opportunity to stop this assault on the ACA, working people and individuals with pre-existing conditions.

“During this moment while we are dealing with the coronavirus and an international health crisis, we need to expand access to healthcare, not restrict it, as President Trump and the GOP have tired to do more than 50 times with their lawsuits against the ACA. High-quality, affordable healthcare should be a human right guaranteed to all; people with underlying health conditions and those in underserved communities are especially at risk.

“More than 70 percent of Americans support the ACA and its protections for people with pre-existing conditions. Rather than seek to eliminate coverage, President Trump and the Republicans could work with Senate Democrats to lower drug costs; the House has already passed H.R. 3, The Elijah E. Cummings Lower Drug Costs Now Act.

“If Donald Trump is re-elected and Republicans have free rein on the government, they will strip these protections from millions of Americans. It is up to voters to turn the tide on the insidious policies of this administration so that countless Americans facing an affordability crisis are no longer forced to exist in perpetual instability.”

March 2, 2020: Senator Ron Wyden (Democrat – Oregon) and Senator Elizabeth Warren (Demcocrat – Massachusetts) posted a press release titled: “Wyden and Warren Demand Answers on Allegations that Trump Administration Has Been Using Confidential Therapy Notes to Detain and Deport Migrant Children”. From the press release:

U.S. Senators Ron Wyden, D-Ore., and Elizabeth Warren, D-Mass., today demanded answers from the Trump administration regarding allegations that confidential information disclosed by unaccompanied migrant children to mental health professionals is being distorted and used against these children by U.S. Immigration and Customs Enforcement (ICE) to pursue deportation or prolonged detention.

Wyden and Warren today sent separate letters to Assistant Secretary for the Administration of Children and Families Lynn Johnson and U.S. ICE Acting Director Matthew Albence following an investigation by the Washington Post alleging that the Office of Refugee and Resettlement (ORR) shares confidential information obtained through private sessions between unaccompanied migrant children and their therapists with ICE officials. It appears that this information is then used by ICE and U.S. Department of Justice (DOJ) officials during asylum proceedings and court filings arguing against asylum.

“ORR is required to act in the best interest of migrant children in their care, as determined by federal law and the Flores Settlement. We are concerned that ORR’s reporting practices run counter to those obligations,” Wyden and Warren wrote to both Johnson and Albence. “Children must have the opportunity to openly share their experiences with their therapists and care providers. They must be able to do so without the fear that what they disclose will later influence their asylum applications. The practice of sharing confidential clinical notes discourages these children from confiding in their therapists and care providers to get the help they need. . . . Trump administration officials recently claimed that this practice has been addressed and resolved by ORR, but we have seen no evidence of this.”

To help the senators better understand how ORR fulfills its mission and meets its requirements to care for unaccompanied migrant children within its custody, as well as how and why ICE obtains confidential data regarding unaccompanied migrant children, Wyden and Warren requested answers to their questions by March 20, 2020…

March 2, 2020: Rewire News posted an article titled: “The ‘Dire Risk’ Louisiana Faces in the ‘June Medical Service’ Decision”. It was written by Lakeesha Harris (Women With a Vision). From the article:

The U.S. Supreme Court will soon hear arguments in June Medical Services v. Russo, a case concerning a Louisiana anti-abortion law that would close all but one of the state’s remaining clinics and leave just a single doctor providing abortion care…

…Louisiana’s clinic shutdown law, known as Act 620, would forbid doctors from providing abortion care if they do not have admitting privileges at a local hospital—a medically unnecessary requirement intended to make it harder for doctors to practice. This law is flatly unconstitutional, and it is identical to a Texas law that the Supreme Court struck down less than four years ago.

For these communities, Act 620 will impose burdens on their access to reproductive health care that could be nearly impossible to overcome. Existing social conditions and restrictive laws already limit access to health care. For instance, only 38 percent of Black Louisianans live in households with a livable income. Many lack access to cars or reliable public transportation. More than 40 percent of all Louisianans live in doctor deserts, with no access to primary health-care professionals. And Louisiana residents who rely on Medicaid insurance must pay for abortion out of pocket because of the Hyde Amendment, which bans the use of government funds for abortion care. The procedure can cost patients several hundred dollars on its own—more than many can afford on a low-income budget…

…Shutting down nearly all the state’s abortion clinics and leaving a single provider—as Act 620 would do—would worsen many of these barriers. Under the law, 71 percent of people seeking abortion care in Louisiana will have to travel more than 150 miles to get an abortion…

March 2, 2020: New York Attorney General Letitia James posted a press release titled: “Supreme Court Grants Review of ACA Repeal Case”. From the press release:

New York Attorney General Letitia James today applauded the U.S. Supreme Court for agreeing to review a case that seeks to repeal the entire Affordable Care Act (ACA) and put tens of millions of Americans’ health care at risk. The court agreed to review a recent Fifth Circuit decision that held the ACA’s individual mandate unconstitutional and called into question whether the remaining provisions of the law could still stand. Those important ACA provisions include guaranteed coverage for the 133 million Americans with pre-existing conditions, subsidies that help working families afford health coverage, investments in public health programs to prevent and combat public health threats like the opioid epidemic, and supporting lab capacity and immunization infrastructure for threats like novel coronavirus (COVID-19).

“The Affordable Care Act has been the law of the land for a decade now and despite efforts by President Trump, his Administration, and Congressional Republicans to take us backwards, we will not strip health coverage away from millions of Americans,” said Attorney General James. “While the president has lied in his tweets, we know the truth is that this is just another attempt to deny coverage to 133 million Americans with preexisting conditions and make it harder for the rest of the nation to afford quality, affordable health coverage. We are taking this fight all the way to the Supreme Court because we will never stop fighting the president’s efforts to kick Americans off their health plans.”

Attorney General James — along with a coalition of 19 states and the District of Columbia — petitioned the Supreme Court for review in order to protect Americans’ health care and resolve the uncertainty created by the Fifth Circuit decision, which threatens the health of millions of Americans, as well as doctors, clinics, and the health care market. 

Attorney General James and the coalition will lead the defense of the ACA in order to protect the important advancements in health care access made under the law, including:

  • More than 12 million Americans now receive health coverage through the ACA’s Medicaid expansion;
  • Nearly nine million individuals nationwide receive tax credits to help subsidize their health insurance coverage through individual marketplaces;
  • Millions of working families rely on high-quality employer-sponsored health insurance plans;
  • Important protections prohibit insurers from denying health insurance to the 133 million Americans with pre-existing conditions, like diabetes, cancer, or pregnancy, or from charging individuals higher premiums because of their health status; and
  • Nearly $1.3 trillion in federal funding has been dedicated to keeping Americans healthy and covered, which includes spending through Medicaid expansion and public health dollars.

And in New York:

  • The state uninsured rate reached its lowest point ever recorded in 2018 — 4.7-percent;
  • More than 4.7 million New Yorkers now receive health coverage through the ACA, including nearly 3.3 million on Medicaid;
  • 58-percent of enrollees were expected to receive $636 million in tax credits to help subsidize the cost of health care in 2019 alone; and
  • The average monthly premium tax credit available to eligible Qualified Health Plan enrollees in 2019 was $335.

Joining Attorney General James in taking this fight to the Supreme Court are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky.

March 2, 2020: EMILY’s List posted a press release titled: “EMILY’s List Puts 11 State Legislative Chambers “On Notice”. From the press release:

Today, EMILY’s List, the nation’s largest resource for women in politics, expanded its “On Notice” opposition program to include 11 state legislative chambers across eight states. EMILY’s List is calling out incumbent Republicans for their anti-women and anti-family records and is working to flip these chambers from red to blue by electing pro-chpice Democratic women in the upcoming 2020 election.

“Republicans in these eight states have ammassed a shameful record of voting to turn back the clock on women’s rights and shortchange working families,” said EMILY’s List President Stephanie Schirock. “Across the board, reproductive rights are under attack. Republicans in these chambers have consistently worked to undercut women’s reproductive freedoms by pursuing six week abortion bans, spreading misinformation, and supporting legislation to force doctors to lie about a medically dubious “abortion reversal” procedure.”

EMILY’s List has put 11 state legislative chambers “On Notice” this cycle: the Arizona House and Senate, the Florida Senate, the Iowa House, the Minnesota Senate, the Michigan House, the North Carolina House and Senate, the Pennsylvania House and Senate, and the Ohio House. A full list of targets at both the state and federal levels can be found here.

Last summer, EMILY’s List announced an unprecedented $20 million investment in state and local elections for the 2019-2020 cycle, targeting more than 500 state legislative races. In addition to focusing on redistricting, the effort prioritizes states where there is great opportunity due to changing demographics, where a woman’s right to choose is under attack, and where there are rising women leaders pushing for change across the board.

March 2, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Bipartisan Coalition in Defending States’ Rights to Regulate the Rising Cost of Prescription Drugs”. From the press release:

California Attorney General Xavier Becerra, leading a bipartisan coalition of 46 attorneys general, filed an amicus brief in the United States Supreme Court supporting states’ rights to regulate and address the rising cost of prescription drugs. In Rutledge v. Pharmaceutical Care Management Association, the attorneys general argue that in order to protect the well-being of consumers, states must regulate pharmacy benefit managers, also known as PBMs. PBMs act as middlemen between pharmacies, drug manufacturers, health insurance plans, and consumers. Their position gives them some power to manipulate the market as they develop and maintain prescription drug formularies, contract with pharmacies, negotiate discounts with drug manufacturers, and process and pay prescription drug claims. Today’s brief supports the state of Arkansas’ position that federal law does not prevent states from regulating PBMs. The brief argues that regulation of the prescription drug market, including PBMs, is a critical tool for states to protect residents and address the access and affordability of prescription drugs.

“Reliable access to prescription drugs saves lives—that’s why we are standing with a bipartisan coalition fighting for affordable and accessible prescription medicine,” said Attorney General Becerra. “As drug prices continue to rise, states continue to lead the fight against pharmaceutical middlemen who manipulate drug prices and the choice of prescription drugs that patients can access in the market. We must do all we can to lower the costs of prescription drugs and make them more accessible for Americans across our nation who depend on these medications for their health.” 

In 2015, the state of Arkansas implemented a law that regulated the reimbursement rates PBMs pay to pharmacies. Under the law, PBMs must raise their reimbursement rate for a drug if that rate falls below the pharmacy’s wholesale costs. The law also created an appeals process for pharmacies to challenge these reimbursement rates. The law was challenged by the Pharmaceutical Care Management Association, a PBM trade association, which argued that the Employment Retirement Income Security Act prevents the state of Arkansas from implementing the law. Arkansas has asked the Supreme Court to reverse a lower court judgment that held the law invalid.

In today’s filing, the California-led coalition of attorneys general argue that state laws regulating pharmacy benefit managers are not restricted by federal law. Regulation is critical to the states’ ability to improve the transparency of prescription drug marketplaces and to protect consumers’ access to affordable prescription drugs, especially those in underserved, rural, and isolated communities. To date, nearly every state has enacted laws that regulate PBMs in some way, including 44 new or amended laws in the last five years. In addition, the attorneys general assert that the regulation of pharmacy benefit managers promotes healthcare access and affordability for residents – taking away a state’s ability to regulate would create confusion and uncertainty in the market and harm patients.

Joining Attorney General Becerra in filing today’s brief are the attorneys general of Alabama, Alaska, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and the District of Columbia. 

A copy of the brief is available here.


March 3, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “New Hampshire Joins 45 Attorneys General in Defending States’ Rights to Regulate the Rising Cost of Prescription Drugs”. From the press release:

Attorney General Gordon J. MacDonald joined a coalition of 45 attorneys general in filing an amicus brief in the United States Supreme Court on March 2, 2020, supporting states’ rights to regulate prescription drug costs.

In the case, Rutledge v. Pharmaceutical Care Management Association, the Supreme Court of the United States will decide whether federal law preempts state regulations of Pharmacy Benefit Managers or PBMs. New Hampshire currently has statutes in place that could be affected by the Supreme Court’s decision. New Hampshire signed the amicus brief in order to defend state statutes and New Hampshire’s ability to regulate within its borders.

March 3, 2020: A group of Senators sent a letter to Director of the Office of Refugee Resettlement, Johnathan H. Hayes, regarding the report in The Washington Post regarding the sharing of confidential psychotherapy notes of immigrant youth. From the article:

…We write to express our strong concern about the reports that the Office of Refugee Resetlement (ORR) is sharing with U.S. Immigration and Customs Enforcement (ICE) confidential psychotherapy notes pertaining to immigrant youth in ORR’s custody, and that ICE is using this information to argue against these young immigrants’ asylum claims. This practice suggests that ORR is not providing adequate care for minors in its custody, and that ORR’s actions are at odds with its statutory mandate.

According to a rcent report in the Washington Post, ORR has been sharing with ICE officials confidential information from unaccompanied minors’ psychotherapy sessions, which ICE is then using in removal proceedings… The Department of Justice (DOJ) has also cited this information in federal court filings arguing against the release of an asylum seeker from custody… In at least one case highlighted in the Washington Post report, ICE weaponized an asylum-seeking child’s self-disclosed trauma to argue for the minor’s continued detention and deportation. Astonishingly, ICE continues to selectively present – and arguably distort – information from the child’s psychotherapy sessions to pursue deportation, even aftr the government certified the individual in question as a victim of severe human trafficking eligible for humanitarian protection.

The 2018 Memorandum of Agreement between ORR and the Department of Homeland Security authorizing information sharing does not address sharing information collected by licensed health care providers or information pertaining to psychotherapy notes… Although you have answered questions on numerous occassions about information sharing practices with ICE, you have failed to make clear that the shared information may include confidential psychotherapy notes… Further, in a Senate Appropriations Subcommittee hearing last week, Department of Health and Human Services Secretary Alex Azar acknowledged this practice, but represented that sharing of psychotherapy notes, outside of narrowly tailored disclosures in instances where an unaccompanied minor is a threat to themselves or others, was “in error”, “a mistake’, that was corected in August 2019 and “going foward… shouldn’t be happening.” Nonetheless, reports suggest that this practice may be continuing today.

ORR’s practice of sharing confidential psychotherapy information undermines its mission and violates the rights of minors under its custody and care. For one, the practice is a significant violation of the rights of minors to recieve health care that meets minimal standards of care. The practice is at odds with professional norms, and “destroys the bond of trust between patient and therapist that is vital to helping the patient.”… Doctors, other health care providers and mental health care workers in particular require some ability to discuss issues privately with patients. At the very least, minrs in ORR’s custody should be provided notice that these communications lack confidentiality, and ORR therapists must stop falsely assuring immigrant children that their therapy sessions will remain confidential, as the Washington Post report documents…

…This practice is deeply concerning to us. Accordingly, we request that, by March 24, 2020, you respond to the following questions and provide the information requested:

1 Has ORR halted the practice of sharing information from confidential psychotherapy notes with ICE, as suggested by Secretary Azar? If so, what steps has ORR taken to ensure ORR staff and contractors have stopped this practice? Please provide any communication to grantees on this topic.

2 Does ORR have clear documentation of every instance in which therapy notes were shared? What percentage of unaccompanied minors in ORR’s custody have had psychotherapy notes shared with ICE? To the extent that ORR has halted this practice, what are the relevant percentages for the time when ORR conducted this practice?

3 Has ORR conducted any analysis of its legal authority to provide this information to ICE, or of the information-sharing policy’s impact on its mission?

a If so, please provide that analysis. If not, why not?

4 Does sharing with ICE information from psychotherapy notes pertaning to an unaccompanied minor in ORR’s care and custody promote the best interests of the child? If so, how?

5 Does ORR provide any notice to unaccompanied minors in its custody that they have no expectation of privacy or confidentiality in any information provided to staff at ORR facilities, including licensed mental health care providers?

a If so, please provide documentation of this notice, as well as any policies, practices, or procedures directing ORR staff or contractors on how to provide such notice.

b If not, please explain why ORR does not provide such notice.

6 Does ORR allow unaccompanied minors in its custody to opt out of mental care?

7 What procedures, if any, does ORR have in place to obtain a minor’s consent to share information disclosed as part of their mental health care?

8 Many state laws afford confidentiality to interactions between liscensed mental health care workers and their patients. In states with such confidentiality restrictions, do state-licensed mental health providers at ORR facilities comply with these laws?

The Senators who signed this letter are (by state):

  • California: Kamala Harris
  • Connecticut: Richard Blumenthal
  • Maryland: Chris Van Hollen
  • Massachusetts: Ed Markey, Elizabeth Warren
  • Minnesota: Tina Smith, Amy Klobuchar
  • Nevada: Jacky Rosen
  • New Jersey: Cory Booker
  • New York: Kristen Gillbrand
  • Oregon: Jeffrey Merkley
  • Pennsylvania: Bob Casey
  • Vermont: Bernard Sanders

March 3, 2020: ABC News posted an article titled: “Virginia bans conversion therapy for LGBTQ minors”. It was written by Ella Torres. From the article:

Virginia became the 20th state in the country to outlaw conversion therapy for LGBTQ minors after Gov. Ralph Northam signed the ban into law on Monday.

Conversion therapy is described as a practice to forcibly change an individual’s sexual orientation or gender identity.

“Conversion therapy sends the harmful message that there is something wrong with who you are,” Northam said in a statement. “This discriminatory practice has been widely discredited in studies and can have lasting effects on our youth, putting them at a greater risk of depression and suicide.”…

…LGBTQ youth who had undergone conversion therapy were more than twice as likely to attempt suicide compared to those who did not, according to the organization.

The other states that have banned conversion therapy for minors are California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Maine, Nevada, New Jersey, New Hampshire, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont and Washington.

The Virginia bill outlaws any health care provider in any profession licensed by a regulatory board of the Department of Health from engaging in conversion therapy, according to a copy of the bill.

The bill also notes that no state funds will be allocated for the purpose of conversion therapy.

It goes into effect July 1.

March 3, 2020: The Salt Lake Tribune posted an article titled: “Utah Senate votes to ban all elective abortions – if Supreme Court ever allows it”. It was written by Lee Davidson. From the article:

The Utah Senate voted Monday to ban elective abortions at all stages of pregnancy in Utah — but only if the U.S. Supreme Court ever reverses its Roe v. Wade decision on the matter first.

Senators advanced SB174 to the House on a 22-6 party-line vote, after Democrats gave last-ditch arguments against it.

Sen. Luz Escamilla, D-Salt Lake City, argued that women and families are better able to make their own decisions on such matters than legislators.

“We are taking away the rights of women,” said Sen. Kathleeen Riebe, D-Cottonwood Heights. “We are saying that they are not responsible for their bodies.”…

…If Roe v. Wade is ever overturned, the bill would ban all elective abortions except in the case of rape, incest or when the mother’s life is threatened. A rape would have to be reported to the police for the exception to apply under the bill.

[Sen. Dan] McCay [R-Riverton] said passing the bill now — instead of waiting for the Supreme Court to act first — helps send a message to the court about what Utah and other states are thinking.

“It is important for the Supreme Court, it is important for the rest of the country to see that there are divided opinions about the way this ought to be dealt with,” McCay told reporters after the vote. “I really am hopeful that in the next few years that they [Supreme Court justices] strike it down.”

However, Gov. Gary Herbert said in his monthly press conference last week at PBS Utah that the bill may be premature.

“We could wait until Roe v. Wade is in fact overturned, if in fact it ever is,” Herbert said. “It may be kind of a feel-good message bill.”

The governor said the bill actually does nothing for now.

“If I sign it, nothing happens. If I don’t sign it, nothing happens” he said. “So I’m a little concerned about it.”…

…Under current law in Utah, before a woman may receive an abortion she must complete a 72-hour waiting period and watch an information module that says the state prefers childbirth to abortion. Lawmakers are also considering legislation this year that would require the burial or cremation of fetal remains and force women to receive an ultrasound before an abortion.

March 3, 2020: CBS News posted an article titled: “Roe v. Wade might not matter after Supreme Court decides this case”. It was written by Katie Smith. From the article:

For nearly 50 years, access to abortion has been largely protected by Roe v. Wade, the 1973 Supreme Court deicision that legalized abortion nationwide. But a case before the high court this week could erode the landmark decision without ever challenging it directly.

The Supreme Court will hear oral arguments Wednesday for June Medical Services v. Russo, a case that challenges a 2014 Louisiana law. The result coudl impact abortion access across the country, and advocates fear the relatively recent additions of two conservative justices make it more likely that the court upholds the law.

Known as the Louisiana “Unsafe Abortion Practice Act,” the law requires doctors who provide abortions to have privileges to admit patients at a nearby hospital. Supporters of the law say its designed to improve patient safety, but critics say it’s intended to shut down clinics that provide abortion.

When the law was signed in 2014, only one of the state’s six abortion clinocs at the time had a physician who was compliant with its regulations. The law has been largely blocked from implementation, but was briefly allowed to go into effect in early 2016, prompting the closure of two of the state’s remaining clinics.

Today, Louisian has just three abortion clinics across the state. If the Supreme Court finds Louisiana’s law constitutional, all of them would stop offering the procedure, as first reported by CBS News. The court’s ultimate decision is expected early this summer…

…The Supreme Court isn’t expected to make a decision in June Medical Service v. Russo until later this year. When it does, abortion rights supporters warn that if the court upholds the law, the ramifications would go beyond Louisiana and could create a patchwork of abortion access across the country…

March 3, 2020: Representative Barbara Lee tweeted: “Instead of working to improve residents’ health, Louisiana lawmakers are blocking access to abortion with a clinic shutdown law. Let me be clear: Abortion is #MyRightMyDecision, regardless of income, zip code, or the opinions of anti-choice politicians”. The tweet included a link to an article from The New York Times.

March 3, 2020: ABC News posted an article titled: “Mississippi seeks abortion ban for race, sex, genetic error”. It was written by Emily Wagster Pettus. From the article:

Mississippi’s Republican-led Legislature is trying to restrict the reasons women may seek abortion, after federal courts blocked time limitations that the state tried to put on the procedure the past two years.

Abortion would be prohibited if a woman is seeking one because of the race, sex or genetic abnormality of the fetus, under a bill that passed a state House committee Tuesday. The only exception would be in a case of a medical emergency. Other states have been sued over similar laws, and opponents questioned whether Mississippi is inviting another lawsuit over abortion.

House Bill 1297 moves to the full House for more debate…

…Anyone who performs an abortion because of race, sex, or genetic abnormality could face one year to 10 years in prison. The woman having the abortion would not face penalties.

Democratic Rep. Sonya Williams-Barnes of Gulfport voted against the bill.

“Women should have a right to make a choice for themselves whether they want to have a child or not,” Williams-Barnes said after the committee meeting.

She questioned whether women would even know about potential genetic abnormalities early enough in a pregnancy to consider abortion. Mississippi law bans abortion at 20 weeks, about the midpoint of a full-term pregnancy.

Speaking of the genetic abnormality portion of the bill, Wiliams-Barnes said: “My concern is, you make the woman have the child that has these deficiencies, but yet are you going to give her any medical aid or home care assistance for the child?”…

March 3, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Chris Sununu, Senator Jeb Bradley Testify in Support of SB 730”. From the press release:

Today, Governor Chris Sununu and Senator Jeb Bradley testified in support of SB 730, establishing the Granite State paid family leave plan – the only shot at delivering viable voluntary paid family leave for New Hampshire families.

“I support paid leave and this bill is the only viable way to get it done,” said Governor Chris Sununu. “Make no mistake – the people of New Hampshire will never support an income tax. I urge all Democrats on this committee to join me in opposing an income tax by delivering this voluntary paid family leave program for New Hampshire families.”

“It is critical that any paid family leave program we pass is both voluntary and does not include an income tax,” said Senator Jeb Bradley (R-Wolfeboro). “This legislation will provide families with the financial relief to care for a loved one while protecting taxpayers at the same time. I commend Governor Sununu for being a leader on this issue and working to find a compromise solution for the people of New Hampshire.”

March 3, 2020: American College of Obstetricians and Gynecologists (ACOG), posted a statement titled: “ACOG Statement on Supreme Court Oral Arguements for June Medical Services LLC v. Russo”. From the statement:

Maureen Phipps, MD, MPH, FACOG, CEO of the American College of Obstetricians and Gynecologists (ACOG), released the following statement regarding today’s arguments in June Medical Services LLC v. Russo:

“As women’s health physicians, we are committed to ensuring safe care for women. We fundamentally believe that in order to keep abortion safe, we must keep it both legal and accessible. Without question, allowing state governments to impose restrictions that are not medically necessary will only make it harder for women to access the safe abortion care that they need.

“Barriers to care established under the guise of concerns about patient safety are bad medicine. Women in need of abortion should not be forced to burden themselves and their families in order to get the health care that is right for them. Other needed forms of health care are not subject to these unfounded restrictions and attacks.

“Laws requiring physicians who provide abortions to have hospital admitting privileges are not medically justified. Laws regulating abortion should be evidence-based and supported by a valid medical justification. This law is neither. We want the Supreme Court to understand there is no medical reason for this restriction and there is no patient safety benefit to this law.

“The House of Medicine made it clear in our amicus brief that abortion is already a safe procedure, that the restrictions at the heart of this case will not make it safer, and that the restrictions are actually harmful to women in Louisiana.

“We hope that members of the court will give preference to our medical opinion when making their deliberations. The health of millions of women is at stake.”

March 3, 2020: U.S. Department of Health and Human Services posted a press release titled: “Health Mart Independent Pharmacies Donate Their Dispensing Services to HHS to Support the Ending of the HIV Epidemic Initiative”. From the press release:

The U.S. Department of Health and Human Services (HHS) and Health Mart today announced that more than 3,300 Health Mart independent pharmacies agreed to donate their dispensing services to support Ready, Set, PrEP, the HHS program that provides free PrEP medication to uninsured individuals. As part of that donation, Health Mart pharmacies will provide patient counseling and take steps to promote medication adherence as well as provide free PrEP medications in store at no cost for those eligible…

…The program is a key component of the initiative, Ending the HIV Epidemic (EHE): A Plan for America. EHE aims to reduce the number of new HIV infections in the United States by 75% in five years and by 90% in 10 years. By increasing awareness of PrEP and its access, the Ready, Set, PrEP program can provide thousands of people a safe, effective way to prevent HIV and bring the U.S. one step closer to ending the HIV epidemic…

…Although more than one million people at risk for HIV in the United States could benefit from PrEP medications, only a small fraction get them. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend PrEP for individuals at risk of acquiring HIV. When taken daily, PrEP is highly effective for preventing HIV…

Beginning no later than March 30, 2020, qualified patients can obtain the PrEP medications at the more than 24,500 participating pharmacy locations throughout 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands or through mail order—all at no cost to patients. These donating pharmacies represent about a third of all the pharmacies in the United States…


March 4, 2020: Representative Jackie Speier tweeted: “Abortion is extremely safe. The risk of complication is lower than from a colonoscopy, wisdom tooth removal, or a tonsillectomy, which do not require admitting privileges. The law before #SCOTUS is all about chipping away at Roe, NOT about protecting women. #MyRightMyDecision” The tweet included a video of Representative Jackie Spier speaking with a reporter as representatives gathered to walk to the Supreme Court.

March 4, 2020: Congresswoman Ayanna Pressley tweeted: “Today SCOTUS is hearing a case on Louisiana’s clinic shutdown law. Today, we are reaffirming that abortion care IS healthcare. Every person, regardless of income, sexual orientation, or gender, deserves equitable access to comprehensive medicine. #MyRightMyDecision”.

March 4, 2020: New York Attorney General Letitia James tweeted: “We took action in this case because in this nation women have a constitutional right to reproductive freedom, and New York will always defend that right. #MyRightMyDecision”. The tweet included a tweet of her’s from December 3, 2019, in which she states: “I’m fighting in the Supreme Court to ensure women across the nation aren’t denied their constitionally-protected right reproductive freedom”. It includes a screenshot of the lawsuit.

March 4, 2020: Representative Jerrry Nadler tweeted: “Today, the Supreme Court considers Louisiana’s admitting privileges law, a nearly identical alw to the one SCOTUS struck down as unconstitutional in 2016. If this law is upheld, Roe v. Wade will be gutted. What’s a constitutional right if you can’t exercise it? #MyRightMyDecision”.

Jerry Nadler followed that tweet with a second tweet: “This case is not an isolated attack. It’s another effort by national anti-abortion groups to chip away at abortion rights and exert control over women and their bodies. As the Supreme Court already found in 2016, these laws don’t make abortion safer, they just shut down clinics.”

Jerry Nadler also posted a third tweet in this thread: “If this law stands, there would only be one clinic in all of Louisiana. So much is on the line, but it’s really quite simple: the Supreme Court must follow precident and strike down the law. For everyone, abortion must be #MyRightMyDecision.”

March 4, 2020: Center for Reproductive Rights tweeted: “Abortion is a human right, one that the majority of Americans support and want people ot have access to. This is not a controversial issue, it’s basic health care. We’re fighting to protect abortion access at #SCOTUS. #MyRightMyDecision”. The tweet included a photo of the outside of the Supreme Court building, filled with people, many of whom are holding up signs in support of abortion access.

March 4, 2020: Ilyse hogue, president of NARAL Pro-Choice America, tweeted: “It’s a beautiful day to defend abortion rights and demand women’s freedom from the Kavenaugh Court. #MyRightMyDecision”. The tweet included a photo from outside the Supreme Court building. A large gathering of people are there. Several are holding signs.

March 4, 2020: Senator Chuck Schumer tweeted: “#MyRightMyDecision SCOTUS just heard the 1st big case on a woman’s right to make her own health care decisions since Justices Kavanaugh & Gorsuch It looks at 1 of 100s of draconian, anti-choice restrictions states tried to pass. We’re here to send a message: Not on our watch!” The tweet includes a video of Senator Chuck Schumer speaking at a podium outside of the Supreme Court.

March 4, 2020: CAPWomen, the Women’s Initiative at American Progress, tweeted: “We’re here at the Supreme Court today rallying in support of abortion rights because abortion is healthcare. #MyRightMyDecision” The tweet included a photo of about ten people, all of who are holding up signs in support of abortion access.

March 4, 2020: Alexis McGill Johnson, Acting President and CEO of Planned Parenthood Action Fund and Planned Parenthood Action, tweeted: “Today is about our right to control our own bodies. To imagine our futures. To be free. I promise you this: Planned Parenthood will never stop fighting to keep abortion safe and legal. We will never stop fighting to make it more accessible. The tweet included a selfie-style photo of herself in front of the outside of the Supreme Court building. A crowd of people are behind her.

March 4, 2020: Planned Parenthood Action tweeted: “Abortion is health care. We will not stop fighting for the basic right to control our own bodies, lives, and futires. We are down at the Supreme Court today, adding our voice. #MyRightMyDecision”. The tweet included a photo from the outside of the Supreme Court. A crowd of people are holding up signs. The largest one in the photo says “Trust Women”.

March 4, 2020: Reprsentative Sylvia Garcia tweeted: “Proud to march with my comrade @RepEscobar and @HouseDemocrats as we make it clear to the #SCOTUS that we stand for a woman’s right to choose. #MyRightMyDecision”. The tweet included three photos. One is of herself with Representative Escobar. Another is a group of Representatives, wearing light blue scarves, and holding signs, are standing in a group. The third photo is of Representative Ayanna Pressley speaking behind a podium in front of the outside of the Supreme Court.

March 4, 2020: NPR posted an article titled: “Beginning Of The End For Roe? Supreme Court Weighs Louisiana Abortion Law”. It was written by Nina Totenberg. From the article:

Abortion rights are on the chopping block Wednesday as the Supreme Court hears arguments in a case nearly indentical to one decided just four years ago.

It’s the first major abortion case to come before the court since the 2018 retirement of Justice Anthony Kennedy, making it the first time the majority of justices hearing an abortion case have anti-abortion-rights judicial records.

In 2016, the justices struck down a Texas law that required abortion-clinic doctors to have admitting privileges at a nearby hospital. In that case, Texas argued that admitting privileges, which allow doctors to admit and care for their patients in hospitals, would protect the health and safety of women seeking abortions.

The justices, however, concluded that rather than protecting women’s health, these requirements simply created unconstitutional obstacles to abortion access by making it difficult or impossible to staff abortion clinics.

Before the court is a Louisiana admitting privileges law that the state conceeds is identical to the Texas law…

…Even though the law has not gone into effect, Louisiana argues that requiring admitting privileges for abortion providers really would make women safer.

But every major medical group in the country – from the American Medical Association to the American College of Obstetricians and Gynecologists – contradicts that assertion. Indeed, although the Trump administration is backing Louisiana in this case, the federal government iteself recently eliminated privilege requirements for doctors who treat Medicare and Medicaid patients at outpatient surgical centers. The federal government found admitting privilege requirements to be burdensome and unnecessary…

…There is one new twist in Wednesday’s case. For the first time, Louisiana and the Trump administration, are claiming that doctors and clinics do not have the legal standing to challenge an abortion law on behalf of patients.

“The doctors who are seeking to have less oversight and reduce regulations upon them do not share the same interests as women,” Louisiana Solicitor General Murrill said of the doctors and clinics who bring lawsuits on behalf of their patients.

For more than 40 years, the Supreme Court has recognized the rights of doctors to challenge abortion laws, not just on behalf of themselves, but on behalf of their patients, too…

…In short, abortion providers see thsi new procedural challenge as a backdoor way to prevent future challenges to anti-abortion laws, or a wolf in sheep’s clothing….

…No court has found that the Hope clinic in Shreveport, which is at the center of Wednesday’s case, to be unsafe. It has long provided about 3,000 abortions a year, and the district court found that in the past 23 years, only four patients had to be transfeerred to a hospital because of a complication…

March 4, 2020: Center for Reproductive Rights posted a press release titled: “U.S. Supreme Court Hears Pivotal Abortion Rights Case”. From the press release:

Today, the U.S. Supreme Court heard oral arguments in June Medical Services v. Russo – the first abortion rights case to be heard under the current makeup of the Supreme Court. The case challenges a Louisiana law that would shut down every abortionclinic in the state except for one. The law (Act 620) bans doctors from providing abortion care unless they have admitting privileges at a hospital within 30 miles.

In a 2016 case also brought and won by the Center – Whole Woman’s Health v. Hellerstedt – the Supreme Court struck down an identical law in Texas, finding that admitting privilege requirements pose an “undue burden” on the right to abortion and are medically unnecessary. In the courtroom today, Center for Reproductive Rights’ Senior Litigation Director Julie Rikelman argued to the Justices that Act 620 should meet the same fate, as nothing has changed since 2016 that would justify a different outcome. Rikelman also argued that the law would close an even greater percentage of clinics in Louisiana than in Texas, and that the medical consensus opposing this kind of law has only grown stronger since 2016.

The Center also argued against Louisiana’s claim that abortion providers and clinics lack legal standing to fight for their patients’ rights in court. Rekelman argued that the state’s attack on standing contradicts 40 years of precedent, and is designed to insulate unconstitutional abortion restrictions from being challenged in court. Nearly all abortion cases today are brought by doctors and clinics. If they did not have third-party standing, patients would have to initiate court proceedings themselves and file a case while still pregnant, at the same time they are urgently seeking abortion care.

Act 620 and the State’s challenge to standing have been denounced by a coalition of leading voices of medicine, law, and public policy who joined with abortion patients and advocates to submit 27 amicus briefs to the Supreme Court in support of the Center’s case.

While the Supreme Court heard arguments, thousands of supporters gathered outside the courthouse to rally against a growing tide of political attacks on women’s reproductive rights. More than 40 speakers addressed the crowd including: celebrities Elizabeth Banks and Busy Phillips; legislators such as Senator Charles Schumer (D-NY.), representatives Diana DeGette (D-CO.), Barbara Lee (D-CA.), Ayanna Pressley (D-MA.), and Judy Chu (D-CA.); abortion providers; faith leaders; and women who have had abortions and experienced first-hand the barriers created by anti-abortion laws.

March 4, 2020: The Guardian posted an article titled: “Abortion rights case is first test for right-leaning US supreme court.” It was written by Jessica Glenza. From the article:

The US supreme court, and its new conservative majority, will hear one of the most consequential abortion rights cases in decades. Oral arguments in the case, called June Medical Services LLC v Russo, take place Wednesday morning.

The case represents the first test for how the nine-member court, which has swung toward the right, will handle a high-profile reproductive rights case.

The case hinges on whether doctors performing abortions at standalone clinics should be required to have “admitting privileges” at local hospitals. If such a law were upheld, it could close abortion clinics across the country and severely limit women’s access to the procedure, without improving women’s health in the process.

Already, the case in question breaks with precedent. The supreme court rarely takes cases similar to recent rulings. Oral arguements Wednesday will focus on a law identical to one the court overturned just four years ago…

…Attorneys for the case will answer questions from the nine justices for one hour. Justices will have the rest of the spring to review briefs, and issue a ruling in June. There is no limit on how broadly or narrowly the court may rule…

…The latest case, June Medical Services v Russo, stems from a law in Louisiana called HB 620. The law required doctors who preform abortions at clinics to have “admitting priviliges” at hospitals within 30 miles.

Such privileges allow a doctor to admit a patient for treatment, but are difficult to obtain. Doctors who have them are typically employed as members of the hospital staff. In rural settings, a clinic may be more than 30 miles from the nearest hospital.

Finally, in America’s private healthcare system, hospitals operate independently and are sensitive to the political concerns of the community. Many actively avoid connections with abortion clinics or doctors who perform them, and won’t grant the doctors the admitting rights they need to continue performing abortions….

…In the June Medical Services case, the government also asked the justices to weigh in on a less high-profile question: should doctors be able to sue states that pass abortion restrictions, on behalf of their patients? Doctors have been able to sue on behalf of women seeking abortions since at least the 1973 Roe v Wade landmark.

The question is a matter of what is called “standing”,or rights to sue, in legal communities. If justices find doctors cannot sue on behalf of women seeking abortions, it could make it far more difficult to challenge even patently unconstitutional anti-abortion laws.

March 4, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on Supreme Court Hearing Louisiana Reproductive Rights Case”. From the press release:

Speaker Nancy Pelosi issued this statement after the U.S. Supreme Court began hearing oral arguments in a case challenging the constitutionality of Louisiana’s new abortion law, which requires doctors performing abortions to have admitting privileges in nearby hospitals:

“Louisiana’s law is a clear and intentional violation of the Constitution. It is explicitly designed to permanently destroy women’s reproductive freedoms and dismantle their right to make their own decisions about their health, bodies and timing and size of their families, and it threatens to imperil the health of countless women.

“Just four years ago, the Supreme Court struck down an identical law in Texas, ruling that the law had ‘no health-related benefits’ and would result in about half of the state’s clinics closing, creating an undue burden on a woman’s access to reproductive health care. Similarly in the Louisiana case, as the plaintiffs point out, only two doctors in the state would be able to meet the law’s new requirements. Respect for women, precedent and the Constitution demand that the Court rule again to protect women’s constitutional right to comprehensive health care and reproductive freedoms.

“In Congress, in the courts and in the states, Republicans are engaged in a systematic campaign to take away women’s right to comprehensive health care, family planning and affordable contraception. The Democratic House will always fight these immoral and dangerous attacks on women’s health and freedoms with all our strength.”

March 4, 2020: Senator Cory Booker posted a press release titled: “Booker, Menendez, Democrats: Trump Administration’s Health Care Sabotage Undermines Coronavirus Response”. From the press release:

Today, U.S. Senators Cory Booker and Bob Menendez joined 39 Democratic Senators in demanding that Secretary of Health and Human Services (HHS) Alex Azar take immediate action to address the many ways the Trump Administration’s health care sabotage has undermined our preparedness for and ability to respond to the novel coronavirus outbreak, specifically calling on Azar to ensure that any potential coronavirus vaccine is affordable to all; stop promoting junk plans that don’t cover the care necessary to prevent the virus’ spread; and stop promoting efforts to undermine Medicaid that jeopardize people’s health care.

“When a patient who has potentially been exposed to the virus develops symptoms consistent with COVID-19, they should be able to seek appropriate medical care without being deterred by the risk of large bills. Patients often forego recommended tests and treatments because of cost,” wrote the senators in a letter to Secretary Azar. “For this reason, we are deeply concerned both by your refusal to commit that a potential vaccine for coronavirus will be affordable to anyone who needs it, and this Administration’s numerous policies that make it harder for patients to get care during an outbreak.”

The Senators also urged the Administration to stop undermining the Affordable Care Act (ACA) with a partisan lawsuit. If the lawsuit is successful, millions of families could lose access to health care or be covered only by a junk plan, and any patient who contracts the coronavirus could face future discrimination from insurers for having a pre-existing condition.

The Senators urged HHS to prioritize our nation’s public health and: 

Commit to ensuring any future coronavirus vaccine is affordable for all. The Trump Administration has thus far refused to put in place price guardrails that would ensure everyone could access a potentially critical vaccine.

Rescind the junk plan rule. The Trump Administration has expanded and promoted junk plans that discriminate against people with pre-existing conditions  and don’t cover essential health benefits like hospital care, emergency care, laboratory services, or preventive services. These plans have already left a patient with an exorbitant bill for necessary care to help combat the spread of coronavirus. Junk plans could even stick patients with the bill for a potential coronavirus vaccine.

Withdraw the 1332 waiver guidance. The administration released guidance encouraging states to apply for waivers that allow for the sale of coverage that doesn’t meet consumer protections for comprehensiveness and affordability. Reducing the comprehensiveness of coverage could leave patients paying bills for necessary care, like tests of vaccines.

Stop working to undermine Medicaid by promoting barriers like work requirements. Medicaid is crucial to our ability to respond to public health crises, but the Trump Administration’s attacks–like promoting harmful work requirements–have already led to patients being kicked off the program and losing access to health care. 

In addition to Senators Menendez and Booker, the letter was signed by Senators Patty Murray (D-Wash.), Ron Wyden (D-Ore.), Sherrod Brown (D-Ohio), Ed Markey (D-Mass.), Chuck Schumer (D-N.Y.), Richard Blumenthal (D-Conn.), Dick Durbin (D-Ill.), Chris Van Hollen (D-Md.), Sheldon Whitehouse (D-R.I.), Chris Murphy (D-Conn.), Jack Reed (D-R.I.), Tammy Baldwin (D-Wis.), Jeanne Shaheen (D-N.H.), Maggie Hassan (D-N.H.), Patrick Leahy (D-Vt.), Ben Cardin (D-Md.), Mark Warner (D-Va.), Tina Smith (D-Minn.), Mazie Hirono (D-Hawaii), Chris Coons (D-Del.), Gary Peters (D-Mich.), Michael Bennet (D-Colo.), Maria Cantwell (D-Wash.), Bernie Sanders (I-Vt.), Jeff Merkley (D-Ore.), Kirsten Gillibrand (D-N.Y.), Amy Klobuchar (D-Minn.), Tim Kaine (D-Va.), Debbie Stabenow (D-Mich.), Catherine Cortez Masto (D-Nev.), Elizabeth Warren (D-Mass.), Kamala Harris (D-Calif.), Brian Schatz (D-Hawaii), Martin Heinrich (D-N.M.), Jacky Rosen (D-Nev.), Bob Casey (D-Pa.), and Tom Carper (D-Del.). 

The full text of the letter is below and HERE. …


March 6, 2020: President Trump tweeted: “I will protect your Social Security and Medicare, just as I have for the past 3 years. Sleepy Joe Biden will destroy both in very short order, and he won’t even know he’s doing it!”

March 6, 2020: Virginia Mercury posted an article titled “Virginia General Assembly caps costs at $50 a month”. It was written by Kate Masters. From the article:

One of the biggest bills of the year is one nobody is talking about, Del. Mike Mullin, D-Newport News, wrote in a tweet on Friday – a hard cap on the price of insulin in Virginia.

Insurers are now limited to chargin a maximum of $50 a month for the drug after Del. Lee Carter, D-Manassas, urged colleagues to accept a Senate amendment to his bill. This price is a little higher than his original cap of $30, but still the lowest ceiling for insulin in the country, he said on the House floor…

…There have been Congressional hearings over the rising costs, but federal regulators have still haven’t settled on a solution to lower prices. Virginia is the third state to pass a law limiting the cost of insulin.

The bill will go to Gov. Ralph Northam for final approval…

The legislation prohibits Virginia insurers from setting a patient’s cost-sharing payment for insulin above $50 a month – including deductibles and copays. The bill was supported by the Medical Society of Virginia and the American Association of Retired Persons, but, unsurprisingly, not by the Virginia Association of Health Plans, which argued that the cap on the cost-sharing payments would be offset by a rise in premiums…


March 9, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Chris Sununu Signs Medicaid to Schools Legislation”. From the press release:

Today, Governor Chris Sununu signed SB 684, relative to Medicaid to schools. The bill was drafted by the New Hampshire Department of Health and Human Services in coordination with the Governor’s office, a bipartisan group of legislators, the New Hampshire Department of Education, and the NH Association of Special Education Administrators.

“With the stroke of a pen, we have ensured that students are still able to receive the critical health care services they need,” said Governor Chris Sununu. “I appreciate the hard work and bipartisan nature surrounding this process, and this bill will help New Hampshire get back on track and ensure critical services to our students while allowing schools to recoup their lost funds.”

“New Hampshire schools needed prompt, direct action to protect the Medicaid-to-schools program,” said Senator Jim Gray (R-Rochester). “Thanks to the leadership of Governor Sununu and the members of the bipartisan working group, New Hampshire has come together to address the issue in a timely manner.”

“This bill will allow greater cooperation across state departments to help local school districts qualify for federal Medicaid funds,” said Deputy Education Commissioner Christine Brennan. “By breaking down bureaucratic silos, we can help schools deliver vital health care services.”

“This legislation, combined with the Governor’s Executive Order and the adoption of the new Medicaid to Schools rule, ensures that schools are able to access a full array of health care providers and receive federal funding through Medicaid, to the benefit of New Hampshire students. SB 684 is the result of the collaboration of leaders across the state, including the Governor, legislators, teachers, providers, and advocates. This law makes for a stronger, more robust Medicaid to Schools program.”

Under the Medicaid to Schools program, school districts are eligible for Medicaid reimbursement for health care services that schools provide to students enrolled in Medicaid. Services eligible for federal reimbursement include behavioral health services, personal care, and rehabilitation therapy services such as physical therapy.

March 9, 2020: U.S. Department of Health and Human Services posted a press release titled: “HHS Finalizes Historic Rules to Provide Patients More Control of Their Health Data”. From the press release:

The U.S. Department of Health and Human Services (HHS) today finalized two transformative rules that will give patients unprecedented safe, secure access to their health data. Interoperability has been pursued by multiple administrations and numerous laws, and today, these rules finally deliver on giving patients true access to their healthcare data to make informed healthcare decisions and better manage their care. Putting patients in charge of their health records is a key piece of giving patients more control in healthcare, and patient control is at the center of the Trump administration’s work toward a value-based healthcare system.

The two rules, issued by the HHS Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act (Cures Act) and support President Trump’s MyHealthEData initiative. MyHealthEData is designed to empower patients around a common aim – giving every American access to their medical information so they can make better healthcare decisions.

Together, these final rules mark the most extensive healthcare data sharing policies the federal government has implemented, requiring both public and private entities to share health information between patients and other parties while keeping that information private and secure, a top priority for the Administration….

…These final rules deliver on the Administration’s promise to put patients at the center of their care by promoting patient access and use of their own health information and spurring the use of and development of new smartphone applications…


March 10, 2020: Rewire News posted an article titled: “Texas Foreshadows How Trump’s ‘Gag Rule’ Will Destroy Teens’ Access to Contraception”. It was written by Martha Kempner. From the article:

Clinics that receive Title X family planning funds have traditionally been a place for teenagers to get confidential contraceptive and sexual health services, even in states that otherwise require parental consent.

The Trump administration, however, has imposed onerous rules that prevent providers from referring patients for abortion care, prioritize so-called natural family planning over more effective forms of contraception, and threaten confidentiality for adolescent patients. While the administration’s domestic “gag rule” is gutting the Title X program across the country, a recent study out of Texas—where cuts to family planning programs began in 2011 thanks to Republican lawmakers—suggests teenagers may be among those who lose the most.

Texas is one of 23 states that doesn’t explicitly allow minors to consent to contraceptive care, and the state’s Children’s Health Insurance Program does not cover contraception. Federally funded Title X clinics provided much-needed access for young people in Texas because federal rules allowing teens to access contraception without parental consent superseded the state laws…

…In Texas, minors can access some sexual and reproductive health services, including STI testing, without parental consent, but not birth control. Staff at some centers would refer young people to clinics that still had Title X funding whereas others would try to obtain parental consent—which led to additional questions, like which forms to use and whether the parent had to sign the forms in front of staff. For some organizations, the rules and procedures changed multiple times during the study period as funding sources shifted. As a result of this confusion, some providers began to discourage walk-in services for teens, creating a new barrier to access.

The researchers concluded that as the network of Title X-funded clinics shrunk, it became more difficult for teens to access contraceptive services. “Access to care became less equitable” as  “teens’ ability to obtain confidential low-cost services was increasingly dependent on the funding sources for their care and services requested.” Only teens on Medicaid or those who could get to a Title X clinic, for example, had confidential access to hormonal contraceptives or long-acting reversible methods….

…Another Trump rule change impacts teenagers. Though Title X clinics are still required to provide confidential services and do not have to obtain parental consent, the new rules require providers to document the “specific actions” they have taken to encourage each adolescent patient to involve family. Studies have shown that many teens would not seek contraceptive health services without a guarantee that their parents would not find out. Requiring parental permission—or forcing them to explain to a doctor why they don’t want their parents involved—would be even more devastating. It’s important to remember that these teens are unlikely to stop having sex. They will just stop protecting themselves from unintended pregnancy.

March 10, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Announces Change To NYS Health Policy Allowing Transgender Minors To Correct Sex Designation On Birth Certificates”. From the press release:

New York Attorney General Letitia James today announced a change in policy at the New York State Department of Health, Vital Records, that allows transgender minors to correct the sex designation on their birth certificates if they were born in New York State. Following a case brought on behalf of a transgender minor — referred to as M.H.W. — who wanted to correct the sex designation on his birth certificate from female to male to match his gender identity, the state changed its policy to ensure M.H.W. and other transgender youth do not need to wait until they are 18 years old to make the change. Now, transgender individuals born in New York State can obtain a certified copy of their birth certificate that accurately reflects their sex, consistent with their gender identity…

…Previously, New York State had a wildly outdated policy that perpetuated the stigma faced by transgender individuals by requiring those born in New York who sought to correct the sex listed on their birth certificate to be at least 18 years old and to submit a notarized affidavit from a physician, nurse practitioner, or physician assistant confirming that surgical procedures had been performed on the applicant to complete sex reassignment. Alternatively, one of these medical professionals could submit an affidavit confirming they had treated, or reviewed and evaluated, the gender-related medical history of the applicant for a series of diagnoses — noting that the provider was making findings on independent and unbiased reviews and evaluations, not related to the applicant.

Starting today, no medical affidavits will be necessary to apply to correct the sex designation on a birth certificate for adults or minors, and individuals under the age of 18 can submit an application to correct their birth certificate. Those age 17 or older can make their request to the New York State Department of Health, Bureau of Vital Records, by submitting 1) a completed and signed application (DOH-5305) and 2) a notarized affidavit form affirming their gender identity (DOH‑5303).

Minors age 16 or younger can make the request for a correction to a birth certificate through their parents or legal guardian(s). The requests must include 1) a completed and signed application by their parents or legal guardian(s) (DOH-5306), as well as 2) a notarized affidavit form affirming the gender identity of their child (DOH‑5304). If those making the request are simultaneously requesting that a name be changed on a birth certificate, that should be noted on the application as well…

…In the suit filed on behalf of M.H.W., the plaintiffs rightfully argued that “the government’s refusal to recognize a person’s sex not only denies a transgender person equal dignity and respect by undermining — indeed denying — their very existence, it also authorizes and invites other public and private entities to similarly discriminate and deny recognition.” Further, a 2015 study showed that transgender individuals who have shown identity documents with a name or gender that did not match their gender presentation were verbally harassed, denied benefits or service, asked to leave, or assaulted by others…

March 10, 2020: Senator Kamala Harris posted a press release titled: “Harris, Underwood, Adams, Black Maternal Health Caucus Unveil Historic Legislative Package to Address America’s Black Maternal Health Crisis”. From the press release:

U.S. Senator Kamala D. Harris (D-CA), Representatives Lauren Underwood (IL-14) and Alma Adams (NC-12), and members of the Black Maternal Health Caucus on Tuesday introduced a historic legislative package to address the United States’ urgent maternal health crisis. The Black Maternal Health Momnibus Act of 2020 will build on existing maternal health legislation by filling gaps through the nine new bills to comprehensively address every dimension of the Black maternal health crisis. The Black Maternal Health Momnibus makes investments in social determinants of health, community-based organizations, the growth and diversification of the perinatal workforce, improvements in data collection and quality measures, digital tools like telehealth, and innovative payment models. In addition to direct efforts to improve Black maternal health outcomes, the Momnibus focuses on high-risk populations, including women veterans, incarcerated women, and Native Americans.

The United States has the worst maternal death rates in the developed world, and the only rate that is rising. The maternal mortality rate is significantly higher among black women, who are three to four times more likely than white women to die from pregnancy-related complications. Black women also experience higher rates of maternal complications and infant mortality. They are twice as likely to lose an infant to premature death, and these disparities have not improved for more than 30 years…

…The Black Maternal Health Momnibus is composed of nine individual bills sponsored by members of the Black Maternal Health Caucus and Senator Harris. The legislation will:  

  • Make critical investments in social determinants of health that influence maternal health outcomes, like housing, transportation, and nutrition;
  • Provide funding to community-based organizations that are working to improve maternal health outcomes, particularly for Black women;
  • Comprehensively study the unique maternal health risks facing women veterans and invest in VA maternity care coordination;
  • Grow and diversify the perinatal workforce to ensure that every mom in America receives maternity care and support from people she can trust;
  • Improve data collection processes and quality measures to better understand the causes of the maternal health crisis in the United States and inform solutions to address it.
  • Invest in maternal mental health care and substance use disorder treatments;
  • Improve maternal health care and support for incarcerated women;
  • Invest in digital tools like telehealth to improve maternal health outcomes in undereserved areas; and
  • Promote innovative payment models to incentivize high-quality maternity care and continuity of health insurance coverage from pregnancy through labor and delivery and up to 1 year postpartum.

In the Senate, the Black Maternal Health Momnibus is co-sponsored by Cory Booker (D-NJ), Gary Peters (D-MI), Kirsten Gillibrand (D-NY), Tammy Baldwin (D-WI), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), Tammy Duckworth (D-IL), Bob Menendez (D-NJ), Richard Blumenthal (D-CT), Michael Bennet (D-CO), Amy Klobuchar (D-MN), and Jeff Merkley (D-OR).

A one-pager of the Black Maternal Health Momnibus can be found here.

A summary of the Black Maternal Health Momnibus can be found here.

The Black Maternal Health Momnibus has also gained endorsements from many of the leading health and family organizations, including the Center for Reproductive Rights, the Black Mamas Matter Alliance, and the American College of Obstetricians and Gynecologists.

Additionally, the Black Maternal Health Momnibus is endorsed by 93 groups. A full list of endorsements of the Momnibus can be found here.


March 11, 2020: Human Rights Watch posted an article titled: “US State Department Again Ignores Women’s Reproductive Rights”. It was written by Acting Co-Director, Women’s Rights Division, Amanda Klasing. From the article:

The US State Department released its annual human rights Country Reports today. For careful readers of the reports issued under the Trump administration, the glaring gaps will seem familiar.

For the past two reports, Human Rights Watch and other human rights and reproductive rights organizations have decried the Trump administration’s cutting of most mentions of key human rights abuses that disproportionately impact women and girls, including country analyses of maternal mortality rate, and unmet contraceptive needs. It’s not just an editorial cut – this deliberate exclusion has repercussions for the promotion of women’s human rights globally.

That record is clear: From the “global gag rule” to a domestic gag rule, the defunding of United Nations Populations Fund, the extraordinary threat of vetoing a UN Security Council resolution on women, peace and security becaues it mentioned survivors’ sexual and reproductive health and rights, to the establishment of the Commission of Unalienable Rights that apepars to directly threaten sexual and reproductive health and rights, to the Women’s Global Development and Prosperity initiative that completely disregards the need women and girls have to access health care to succeed in their own economic empowerment.

The administration is also playing an invidious role at international forums, recruiting other anti-choice governments to push back on the global consensus around sexual and reproductive health and rights.

Frankly, it is exhausting to have to continue, 25 years after the Beijing women’s conference, to fight so hard to have basic recognition that women’s rights are human rights. Individuals, organizations, and the US Congress should not relent, despite the constant assault. Without delay, the Global HER Act, repealing the global gag rule permanently, and the Reproductive Rights are Human Rights Act, requiring the State Department to report on violations of women’s reproductive rights, should be passed.

March 11, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Sununu Statement Following Senate Vote on SB 687”. From the press release:

Today, Governor Chris Sununu issued the following statement after the Senate voted to pass SB 687, an act relative to transparency in prescription drug pricing and establishing a New Hampshire prescription drug affordability board:

“This bill will create a drug affordability board in New Hampshire to monitor changes in the cost of prescription drugs to keep the industry honest and to keep an eye on prices to prevent price spikes,” said Governor Chris Sununu. “Often, many of the challenges in health care can start to be addressed through greater transparency in pricing. That transparency brings scrutiny and accountability as to why the cost of a particular drug is high or higher than similar drugs. I look forward to signing this bill into law.”

March 11, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Urges U.S. Supreme Court to Retain Current Balancing Test Protecting Workers and Religious Freedom”. From the press release:

California Attorney General Xavier Becerra today filed a multistate amicus brief in two consolidated cases urging the U.S. Supreme Court to retain a previously established multi-factor test designed to safeguard the rights of workers and religious organizations. The test has been used since 2012 to determine which employees fall under the so-called “ministerial exception” and are therefore not protected by state and federal anti-discrimination laws. The defendants in each case have asked the court to broadly expand the exception, which could risk the unnecessary elimination of workplace protections for employees of religious organizations across the country.

“Our nation’s labor laws are designed to protect workers all across the country,” said Attorney General Becerra. “Broadening the ministerial exception would rob Americans of critical, hard-fought antidiscrimination protections. At the California Department of Justice, we’re committed to doing our part to uphold the rights of both our state’s religious organizations and workers.”

The consolidated cases stem from discrimination lawsuits filed by teachers at two different religious schools in California. In Biel v. St. James School, a fifth-grade teacher alleged that the school violated the Americans with Disabilities Act when administrators chose not to renew her contract after she informed them that she would need time off to treat her breast cancer. In Morrissey-Berru v. Our Lady of Guadalupe School, a different teacher alleged that she was first demoted, then fired, in violation of the Age Discrimination in Employment Act. In each case, the school maintained that even if the teachers were right about why they were fired, courts could not grant them relief, because the teachers’ employment was subject to the ministerial exception from antidiscrimination laws. The U.S. Court of Appeals for the Ninth Circuit rejected that defense in both cases and held that the teachers could move forward to try to prove their discrimination lawsuits. However, following petitions by the schools, the cases are now under review by the U.S. Supreme Court.

Under current law, the government is barred from interfering with the employment decisions of religious organizations with respect to ministers. Under the test that the Supreme Court established in 2012 in Hosanna-Tabor Evangelical Lutheran Church and School v. Equal Employment Opportunity Commission, courts examine multiple factors to determine if a particular employee is actually covered under the religious exception. Those circumstances include:

  • The employee’s title within the organization;
  • Whether the individual has had significant religious training;
  • Whether the employee holds himself or herself out as a minister of the church; and
  • Whether the individual’s duties include a religious function with respect to conveying the organization’s religious message and carrying out its mission.

The defendants in these cases have argued that the first three factors should not be given weight, and that the test should focus only on any religious function the employee carries out. That raises the possibility that individuals who are assigned even a small degree of religious work in large organizations such as schools or hospitals could be subjected to the religious exception and lose workplace protections. In the amicus brief filed today, the coalition of states emphasizes the importance of state and federal antidiscrimination laws in removing barriers to employment and advancement for those who face discrimination on the basis of age, disability, race, color, religion, sex, LGBTQ status, national origin, and more. The brief highlights how an overbroad ministerial exception could weaken those efforts…

…A copy of the amicus brief is available here.


March 12, 2020: Planned Parenthood posted a press release titled: New: Vast Majority of Missouri Patients Crossing State Line for Abortion”. From the press release:

New data reveals the vast majority of Missouri residents seeking abortion are crossing state lines just to get care. Reproductive Health Services of Planned Parenthood of the St. Louis Region (RHS), the last remaining abortion clinic in the state, has found that all but a handful of patients are accessing abortion outside of the state. Many patients have told RHS the same thing: The long list of medically unnecessary abortion restrictions make it too difficult to access the care they need. This comes just over one week after the Supreme Court heard oral arguments in a case about whether similarly harmful and medically unnecessary restrictions in Louisiana are constitutional. If the Supreme Court rules the wrong way, what’s happening in Missouri — and in other states down to one abortion provider — could soon be the reality for states across the country. For decades, Missouri has imposed restriction after restriction on people’s access to abortion. As a direct result of those restrictions, there is only one health center left providing abortion in the state.

Missouri Gov. Mike Parson and Department of Health and Senior Services Director Randall Williams are weaponizing Missouri’s health center licensing process to try and end access to abortion at the last health center providing abortion in Missouri. The same administration invaded patient privacy by logging menstrual cycles in a spreadsheet to track abortion patients. In addition, last year, Gov. Parson signed into law one of the most extreme anti-abortion bills in the country – chock full of various abortion bans targeting all stages of pregnancy. all in one…

The dramatic increase in the number of patients fleeing Missouri to obtain abortions comes as RHS fights to keep the last remaining abortion clinic in Missouri open. As Planned Parenthood in Missouri waits for a decision in RHS’ abortion license case, politicians in the state have used every avenue to ensure that having a licensed provider no longer ensures access for patients…

March 12, 2020: New Hampshire Governor Chris Sununu posted a press release titled: “Governor Sununu Announces an Insurance Department Order for Insurers to Cover Testing for Coronavirus”. From the press release:

Governor Chris T. Sununu today announced that Insurance Commissioner Nicolopoulos has issued an Order requiring New Hampshire health insurers to cover services associated with testing for the novel coronavirus 2019 (COVID-19) without cost-sharing, and to take a series of related measures designed to promote early detection and access to prevention, treatment, and recovery services.

The Order outlines a series of actions that New Hampshire health insurers are required or advised to take, including keeping New Hampshire residents informed about available benefits; offering telehealth medical advice and treatment, when possible; and expanding access to prescription drug refills.

“I want to thank Commissioner Nicolopoulos for issuing this Order to make sure that New Hampshire residents can access testing and treatment for the coronavirus,” said Governor Sununu.”Several insurance companies operating in New Hampshire have been very proactive in their efforts to combat the coronavirus outbreak, and this Order will help more New Hampshire consumers feel confident that they can access necessary services without cost acting as a barrier.”

“We want to ensure that New Hampshire residents have insurance coverage for health care services associated with the coronavirus. It is important to remove actual or perceived barriers to testing and treatment for New Hampshire residents. We do not want anyone to be reluctant to seek medical services due to anticipated costs,” said Insurance Commissioner Chris Nicolopoulos. “If people are getting the care that they need, we may be able to mitigate overall costs to the health insurance markets.”

The New Hampshire Department of Health and Human Services will ensure that New Hampshire residents receiving Medicaid coverage have their testing costs covered. Medicaid recipients may have very nominal cost sharing ($1-$2) for prescription drugs. Medicare Part B will cover testing for COVID-19. New Hampshire residents enrolled in self-funded employer-based health insurance plans that are not regulated by the NHID should contact their employer to fully understand the scope of coverage.

The Order issued by the Insurance Department to health insurance companies regarding actions they should take in relation to the potential impact of COVID-19 on New Hampshire includes:

Keeping Consumers Informed: NHID is directing insurers to keep their members informed with accurate information about coverage for COVID-19 related testing and treatment.

Testing for COVID-19 and Treatment for Initial Diagnosis: Health insurance companies must provide coverage, prior to application of any deductible and without cost-sharing, for the initial health care provider visit and test for their members who meet the CDC criteria for testing, as determined by the insured’s health care provider.

Providing Telehealth Appointments: Given that COVID-19 is a communicable disease, some members may utilize telemedicine in seeking an initial diagnosis instead of in-person heath care services. Health insurance companies are reminded that they may not deny coverage, including mental health services provided to a quarantined individual, simply because it was provided through telemedicine. Health insurers are directed to ensure that their telehealth programs will be able to meet any increased demand.

Preparing Health System for Increased Cases: NHID is directing insurers to verify that their provider networks are adequately prepared to handle a potential increase in the need for health care services, including offering access to out-of-network services where appropriate and required, in the event more COVID-19 cases are diagnosed in New Hampshire.

Prescription Drug Refills: Health insurance companies are directed take steps to ensure that members have continuous access to prescription medications. Members are able to obtain a one-time refill of their covered prescription medications prior to the expiration of the waiting period between refills in order to maintain an adequate supply of medications. For maintenance medications, insurers are directed to permit members to obtain a 90-day supply. With regard to refills of certain drug classes, such as opioids, benzodiazepines, and stimulants, insurers may limit early refills as necessary to take into consideration patient safety risks.

March 12, 2020: NPR posted an article titled: “As Missouri Clinic Awaits Its Legal Fate, Abortions In State Have Virtually Halted”. It was written by Sarah McCammon. From the article:

Missouri could soon be the first state in the nation without a clinic providing abortions, but Planned Parenthood officials say the last remaining oen there has alreayd all byt ceased performing the procedure.

The clinic, Reproductive Health Services of Planned Parenthood of the St. Louis Region, is at the center of a licensing dispute between the organization and Missouri Republican Gov. Mike Parson’s administration. That clinic;s future is in the hands of a state commission that is expected to issue a decision in the coming weeks or months.

A new analysis provided to NPR by Planned Parenthood suggests that already very few abortions are being performed in Missouri. It shows that the vast majority of patients in Missouri seeking abortions have begun crossing state lines to obtain it – many of them traveling to a new Planned Parenthood clinic in Fairview Heights, Ill., near St. Louis, that opened in October.

Just three patients were provided abortions at the St. Louis region clinic in February of this year, down from 174 for the month the previous year, according to the data. Last month, 323 patients from Missouri obtained the procedure at the Illinois clinic…

…As a result of the licensing dispute, clinic administrators in several states neighboring Missouri told NPR last year that they were preparing for a possible influx of patients.

That dispute comes as the U.S. Supreme Court is considering a challenge to a Louisiana law that also centers around health requirements that critics say will effectively shutter clinics by requiring abortion providers to have hospital admiting privileges…


March 13, 2020: Los Angeles Times posted an article titled: “Under pressure, Trump administration opens door to mobilizing Medicaid to fight coronavirus”. It was written by Noam N. Levey. From the article:

Facing mounting pleas from California and other states, the Trump administration moved Friday to allow states to use Medicaid more freely to respond to the coronavirus crisis and expand access to medical services.

President Trump’s emergency declaration may clear the way for states to more quickly enroll low-income Americans in Medicaid so they can get necessary testing or treatment if they are exposed to the virus, as several states have wanted to do since early in the crisis.

His move also could speed efforts by states to bring on new medical providers, set up emergency clinics or begin quarantining and caring for homeless Americans at high risk from the virus.

“The announcement is welcome but woefully overdue,” said Cindy Mann, who oversaw the Medicaid program in the Obama administration and worked with states to help respond to the H1N1 flu crisis in 2009.

Mann noted that states still face a challenge as they will have to negotiate with the federal government to waive Medicaid rules, a potentially lengthy process.

“This will all take time and time is not on our side,” she said.

But until Friday’s declaration by the president, the White House and senior federal health officials hadn’t taken the necessary steps to give states simple pathways to fully leverage the mammoth safety net program to prevent a wider epidemic.

One reason federal health officials took so long to act appeared to be Trump’s reluctance to declare a national emergency, which would have conflicted with his repeated efforts to downplay the seriousness of the epidemic.

Another element may be ideological: The administration official who oversees Medicaid, Seema Verma, head of the government’s Centers for Medicare and Medicaid Services, has been a champion of efforts by conservative states to trim the number of people enrolled in Medicaid.

The steps that California, Washington and other states hit hard by the epidemic want to take would likely increase the number of people enrolled in the program…

…By finally issuing the order Friday afternoon, the president cleared the way for the Centers for Medicare and Medicaid Services, or CMS, to issue formal waivers to states, loosening Medicaid rules for enrolling people and paying for medical services…

…Similar flexibility is needed now, said Jacey Cooper, who directs Medi-Cal, as California’s mammoth Medicaid program is called. Medi-Cal currently covers about 13 million low-income Californians.

Cooper said an emergency declaration would “really help us get services to people who need it.”

California officials were reviewing the president’s order Friday to assess whether it will allow the state to better respond to the coronavirus crisis.

Among other things, Cooper said the state wants to shorten lengthy verification procedures to quickly enroll people. Public health experts fear that gaps in insurance coverage make controlling coronavirus more difficult because patients who don’t have insurance won’t seek medical attention and testing they fear they can’t afford.

California and other states also want to ensure that mobile clinics and other temporary facilities set up to handle a crush of patients can bill Medicaid, which also would require a waiver.

Facing mounting pleas from California and other states, the Trump administration moved Friday to allow states to use Medicaid more freely to respond to the coronavirus crisis and expand access to medical services.

President Trump’s emergency declaration may clear the way for states to more quickly enroll low-income Americans in Medicaid so they can get necessary testing or treatment if they are exposed to the virus, as several states have wanted to do since early in the crisis.

His move also could speed efforts by states to bring on new medical providers, set up emergency clinics or begin quarantining and caring for homeless Americans at high risk from the virus.

“The announcement is welcome but woefully overdue,” said Cindy Mann, who oversaw the Medicaid program in the Obama administration and worked with states to help respond to the H1N1 flu crisis in 2009.

Mann noted that states still face a challenge as they will have to negotiate with the federal government to waive Medicaid rules, a potentially lengthy process.

“This will all take time and time is not on our side,” she said.

But until Friday’s declaration by the president, the White House and senior federal health officials hadn’t taken the necessary steps to give states simple pathways to fully leverage the mammoth safety net program to prevent a wider epidemic.

One reason federal health officials took so long to act appeared to be Trump’s reluctance to declare a national emergency, which would have conflicted with his repeated efforts to downplay the seriousness of the epidemic.

Another element may be ideological: The administration official who oversees Medicaid, Seema Verma, head of the government’s Centers for Medicare and Medicaid Services, has been a champion of efforts by conservative states to trim the number of people enrolled in Medicaid.

The steps that California, Washington and other states hit hard by the epidemic want to take would likely increase the number of people enrolled in the program…

…By finally issuing the order Friday afternoon, the president cleared the way for the Centers for Medicare and Medicaid Services, or CMS, to issue formal waivers to states, loosening Medicaid rules for enrolling people and paying for medical services…

…Similar flexibility is needed now, said Jacey Cooper, who directs Medi-Cal, as California’s mammoth Medicaid program is called. Medi-Cal currently covers about 13 million low-income Californians.

Cooper said an emergency declaration would “really help us get services to people who need it.”

California officials were reviewing the president’s order Friday to assess whether it will allow the state to better respond to the coronavirus crisis.

Among other things, Cooper said the state wants to shorten lengthy verification procedures to quickly enroll people. Public health experts fear that gaps in insurance coverage make controlling coronavirus more difficult because patients who don’t have insurance won’t seek medical attention and testing they fear they can’t afford.

California and other states also want to ensure that mobile clinics and other temporary facilities set up to handle a crush of patients can bill Medicaid, which also would require a waiver.

And a number of states with large homeless populations — including California, Washington and New York — are interested in potentially using Medicaid funding to help homeless victims of coronavirus who need not only medical care but also housing and other services…


March 14, 2020: New Hampshire Governor Chris Sununu sent a letter to Majority Leader Mitch McConnell. From the letter:

Earlier today, the U.S. House of Representatives passed the Families First Coronavirus Response Act (H.R. 6201). This package provides critical support to compliment many of the efforts that the State of New Hampshire has undertaken.

Provisions within H.R. 6201 include: free testing for COVID-19, paid emergency leave, enhancements to Unemployment Insurance, and strengthening food security initiatives. It also includes critical Medicaid funding to states. My administration has pledged to the people of New Hampshire that we wll take all necessary steps to protect the public and this legislation will greatly expand and expedite our efforts.

Among other critical provisions, the legislation provides for:

  • Would appropriate $250 million for Health and Human Services Department programs that aid elderly Americans.
  • $500 million in emergency funding for the WIC program and $400 million for the Commodity Assistance Program for the emergency food assistance program (TEFAP).
  • Authorizing states to be eligible for a 6.2 percentage point increase in their federal medical assistance percentages (FMAP), which would have to provide coverage of coronavirus testing without cost sharing and meet other criteria. This includes not only imposing more stringent eligibility standards or additional premiums.
  • An emergency paid leave program to directly respond to the coronavirus. Private sector employers with fewer than 500 workers and government entities would have to provide as many as 12 weeks of job-protected leave under the Family and Medical Leave Act (FMLA).
  • $60 million for Veterans Affairs Department to protect our veterans.

This bill now awaits Senate action. My administration has worked closely and productively with our state’s federal delegation and they are ready to take immediate action. I encourage you in the strongest terms possible to bring the legislation to a vote and put it on President Trump’s desk for signature as quickly as possible.

New Hampshire is ready to be good stewards of federal taxpayer support and we will use thse resources efficiently and effectively to keep Granite Staters safe and healthy.


March 16, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a joint statement titled: “Joint Statement on Elective Surgeries”. From the joint statement:

The American College of Obstetricians and Gynecologists joins the American Association of Gynecologic Laparoscopists, American Society for Reproductive Medicine, the American Urogynecologic Society, the Society of Family Planning, the Society of Gynecologic Surgeons, the Society for Maternal-Fetal Medicine, and the Society of Gynecologic Oncology in providing the following recommendations for obstetrician-gynecologists regarding the American College of Surgeons’ statement on elective surgery and the U.S. Surgeon General’s recommendation that hospitals suspend elective surgeries during the COVID-19 pandemic.

The COVID-19 pandemic is a public health crisis that requires the full attention and resources of our health care systems. The pandemic is and will create stress and pressure on health care systems throughout the country, especially in under-resourced areas. As hospital systems, clinics, and communities prepare to meet anticipated increases in demand for the care of people with COVID-19, strategies to mitigate spread of the virus and to maximize health care resources are evolving. Some health systems, at the guidance of the U.S. Centers for Disease Prevention and Control, are implementing plans to cancel elective and non-urgent procedures to expand hospitals’ capacity to provide critical care.

While elective surgery can serve important roles in furthering patient wellbeing, we endorse the Surgeon General’s statement regarding elective surgery. Surgical procedures performed by obstetrician–gynecologists are generally medically indicated procedures necessary for the furtherance of patient health and safety. In areas where COVID-19 is particularly prevalent or where there is particular stress on the health care system, it may be advantageous to identify and modify surgical scheduling, including for procedures that are medically indicated, when a patient’s health and safety would not be harmed by such delay. Decisions should be made on a local-regional level, considering the risks and resources specific to each area.

Obstetric and gynecologic procedures for which a delay will negatively affect patient health and safety should not be delayed. This includes gynecologic procedures and procedures related to pregnancy for which delay would harm patient health. Obstetrician–gynecologists and other health care practitioners should be aware of the unintended impact that policies responding to COVID-19 may have, including limiting access to time-sensitive obstetric and gynecological procedures.

This is an unusual time with rapidly evolving circumstances, and we would expect recommendations to change. We encourage individual physicians to work closely with their hospital systems to ensure that patient’s needs are being met and that time-sensitive procedures are not rendered inaccessible. Please consult the CDC’s Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the United States.

March 16, 2020: Senator Cory Booker posted a press release titled: “Booker, Menendez Announce $25M to Support Community Health Centers Across NJ”. From the press release:

U.S. Senators Cory Booker and Bob Menendez today announced a total of $24,655,479 in continued funding from the U.S. Department of Health and Human Services (HHS) to support the operations of 13 of New Jersey’s Federally Qualified Health Centers (FQHCs). FQHCs are trusted providers for many in lower-income communities who need access to health care services. 

New Jersey’s senators advocated for the $8.3 billion coronavirus emergency package that was signed into law several weeks ago and included an additional $100 million to support FQHCs’ efforts in responding to the outbreak. 

“Our community health centers provide New Jerseyans with important health education and preventive services while encouraging healthy lifestyles to keep families and our communities thriving,” said Sen. Booker. “These federal dollars will support access to quality and comprehensive health care services for some of our most underserved communities across New Jersey.” 

“The health care workers at our community health centers are working hard every day to protect our state’s most vulnerable communities,” said Sen. Menendez, a senior member of the Senate Finance Committee that sets national health policy. “This funding comes during a vital time when our country is facing a public health crisis. With this funding, FQHCs will be able to continue to serve high-quality and affordable health care services to residents who need it most.”

The following FQHCs received grants: 

  • $4,728,017 – Henry J. Austin Health Center, Inc.
  • $2,899,453 – Southern Jersey Family Medical Centers, Inc.
  • $2,692,623 – Community Health Care, Inc.
  • $2,265,948 – Zufall Health Center, Inc.
  • $2,085,380 – Newark Community Health Centers, Inc.
  • $1,552,565 – Rutgers, The State University of New Jersey
  • $1,388,501 – CAMcare Health Corporation
  • $1,279,557 – Ocean Health Initiatives, Inc.
  • $1,199,744 – Atlanticare Health Services, Inc.
  • $1,177,721 – City of Newark
  • $1,173,420 – Horizon Health Center, Inc.
  • $1,124,270 – Paterson Community Health Center, Inc.
  • $1,088,280 – Jewish Renaissance Medical Center 

In New Jersey, there are 24 Community Health Centers that operate 137 satellite sites, providing preventive and primary health care services to over a half-million New Jersey residents.


March 18, 2020: The American College of Obstetricians and Gynecologists (ACOG) posted a joint statement titled: “Joint Statement on Abortion Access During the COVID-19 Outbreak”. From the statement:

The American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology, together with the American Association of Gynecologic Laparoscopists, the American Gynecological & Obstetrical Society, the American Society for Reproductive Medicine, the Society for Academic Specialists in General Obstetrics and Gynecology, the Society of Family Planning, and the Society for Maternal-Fetal Medicine, released the following statement:

“As hospital systems, clinics, and communities prepare to meet anticipated increases in demand for the care of people with COVID-19, strategies to mitigate spread of the virus and to maximize health care resources are evolving. Some health systems, at the guidance of the CDC, are implementing plans to cancel elective and non-urgent procedures to expand hospitals’ capacity to provide critical care.

“While most abortion care is delivered in outpatient settings, in some cases care may be delivered in hospital-based settings or surgical facilities. To the extent that hospital systems or ambulatory surgical facilities are categorizing procedures that can be delayed during the COVID-19 pandemic, abortion should not be categorized as such a procedure. Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and well-being.

“The American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology, together with the American Association of Gynecologic Laparoscopists, the American Gynecological & Obstetrical Society, the American Society for Reproductive Medicine, the Society for Academic Specialists in General Obstetrics and Gynecology, the Society of Family Planning, and the Society for Maternal-Fetal Medicine, do not support COVID-19 responses that cancel or delay abortion procedures. Community-based and hospital-based clinicians should consider collaboration to ensure abortion access is not compromised during this time.”

March 18, 2020: Planned Parenthood posted a press release titled: “Latest Government Report Confirms: Global Gag Rule is Harmful and Must Be Repealed”. From the press release:

Today the U.S. Government Accountability Office (GAO) released a report confirming the unprecedented scale and devastating impact of the Trump-Pence Administration’s global gag rule, which has been well-documented by Planned Parenthood Global and other organizations. The report identifies at least 54 projects that have lost funding as a result of the policy. These projects span a wide range of countries and global health issues, including family planning/reproductive health, HIV/AIDS, tuberculosis, nutrition, and maternal and child health.  

The GAO report, issued at the request of a bicameral, bipartisan group of Congress members, follows a six-month review of the global gag rule conducted by the U.S. State Department, which was an incomplete and insufficient analysis. The State Department said they would conduct an additional review of the policy by December 2018, which has yet to be released and is over a year late…

…Since 2017, the global gag rule has prohibited foreign non-governmental organizations (including sub-partners) from receiving any U.S. global health assistance if they provide information, referrals, or services for legal abortion or advocate for the legalization of abortion in their country, even if these activities are supported solely with non-U.S. funds. The Trump administration has twice expanded this harmful policy, first to apply to all global health assistance and again by extending the gag to any funds from any source that flow through a gagged organization.

Key takeaways from the Government Accountability Office report:

1 The topline numbers in the report confirm what we already knew – the global gag rule is harming the work of hundreds of organizations in countries around the world.

  • Previous research from the Kaiser Family Foundation indicated that over 1,200 NGOs in over 60 countries would be impacted by this policy. The GAO documents over $12 billion of gagged funds applies to over 1,300 global health grants.
  • The report identifes at least 54 instances (7 prime recipient and 47 sub-recipients) where projects have lost funding as a result of the global gag rule. These projects span a wide range of countries and global health issues, including family planning/reproductive health, HIV/AIDS, tuberculosis, nutrition, and maternal and child health. The GAO did not look at agencies’ efforts to reprogram the funds associated with losing these qualified partners.

2 The loss of funding for organizations who do not comply with the gag rule disrupts access to a wide range of health service, especially for communities who already face the greatest barrier to care.

  • The report cites a few examples of non-governmental organizations (NGOs) who lost funding as a result of the policy, including: an NGO in Zimbabwe working on HIV prevention among adolescent girls and young women, an NGO in India working to provide innovative solutions to tuberculosis, an NGO in Ethiopia delivering HIV services to sex workers, and several other NGOs that were working with multiple countries to deliver family planning services integratd with other critical care, like maternal and child health and HIV services.

3 The global gag rule limits access to abortion in countries, even where it is legal and beyond the policy’s narrow exception of rape, incest, and life endangerment.

  • Previous analysis indicated more than haf of the countries receiving global health assistance allow legal abortion in at least one case not permissible under the global gag rule.
  • The GAO report highlights the problem, wherein foreign NGOs receiving any U.S. global health assistance in countries where abortion is legal are prohibited both from providing a legal health care service and from providing information or counseling about legal abortion in their own countries.

March 18, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “Joint Statement on Abortion Access During the COVID-19 Outbreak”. From the statement:

The American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology, together with the American Association of Gynecologic Laparoscopists, the American Gynecological & Obstetrical Society, the American Society for Reproductive Medicine, the Society for Academic Specialists in General Obstetrics and Gynecology, the Society of Family Planning, and the Society for Maternal-Fetal Medicine, released the following statement:

“As hospital systems, clinics, and communities prepare to meet anticipated increases in demand for the care of people with COVID-19, strategies to mitigate the spread of the virus and to maximize health care resources are evolving. Some health systems, at the guidance of the CDC, are implementing plans to cancel elective and non-urgent procedures to expand hospitals’ capacity to provide critical care.

“While most abortion care is delivered in outpatient settings, in some cases care may be delivered in hospital-based settings or surgical facilities. To the extent that hospital systems or ambulatory surgical facilities are categorizing procedures that can be delayed during the COVID-19 pandemic, abortion should not be categorized as such a procedure. Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impacts a person’s life, health, and well-being.

“The American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology, together with the American Association of Gynecologic Laparoscopists, the American Gynecological & Obstetrical Society, the American Society for Reproductive Medicine, the Society for Academic Specialists in General Obstetrics and Gynecology, the Society of Family Planning, and the Society for Maternal-Fetal Medicine, do not support COVID-19 responses that cancel or delay abortion procedures. Community-based and hospital-based clinicians should consider collaboration to ensure abortion access is not compromised during this time.”

March 18, 2020: New Hampshire Governor Chris Sununu sent a letter to Secretary of United States Health and Human Services Alex Azar and Administrator of Centers for Medicare and Medicaid Seema Verma. From the letter:

As states continue to act and find innovative solutions to help our citizens combat the COVID-19 outbreak, I ask that the United States Department of Health and Human Services allow for a special open-enrollment period for a 60-90-day period.

This action would allow individuals, especially those who are potentially most at-risk for COVID-19 to access affordable health care coverage through the federally facilitated individual insurance market place. Individuals who believe they are demonstrating symptoms of the virus will have greater confidence to get tested, seek treatment and guard against further spread if they know they have a health care plan that will cover them.

We have taken proactive steps to ensure Granite Staters are safe, healthy, and have access to health care. Earlier this month, my administration directed insurance companies to provide testing for COVID-19 without cost-sharing.

In light of this outbreak, we must take every opportunity possible to expand health care options and coverage. As such, allowing for a special open-enrollment period is a simple step that increases access to quality, affordable healthcare at a time when it is critically needed.


March 18, 2020: U.S. President Donald Trump signed H.R. 6201 – Families First Coronavirus Response Act. It became a law that same day. Here is what it took to get that law passed:

  • March 11, 2020: Reprsentative Nita Lowey (Democrat – New York District 17) introduced H.R. 6201 in the U.S. House of Representatives.
  • March 14, 2020: The U.S. House of Representatives passed the bill with 223 YEAS to 140 NAYS.

The following U.S. Representatives voted YEA. These Representatives voted to give help to Americans during the COVID-19 pandemic. They are listed by state:

  • Alabama: Alma Adams (D), Gray Palmer (R), Robert Aderholt (R), Martha Roby (R), Mo Brooks (R) Rick Crawford (R), Terri A. Sewell (D)
  • Arkansas: French Hill (R), Greg Stanton (D), Bruce Westerman (D), Steve Womack (R)
  • Arizona: Ruben Gallego (D), Tom O’Halleran (D) David Schweikert (R)
  • California: Jimmy Panetta (D), Pete Agular (D). Nancy Pelosi (D), Josh Harder (D), Nanette Barragán (D), Katie Porter (D), Karen Bass (D), Ami Bera (D), Jared Huffman (D), Harley Rouda (D), Lucille Roybal-Allard (D), Raul Ruiz (D), Ken Calvert (R), Salud Carbajal (D), Tony Cárdenas (D), Linda Sánchez (D), Jan Schakowsky (D), Adam Schiff (D), Judy Chu (D), Gilbert Ray Cisneros Jr. (D), Paul Cook (R), Luis J, Correa (D), Jim Costa (D), TJ Cox (D), Susan Davis (D), Anna G. Eshoo (D), John Garamendi (D), Jimmy Gomez (D), Ro Khanna (D), Doug LaMalfa (R), Barbara Lee (D), Ted Lieu (D), Zoe Lofgren (D), Alan Lowenthal (D), Doris Matsui (D), Jerry McNerney (D), Grace Napolitano (D), Devin Nunes (R), Scott Peters (D), Brad Sherman (D), Eric Swalwell (D), Mark Takano (D), Mike Thompson (D), Norma Torres (D), Juan Vargas (D), Maxine Waters (D)
  • Colorado: Ed Perlmutter (D), Jim Himes (D) Jason Crow (D), Diana DeGette (D), Doug Lamborn (R), Joe Neguse (D), Scott Tipton (R)
  • Connecticut: Jahana Hayes (D), Joe Courtney (D), Rosa L. DeLauro (D), Jim Himes (D), John B. Larson (D),
  • Delaware at Large: Lisa Blunt Rochester (D)
  • Florida: Alcee L. Hastings (D), Bill Posey (R), Gus M. Bilirakis (R), Vern Buchanan (R), John Rutherford (R), Cathy Castor (D), Charlie Crist (D), Val Demings (D), Ted Deutch (D), Neal Dunn (R), Lois Frankel (D), Al Larson (D), Brian Mast (R), Debbie Mucarel-Powell (D), Stephanie Murphy (R), Donna E. Shalala (D), Darren Soto (D), Ross Spano (R), Debbie Wasserman Schultz (D), Daniel Webster (R), Frederica Wilson (D)
  • Georgia: Rick Allen (R), Henry “Hank” C. Johnson Jr. (D), Buddy Carter (R), Drew A. Ferguson (R), Scott Austin (R), David Scott (D), Rossi Spano (R), Robert Woodall (R) Sanford D. Bishop Jr. (D)
  • Hawaii: Ed Case (D), Tulsi Gabbard (D),
  • Idaho: Mike Simpson (R)
  • Illinois: Mike Quigley (D), Mike Bost (R), Cheri Bustos (D), Bobby Rush (D), Sean Casten (D), Bradley Schneider (D), Robin Kelly (D), Danny K. Davis (D), Rodney Davis (R), Bill Foster (D), Jesús “Chuy” Garcia (D), Adam Kinzinger (R), Raja Krishnamoorthi (D), Darin LaHood (R), Kevin McCarthy (R), Jan Schakowsky (D), John Snimkus (R), Lauren Underwood (D)
  • Indiana: Greg Pence (R), James Baird (R), Trey Hollingsworth (R), Susan W. Brooks (R), Larry Bucshon (R), André Carson (D), Peter Visclosky (D), Jackie Walorski (R)
  • Iowa: Cynthia Axne (D), Abby Finkenauer (D), David Loebsack (D),
  • Kansas: Sharice Davids (D), Ron Estes (R), Roger Marshall (R) Steve Watkins (R)
  • Kentucky: Brett S. Guthrie (R), Andy Barr (R), Harold Rogers (R), John A. Yarmuth (D)
  • Louisiana: Garret Graves (R), Clay Higgins (R), Cedric Richmond (D), Mike Johnson (R), Steve Scalise (R)
  • Maine: Jared Golden (D)
  • Maryland: Andy Harris (R), Jaime Raskin (D), Steny H. Hoyer (D), Anthony Brown (D), C.A. Dutch Ruppersberger (D), John P. Sarbanes (D), David Trone (D)
  • Massachusetts: Ayanna Pressley (D), William Keating (D), Katherine Clark (D), Joseph P. Kennedy, III (D), Stephen F. Lynch (D), James McGovern (D), Seth Moulton (D), Richard E. Neal (D), Lori Trahan (D)
  • Michigan: Jack Bergman (R), Bill Huizenga (R), Daniel Kildee (D), Andy Levin (D), Paul Mitchell (R), John Moolenaar (R), Elissa Slotkin (D), Haley Stevens (D), Rashida Tlaib (D), Fred Upton (R), Tim Walberg (R)
  • Minnesota: Jim Hagedorm (R), Dean Phillips (D), Angie Craig (D), Betty McCollum (D), Ilhan Omar (D), Collin Peterson (D), Pete Stauber (R)
  • Mississippi: Michael Guest (R), Bennie G. Thompson (D)
  • Missouri: Sam Graves (R), Vicky Hartzler (R), William “Lacy” Clay Jr. (D), Emanuel Cleaver (D), Blaine Luekemeyer (R), Ann Wagner (R)
  • Montana at Large: Greg Gianforte (R)
  • Nebraska: Brian Bacon (R), Jeff Fortenberry (R), Adrian Smith (R)
  • Nevada: Mark Amodei (R), Steven Horsford (D), Susie Lee (D), Dina Titus (D)
  • New Hampshire: Chris Pappas (D), Ann Kuster (D)
  • New Jersey: Josh Gottheimer (D), Bill Pascrell Jr. (D), Donald Payne Jr. (D), Andy Kim (D), Tom Malinowski (D), Donald Norcross (D), Frank Pallone Jr. (D), Mikie Sherill (D), Albio Sires (D), Chris Smith (R), Jefferson Van Drew (R), Bonnie Watson Coleman (D)
  • New Mexico: Debra Haaland (D), Ben Luján (D), Xochitil Torres Small (D),
  • New York: Brian Higgins (D), Tom Reed (R), Kathleen Rice (D), Anthony Brindisi (D), Max Rose (D), Hakeem Jeffries (D), John Katko (R), Yvette D. Clarke (D), Antonio Delgato (D), Eliot Engel (D), Adriano Espaillat (D), Pete King (R), Nita Lowey (D), Carolyn B. Maloney (D), Sean Patrick Maloney (D), Gregory Meeks (D), Grace Meng (D), Jerrold Nadler (D), Alexandria Ocasio-Cortez (D), Max Rose (D), José E. Serrano (D), Ellie Stefanik (R), Thomas Suozzi (D), Paul D. Tonko (D), Nydia Velázquez (D), Lee Zeldin (R)
  • North Carolina: David Price (D), George Holding (R), Richard Hudson (R), David Rouzer (R), G.K Butterfield (D), Virginia Fox (R), Patrick McHenry (R), Mark Walker (R)
  • North Dakota (at Large): Kelly Armstrong (R)
  • Ohio: Troy Balderson (R), Joyce Beaty (D), Bill Johnson (R), Tim Ryan (D), David Joyce (R), Marcy Kaptur (D), Steve Chabot (R), Marcia L. Fudge (D), Bob Gibbs (R), Anthony Gonzalez (R), Robert E. Latta (R) , Steve Stivers (R), Michael Turner (R), Brad Wenstrup (R)
  • Oklahoma: Kendra Horn (R) Tom Cole (R), Frank Lucas (R)
  • Oregon: Earl Blumenauer (D), Suzanne Bonamici (D), Kurt Schrader (D), Peter DeFazio (D), Greg Walden (R)
  • Pennsylvania: Scott Perry (D), Guy Reschenthaler (R), Brendan Boyle (D), Chrissy Houlahan (D), John Joyce (R), Matt Cartwright (D), Mary Scanlon (D), Fred Keller (R), Madeleine Dean (D) Michael F. Doyle (D), Mike Kelly (R), Conor Lamb (D), Daniel Meuser (R), Lloyd Smucker (R), Glenn Thompson (R), Susan Wild (D)
  • Rhode Island: David Ciciline (D), Dwight Evans (D), Brian Fitzpatrick (R)
  • South Carolina: Tom Rice (R), James E. Clyburn (D), Joe Cunningham (D), Jim Langevin (D),
  • South Dakota at Large: Dusty Johnson (R)
  • Tennessee: Phil Roe (R), Steve Cohen (D), Jim Cooper (D), David Kustoff (R)
  • Texas: Kay Granger (R), Collin Allred (D). Al Green (D), Jodey Arrington (R), Kevin Brady (R), Will Hurd (R), Shelia Jackson Lee (D), Michael Burgess (R), Eddie Bernice Johnson (D), John Carter (R), Joaquin Castro (D) Michael K. Conaway (R), Dan Crenshaw (R), Henry Cuellar (D), Lloyd Doggett (D), Veronica Escobar (D), Lizzie Fletcher (D), Bill Flores (R), Sylvia Garcia (D), Vicente Gonzalez (D), Michael McCaul (R), Van Taylor (R), Mac Thornberry (R), Marci Veasey (D), Filemon Vela (D), Roger Wiliams (R), Ron Wight (R)
  • Utah: John R. Curtis (R), Lucy McBath (D), Chris Steward (R)
  • Vermont at Large: Peter Welch (D)
  • Virginia: Morgan Griffith (R), Denver Riggleman (R), Gerald “Gerry” E. Conaway (R), Elaine Luria (D), Donald McEachin (D), David Schweikert (R), Abigail Spanberger (D), Jennifer Wexton (D) Robert Whittman (R)
  • Washington: Denny Heck (D), Jaime Hererra Beulter (R), Pramila Jayapal (D), Suzan DelBene (D), Derek Kilmer (D), Ron Kind (D), Dan Newhouse (R), Cathy McMorris Rogers (R), Kim Schrer (D), Adam Smith (D)
  • West Virginia: David McKinley (R), Carol Miller (R)
  • Wyoming at Large: Liz Cheyney (R)
  • Wisconsin: Mark Pocan (R), Rick Larsen (D), Gwen Moore (D)

The following U.S. Representatives voted NAY. These Representatives voted against helping Americans to survive during the COVID-19 pandemic. They are listed by state:

  • Alabama: Bradley Byrne (R)
  • Arizona: Andy Biggs (R), Debbie Lesko (R),
  • California: Tom McClintock (R)
  • Colorado: Ken Buck (R)
  • Florida: Gregory W. Stube (R), Michael Waltz (R)
  • Georgia: Jody Hice (R), Berry Loudermilk (R)
  • Idaho: Russi Fulcher (R)
  • Iowa: Steve King (R)
  • Indiana: Jim Banks (R)
  • Minnesota: Tom Emmer (R)
  • Missouri: Billy Long (R), Jason Smith (R)
  • North Carolina: Dan Bishop (R), Ted Budd (R)
  • Ohio: Warren Davidson (R), Jim Jordan (R)
  • Oklahoma: Kevin Hern (R)
  • South Carolina: Jeff Duncan (R), Ralph Norman (R), William Timmons (R), Joe Wilson (R)
  • Tennessee: Tim Burchett (R), Scott DesJarlais (R), Mark Green (R), John W. Rose (R)
  • Texas: Brian Babin (R), Michael Cloud (R), Louis Gohmert (R), Lance Gooden (R), Chip Roy (R) Randy Webber (R)
  • Virginia: Ben Cline (R)
  • West Virginia: Alex Mooney (R)
  • Wisconsin: Mike Gallagher (R), Glen Grothman (R), James F. Sensenbrenner (R), Bryan Steil (R)

The following Representatives did not vote at all. They are listed by state:

  • Alabama: Mike Rogers (R)
  • Alaska at Large: Don Young (R)
  • Arizona: Paul A. Gosar (R), Raul Grijalva (D), Ann Kirkpatrick (D)
  • California: Julia Brownley (D), Mark DeSaulnier (D), Jackie Speier (D)
  • Florida: Matt Gaetz (R), Francis Rooney (R), Ted Yoho (R)
  • Georgia: Rob Bishop (R), Tom Graves (R), John Lewis (D) – stage 5 pancreatic cancer
  • Illinois: Daniel Lipinski (D)
  • Kentucky: Thomas Massie (R)
  • Maine: Chellie Pingree (D)
  • Michigan: Justin Amash (L) – answered “present”
  • Mississippi: Mike Kelly (R), Steven Palazzo (R)
  • Oklahoma: Markwayne Mulin (R)
  • North Carolina: Mark Meadows (R) – resigned from Congress on March 31, 2020.
  • Texas: Kenny Marchant (R), Pete Olsen (R), John Ratcliffe (R), John Ratcliffe (R)
  • Virginia: Don Beyer (R)

On March 18, 2020, some Senators attempted to attach Amendments to the Families First Coronavirus Response Act.

S. Amend, 1556 was sponsored by Senator Rand Paul (R – Kentucky). The purpose of this amendment was: To amend the Internal Revenue Code of 1986 to require a social security number for purposes of the child tax credit, to provide the President with the authority to transfer funds as necessary, and to terminate United States military operations and reconstruction activities in Afghanistan.

The Senate voted 3 YEAS to 95 NAYS on S. Amend 1556. It needed a 3/5 majority in order to pass (60 YEA votes). It did not pass, and was not added to the Families First Coronavirus Response Act.

The Senators who voted YEA were: Mike Brown (R-Kentucky), Mike Lee (R-Utah) and Rand Paul (R-Kentucky).

The Senators who did not vote were: Cory Gardner (R-Colorado) and Tim Scott (R-South Carolina)

S Amdt 1557 was sponsored by Senator John Kennedy (R- Louisiana). The purpose of this amendment was for making emergency supplemental appropriations for the fiscal year ending September 30, 2020, and for other purposes. It was ordered to lie on the table.

This amendment is in regards to the SPR Petroleum Account. It said: For an additional amount for the SPR Petroleum Account established under section 167 (a) of the Energy policy and Conservation Act (42 U.S.C. 6247 (a)), $3,000,000,000, to be derived by transfer from the amounts provided by section 129 (a) of the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009… to remain available until September 30, 2020.

This amendment was not voted on, and therefore, did not become part of the Families First Coronavirus Response Act.

S.Amdt. 1558 was sponsored by Senator Ron Johnson (R-Wisconsin). It was co-sponsored by Patrick J. Toomey (R-Pennsylvania), Mike Braun (R-Indiana), Rick Scott (R-Florida), Mike Lee (R-Utah), Marsha Blackburn (R-Tennessee), Tom Cotton (R-Arizona), Ted Cruz (R-Texas), Kelly Loeffler (R-Georgia), David Perdue (R-Indiana), Ben Sasse (R-Nebraska), and John Barasso (R-Wyoming).

The purpose of this amendment was to strike Federally mandated sick pay and paid family leave from the Families First Coronavirus Response Act, and replace it with financial support through the State administered unemployment insurance systems and funds.

This amendment recieved 50 YEAS and 48 NAYS. It needed to get a 3/5 majority in order to pass (60 YEAS). The amendment did not pass, and was not included in the Families First Coronavirus Response Act.

All 45 Democrats voted NAY on this amendment. Both Independent Senators voted NAY. 50 Republicans voted YEA.

Two Senators did not vote: Cory Gardner (R-Colorado), and Rick Scott (R-Florida) – who was one of the co-sponsors of the amendment.

S. Amdt. 1559 was sponsored by Senator Patty Murray (D-Washington). It was co-sponsored by Kirsten E. Gillibrand (D-New York), and Kamala Harris (D-California).

The purpose of this amendment was to provide Americans with paid sick time and paid leave so that they can address their own health needs and the needs of their families.

This amendment recieved 47 YEAS to 51 NAYS. It needed to get a 3/5 majority of YEA votes in order to pass (60 YEAS). It did not pass and was not included in the Families First Coronavirus Response Act.

All 45 Democrats, and both Independants, voted YEA on this amendment. 51 Republicans voted NAY.

Two Senators did not vote: Cory Gardner (R-Colorado), and Rick Scott (R-Florida)

S.Amdt 1560 was sponsored by Jerry Moran (R-Kansas). The purpose of this amendment was to provide coverage for allergy diagnostic testing services under Medicare and Medicaid. This amendment was ordered to lie on the table and was not voted on.

On March 18, 2020, the U.S. Senate passed the Families First Coronavirus Response Act with 90 YEAS to 8 NAYS.

The following U.S. Senators voted YEA. These Representatives voted to give help to Americans during the COVID-19 pandemic. They are listed by state:

  • Alabama: Doug Jones (D), Richard Shelby (R)
  • Alaska: Lisa Murkowski (R), Dan Sullivan (R)
  • Arizona: Martha McSally (R), Krysten Simena (D)
  • Arkansas: John Boozman (R), Tom Cotton (R)
  • California: Dianne Feinstein (D), Kamala Harris (D)
  • Colorado: Michael F. Bennet (D)
  • Connecticut: Richard Blumenthal (D), Christopher Murphy (D)
  • Delaware: Benjamin L. Carper (D), Christopher A. Coons (D)
  • Florida: Marco Rubio (R)
  • Georgia: Kelly Loeffler (R), David Perdue (R)
  • Hawaii: Mazie K. Hirono (D), Brian Schatz (D)
  • Idaho: Mike Crapo (R), James E. Risch (R)
  • Illinois: Tammy Duckworth (D), Richard J. Durbin (D)
  • Indiana: Mike Braun (R), Todd Young (R)
  • Iowa: Joni Ernst (R), Chuck Grassley (R)
  • Kansas: Jerry Moran (R), Pat Roberts (R)
  • Kentucky: Mitch McConnell (R),
  • Louisiana: Bill Cassidy (R), John Kennedy (R)
  • Maine: Susan M. Collins (R), Angus S. King Jr. (I)
  • Maryland: Benjamin L. Cardin (D), Chris Van Hollen (D)
  • Massachusetts: Edward J. Markey (D), Elizabeth Markey (D)
  • Michigan: Gary C. Peters (D), Debbie Stabenow (D)
  • Minnesota: Amy Klobuchar (D), Tina Smith (D)
  • Mississippi: Cindy Hyde-Smith (R), Roger F. Wicker (R)
  • Missouri: Roy Blunt (R), Josh Hawley (R)
  • Montana: Steve Daines (R), Jon Tester (D)
  • Nebraska: Deb Fischer (R),
  • Nevada: Catherine Cortez-Masto (D), Jacky Rosen (D)
  • New Hampshire: Margaret Wood Hassan (D), Jeanne Shaheen (D)
  • New Jersey: Cory Booker (D), Robert Menendez (D)
  • New Mexico: Martin Heinrich (D), Tom Udall (D)
  • New York: Kirsten E. Gillibrand (D), Charles E. Shumer (D)
  • North Carolina: Richard Burr (R), Thom Tillis (R)
  • North Dakota: Kevin Cramer (R), John Hoeven (R)
  • Ohio: Sherrod Brown (D), Rob Portman (R)
  • Oklahoma: James Lankford (R)
  • Oregon: Jeff Merkey (D), Ron Wyden (R)
  • Pensylvania: Robert P. Casey Jr. (D), Patrick J. Toomey (R)
  • Rhode Island: Jack Reed (D), Sheldon Whitehouse (D)
  • South Carolina: Lindsey Graham (R), Tim Scott (R)
  • South Dakota: Mike Rounds (R), John Thune (R)
  • Tennessee: Lamar Alexander (R),
  • Texas: John Cornyn (R), Ted Cruz (R)
  • Utah: Mitt Romney (R)
  • Vermont: Patrick J. Leahy (D), Bernard Sanders (I)
  • Virginia: Tim Kaine (D), Mark R. Warner (D)
  • Washington: Maria Cantwell (D), Patty Murray (D)
  • West Virginia: Shelley Moore Capito (R), Joe Manchin, III (D)
  • Wisconsin: Tammy Baldwin (D)

The following U.S. Senators voted NAY. These Senators voted not to give help to Americans during the COVID-19 pandemic. They are listed by state:

  • Kentucky: Rand Paul (R)
  • Nebraska: Ben Sasse (R)
  • Oklahoma: James M. Inhofe (R)
  • Tennessee: Marsha Blackburn (R)
  • Utah: Mike Lee (R)
  • Wisconsin: Ron Johnson, (R)

Cory Gardner (R- Colorado) and Rick Scott (R-Florida) did not vote.

March 18, 2020: The bill was sent to President Trump, who signed it. The Families First Coronavirus Response Act became a law.

Here is a summary of H.R. 6201 – Families First Coronavirus Response Act:

This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak by providing paid sick leave, tax credits, and free COVID-19 testing; expanding food assistance and unemployment benefits; and increasing Medicaid funding.

DIVISION A–SECOND CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020

Second Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020

This division provides FY2020 supplemental appropriations for federal agencies to respond to the COVID-19 outbreak.

The supplemental appropriations are designated as emergency spending, which is exempt from discretionary spending limits.

TITLE I–DEPARTMENT OF AGRICULTURE

This title provides appropriations to the Department of Agriculture (USDA) for

  • the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and
  • the Emergency Food Assistance Program (TEFAP).

(Sec. 1101) This section allows USDA to approve state plans to provide emergency Supplemental Nutrition Assistance Program (SNAP, formerly known as the food stamp program) benefits to households with children who would otherwise receive free or reduced-price school meals if their schools were not closed due to the COVID-19 public health emergency. The child’s school must be closed for at least five consecutive days for the household to be eligible for benefits. States may provide the benefits using the Electronic Benefit Transfer system.

(Sec. 1102) This section provides appropriations to USDA for grants to the Northern Mariana Islands, Puerto Rico, and American Samoa for nutrition assistance in response to a COVID-19 public health emergency.

TITLE II–DEPARTMENT OF DEFENSE

This title provides appropriations to the Defense Health Program for COVID-19 diagnostic testing and services.

TITLE III–DEPARTMENT OF THE TREASURY

This title provides appropriations to the Internal Revenue Service to implement the tax credits included in this bill.

TITLE IV–DEPARTMENT OF HEALTH AND HUMAN SERVICES

This title provides appropriations to the Indian Health Service for COVID-19 diagnostic testing and services.

TITLE V–DEPARTMENT OF HEALTH AND HUMAN SERVICES

This title provides appropriations to the Administration for Community Living for nutrition programs that assist the elderly.

The title also provides appropriations to the Public Health and Social Services Emergency Fund. The funds are provided for the National Disaster Medical System to reimburse the costs of providing COVID-19 diagnostic testing and services to individuals without health insurance.

TITLE VI–DEPARTMENT OF VETERANS AFFAIRS

This title provides appropriations to the Veterans Health Administration for COVID-19 diagnostic testing and services.

TITLE VII–GENERAL PROVISIONS–THIS ACT

(Sec. 1701) This section requires agencies that receive funding in this division to report to Congress regarding the anticipated uses of the funds.

(Sec. 1702) This section requires state and local governments that receive funding or assistance in this division to ensure that (1) the respective State Emergency Operations Center receives regular and real-time reporting on aggregated data on testing and results from state and local public health departments, and (2) the data is transmitted to the Centers for Disease Control and Prevention.

(Sec. 1703) This section specifies that the funds provided by this division are in addition to funds otherwise appropriated for the fiscal year involved.

(Sec. 1704) Funds provided by this division may not remain available beyond the current fiscal year, unless this division provides otherwise.

(Sec. 1705) Unless otherwise specified by this division, the funds provided by this division are subject to the authorities and conditions that apply to the applicable appropriations account for FY2020.

(Sec. 1706) This section provides that amounts designated by this division as emergency requirements are only available (or rescinded, if applicable) if the President subsequently designates the amounts and transmits the designations to Congress.

(Sec. 1707) This section specifies that the emergency funds that are transferred pursuant to this division retain the emergency designation.

DIVISION B–NUTRITION WAIVERS

This division expands food and nutrition programs of the Department of Agriculture (USDA) due to COVID-19.

TITLE I–MAINTAINING ESSENTIAL ACCESS TO LUNCH FOR STUDENTS ACT

Maintaining Essential Access to Lunch for Students Act or the MEALS Act

(Sec. 2102) This title modifies USDA food and nutrition programs to allow certain waivers of requirements for the school meal programs, including waivers that increase federal costs during a COVID-19-related school closure. Such waivers must be requested by a state or service provider and be for purposes of providing meals and snacks during such a closure.

TITLE II–COVID-19 CHILD NUTRITION RESPONSE ACT

COVID-19 Child Nutrition Response Act

(Sec. 2202) This section authorizes USDA to

  • issue a single waiver of child nutrition program requirements to all states under the National School Lunch Program for purposes of providing meals and snacks with appropriate safety measures with respect to COVID-19,
  • grant waivers of requirements to allow non-congregate feeding in the Child and Adult Care Food Program for purposes of providing meals and snacks with appropriate safety measures with respect to COVID-19, and
  • grant waivers related to the nutritional content of meals served in child nutrition programs if it determines the waiver is necessary to provide meals and snacks and there is a food supply chain disruption due to COVID-19.

(Sec. 2203) USDA may

  • grant waivers allowing participants under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to get certified or recertified without being physically present at a WIC clinic, and
  • defer anthropometric and bloodwork requirements necessary to determine nutritional risk.

State agencies must submit waiver requests to USDA.

(Sec. 2204) USDA may also grant waivers from administrative requirements for WIC if it determines that (1) the requirement cannot be met by a state due to COVID-19, and (2) the waiver is necessary to provide assistance under WIC.

TITLE III–SNAP WAIVERS

(Sec. 2301) This section temporarily suspends work requirements under the Supplemental Nutrition Assistance Program (SNAP, formerly known as the food stamp program) during a public health emergency declaration due to COVID-19, allowing participants who would have lost eligibility due to such requirements to continue to receive SNAP benefits.

(Sec. 2302) This section provides for emergency SNAP benefits during a public health emergency declaration due to COVID-19.

States may request waivers from USDA to provide emergency allotments to households participating in SNAP to address temporary food needs not greater than the applicable maximum monthly allotment for the household size. State requests must be supported with sufficient data.

USDA may adjust (through guidance or based on states’ requests) administrative requirements such as issuance methods and reporting requirements to be consistent with what is practicable under actual conditions in affected areas.

DIVISION C–EMERGENCY FAMILY AND MEDICAL LEAVE EXPANSION ACT

Emergency Family and Medical Leave Expansion Act

(Sec. 3102) This section permits employees to take public health emergency leave through December 31, 2020, to care for the employee’s child during a COVID-19 (i.e., coronavirus disease 2019) public-health emergency. Specifically, employers of fewer than 500 workers must provide up to 12 weeks paid leave for an employee who cannot work because the school or child-care provider of that employee’s child is closed as a result of a public-health emergency.

Employers are not required to pay employees for the first 10 days of such public health emergency leave. However, an employee may use accrued paid leave during such time. After the first 10 days, employers must pay not less than two-thirds of an employee’s regular pay for the number of hours per week the employee normally works. The maximum amount of compensation for such leave is $200 per day and $10,000 in aggregate.

Further, employers are generally required to restore an employee’s former position following the use of public health emergency leave unless, the employer (1) has fewer than 25 workers and (2) has made reasonable efforts to retain the employee’s position but such position no longer exists due to economic conditions caused by such public health emergency.

With a finding of good cause, the Department of Labor may (1) exclude certain health care providers and emergency responders from eligibility for public health emergency leave, and (2) exempt employers with fewer than 50 employees if the requirements of this section would place the viability of that business at risk.

(Sec. 3103) Employers subject to multiemployer bargaining agreements may make contributions to a multiemployer fund to fulfill the employer’s obligations under this division and employees may secure compensation from such fund for leave taken subject to this division.

(Sec. 3104) Employers with fewer than 50 employees for each working day during each of at least 20 workweeks during the preceding year are not subject to civil liability for a violation of this division.

(Sec. 3105) Employers of health care providers or emergency responders may exclude employees from the requirements of this division.

(Sec. 3106) This division takes effect not later than 15 days after enactment.

DIVISION D–EMERGENCY UNEMPLOYMENT INSURANCE STABILIZATION AND ACCESS ACT OF 2020

Emergency Unemployment Insurance Stabilization and Access Act of 2020

(Sec. 4102) This section funds emergency grants for FY2020 to administer unemployment programs in states meeting certain requirements. The amount of available funds for each state is based on the Department of Labor’s determination of the proportion of the total taxable wages attributable to a state during the preceding year. Each state receives 50% of such determined amount if the state

  • requires employers to notify employees about the availability of unemployment compensation at the time the employee separates from an employer;
  • ensures that unemployment applications are available through at least two of three methods: in-person, by phone, or online; and
  • provides assistance with processing unemployment applications.

Additionally, a state receives the remaining 50% of such funds if, among other requirements

  • the number of unemployment claims in the state has increased by at least 10% compared with the same quarter during the previous year; and
  • the state demonstrates policies to increase access to unemployment compensation such as waiving the requirement to search for work and the one-week waiting period to receive benefits, among others.

(Sec. 4103) This section suspends the accrual of interest through December 31, 2020, on federal payments made to states for assistance with unemployment compensation.

(Sec. 4104) Labor must assist states in raising public awareness about available short-time compensation programs and provide technical assistance and guidance for such programs.

(Sec. 4105) This section increases to 100% the federal share of payments to states for extended and regular unemployment compensation through December 31, 2020.

DIVISION E–EMERGENCY PAID SICK LEAVE ACT

Emergency Paid Sick Leave Act

(Sec. 5102) This section requires employers to provide paid sick time to employees who are unable to work due to the effects of COVID-19 (i.e., coronavirus disease 2019). Specifically, full-time employees are entitled to 80 hours of paid sick time, which is available immediately, for use if the employee

  • is subject to a governmental quarantine or isolation order,
  • has been advised by a health-care provider to self-quarantine,
  • is caring for an individual who is subject to governmental or self-quarantine,
  • is caring for the employee’s child because the child’s school or child-care provider is closed, or
  • is experiencing a substantially similar circumstance related to COVID-19 as specified by the Department of Health and Human Services, in consultation with the Department of Labor.

Paid sick time under this section may be used before other paid leave that may be available to an employee. Part-time employees are entitled to such paid sick time for the average number of hours the part-time employee works during an average two-week period. Paid sick time under this section may not carry over from one year to the next.

(Sec. 5103) Employers must provide conspicuous notice in the workplace of the emergency paid sick time requirements under this division and Labor must provide publicly-available models of such notice not later than seven days after the enactment of this division.

(Sec. 5104) Employers are prohibited from taking adverse actions against employees who take leave under this division or take actions to enforce the requirements of this division.

(Sec. 5105) Employers who violate the emergency paid sick time requirements are subject to fines and imprisonment pursuant to the Fair Labor Standards Act of 1938.

(Sec. 5106) Employers subject to multiemployer bargaining agreements may make contributions to a multiemployer fund to fulfill the employer’s obligations under this division and employees may secure compensation from such fund for emergency paid sick time used subject to this division.

(Sec. 5107) This division does not affect employer rights or benefits under any other law, collective bargaining agreement, or existing employer policy. Employers are not required to pay employees for unused emergency paid sick time if an employee resigns, retires, or is terminated.

(Sec. 5108) The emergency paid sick time requirements take effect not later than 15 days after the enactment of this division.

(Sec. 5109) The emergency paid sick time requirements expire on December 31, 2020.

(Sec. 5110) Employers with fewer than 500 employees and federal, state, and local public agencies are subject to the requirements of this division. Employers must pay the regular rate of pay up to

  • $511 per day, and $5,110 in aggregate, for paid sick time used by an employee who experiences symptoms of COVID-19 or is required or advised to self-quarantine; or
  • $200 per day, and $2,000 in aggregate, for paid sick time used by an employee to care for the employee’s child or other impacted person.

(Sec. 5111) With a finding of good cause, Labor may (1) exclude certain health care providers and emergency responders from eligibility for emergency paid sick leave, and (2) exempt employers with fewer than 50 employees if the requirements of this division would place the viability of that business at risk.

DIVISION F–HEALTH PROVISIONS

(Sec. 6001) This section requires private health insurance to cover testing for COVID-19 without imposing cost-sharing (e.g., deductibles, coinsurance, or copayments) for the duration of the public health emergency declared on January 31, 2020. This coverage includes the cost of administering such approved tests and related visits to health care providers.

(Sec. 6002) This section requires Medicare to cover, without cost-sharing, visits to health care providers that relate to COVID-19 testing during the public health emergency.

(Sec. 6003) Medicare Advantage (MA) plans must also cover COVID-19 testing and related visits without cost-sharing during the public health emergency. MA plans are also prohibited from instituting prior authorization or other utilization management requirements with respect to coverage of such services.

(Sec. 6004) Additionally, COVID-19 testing and related visits must be covered without cost-sharing under the Children’s Health Insurance Program (CHIP) and Medicaid during the public health emergency.

State Medicaid programs may also cover COVID-19 testing and related visits for uninsured individuals during this period. The section applies a 100% Federal Medical Assistance Percentage (FMAP) to such coverage.

(Sec. 6005) This section extends targeted liability protection to certain manufacturers, distributors, prescribers, and users of approved respiratory protective devices that are (1) subject to specified emergency use authorizations; and (2) used during the period beginning on January 27, 2020, and ending on October 1, 2024. (Emergency use authorizations allow for the use of unapproved drugs, biological products, or devices, or for the unapproved use of such products, to respond to a declared emergency.)

(Sec. 6006) During the emergency period, the Department of Defense (i.e., TRICARE) and Department of Veterans Affairs are also prohibited from requiring cost-sharing for COVID-19 testing and related visits. Additionally, individuals in civil service (i.e., all appointive positions in the executive, judicial, and legislative branches, excluding the uniformed services) who are enrolled in a health benefits plan shall not be subject to cost-sharing requirements for such services.

(Sec. 6007) This section requires the Department of Health and Human Services to cover, during the public health emergency and without cost-sharing, COVID-19 testing and related visits for Native Americans, including Alaska Natives, who receive health services through the Indian Health Service (IHS), regardless of whether the COVID-19 services are covered under IHS.

(Sec. 6008) This section increases the Medicaid FMAP for all states and U.S. territories during the public health emergency, in accordance with specified conditions. For example, in order to receive the increased FMAP, a state Medicaid program may not require standards for eligibility that are more restrictive than the standards that were in effect on January 1, 2020.

(Sec. 6009) This section increases Medicaid funding for U.S. territories for FY2020-FY2021.

DIVISION G–TAX CREDITS FOR PAID SICK AND PAID FAMILY AND MEDICAL LEAVE

(Sec. 7001) This section allows a credit against payroll taxes for 100% of the employer-paid qualified sick leave wages paid each calendar quarter, subject to specified limitation. The amount of sick leave wages taken into account for purposes of the credit may not exceed $200 for any employee ($511 per day employees as defined under the Emergency Paid Sick Leave Act) and the aggregate number of days taken into account is limited to 10, over the number of days taken into account for preceding calendar quarters.

Transfers from the general fund of the Treasury are authorized to cover reductions in revenue resulting from this credit.

(Sec. 7002) This section allows a refundable income tax credit for 100% of sick leave amounts of self-employed individuals under the Emergency Paid Sick Leave Act. For other employees, the credit percentage is 67.

Self-employed individuals must maintain documentation prescribed by the Internal Revenue Service to establish eligibility for the credit.

(Sec. 7003) This section allows an employer a 100% payroll tax credit for qualified family leave wages paid by such employer for each calendar quarter. The amount of qualified family leave wages that may be taken into account for each employee is limited to $200 per day and $10,000 for all calendar quarters.

Transfers from the general fund of the Treasury are authorized to cover reductions in revenue resulting from this credit.

(Sec. 7004) This section allows a refundable income tax credit for 100% of the qualified family leave amounts of self-employed individuals, subject to a specified formula for determining the leave amounts.

Self-employed individuals must maintain documentation prescribed by the Internal Revenue Service to establish eligibility for the credit.

(Sec. 7005) This section provides that wages required to be paid to employees under the Emergency Paid Sick Leave Act and the Emergency Family and Medical Leave Expansion Act shall not be considered wages for purposes of the Federal Insurance Contributions Act (FICA). Transfers to specified Social Security trust funds are authorized to cover reductions in revenues.

DIVISION H–BUDGETARY EFFECTS

(Sec. 8001) This section exempts the budgetary effects of division B and each succeeding division of this bill from (1) the Statutory Pay-As-You-Go (PAYGO) Act of 2010, (2) the Senate PAYGO rule, and (3) certain budget scorekeeping rules.


March 18, 2020: New Hampshire Governor Chris Sununu sent a letter to Secretary of United States Health and Human Services Alex Azar and Administrator of Centers for Medicare and Medicaid Seema Verma. From the letter:

As states continue to act and find innovative solutions to help our citizens combat the COVID-19 outbreak, I ask that the United States Department of Health and Human Services allow for a special open-enrollment period for a 60-90-day period.

This action would allow individuals, especially those who are potentially most at-risk for COVID-19 to access affordable health care coverage through the federally facilitated individual insurance market place. Individuals who believe they are demonstrating symptoms of the virus will have greater confidence to get tested, seek treatment and guard against further spread if they know they have a health care plan that will cover them.

We have taken proactive steps to ensure Granite Staters are safe, healthy, and have access to health care. Earlier this month, my administration directed insurance companies to provide testing for COVID-19 without cost-sharing.

In light of this outbreak, we must take every opportunity possible to expand health care options and coverage. As such, allowing for a special open-enrollment period is a simple step that increases access to quality, affordable healthcare at a time when it is critically needed.


March 19, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Joins 18 Attorneys General Calling on Trump Administration to Halt Implementation of its Public Charge Rule Which Could Undermine COVID-19 Response”. From the press release:

California Attorney General Xavier Becerra joined a coalition of 18 attorneys general calling on Acting Deputy Secretary of the Department of Homeland Security Ken Cuccinelli, for a second time, to halt implementation of its “Public Charge” Rule while the COVID-19 outbreak and response are ongoing. Cuccinelli is a member of the White House coronavirus task force.  

The rule unnecessarily targets working immigrants and their families by turning the use of critical health, nutrition, and housing programs that supplement their modest incomes into barriers to lawful admission to the United States. The letter by the attorneys general asks the Administration to halt the policy which discourages people from accessing healthcare they are entitled to in the midst of a public health crisis. The federal government’s own analysis predicted that the new Public Charge policy would increase the spread of infectious diseases.    

“To protect all our families facing the unprecedented public health threat of the coronavirus, we are calling on DHS to halt implementation of its Public Charge Rule,” said Attorney General Becerra. “This is not the time to discourage any of our neighbors, coworkers, or the community-at-large from complying with protective measures needed to prevent and contain the coronavirus. It is not just prudent but imperative that our immigrant neighbors who live and work among us not fear participating with us in those protective measures.”

Attorney General Becerra has raised concerns about the Trump Administration’s proposed Public Charge Rule from the beginning. Last year, he detailed how the rule would negatively impact California’s public health, social services, housing, educational programs, and economy. Shortly afterward, the Attorney General filed a lawsuit asserting that the rule would have a chilling effect that would discourage many immigrants, who are not otherwise subject to the rule, from accessing benefits that they need. The Attorney General also filed a motion for a preliminary injunction to halt the rule’s implementation. California’s case is currently before the U.S. Court of Appeals for the Ninth Circuit. 

A copy of the letter is available here.

March 19, 2020: Alliance of Community Health Plans (ACHP) posted a letter titled: “Special Enrollment Period During COVID-19 National Emergency”. The letter was sent to Centers for Medicare & Medicaid Administrator Seema Verma. From the letter:

…We appreciate the Center for Medicare and Medicaid Services (CMS) working with the Alliance of Community Health Plans (ACHP) and our member organizations at this time of national emergency. Our member plans have deep roots in the communities they serve giving them insight into immediate needs and concerns.

Given an increasing and urgent demand on our health care infrastructure, ACHP urges the Administration to establish a Special Enrollment Period during the COVID-19 National Emergency to be applicable to all Affordable Care Act Marketplace coverage. The nearly 30 million uninsured Americans and estimated 44 million underinsured should have the ability to enroll in health are coverage during a time of high anxiety and uncertainty. These individuals face two options: go untreated and risk spreading the virus or face unmanagable medical bills. As we see small businesses temporarily – or permanently – shuttering, the need for a health care safety net will be even more necessary in the coming weeks and months. Already, our members are hearing from small businesses contemplating dropping employee coverage as they face drastic reductions in revenue.

ACHP believes that a Special Enrollment Period during the COVID-19 National Emergency is an appropriate next step following the declaration of COVID-19 as a National Emergency on March 13, 2020. Maryland, Washington, New York, Connecticut and Massachusetts have already declared Special Enrollment Periods to address coverage needs within their states. Individuals nationwide should be afforded the same opportunity. There is precedent for HHS declaring a Special Enrollment Period during an emergency. In 2017 and 2019, HHS established a Special Enrollment Period for affected individuals following devistating hurricanes (Irma, Maria, Nate, Harvey and Dorian).

A Special Enrollment Period would offer much needed coverage to millions of Americans and mitigate the potential impact on providers and hospitals which will be forced to rely on emergency funding, an especially dire scenario for rural providers and hospitals.

ACHP appreciates the Administration’s recent flexibilities around telehealth benefits and services. Given these flexibilities, increased health care coverage would mean fewer people seeking care in brick and mortar institutions and more people being directed to telehealth services. ACHP strongly recommends the Administration move forward with this proposal to augment the process already made, continue our national efforts to flatten the curve and ensure all American’s have access to care and coverage in this uncertain time. We look forward to closely collaborating with the Administration and responding to this crisis…

March 19, 2020: Senator Kamala Harris posted a press release titled: “Harris, Senate Democrats Condemn Trump Administration on Approval of Texas Medicaid Waiver that Limits Women’s Choice of Health Care Provider”. From the press release:

U.S. Senator Kamala D. Harris (D-CA) on Wednesday joined Senators Ron Wyden, (D-OR) and Patty Murray, (D-WA), and 30 of their Senate colleagues in condemning the Trump administration’s decision to approve a Medicaid waiver request submitted by Texas that allows the state to receive federal funding while excluding providers like Planned Parenthood from their family planning program.

In a letter addressed to Center for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the senators wrote, “Texas women should be able to depend on access to all qualified providers so they can get the family planning services and preventive care they need. CMS’s approval is in violation of Congressional intent and federal law and must be withdrawn.”

The senators also highlighted that after the Obama administration declined to approve a similar request from Texas in 2013, Texas decided to forgo federal support moving forward with the discriminatory program. Following that decision women in Texas experienced worsening health outcomes and access to health services. Despite recent evidence, Trump’s CMS approved the Medicaid waiver request for Texas earlier this year.

“Unfortunately, instead of working to address the poor health outcomes that have arisen from restricting beneficiaries’ choice of qualified provider in Texas, CMS has now approved Texas’s request … to operate its family planning program without applying Medicaid’s longstanding guarantee allowing women to choose their own family planning provider and significantly restricting providers available to beneficiaries of the program,” the senators continued 

The approval of the waiver, the senators argue, “[is] clearly part of this Administration’s ongoing efforts to undermine access to family planning providers, including Planned Parenthood, and advance ideological goals without concern for the health and well-being of women across the country … with the ultimate goal of making legal abortion services unavailable in states such as Texas.”

Joining Harris, Wyden, and Murray on the letter are U.S. Senators Sherrod Brown (D-OH), Bob Menendez (D-NJ), Jeanne Shaheen (D-NH), Ben Cardin (D-MD), Ed Markey (D-MA), Tammy Baldwin (D-WI), Jacky Rosen (D-NV), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Chris Van Hollen (D-MD), Cory Booker (D-NJ), Jon Tester (D-MT), Patrick Leahy (D-VT), Jeff Merkley (D-OR), Elizabeth Warren (D-MA), Mazie Hirono (D-HI), Maria Cantwell (D-WA), Catherine Cortez Masto (D-NV), Bernie Sanders (I-VT), Tom Carper (D-DE), Amy Klobuchar (D-MN), Debbie Stabenow (D-MI), Maggie Hassan (D-NH), Tina Smith (D-MN), Tim Kaine (D-VA), Michael Bennet (D-CO), Chris Murphy (D-CT), and Dianne Feinstein (D-CA).

A copy of the letter is available here.


March 20, 2020: New York Attorney General Letitia James posted a press release title: “Attorney General James Implores Trump Admin. to Halt Implementation of Public Charge Rule During Coronavirus Pandemic”. From the press release:

New York Attorney General Letitia James and a coalition of 17 additional attorneys general from around the nation have called on the Trump Administration to delay implementation of its Public Charge Rule as the coronavirus disease 2019 (COVID-19) progresses nationwide. The Public Charge Rule drives immigrants and their families away from accessing the health benefits to which they are entitled by threatening their eligibility for green cards and visas. As the coronavirus spreads across the country, immigrants should be encouraged to access health insurance and medical care, but the Trump Administration’s rule does the opposite. 

“Every person who doesn’t get the health coverage they need today risks infecting another person tomorrow,” said Attorney General James. “More and more individuals across the nation become infected with the coronavirus every day, yet the Trump Administration refuses to assure immigrants that getting the tests and health coverage they need will not be used against them. At this time, we should all be working to make testing and health coverage available to every single person in this country, regardless of immigration status. Our coalition will continue fighting to protect the health and well-being of our nation by halting this rule.” 

Federal law allows lawful immigrants to apply for public benefits if they have been in the country for at least five years. But the new Public Charge Rule creates a “bait-and-switch” ― if immigrants use the public assistance to which they are legally entitled, they would jeopardize their chances of later renewing their visa or becoming permanent residents. As a result, since the spread of COVID-19 began in the United States, immigrants may now be afraid to seek out the health coverage they need to remain healthy…

Earlier this month, Attorney General James and a coalition of attorneys general sent a letter to the U.S. Department of Homeland Security (DHS) and U.S. Citizenship and Immigration Services (USCIS) seeking to suspend the Public Charge Rule as coronavirus infections began increasing in the United States. Though neither agency responded to the initial letter, last week, USCIS posted a confusing and contradictory alert claiming to offer a resolution for immigrants. The alert said the government would not consider any form of testing or care related to COVID-19 in immigrants’ public charge assessment, “even if such treatment is provided or paid for by one or more public benefits, as defined in the rule (e.g. federally funded Medicaid).”

In response, Attorney General James and the coalition have now sent another letter to DHS and USCIS again calling for a halt of the rule, pointing out that last week’s alert contains confusing and contradictory statements about the impact that using Medicaid would have on non-citizens.

“If DHS is attempting to ensure noncitizens in our communities remain enrolled in Medicaid so they can use Medicaid services should they have symptoms of COVID-19, the Alert fails to achieve this,” the attorneys general’s letter states. “And likewise, if DHS is attempting to ensure that noncitizens seek testing and treatment for COVID-19 without fear of public charge consequences, the Alert also utterly fails to achieve this.”

The letter continues, “The Alert fails to recognize that in order to receive adequate health services, our residents need adequate health insurance benefits. To achieve DHS’s stated goal of encouraging noncitizens to seek testing and treatment for COVID-19, noncitizens must be encouraged to enroll or remain enrolled in health insurance programs, including Medicaid, and they must be assured that such enrollment during this dire national health emergency will not be considered in any future public charge determination.”

The conflicting statements could cause immigrants to forgo medical treatment during this national crisis, which could be critical to protecting communities from the spread of COVID-19, the attorneys general write.

“Given the grave danger facing our nation’s health and economy, it is imperative that DHS not chill immigrants from enrolling in Medicaid or using Medicaid benefits for any purpose until the COVID-19 crisis is over. Under the Alert, however, noncitizens who remain enrolled in Medicaid continue to risk their green cards and visas. As DHS previously conceded, this will prompt immigrants to disenroll from Medicaid and lead to an ‘increased prevalence of communicable diseases,’ as the nation is now experiencing at a horrifying rate.”

They continue, “To protect the residents of our states and the rest of the country, we ask that DHS immediately announce that the Rule is stayed pending successful containment of COVID-19. Short of that, however, it is imperative that DHS at least make clear that enrollment in Medicaid and the use of Medicaid benefits for any reason will not be considered in the public charge assessment. Given that these benefits were not considered in the public charge assessment for many years prior to DHS’s recent change of policy, it is inexplicably harmful for the agency to begin counting them now, during the outbreak of a lethal global pandemic.”

Last August, Attorney General James and a coalition of states and New York City filed a lawsuit challenging the Trump Administration’s Public Charge Rule, citing that the rule specifically targets immigrants of color, while putting these communities at risk, and would have short- and long-term impacts on public health and the economy. 

Joining Attorney General James in sending today’s letter to USCIS are the attorneys general of California, Connecticut, Delaware, Hawaii, Iowa, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New Jersey, Oregon, Pennsylvania, Vermont, Virginia, Washington, and the District of Columbia. 


March 21, 2020: NPR posted an article titled: “In Ohio And Texas, A Debate Over Whether Abortion Is ‘Essential Service”. It was written by Sarah McCammon. From the article:

Abortion rights groups are accusing the attorney general of Ohio of using the coronavirus crisis to restrict abortion access after clinics in the state were sent letters this week faulting them for not complying with an order aimed at preserving a limited supply of surgical equipment and protective gear.

In a letter dated Tuesday, Ohio’s Department of Health ordered all non-essential surgical and elective procedures postponed so that protective equipment like masks and gowns can be reserved for doctors caring for coronavirus patients. Ohio has seen 174 coronavirus cases and three deaths.

The order outlines several criteria for non-essential services, including procedures that can be delayed without risking a patient’s life or long-term health, and without rapidly worsening a health condition.

Following the order, the office of Attorney General Dave Yost issued letters instructing Planned Parenthood and other abortion providers to stop performing procedures that “can be delayed without undue risk to the current or future health of the patient.”

Reproductive rights groups say abortion should be considered an essential service not subject to delays, as many health procedures are postponed nationwide during the coronavirus outbreak. Meanwhile, abortion rights opponents are calling on governors of additional states to stop procedures during the coronavirus outbreak…

…On Monday, Texas Attorney Ken Paxton released a statement warning all licensed health facilities “including abortion providers” to “postpone all surgeries and procedures that are not immediately medically necessary” in response to an order issued by Gov. Greg Abbott over the weekend . Violators face $1,000 fine or up to 180 days in jail, according to the Texas attorney general…


March 22, 2020: Texas Governor Greg Abbott (Republican) posted a press release titled: “Governor Abbott Issues Executive Order Increasing Hospital Capacity, Announces Supply Chain Strike Force For COVID-19 Response”. From the press release:

Governor Greg Abbott today signed an Executive Order to expand hospital bed capacity as the state responds to the COVID-19 virus. These actions will reinforce Texas’ health care capabilities and provide additional space for hospitals to provide care to COVID-19 patients. Under this order, the Governor directed all licensed health care professionals and facilities to postpone all surgeries and procedures that are not immediately, medically necessary to correct a serious medical condition or to preserve the life of a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician. This does not apply to any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster.

The Governor also suspended certain regulations as requested by the Texas Health and Human Services Commission (HHSC) to allow for increased occupancy of hospital rooms — meaning hospitals will be able to treat more than one patient in a patient room, thus increasing their ability to care for the growing number of COVID-19 patients…

…The Governor’s Executive Order takes effect immediately, and remains in effect and in full force until 11:59 p.m. on April 21, 2020, unless it is modified, amended, rescinded, or superseded by the Governor.

The executive order is here.


March 23, 2020: California Attorney General Xavier Becerra posted a press release titled: “As This Life-Saving Law Turns Ten, It’s Especially Urgent to Protect Public Health”. From the press release:

On the 10-year anniversary of the Affordable Care Act, California Attorney General Xavier Becerra – who leads 20 states and the District of Columbia in California v. Texas to defend the law in its entirety – issued the following statement: 

“As this life-saving law turns ten, we count its blessings: protections for 133 million people with pre-existing conditions, prescription drug coverage for seniors, coverage for adult children under age 26, expanded Medicaid coverage for modest income Americans, and so much more,” said Attorney General Becerra. “These very safeguards are under attack as the Trump Administration attempts to repeal the Affordable Care Act in court. With the COVID-19 pandemic upon us, we should do all we can to protect Americans’ public health. That is precisely what our coalition of 20 states and DC is doing as we defend the ACA before the Supreme Court.”

March 23, 2020: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Remarks on 10th Anniversary of Affordable Care Act & Unveiling of Take Responsibility for Workers and Families Act”. From the press release:

Speaker Nancy Pelosi delivered a statement on the 10th anniversary of the Affordable Care Act and the introduction of House Democrats’ Take Responsibility for Workers and Families Act. Below are the Speaker’s remarks:

…Speaker Pelosi: Ten years ago today, on March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. On that proud day, we took a monumental step forward for the health and financial security of the American people.

We expanded new health coverage to 20 million people and delivered better coverage to the more than 150 million Americans with health insurance through their employer.

We passed the Affordable Care Act because we believed that in the United States of America, health care must be a right, not a privilege. The late Senator Ted Kennedy made that belief the fight of his life…

…Now we find ourselves in the depths of one of the most serious health and economic emergencies our nation has ever faced. The protections of the Affordable Care Act are more important now than ever. But right now, in the middle of coronavirus, the Trump Administration is in court suing to tear down the entire AffordableCare Act. Every last protection and benefit.

If President Trump succeeds in striking down the ACA in court, gone is the ban on insurers putting limits on your healthcare, gone are guaranteed essential health benefits and free preventative services, gone are young people staying on their parent’s insurance until age 26, gone is the health insurance of 20 million Americans and gone are the lifesaving protections for more than 130 Americans with pre-existing conditions.

Today, therefore, I am calling on President Trump to abandon his lawsuit seeking to strike down the Affordable Care Act. Instead, the President must urge the fourteen states who have refused to expand Medicaid to do so…

…Today, House Democrats are unveiling the Take Responsibility for Workers and Families Act – a bill that takes responsibility for the health, wages and well-being of America’s workers.  Democrats take responsibility for our workers.  We require that any corporation that takes taxpayer dollars must protect their workers’ wages and benefits – not CEO pay, stock buybacks or layoffs.  We strengthen Unemployment Insurance so that it can replace the average wages of our workers who are losing their jobs and hours.

For our small businesses, we provide fast relief with grants and loans to tide them through this crisis. 

For our doctors, nurses, health care workers and first responders and hospitals and other health institutions, we provide desperately needed funds to care for those who are sick – and to ensure they have Personal Protective Equipment, PPE, that they need.  We protect our health care workers by requiring the Administration to enforce our stronger OSHA protections.

For our families, we give direct payments to America’s families in a robust way and strengthen the Child Tax Credit and the Earned Income Tax Credit.  We give more workers the security of guaranteed paid family and medical leave, including those caring for our seniors.  And we make coronavirus treatment free for the patient.

For our students, we provide emergency funds for our schools and universities.  We help current borrowers with their student debt burden and the GI Bill benefits.  We bolster SNAP and other initiatives to address food insecurity.

For our democracy, we ensure that states can carry out this year’s election and require early voting and vote-by-mail…

…The Senate Republican bill put corporations first. But because of the insistence of Leader Chuck Schumer and Senate Democrats, progress has been made. We urge the Senate to move closer to the values in the Take Responsibility for Workers and Families Act…


March 24, 2020: New York Attorney Letitia James posted a press release titled: “Attorney General James Marks 10 Year Anniversary of ACA by Continuing to Fight to Protect Health Reform Law”. From the press release:

New York Attorney General Letitia James today marked the 10-year anniversary of the passage of the Patient Protection and Affordable Care Act (ACA) by releasing the following statement:

“In the 10 years since the passage of the ACA, there has never been a time when ensuring access to quality, affordable health coverage is more essential for every New Yorker. As we battle a global pandemic, imagine if Americans were charged more for health coverage because of a pre-existing condition, like the coronavirus, or worse, if they were denied coverage altogether. If a number of states and the Trump Administration have their way, that grim nightmare could be a reality. Overnight, health coverage could be stripped away from 20 million Americans and 133 million Americans could be denied coverage because of their preexisting conditions. It’s time the president and Republican states drop this lawsuit and realize America is healthier and more prosperous today because of the ACA. If they don’t, our coalition will continue the fight to ensure we do not go backwards.”

President Barack Obama signed the ACA into law on March 23, 2010. In the 10 years since its passage, the law has faced multiple challenges — through Congress and in the courts, including in the U.S. Supreme Court. Despite all these challenges, the health care reform law remains largely intact and has ensured coverage for millions of Americans. Earlier this month, the Supreme Court agreed to review another case that seeks to repeal the entire ACA and that puts tens of millions of Amercans’ health care at risk, which Attorney General James — as part of a 21-state coalition — is leading the fight against.

Attorney General James and the coalition will lead the defense of the ACA in order to protect the important advancements in health care access made under the law, including:

  • More than 12 million Americans now receive health coverage through the ACA’s Medicaid expansion;
  • Nearly nine million individuals nationwide receive tax credits to help subsidize their health insurance coverage through individual marketplaces;
  • Millions of working families rely on high-quality employer-sponsored health insurance plans;
  • Important protections prohibit insurers from denying health insurance to the 133 million Americans with pre-existing conditions, like diabetes, cancer, or pregnancy, or from charging individuals higher premiums because of their health status; and
  • Nearly $1.3 trillion in federal funding has been dedicated to keeping Americans healthy and covered, which includes spending through Medicaid expansion and public health dollars.

And in New York:

  • The state uninsured rate reached its lowest point ever recorded in 2018 — 4.7-percent;
  • More than 4.7 million New Yorkers now receive health coverage through the ACA, including nearly 3.3 million on Medicaid;
  • 58-percent of enrollees were expected to receive $636 million in tax credits to help subsidize the cost of health care in 2019 alone; and
  • The average monthly premium tax credit available to eligible Qualified Health Plan enrollees in 2019 was $335.

March 24, 2020: KCBX FM posted an article titled: “Anti-Abortion Rights Groups Ask HHS to Urge End To Abortion During Pandemic”. It was written by Sarah McCammon. From the article:

A coalition of anti-abortion rights groups is asking federal health officials to urge abortion providers to shut down during the coronavirus outbreak.

In a letter to Health and Human Services Alex Azar, dozen of national conservative groups opposed to abortion rights call on federal health officials to urge abortion providers to “cease operation” and donate medical equipment like masks and hospital gowns to the coronavirus response. Signers include the Susan B. Anthony List, the American Center for Law and Justice, and the Southern Baptist Ethics & Religious Liberty Commission.

The letter also asks officials to make sure that access to medication abortion is not expanded via telemedicine or other methods as a result of the pandemic, and that emergency response funds are not given to abortion providers.

It follows actions by Republican governors and attorneys general in Texas and Ohio who’ve ordered clinics in their states to stop performing most abortions as part of a larger effort to preserve personal protective equipment, or PPE, for medical professionals caring for COVID-19 patients.

In other states, such as Massachusetts and New Jersey, officials have explicitly clarified that abortion is not subject to orders postponing non-essential and elective procedures during the pandemic.

Reproductive health groups, including the American College of Obstetricians and Gynecologists, say abortion is an essential procedure, and that delaying it can be harmful to pregnant patients.

March 24, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood: “Anti-Abortion Activists Are Exploiting the COVID-19 Pandemic”. From the press release:

Today, Planned Parenthood Federation of America released the below statement in response to anti-abortion activists exploiting the COVID-19 pandemic. Anti-abortion activists sent a letter to Secretary Alex Azar urging the Department of Health and Human Services to restrict access to safe, legal abortion during the current pandemic. These types of actions are political distractions the American people cannot afford right now as the country scrambles to respond to a public health emergency.

Statement from Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America:

“A public health emergency is not the time to play politics. The safety and health of patients, our staff, and our communities must remain the highest priority as our country faces an unprecedented crisis. 

“Abortion is an essential and time-sensitive medical procedure, as confirmed by medical experts like the American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology. Delays or additional barriers to care can make it more difficult or even impossible for some patients to access safe, legal abortion. While we continue to provide critical care during this pandemic and work with our partner health care providers, we must still ensure that patients can access the services they need.

“Unfortunately, while public health providers are working together in our communities to be there for patients whose health care can’t wait, anti-abortion activists are exploiting the COVID-19 pandemic to push their ideological agenda. This is not the time for politicians or groups to advance their own agenda by taking advantage of a worldwide pandemic.” 

March 24, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Urges the Trump Administration to Fully Invoke the Defense Production Act and Provide Supplies to Combat COVID-19”. From the press release:

California Attorney General Xavier Becerra today sent two letters – one on behalf of California and one as part of a coalition of 16 attorneys general – urging President Trump to fully invoke the Defense Production Act to respond to states’ immediate need for additional vital supplies to fight the coronavirus pandemic. Both letters urge the federal government to act swiftly and decisively to get as many needed supplies produced and distributed as quickly as possible in California and states across the country.

“It is crucial that we use every tool in our arsenal to fight coronavirus. Every moment counts in our work to expand access to crucial medical resources needed by our frontline responders,” said Attorney General Becerra. “That’s why we are calling on the President to take decisive action now and fully invoke the Defense Production Act to accelerate access to critical medical supplies such as N95 masks, testing kits, and ventilators in California and states throughout the country. We must ensure that those on ground zero of this pandemic, our nurses, doctors, and other first responders have these life-saving resources to combat this extraordinary public health threat.” 

In the multistate letter, the attorneys general highlight the acute need to dramatically increase the nation’s healthcare capacity; the supply of personal protective equipment for healthcare providers and first responders; and COVID-19 testing capacity. While the states recognize that the federal government has distributed – and will continue distributing – these critical supplies, the letters emphasize that a far greater volume of supplies is needed to combat the public health threat posed by COVID-19. 

In California alone, there are currently 2,220 confirmed cases of COVID-19 and 42 deaths resulting from the virus. And these numbers are likely to increase exponentially. Yesterday, California Governor Gavin Newsom reported that our state is short 50,000 hospital beds, 1 billion protective gloves, and hundreds of millions of masks. Hospitals and medical centers have been forced to ration test swabs and personal protective equipment to protect healthcare providers. The rate of infection threatens to overwhelm the state, its healthcare system, and its residents.

Additionally, state healthcare systems across the country require more ventilators and ICU beds. Healthcare professionals on the front lines need personal protective equipment such as N95 respirators, surgical masks, face shields, eye protection, gloves, gowns, sanitizers, cleaning supplies, and thermometers. 

Furthermore, there is a nationwide need to increase the supply of the reagents and swabs used for COVID-19 testing so that testing can be expanded substantially. These resources will allow states, public health officials, and healthcare professionals to work more effectively to combat and defeat the public health threat.

A copy of the California letter is available here. A copy of the multistate letter is available here.

March 24, 2020: Covered California tweeted: “All Californians are required to have health insurance this year or they may face a penalty when filing their state taxes in 2021. If you need health coverage, contact us today to enroll through #CoveredCA. You may also be eligible to receive financial help”.


March 25, 2020: Planned Parenthood posted a press release titled: “Texas Abortion Providers File Emergency Lawsuit to Keep Essential Abortion Procedures Available During Pandemic”. From the press release:

Today, a group of Texas abortion providers – represented by Planned Parenthood Federation of America, the Center for Reproductive Rights and the Lawyering Project – sued Gov. Greg Abbott and other state officials to ensure that patients can continue to access essential, time-sensitive abortion services during the COVID-19 pandemic. While doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be medical decisions. As a result, providers, including Planned Parenthood Gulf Coast (PPGC) Planned Parenthood Greater Texas (PPGT), Planned Parenthood South Texas (PPST), Whole Women’s Surgery Center, and Austin Women’s Health Center, are canceling hundreds of patients in the ensuing confusion.

Experts, including the American College of Obstetricians and Gynecologists and the American Boardof Obstetrics and Gynecology agree that abortion is an essential, time-sensitive procedure, that cannot be delayed. The groups note that delaying this care could “profoundly impact a person’s life, health, and well-being.” Delays or additional barriers to care can make it more difficult or even impossible for patients to access safe, legal abortion. For many people of color, who have always faced systemic barriers to health care and are more vulnerable to COVID-19, adding unnecessary restrictions on abortion access poses dangerous risks…

…This political distraction is just one of the many examples of Gov. Abbott’s failed leadership. Not only does Texas already have some of the most restrictive abortion laws in the nation, but due to years of failing to protect the social safety net, Texans are fighting this pandemic with fewer hospitals, providers, and inadequate health insurance coverage.

Gov. Abbott’s relentless attacks against basic health care are nothing new. Texas has one of the highest uninsured rates in the country. Gov. Abbott passed laws in recent years that have chipped away at health care in his state. He’s blocked patients with low-incomes from accessing vital cancer screenings and banned insurance coverage of abortions,

The plaintiff abortion providers are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project and the Law Offices of Patrick J. O’Connell PLLC. A copy of the complaint filed today can be found here.

March 25, 2020: Center for Reproductive Rights posted a press release titled: “Abortion Proviers File Legislation in Four States To Protect Access to Essential Abortion Care”. From the press release:

Today, abortion providers in Alabama, Iowa, Ohio, and Oklahoma — represented by Planned Parenthood Federation of America, the American Civil Liberties Union (ACLU), the Center for Reproductive Rights, and local lawyers — filed litigation to stop anti-abortion politicians from trying to use the COVID-19 pandemic to block access to time-sensitive, essential abortion care. This follows a similar legal action last week in Texas after Gov. Greg Abbott shamelessly used the pandemic to eliminate abortion access, forcing clinics to turn away hundreds of patients, many of whom have no options, while others travel hundreds of miles across state lines during a public health emergency. 

In the midst of a pandemic, anti-abortion activists and politicians have jumped to exploit the fear and the urgency of the COVID-19 response as an opportunity to block access to abortion, costing state officials valuable time and resources needed to respond to the public health crisis….

…Last week, Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project filed suit against Texas Gov. Abbott’s administration to ensure that abortion remains accessible in Texas.

The plaintiff abortion providers across the country are represented by attorneys from Planned Parenthood Federation of America, the ACLU, the Center for Reproductive Rights, The Lawyering Project, and other national and local firms. 

A copy of the emergency complaint filed in Alabama can be found here.

A copy of the emergency motion filed in Iowa can be found here.

A copy of the emergency motion filed in Ohio can be found here.

A copy of the emergency motion filed in Texas can be found here.


March 26, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Fights to Ensure Women Nationwide Are Able to Obtain Abortions During Coronavirus Pandemic”. From the press release:

New York Attorney General Letitia James today released the following statement calling on both the federal government and states across the country to ensure women’s access to safe, legal abortions are not jeopardized or curtailed as a result of the spread of the coronavirus disease 2019 (COVID-19):

“Nearly 50 years after Roe codified into law the fundamental right to an abortion for every woman in this country, anti-choice activists nationwide still work day-after-day to make it harder for women to access the abortion coverage they are constitutionally guaranteed. To be clear, the coronavirus is not an excuse for federal, state, or local governments to curtail women’s reproductive freedoms or limit their choices. Any woman who wants to go into a doctor’s office or into a clinic today and get an abortion should continue to be able to do so. And for those who do not feel comfortable leaving their homes as we battle COVID-19, we are fighting to maintain women’s access to abortion and the abortion pill so that their reproductive choices are not limited. The restrictions we are seeing be put into place are simply aimed at controlling women’s bodies, women’s choices, and women’s freedom, and I will do everything in my power to stop this attack on a woman’s constitutional right to an abortion.”

Since taking office last January, Attorney General James has been a leader in the fight to protect women’s reproductive freedom.

March 26, 2020: Covered California tweeted: “Recently lost Medi-Cal eligibility? You may qualify through #CoveredCA! Contact us or learn more about enrolling in health insurance, here: https://covrdca.com/2ThDSCS

The tweet included a link to the Covered California website that explains what Medi-Cal is and how to tell if you are eligible for it.

March 26, 2020: Senator Dianne Feinstein (Democrat – California) tweeted: “This is a vulnerable time for those with substance use disorders. DEA and the Substance Abuse & Mental Health Services Administration are working to ensure those affected by coronavirus can access medications.” The tweet included a link to the U.S. Department of Justice Diversion Control Division.

March 26, 2020: Senator Dianne Feinstein (Democrat – California) tweeted: “DEA is also expanding access to telemedicine services for substance use disorders so patients can access the care they need.” The tweet included the same link to the U.S. Department of Justice Diversion Control Division.


March 27, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Joins Multistate Coalition Calling on Trump Administration to Suspend Title IX Rulemaking During Public Health National Emergency”. From the press release:

California Attorney General Xavier Becerra today joined a coalition of 18 attorneys general in a letter calling on Secretary of Education Betsy DeVos and Office of Management and Budget Acting Director Russell Vought to suspend the federal rulemaking process for the proposed regulation on Title IX of the Education Amendments Act of 1972 (Title IX) during the current COVID-19 pandemic, which has put unprecedented strain on schools and students across the country. Attorney General Becerra previously led a coalition of 19 attorneys general in filing a comment letter opposing the proposed changes to Title IX. With school resources already stretched thin, now is not the time to burden schools with new, complex regulations, which will require schools to revise and implement new policies. Further, OMB recently put out a directive to federal agencies to take appropriate steps to prioritize directing all resources toward the slowing of the transmission of COVID-19, while ensuring mission-critical activities continue.

“During this pandemic, we need to do everything in our power to help our students, parents and schools get through these unprecedented times,” said Attorney General Becerra“Now is not the time to advance a proposal that would increase burdens on schools fighting to protect our children. We urge Secretary DeVos and Acting Director Vought to delay finalizing these rules at this time. It’s going to take all of us working together to keep our students safe during this crisis.”

In the letter to Secretary DeVos and Acting Director Vought, the coalition urges the Trump Administration to suspend the Title IX rulemaking process until the national emergency has ended. The attorneys general highlight the unprecedented steps schools are taking all across the country in response to the COVID-19 pandemic. For instance, in response to this extraordinary national public health emergency, more than 90 percent of K-12 institutions have closed or will be closing, affecting more than 55 million students and their families. In addition, more than 1,100 colleges are temporarily closed and are transitioning to remote learning, affecting more than 14.5 million students.

Title IX is a landmark law that is immensely important to states, students, families, teachers, and communities. California has a strong interest in vigorously enforcing state anti-discrimination laws that work in conjunction with Title IX and promote students’ ability to learn in a safe environment free from violence and harassment. Title IX states: No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance…

…In sending the letter, Attorney General Becerra joins the attorneys general of Pennsylvania, Colorado, Connecticut, Delaware, Hawaii, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Rhode Island, Vermont, Virginia, and the District of Columbia. 

A copy of the letter is available here.

March 27, 2020: Des Moines Register posted an article titled: “Governor’s office says order suspending ‘non-essental’ surgery includes surgical abortions”. It was written by Barbara Rodriguez. From the article:

Gov. Kim Reynolds’ office on Friday said the governor’s proclamation this week to suspend non-essential medical procedures in the state in response to the coronavirus outbreak includes surgical abortions, an interpretation that would mirror recent efforts in a handful of conservative states.

Pat Garrett, a spokesman for Reynolds, confirmed the governor’s orders through a one-sentence statement to the Des Moines Register.

“Proclamation suspends all nonessential or elective surgeries and procedures until April 16th, that includes surgical abortion procedures,” he said in an email.

Reynolds’ move will mix a national political debate about women’s reproductive health into the state’s ongoing response to coronavirus. Reynolds, a Republican, has long been vocal about her opposition to abortion. She has supported legislation in the Iowa Legislature over the years that would restrick the legal procedure…

March 27, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James to Lead Coalition of States Fighting to Stop Texas from Blocking Abortions During Coronavirus Pandemic”. From the press release:

New York Attorney General Letitia James today announced that she will be building and leading a multistate coalition of attorneys general from around the country to ensure women nationwide can continue to have access to abortions during the coronavirus disease 2019 (COVID-2019) public health crisis. Attorney General James plans to file an amicus brief supporting the plaintiffs in Planned Parenthood v. Abbott, in the U.S. District Court for the Western District of Texas, after the State of Texas earlier this week issued a directive banning nearly all abortion services in the state, using the coronavirus as an excuse.

“Texas and other states are using the coronavirus as an excuse to deny women their constitutional right to an abortion,” said Attorney General James. “This is a full-on assault on women’s reproductive rights not only in Texas, but across the country, and I will not allow any state to usurp the rights of women enshrined in the Constitution. I will soon be leading a coalition of attorneys general from around the nation to stop the Texas attorney general and any other attorney general who uses the coronavirus as a veiled assault on women’s reproductive freedoms. I stand shoulder-to-shoulder with the millions of women who are being attacked by these unconstitutional bans.”

The coalition Attorney General James will build and lead will be filing an amicus brief supporting the lawsuit filed by the Center for Reproductive Rights, Planned Parenthood Federation of America, and the Lawyering Project. The suit calls for the courts to immediately issue a temporary restraining order to block the ban. According to news reports, women in Texas have already been turned away when seeking an abortion because of the directive.

Since taking office last January, Attorney General James has been a leader in the fight to protect women’s reproductive freedom. In January, Attorney General James co-led a coalition of seven attorneys general in filing a lawsuit against the Trump Administration for making it more difficult for women in New York and across the nation to access abortion services under the Affordable Care Act.

Yesterday, Attorney General James called on the federal government and states across the country to ensure women’s access to safe, legal abortions are not jeopardized or curtailed as a result of the spread of COVID-19.

Also in January, Attorney General James filed an amicus brief, in Reproductive Health Services v. Planned Parenthood of St. Louis, challenging the constitutionality of several recently enacted abortion bans in the State of Missouri.  

Additionally in January, Attorney General James secured a victory for women in Rochester seeking to have an abortion without being harassed, threatened, or blocked before entering a clinic when a district court judge dismissed a lawsuit by anti-abortion activists seeking to bypass a 15-foot “buffer zone” outside a local Planned Parenthood facility.

Even earlier in January, Attorney General James filed a multistate amicus brief in support of a lawsuit that seeks to protect a woman’s right to safe and legal abortion care without the burdensome restrictions imposed by Arkansas laws. The brief — filed in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutledge, now before the Eighth Circuit Court of Appeals — supports the last surgical abortion clinic in Arkansas as it challenges four state laws that would restrict the ability for women in Arkansas to access abortions by banning abortions after 18 weeks and otherwise restricting women’s access to reproductive care…

March 27, 2020: Oklahoma Governor Kevin Stitt posted a press release titled: “Governor Stitt Clarifies Elective Surgeries and Procedures Suspended Under Executive Order”. From the press release:

On Tuesday, Governor Stitt through his Executive Order 2020-07 (4th amended) postponed all elective surgeries and minor medical procedures until April 7.

Today, Governor Stitt clarified that any type of abortion services as defined in 63 O.S. § 1-730(A)(1) which are not a medical emergency as defined in 63 O.S. § 1-738.1 or otherwise necessary to prevent serious health risks to the unborn child’s mother are included in that Executive Order.

This also includes routine dermatological, ophthalmological, and dental procedures, as well as most scheduled healthcare procedures such as orthopedic surgeries.

The rapid spread of COVID-19 has increased demands for hospital beds and has created a shortage of personal protective equipment (PPE) needed to protect health care professionals and stop transmission of the virus.

“We must ensure that our health care professionals, first responders and medical facilities have all of the resources they need to combat COVID-19,” said Gov. Stitt. “I am committed to doing whatever necessary to protect those who are on the front lines fighting against this virus.”


March 30, 2020: Planned Parenthood posted a press release titled: “Ohio Abortion Providers File Emergency Lawsuit to Preserve Essential Abortion Procedures during Pandemic”. From the press release:

Today, abortion providers in Ohio, represented by the American Civil Liberties Union (ACLU), ACLU of Ohio, and Planned Parenthood Federation of America along with local Ohio lawyers, took emergency legal action to ensure that they can remain open to provide time-sensitive, essential abortion care to patients.

The legal action seeks immediate relief to allow clinics to continue providing access to critical, time-sensitive abortion services during the COVID-19 pandemic. For over a week, while health centers cared for patients, anti-abortion activists harassed state officials, taking advantage of a public health crisis to push their political agenda. The Ohio Department of Health caved to these fringe groups, threatening access to abortion. Now Preterm, Planned Parenthood Southwest Ohio, Planned Parenthood of Greater Ohio, Women’s Med Group Professional Corporation, and Northeast Ohio Women’s Center are going to court to ensure access to critical, time-sensitive care…

A copy of the emergency legal action against Ohio can be found here.

March 30, 2020: Center for Reproductive Rights posted a press release titled: “Abortion Providers File Litigation in Four States to Protect Access to Essential Abortion Care”. From the press release:

Today, abortion providers in Alabama, Iowa, Ohio, and Oklahoma — represented by Planned Parenthood Federation of America, the American Civil Liberties Union (ACLU), the Center for Reproductive Rights, and local lawyers — filed litigation to stop anti-abortion politicians from trying to use the COVID-19 pandemic to block access to time-sensitive, essential abortion care. This follows a similar legal action last week in Texas after Gov. Greg Abbott shamelessly used the pandemic to eliminate abortion access, forcing clinics to turn away hundreds of patients, many of whom have no options, while others travel hundreds of miles across state lines during a public health emergency. 

In the midst of a pandemic, anti-abortion activists and politicians have jumped to exploit the fear and the urgency of the COVID-19 response as an opportunity to block access to abortion, costing state officials valuable time and resources needed to respond to the public health crisis. 

Statement from Nancy Northup, President & CEO of the Center for Reproductive Rights:

“These emergency abortion bans are an abuse of power and part of an ongoing effort to use sham justifications to shut down clinics and make an end run around Roe v. Wade. These same states have tried to ban abortion access for years—no one should be fooled that this is warranted by the current crisis. We will use every legal means to ensure that abortion care remains available during this critical time.” 

Statement from Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America

“Right now, people are just trying to survive this crisis. Women are just trying to survive this crisis.  And politicians are trying to take away their health care and are exploiting the fear and urgency of this moment to push their political agenda to ban abortion. These are the same politicians who have been eroding the public health infrastructure for decades. It’s left many of these states fighting a pandemic with fewer hospitals, providers, and inadequate health insurance for people. Elected officials should be focused on responding to the crisis at hand. We should be working together to ensure everyone has access to care. Instead, politicians are wasting valuable time and resources to play a political game. As a result, more people will suffer. Women will suffer. The priority of all Planned Parenthood health centers is the health and safety of our patients, staff, and community, and ensuring people still have access to essential health care.” 

Statement from Jennifer Dalven, director, ACLU Reproductive Freedom Project:

“We must all do our part to protect our communities, but government actions must be driven by science and public health, not politics. The simple fact is that pregnant people don’t stop needing health care in a public health care crisis: they must either get abortion care or prenatal care and childbirth services.  Banning abortion doesn’t slow the transmission of the virus, it just forces people to stay pregnant — and have children — against their will.  So, it’s not surprising that the states that are now trying to use the COVID-19 crisis to stop people from getting abortion care are the same states that have passed laws banning abortion or used other sham laws to try to shut down abortion clinics.” 

Experts, including the American College of Obstetricians and Gynecologists and the American Board of Obstetrics and Gynecology, agree that abortion is an essential, time-sensitive procedure that cannot be delayed. The groups note that delaying this care could “profoundly impact a person’s life, health, and well-being. Delays or additional barriers to care can make it more difficult or even impossible for patients to access safe, legal abortion. For many people of color, who have always faced systemic barriers to health care, adding unnecessary restrictions on abortion access poses dangerous risks.

Last week, Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project filed suit against Texas Gov. Abbott’s administration to ensure that abortion remains accessible in Texas.

The plaintiff abortion providers across the country are represented by attorneys from Planned Parenthood Federation of America, the ACLU, the Center for Reproductive Rights, The Lawyering Project, and other national and local firms. 

A copy of the emergency complaint filed in Alabama can be found here.

A copy of the emergency motion filed in Iowa can be found here.

A copy of the emergency motion filed in Ohio can be found here.

A copy of the emergency motion filed in Texas can be found here.

March 30, 2020: Cleveland.com posted an article titled: “Federal judge blocks Ohio from using coronavirus health order to restrict abortions”. It was written by Andrew J. Tobias. From the article:

A federal judge has temporarily banned Ohio officials from using a public-health order forbidding nonessential surgeries during the coronavirus pandemic to restrict providers from performing abortions within the state.

The ruling, issued Monday evening by Senior U.S. District Judge Michael Barrett in Cincinnati, came just hours after Planned Parenthood, Preterm Cleveland and otehr providers had requested the court to intervene.

The judge’s order will last for 14 days unless he changes it. Barrett indicated he is considering whether to issue another ruling, called a preliminary injunction, that would continue to bar the state from restricting such abortions while the clinics pursue legal claims on the subject.

Attorney General Dave Yost, a Republican, on March 21 sent letters to two abortion clinics citing the order, telling them to “immediately stop performing non-essential and elective surgical abortions.” Gov. Mike DeWine, a Republican, has said providers shouldn’t perform abortions while the order is in effect when the woman’s life is not at risk.

But Barrett wrote Monday that decision is up to the woman’s doctor. He also wrote: “The law is well-settled that women possess a fundamental constitutional right of access to abortions.”

“If a healthcare provider determines, on a case-by-case basis, that the surgical procedure is medically indicated and cannot be delayed, based on the timing of pre-viability or other medical conditions, said procedure is deemed legally essential to preserve a woman’s right to constitutionally protected access to abortions,” Barrett wrote in his eight-page ruling…

A copy of Senior U.S. District Judge Michael Barrett’s temporary restraining order is embedded in the article.

March 30, 2020: Planned Parenthood posted a press release titled: “BREAKING: HOURS AFTER ABORTION PROVIDERS SUE OHIO, JUDGE GRANTS EMERGENCY RELIEF FOR PATIENTS SEEKING ABORTION”. From the press release:

Today, just hours after Ohio abortion providers — including Preterm, Planned Parenthood Southwest Ohio, Planned Parenthood of Greater Ohio, Women’s Med Group Professional Corporation, and Northeast Ohio Women’s Center — asked a federal court for relief, the court granted their request for a temporary restraining order to allow abortion procedures to continue for the time being during the COVID-19 pandemic.

This means Ohioans can continue accessing essential and time-sensitive abortion care, for now. This decision comes after anti-abortion activists tried to weaponize the state’s COVID-19 pandemic response in an effort to block access to abortion. Ohio abortion providers — represented by Planned Parenthood Federation of America, the American Civil Liberties Union (ACLU), and local attorneys — went to court to protect patients’ access to abortion. Abortion providers in other states including Alabama, Iowa, and Oklahoma also filed similar lawsuits today in order to protect abortion access during the COVID-19 pandemic. Earlier today, a judge in Texas issued a similar restraining order, granting patients in the state emergency relief and protecting their access to abortion for now.

While doctors and nurses in states everywhere work around the clock to care for patients suffering from COVID-19, anti-abortion activists inserted politics into what should be a personal medical decision. As a result, Ohio providers have had to delay appointments in the ensuing confusion.

Judge Michael Barrett wrote: “…enforcement of the Director’s Order as applied to surgical abortion procedures will result in an unconstitutional deprivation of Plaintiffs’ patients’ Fourteenth Amendment right to substantive due process because enforcement creates a substantial obstacle in the path of patients seeking pre-viability abortions, thus creating an undue burden on abortion access.”…

March 30, 2020: Center for Reproductive Rights posted a press release titled: “Oklahoma’s COVID-19 Ban on Abortion Challenged in Court”. From the press release:

Today, the Center for Reproductive Rights, Planned Parenthood Federation of America and Dechert LLP challenged an Oklahoma order effectively banning abortion care in the state. The March 24 order, issued by Oklahoma Governor Kevin Stitt in response to the coronavirus (COVID-19) pandemic, requires all “elective” medical and surgical procedures be postponed. In a press release issued March 27, Governor Stitt singled out abortion care, claiming the order prohibited all abortions in the state. 

“Oklahoma’s abuse of emergency powers to ban abortion care is dangerous and unconstitutional,” said Nancy Northup, President and CEO of the Center for Reproductive Rights. “Oklahoma has tried year after year to limit access to abortion and the Governor’s order is a cynical attempt to use the current crisis to push an ideological agenda. We have filed suit to protect access to essential, time-sensitive health care that profoundly impacts women’s lives, health and wellbeing.” 

“The state claims this order is meant to protect health care professionals and stop the spread of the virus, but forcing women to travel out of state for abortion care is completely contrary to that goal,” said Julie Burkhart, Founder and CEO of Trust Women. “Like many of us, our patients are taking care of kids while schools are closed, and some have lost their jobs. Having to tell them that we can’t help them, that the state has tied our hands, is heart-wrenching.”

“Abortion is an essential and time-sensitive medical procedure — and it must remain accessible, no matter what,” said Brandon Hill, PhD, president and CEO of Comprehensive Health of Planned Parenthood Great Plains. “In a time when officials should focus on science and data to stem the tide of a public health crisis, it is unconscionable to take any action that would delay or deny access to safe, legal abortion. Emergency orders during a pandemic should advance the health and safety of Oklahomans, not try to score political points by using a national crisis to deny critical health care.”

“A global pandemic is not an excuse to attack essential, time-sensitive medical procedures like abortion,” said Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America. “Yet that’s exactly what anti-abortion politicians and activists are trying to do, instead of working together to ensure everyone has access to health care. These political distractions cost valuable time and resources that our state and federal officials cannot afford to waste. Abortion is essential and patients who need care cannot wait. This is what it’s come down to: court battles just so doctors and nurses can care for patients during a public health crisis. Anti-abortion politicians have gone too far.”

Just last week, the Center for Reproductive Rights and Planned Parenthood, along with the Lawyering Project, sued the state of Texas after Attorney General Ken Paxton announced his office would similarly target abortion providers under a statewide order prohibiting unnecessary surgeries and procedures.

The American College of Obstetricians and Gynecologists and other leading medical groups released a statement earlier this month denouncing attempts to ban abortion in light of COVID-19 and stating that “abortion is an essential component of comprehensive health care,” and that any delay could “profoundly impact a person’s life, health, and well-being.” 

The lawsuit filed today argues that Oklahoma’s order effectively bans abortion in Oklahoma, violating Roe v. Wade and nearly 50 years of Supreme Court precedent protecting a woman’s right to liberty and autonomy under the Fourteenth Amendment. The lawsuit also argues that forcing women to travel out of state for abortion care, or to carry an unwanted pregnancy to term and give birth, will increase the risk of spreading COVID-19 and undermine the state’s asserted goal of preserving medical resources. 

The Center is challenging a host of other abortion restrictions in Oklahoma, including: a ban on the use of telemedicine to provide medication abortion care; a law that forces patients to delay their abortion care for at least 72 hours after receiving certain state-mandated information; a “physician-only” law that bans qualified medical professionals from providing medication abortion care; a ban on the standard method of abortion after approximately 14 weeks of pregnancy; and a law requiring doctors to tell patients that some abortions can be “reversed”—a patently false statement.

This lawsuit was filed by T.J. Tu with the Center for Reproductive Rights, along with Planned Parenthood Federation of America, pro-bono counsel Dechert LLP, and local counsel Blake Patton of Walding & Patton PLLC. Plaintiffs in the case are Trust Women—an abortion provider with clinics in Oklahoma and Kansas—Dr. Larry Burns, and Comprehensive Health of Planned Parenthood of the Great Plains.

The full complaint is available here.  

March 30, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Coalition of 21 Attorneys General Asking FDA to Increase Access to Reproductive Telehealth Care During COVID-19 Pandemic”. From the press release:

California Attorney General Xavier Becerra today led a multistate coalition of 21 attorneys general in sending a letter to the U.S. Department of Health and Human Services and its U.S. Food and Drug Administration (FDA) requesting that they increase access to reproductive healthcare, including safe and legal abortion, during the COVID-19 pandemic. The coalition urges the Administration to waive or utilize its discretion on enforcement of its Risk Evaluation and Mitigation Strategy (REMS) designation, which impedes women’s access to the medication abortion prescription drug known as Mifepristone. The attorneys general call on the Administration to ensure that women across the country have access to this critical healthcare service while the pandemic leaves many women unable to seek in-person care, putting them in harm’s way. The American College of Obstetricians, the American Medical Association, and the American Association of Family Physicians all support removal of the REMS on medication abortion.

“As communities across the nation shelter in place to help prevent the spread of COVID-19, we must ensure that women can continue to safely access essential health services including safe and legal abortion,” said Attorney General Becerra. “Forcing women to unnecessarily seek in-person reproductive healthcare during this public health crisis is foolish and irresponsible. That’s why we’re calling on the Trump Administration to remove red tape that makes it more difficult for women to access the medication abortion prescription drug.”

In the letter, the attorneys general point out that medication abortion has been proven safe and effective, and should not be subject to unnecessary restrictions. Mifepristone has been approved by the FDA since 2000, and it remains the only drug approved in the United States for pregnancy termination. Since its approval, about three million women in the United States have used the medication. And according to the FDA, this medication “has been increasingly used as its efficacy and safety have become well-established by both research and experience.”

During this unprecedented crisis, it is essential that women across the country have access to critical healthcare services. Many states have already taken steps to increase telehealth care, at the federal government’s request. Yet, the current FDA REMS creates unnecessary barriers for women to access abortion care. Under the REMS, the FDA requires that: 

  • Patients must be handed the medication at a clinic, medical office, or hospital under the supervision of a healthcare provider; 
  • Healthcare providers must be registered with the drug manufacturer; and
  • Patients must sign a “Patient Agreement” form confirming that they received counseling on the risks associated with the medication.  

These onerous and medically unnecessary requirements limit healthcare providers’ ability to assist their female patients, particularly during this global healthcare crisis. Furthermore, these requirements impose significant burdens on women in rural and medically underserved communities who would be required to travel long distances for time-sensitive, in-person care. Forcing women to travel at a time when many states and the federal government are urging people to stay home to curb the spread of COVID-19 is not only shortsighted but puts women across the country in harm’s way. Consequently, the attorneys general urge the Trump Administration to immediately remove the FDA REMS designation, and waive enforcement in the meantime, so that women can access constitutionally protected healthcare without putting themselves and their families at risk.

In filing the letter, Attorney General Becerra is joined by the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and the District of Columbia.   

A copy of the letter is available here

March 30, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood and ACLU File Emergency Lawsuit to Keep Essential Abortion Procedures Available in Iowa During Pandemic”. From the press release:

Today, the ACLU of Iowa and Planned Parenthood Federation of America, on behalf of Planned Parenthood of the Heartland, and along with the Emma Goldman Clinic, filed a lawsuit against Iowa Gov. Kim Reynolds and other state officials to ensure that patients can continue to access essential, time-sensitive surgical abortion services during the COVID-19 pandemic. 

The lawsuit is in response to Gov. Reynolds’ Proclamation of Disaster Emergency for COVID-19 and her statement published in the Des Moines Register on Friday, March 27, 2020, taking the position that surgical abortion is prohibited under her Proclamation.  While health care providers across Iowa are working tirelessly to prevent the spread of COVID-19 and care for patients suffering from COVID-19, Gov. Reynolds is focused on advancing her political agenda and interfering in medical decisions that should be left to patients and their doctors…

…The lawsuit, filed in Johnson County District Court, asks the court to block the Governor’s Proclamation as it applies to abortions…

A copy of the emergency lawsuit against Iowa can be found here.

March 30, 2020: American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “Patient-Centered Care for Pregnant Patients During the COVID-19 Pandemic”. From the press release:

The American College of Obstetricians and Gynecologists joins the American College of Nurse-Midwives, American Academy of Family Physicians, and Society for Maternal-Fetal Medicine in issuing this statement.

As the physicians, certified nurse-midwives (CNM) and certified midwives (CM) who care for patients and their families, we see firsthand the stress and uncertainty facing pregnant people, parents, and their support networks during the COVID-19 pandemic. We are listening to the people we care for and share their concerns about the impact of this pandemic on their intended plans for labor and birth. We stand in solidarity with our patients and are committed to working tirelessly to deliver evidence-based, respectful, patient-centered care to ensure parents and their families are supported during this time of pandemic.

Prenatal, delivery, and postpartum care are essential to the health and well-being of patients and infants. In the wake of the COVID-19 pandemic, the health care team is committed to delivering care in the safest, most respectful and appropriate way possible, including providing the critical support those who are giving birth deserve. Amid the significant strain on the health care system, the entire maternity care team is committed to making sure laboring patients get the support they need to birth confidently, safely and respectfully. Our organizations are rapidly developing and communicating guidance for our members and their patients based on the best available evidence to help inform their provision of care amid the pandemic.

Patients who are questioning the settings in which to give birth should have access to the most accurate health information about safety and risk. Hospitals and birth centers that are both licensed and accredited remain safe places to give birth in the United States. Effective communication is essential in this time of increased stress and uncertainty and we encourage pregnant patients to stay with the health care professionals who have been providing their care and talk with their physician or midwife about their concerns regarding labor support and safe birth care. This is especially true in some COVID-19 hot spots where hospitals are being forced to make difficult decisions as they confront significant challenges caused by the pandemic. Physicians, certified nurse-midwives and certified midwives, and the entire health care team will work to ensure that precautions are taken to make labor and delivery as safe as possible for their patients.

The safety and well-being of families and communities is of paramount importance. We are committed to providing quality, patient-centered care to pregnant patients and their infants during this challenging time.

March 30, 2020: Planned Parenthood posted a press release titled: “Oklahoma’s COVID-19 Ban on Abortion Challenged in Court”. From the press release:

Today, the Center for Reproductive Rights, Planned Parenthood Federation of America and Dechert LLP challenged an Oklahoma order effectively banning abortion care in the state. The March 24 order, issued by Oklahoma Governor Kevin Stitt in response to the coronavirus (COVID-19) pandemic, requires all “elective” medical and surgical procedures be postponed. In a press release issued March 27, Governor Stitt singled out abortion care, claiming the order prohibited all abortions in the state.

“A global pandemic is not an excuse to attack essential, time-sensitive medical procedures like abortion,” said Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America. “Yet that’s exactly what anti-abortion politicians and activists are trying to do, instead of working together to ensure everyone has access to health care. These political distractions cost valuable time and resources that our state and federal officials cannot afford to waste. Abortion is essential and patients who need care cannot wait. This is what it’s come down to: court battles just so doctors and nurses can care for patients during a public health crisis. Anti-abortion politicians have gone too far.”..

…“The state claims this order is meant to protect health care professionals and stop the spread of the virus, but forcing women to travel out of state for abortion care is completely contrary to that goal,” said Julie Burkhart, Founder and CEO of Trust Women. “Like many of us, our patients are taking care of kids while schools are closed, and some have lost their jobs. Having to tell them that we can’t help them, that the state has tied our hands, is heart-wrenching.”…

…The lawsuit filed today argues that Oklahoma’s order effectively bans abortion in Oklahoma, violating Roe v. Wade and nearly 50 years of Supreme Court precedent protecting a woman’s right to liberty and autonomy under the Fourteenth Amendment. The lawsuit also argues that forcing women to travel out of state for abortion care, or to carry an unwanted pregnancy to term and give birth, will increase the risk of spreading COVID-19 and undermine the state’s asserted goal of preserving medical resources.

This lawsuit was filed by T.J. Tu with the Center for Reproductive Rights, along with Planned Parenthood Federation of America, pro-bono counsel Dechert LLP, and local counsel Blake Patton of Walding & Patton PLLC. Plaintiffs in the case are Trust Women—an abortion provider with clinics in Oklahoma and Kansas—Dr. Larry Burns, and Comprehensive Health of Planned Parenthood of the Great Plains.

The full complaint is available here.

March 30, 2020: Planned Parenthood posted a press release titled: “BREAKING: Texas Abortion Providers Secure Emergency Relief to Keep Essential Abortion Procedures Available During Pandemic”. From the press release:

Today, a federal district judge granted Texas abortion providers a temporary restraining order to allow abortion services to continue for the time being during the COVID-19 pandemic. This means that abortion providers can resume offering the essential and time-sensitive they need, for now. This decision comes in response to Gov. Greg Abbott’s attempt to exploit the pandemic to block abortion access. His irresponsible and harmful actions forced a group of Texas abortion providers — represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the Lawyering Project — to go to court to protect patients. Abortion providers in other states including Alabama, Iowa, Ohio, and Oklahoma also filed similar lawsuits today in order to protect abortion access during the COVID-19 pandemic.

While doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — have had to cancel appointments for hundreds of patients in the ensuing confusion.

Judge Lee Yeakel wrote: “Plaintiffs’ patients will suffer serious and irreparable harm in the absence of a temporary restraining order. The attorney general’s interpretation of the Executive Order prevents Texas women from exercising what the Supreme Court has declared is their fundamental constitutional right to terminate a pregnancy before a fetus is viable.”…

…This is just one of the many examples of Gov. Abbott’s failed leadership. Not only does Texas already have some of the most restrictive abortion laws in the nation, but due to years of politicians undermining the social safety net, Texans are fighting this pandemic with fewer hospitals, providers, and inadequate health insurance coverage.

The plaintiff abortion providers are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project and the Law Offices of Patrick J. O’Connell PLLC. …

March 30, 2020: Politico posted an article titled: “Judges block 3 states from enforcing abortion bans pegged to pandemic”. It was written by Alice Miranda Ollstein. From the article:

Federal judges on Monday lifted restrictions Texas, Ohio and Alabama imposed on abortion during the coronavirus pandemic in decisions that could have repercussions for several more Republican-led states that have deemed the procedure non-essential during the crisis.

In Texas, District Court Judge Lee Yeakel sided with abortion clinics and granted a temporary restraining order through April 13 while arguments on the underlying legality of the state’s order play out.

In Ohio, District Court Judge Michael Barrett similarly sided with Planned Parenthood and other groups challenging the state’s ban and issued a two-week temporary restraining order.

In Alabama, District Court Judge Myron Thompson ordered the suspension of the state’s abortion ban until he can hear arguments in a video conference on April 6.

“The State’s interest in immediate enforcement of the March 27 order — a broad mandate aimed primarily at preventing large social gatherings — against abortion providers does not, based on the current record, outweigh plaintiffs’ concerns,” he said.

Iowa, Mississippi and Oklahoma are among the other states that recently moved to suspend access to the procedure as the pandemic intensified, arguing it would preserve desperately needed medical supplies. Texas’ order was one of the strictest, threatening a $1,000 fine or 180 days of jail time on abortion providers who violated the ban.

Yeakel agreed with Texas clinics who argued that women who need an abortion can’t live with a weeks – or possibly months-long delay. Clinic operators told reporters Monday that they’ve already had to cancel hundreds of appointments since the ban took effect last week.

Texas Attorney General Ken Paxton has argued that the state exercised proper discretion in halting the procedures because abortions are not “immediately medically necessary” or needed to save the life or health of the mother…

The Ohio abortion clinics that challenged the state’s ban said inspectors visited their clinics on March 26 and 27 but never indicated whether or not they were found to be violating the prohibition. The clinics on Monday sued and asked for the temporary restraining order, arguing their “physicians credibly fear being immediately shut down and prosecuted if they continue to provide surgical abortions.”

Barrett, also a Bush appointee, agreed to halt enforcement of the ban while he hears arguments in the case.

He wrote the state did not make a convincing case that banning abortions would save enough masks and other gear for medical workers dealing with the pandemic to outweigh the “irreparable harm” it would cause to individuals wanting to terminate their pregnancies…

March 30, 2020: Planned Parenthood posted a press release titled: “BREAKING: 5th Circuit Allows Gov. Abbott to Block Abortion Procedures During a Pandemic”. From the press release:

Today, a three-judge panel of the 5th Circuit Court of Appeals used an extraordinary measure to allow Gov. Greg Abbott to drastically restrict essential, time-sensitive abortion procedures using his COVID-19 executive order. The court issued its stay before the abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — could even respond to arguments made to the court late yesterday by Gov. Abbott. Today’s order stays Monday’s temporary restraining order granted by a federal district court, which would have helped ensure Texans have access to essential abortion care during the COVID-19 pandemic. This move by the 5th Circuit puts people across Texas in a perilous position, yet again, as they scramble to access care during a public health crisis. The abortion provider plaintiffs will ask the 5th Circuit not to stay the temporary restraining order and to keep the temporary restraining order in place until the district court can hold a hearing — scheduled for April 13 — on their request for a preliminary injunction.

As doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — have had to cancel appointments for hundreds of patients in the ensuing confusion. Patients are putting themselves and others at risk, forced to travel hundreds of miles, in a pandemic just to access care…

…Abortion providers in four other states — Alabama, Iowa, Ohio, and Oklahoma — also filed similar lawsuits this week to protect abortion access during the COVID-19 pandemic. Thus far, judges have provided temporary relief to protect access to care in Alabama and Ohio…

March 30, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Pushes to Increase Abortion Access by Medication During Coronavirus Pandemic”. From the press release:

New York Attorney General Letitia James today continued her to push to ensure women across New York and the nation are able to access safe and legal abortions during the coronavirus disease 2019 (COVID-19) public health crisis. In a letter to both the U.S. Department of Health and Human Services (HHS) and the U.S. Food and Drug Administration (FDA), Attorney General James, as part of a multistate coalition of 21 attorneys general from around the nation, requested that the Trump Administration waive or utilize its discretion not to enforce its Risk Evaluation and Mitigation Strategy (REMS) designation, which dictates and subsequently impedes women’s access to the medical-abortion prescription drug known as Mifepristone. The attorneys general call on the Administration to ensure that women across the country can more easily access this critical health care service while the pandemic leaves many women unable to seek in-person care.

“As the coronavirus spreads across the country and residents are asked to stay at home, the federal government should be doing everything in its power to ensure women can maintain control of their reproductive choices,” said Attorney General James. “While any woman who wants to go into a doctor’s office or into a clinic today and get an abortion should continue to be able to do so, control over one’s reproductive freedom should not be limited to those able to leave their homes as we battle the coronavirus. Our coalition is calling on the federal government to make Mifepristone more easily accessible so that no woman is forced to risk her health while exercising her constitutional right to an abortion.”

In 2000, the prescription drug Mifepristone — sometimes referred to as RU-486 — became the first FDA-approved medication to induce medical abortions, and today still remains the only drug approved in the United States for pregnancy termination. Since its approval, three-million women in the United States have used the medication, which entails women taking two different medicines to bring about an abortion. According to the FDA, this medication “has been increasingly used as its efficacy and safety have become well-established by both research and experience.” Women alternatively have the option of an aspiration or surgical abortion that typically requires a short procedure.

In their letter to HHS and the FDA, Attorney General James and the coalition of attorneys general point out that medical abortions have been proven safe and effective, and should not be subject to unnecessary restrictions. The coalition goes on to note that while the nation endures the unprecedented COVID-19 crisis, it is essential that women across the country are able to continue accessing critical health care services. Many states have already taken steps to increase telehealth care, at the federal government’s request, yet, the current REMS set forward by the FDA creates unnecessary barriers for women to access the abortion care they so choose. Under the REMS, the FDA requires that:

  • Patients must be handed the medication at a clinic, medical office, or hospital under the supervision of a health care provider;
  • Health care providers must be registered with the drug manufacturer; and
  • Patients must sign a “Patient Agreement” form confirming that they received counseling on the risks associated with the medication.

These onerous and medically unnecessary requirements limit a health care provider’s ability to assist their female patients, particularly during the COVID-19 global public health crisis.

Furthermore, these requirements impose significant burdens on women across the nation. Those in rural and medically underserved communities could be required to travel long distances for time-sensitive, in-person care. And those women in more compact, urban cities may not have the option to practice social distancing outside the home, therefore increasing the likelihood of coming in contact with an individual who has contracted COVID-19.

The attorneys general go on to contend, in their letter, that forcing women to travel at a time when many states and the federal government are urging people to stay home to curb the spread of the coronavirus is not only shortsighted, but also puts women across the country in harm’s way. Consequently, the attorneys general urge the Trump Administration to immediately remove the FDA REMS designation, and waive enforcement in the meantime, so that women can continue to make their own constitutionally-protected reproductive decisions without putting themselves and their families at risk.

The American College of Obstetricians, the American Medical Association, and the American Association of Family Physicians all support removal of the REMS on medical abortions.

Today’s letter is just the latest action Attorney General James has taken to protect women’s access to abortion coverage since the spread of COVID-19 began in the United States. On Friday, Attorney General James announced that she will begin building and will soon lead a multistate coalition of attorneys general from around the nation in filing an amicus brief supporting the plaintiffs in Planned Parenthood v. Abbott, in the U.S. District Court for the Western District of Texas, after the State of Texas last week issued a directive banning nearly all abortion services in the state, using the coronavirus as an excuse…

March 30, 2020: American Medical Association (AMA) posted a statement titled: “AMA statement on government interference in reproductive health care”. The statement is attributed to Patrice A. Harris, M.D., M.A., President, American Medical Association. From the statement:

“While many physicians and health care workers are on the front lines in the COVID-19 pandemic, it is unfortunate that elected officials in some states are exploiting this moment to ban or dramatically limit women’s reproductive health care, labeling procedures as ‘non-urgent.’

“The AMA will always defend shared decision making and open conversations between patients and physicians, and fight government intrusion in medical care. At this critical moment and every moment, physicians – not politicians – should be the ones deciding which procedures are urgent-emergent and need to be performed, and which ones can wait, in partnership with our patients.”

March 30, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Applauds Courts for Standing Up for Women’s Reproductive Rights During Coronavirus Pandemic.” From the press release:

New York Attorney General Letitia James today released the following statement after a federal judge ensured that women in the State of Texas and those all over the country can continue to access the reproductive care they so choose, after he stopped Texas from enforcing an order — issued last week — that bans nearly all abortions in the state, using the coronavirus disease 2019 (COVID-19) public health crisis as an excuse:

“This is welcome news for every woman in the State of Texas and in the multitude of other states that are using the coronavirus as an excuse to trample on women’s reproductive rights. No state has the right to deny a woman her constitutional right to an abortion, even during a national emergency, and the court made that perfectly clear today. As the lawsuit to stop this order continues, I will be leading a coalition of attorneys general from around the nation to stop Texas and any other state that uses the coronavirus as a veiled assault on women’s reproductive freedoms.”

This afternoon, Judge Lee Yeakel of the U.S. District Court for the Western District of Texas issued a temporary restraining order that stops Texas from enforcing the order issued one week ago today. The lawsuit, Planned Parenthood v. Abbott — which was filed last Wednesday by the Center for Reproductive Rights, Planned Parenthood Federation of America, and the Lawyering Project to permanently stop the order — will continue in the meantime.

In his ruling today, Judge Yeakel made clear Texas’s ban is an unconstitutional infringement of women’s reproductive rights. “Regarding a woman’s right to a pre-fetal-viability abortion, the Supreme Court has spoken clearly. There can be no outright ban on such a procedure,” stated Judge Yeakel, adding, “This court will not speculate on whether the Supreme Court included a silent ‘except-in-a-national-emergency clause’ in its previous writings on the issue. Only the Supreme Court may restrict the breadth of its rulings.”…


March 31, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Files Motion for Summary Judgement to Halt Trump Administration Attack on Reproductive Healthcare Access”. From the press release:

California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of eight attorneys general, filed a motion for summary judgment in their case against the U.S. Department of Health and Human Services (HHS) for its unlawful reinterpretation of Section 1303 of the Affordable Care Act (ACA), which limits healthcare coverage including reproductive care. On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to send and collect separate bills—one for a health insurance premium and one of at least one dollar for abortion coverage. If a consumer misses the one dollar payment, they could lose all coverage on the exchange. This onerous and confusing requirement threatens women’s access to abortion and puts millions at risk of accidentally losing their health insurance coverage. Today’s motion argues that the new rule violates federal law and is inconsistent with the ACA and therefore should be vacated. 

“As our nation wrestles with the COVID-19 public health crisis, it is more important than ever that we safeguard every American’s healthcare coverage, not endanger it with burdensome rules,” said Attorney General Becerra. “Let’s be clear: this rule is just another unprincipled attempt to interfere with women’s reproductive care. In California, we fight to protect women’s access to comprehensive reproductive healthcare, including abortion. An unlawful federal administrative rule won’t change that.”

Under California law, all health plans regulated by the state are required to offer abortion coverage as part of their basic healthcare services. The Trump Administration rule requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage, requiring consumers to make a separate payment of at least one dollar for these services. Failure to pay the separate bill puts individuals at risk of losing all of their healthcare coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion, putting more than 1.4 million enrollees in California alone at risk of losing coverage if they inadvertently fail to make full premium payments on time. The rule also burdens states with unnecessary administrative costs and harms consumers who may face higher insurance premiums as a result of increased costs to carriers. 

In today’s motion for summary judgment, the coalition argues that the rule is unlawful because it:

  • Violates the Administrative Procedure Act and is unlawful under the ACA;
  • Violates Section 1557 of the ACA, as it discriminates against women by targeting a healthcare service — abortion — unique to those with reproductive capacity;
  • Violates Section 1554 of the ACA, which prohibits the promulgation of any regulation that creates unreasonable barriers to the ability of individuals to obtain appropriate medical care; and
  • Seeks to frustrate state sovereignty by coercing states to change their policies relating to the protection of abortion care…

…Attorney General Becerra was joined in filing today’s motion by the attorneys general of New York, Colorado, Maryland, Maine, Oregon, Vermont, and the District of Columbia. 

A copy of the motion for summary judgment is available here.

March 31, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Continues Fight to Halt Trump Administration’s Attack on Reproductive Health Care Access”. From the press release:

New York Attorney General Letitia James today co-led a multistate coalition of seven attorneys general in asking the federal courts to immediately rule on a lawsuit filed against the Trump Administration for making it more difficult for women in New York and across the nation to access abortion services under the Affordable Care Act (ACA). In late December 2019, the U.S. Department of Health and Human Services (HHS) issued a final rule that unlawfully reinterpreted Section 1303 of the ACA by requiring qualified health plans that participate in the state exchanges — like the New York State of Health — to send separate bills and collect separate payments of at least one dollar for abortion services. If a consumer misses the one-dollar payment, they could lose all coverage on the exchange. In their lawsuit, Attorney General James and the coalition argue that HHS’s onerous and confusing requirement threatens women’s access to abortion and puts millions at risk of accidentally losing their health insurance coverage. The lawsuit also highlights that the new rule is incompatible with the ACA’s requirement of equitable access to health care and disproportionately affects states — like New York, California, Maine, Oregon, and Vermont — that are committed to ensuring access to comprehensive reproductive health care by requiring health plans to provide abortion coverage. Today’s motion for summary judgment argues that the new rules violates federal law and is inconsistent with the ACA and therefore should be immediately vacated.

“As states across the nation take unlawful actions and use the coronavirus as an excuse to deny women their constitutional right to an abortion, it’s more important than ever that the federal government stops its attack on women’s reproductive rights,” said Attorney General James. “This new rule is simply another attempt to control women’s bodies and make it harder for those struggling financially to make the health care decisions that are right for them. We cannot sit by as a continued assault on women spreads across our nation, which is why our coalition will never stop fighting to ensure every woman is able to make her own reproductive choices. We’re calling on the courts to immediately rule that the Trump Administration’s continued attacks on women are unconstitutional and in direct violation of the precedent set by the Supreme Court.”

Under New York law, all private health plans regulated by the state are required to offer abortion coverage as part of their basic health care services, but the new Trump Administration rule requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage. The rules also requires consumers to make a separate payment of at least one dollar for these services or risk losing all of their health care coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion for the more than 260,000 New Yorkers that have already enrolled in a qualified health plan this year. Additionally, the rule burdens states with unnecessary administrative costs and harms consumers who may face higher insurance premiums as a result of increased costs to carriers. For example, initial compliance is expected to cost all impacted insurance companies nearly $400 million, with another $100 million in estimated annual costs to maintain the separate systems. These excessive costs put pressure on insurers to remove abortion coverage from their plans and punish those companies that do business in states, like New York, where abortion coverage is required. 

In today’s motion for summary judgment — led by Attorney General James and California Attorney General Xavier Becerra — the coalition argues that the rule is unlawful because it:

  • Violates the Administrative Procedure Act and is unlawful under the ACA;
  • Violates Section 1557 of the ACA, as it discriminates against women by targeting a health care service unique to those with the ability to bear children — abortion;
  • Violates Section 1554 of the ACA, which prohibits the promulgation of any regulation that creates unreasonable barriers to the ability of individuals to obtain appropriate medical care; and
  • Seeks to frustrate state sovereignty by coercing states to change their policies relating to the protection of abortion care…

March 31, 2020: HuffPost posted an article titled: “The Abortion Ban In Texas Is Back On”. It was written by Melissa Jeltsen. From the article:

An abortion ban in Texas during the coronavirus outbreak can temporarily continue, a federal appeals court ruled on Tuesday.

Patients may not receive an abortion in the state unless it is medically necessary to preserve their life or health. Providers who violate the executive order could face a fine of up to $1,000 or 180 days of jail time.

Last week, Texas Gov. Greg Abbott (R) issued an executive order postponing all “unnecessary medical procedures” to save medical supplies for the health professionals combating the coronavirus. Ken Paxton, the attorney general, clarified that abortions were considered unnecessary under the executive order. 

As a result, abortion clinics in the state were forced to cancel hundreds of appointments. A coalition of reproductive rights groups filed a lawsuit challenging the ban on Wednesday. 

On Monday, a federal judge temporarily blocked Texas from enforcing the abortion restriction. “The attorney general’s interpretation of the Executive Order prevents Texas women from exercising what the Supreme Court has declared is their fundamental constitutional right to terminate a pregnancy before a fetus is viable,” U.S. District Judge Lee Yeakel wrote in his decision. 

Less than 24 hours later, the U.S. Court of Appeals for the 5th Circuit reversed the ruling. In a 2-1 opinion, the appeals court ruled that the order from the lower court be stayed until an appeal from Texas is considered…

…State officials in Texas have defended the ban as an important public health measure…

…But reproductive rights groups say Texas is among a growing number of states that are taking advantage of the pandemic to stealthily erode abortion access. Ohio, Iowa, Alabama, Mississippi and Kentucky have all taken steps to halt abortion, claiming that the procedure is elective and can simply be postponed…

…The impact of Texas’ abortion ban has already been felt by many women in the state. One college student told HuffPost that she had to drive 24 hours and stay in an Airbnb in another state to access the abortion pill…

March 31, 2020: Centers for Reproductive Rights posted a press release titled: “5th Circuit Allows Gov. Abbott to Block Abortion Procedures During a Pandemic”. From the press release:

Today, a three-judge panel of the 5th Circuit Court of Appeals used an extraordinary measure to allow Gov. Greg Abbott to drastically restrict essential, time-sensitive abortion procedures using his COVID-19 executive order. The court issued its stay before the abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — could even respond to arguments made to the court late yesterday by Gov. Abbott. Today’s order stays Monday’s temporary restraining order granted by a federal district court, which would have helped ensure Texans have access to essential abortion care during the COVID-19 pandemic. This move by the 5th Circuit puts people across Texas in a perilous position, yet again, as they scramble to access care during a public health crisis. The abortion provider plaintiffs will ask the 5th Circuit not to stay the temporary restraining order and to keep the temporary restraining order in place until the district court can hold a hearing — scheduled for April 13 — on their request for a preliminary injunction.

As doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — have had to cancel appointments for hundreds of patients in the ensuing confusion. Patients are putting themselves and others at risk, forced to travel hundreds of miles, in a pandemic just to access care. 

Statement from Nancy Northup, president and CEO, Center for Reproductive Rights:
“The Fifth Circuit is escalating the fear and confusion women seeking abortion in Texas are already experiencing. The trial court found just yesterday that women will suffer irreparable harm if clinics are closed. We will continue fighting this legal battle against Texas’ abuse of emergency powers.”

Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“How heartless do you have to be to, in a time of crisis, take extraordinary measures to take away people’s health care? Abortion is essential health care, and it is urgent and time-sensitive.  While people everywhere are trying to survive the COVID-19 pandemic, politicians like Gov. Abbott continue this perverse obsession with banning abortion. Those who are caring for their families, forced to work essential jobs, and doing what they can to stay healthy need access to health care right now. Instead, these politicians are forcing patients to travel hundreds of miles putting themselves and their families at risk. 

“No other form of health care is being targeted this way — only abortion. Don’t be fooled: Gov. Abbott’s use of his executive order to ban abortion has nothing to do with health or safety. If Gov. Abbott cared about the lives of Texans, he’d be addressing the public health crisis at hand. Planned Parenthood is here with our patients. We will not cower before politicians who insist on exploiting a global pandemic to score political points.”

Today, a three-judge panel of the 5th Circuit Court of Appeals used an extraordinary measure to allow Gov. Greg Abbott to drastically restrict essential, time-sensitive abortion procedures using his COVID-19 executive order. The court issued its stay before the abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — could even respond to arguments made to the court late yesterday by Gov. Abbott. Today’s order stays Monday’s temporary restraining order granted by a federal district court, which would have helped ensure Texans have access to essential abortion care during the COVID-19 pandemic. This move by the 5th Circuit puts people across Texas in a perilous position, yet again, as they scramble to access care during a public health crisis. The abortion provider plaintiffs will ask the 5th Circuit not to stay the temporary restraining order and to keep the temporary restraining order in place until the district court can hold a hearing — scheduled for April 13 — on their request for a preliminary injunction.

As doctors and nurses in his state work around the clock to care for patients suffering from COVID-19, Gov. Abbott inserted politics into what should be a personal medical decision. As a result, providers — including Planned Parenthood Center for Choice, Planned Parenthood Greater Texas Surgical Health Services, Planned Parenthood South Texas Surgical Center, Whole Woman’s Health, Whole Woman’s Health Alliance, Southwestern Women’s Surgery Center, and Austin Women’s Health Center — have had to cancel appointments for hundreds of patients in the ensuing confusion. Patients are putting themselves and others at risk, forced to travel hundreds of miles, in a pandemic just to access care. 

Statement from Nancy Northup, president and CEO, Center for Reproductive Rights:
“The Fifth Circuit is escalating the fear and confusion women seeking abortion in Texas are already experiencing. The trial court found just yesterday that women will suffer irreparable harm if clinics are closed. We will continue fighting this legal battle against Texas’ abuse of emergency powers.”

Statement of Alexis McGill Johnson, acting president and CEO, Planned Parenthood Federation of America:
“How heartless do you have to be to, in a time of crisis, take extraordinary measures to take away people’s health care? Abortion is essential health care, and it is urgent and time-sensitive.  While people everywhere are trying to survive the COVID-19 pandemic, politicians like Gov. Abbott continue this perverse obsession with banning abortion. Those who are caring for their families, forced to work essential jobs, and doing what they can to stay healthy need access to health care right now. Instead, these politicians are forcing patients to travel hundreds of miles putting themselves and their families at risk. 

“No other form of health care is being targeted this way — only abortion. Don’t be fooled: Gov. Abbott’s use of his executive order to ban abortion has nothing to do with health or safety. If Gov. Abbott cared about the lives of Texans, he’d be addressing the public health crisis at hand. Planned Parenthood is here with our patients. We will not cower before politicians who insist on exploiting a global pandemic to score political points.”

Statement from Rupali Sharma, senior counsel and director, Lawyering Project:
“Today’s ruling will push abortion out of reach for some Texans.  That’s not only unconscionable, it’s unconstitutional.  The Lawyering Project will continue to stand with people who need abortions in Texas.”

Abortion providers in four other states — Alabama, Iowa, Ohio, and Oklahoma — also filed similar lawsuits this week to protect abortion access during the COVID-19 pandemic. Thus far, judges have provided temporary relief to protect access to care in Alabama and Ohio. 

Experts — including the American College of Obstetricians and Gynecologists and the American Board of Obstetrics and Gynecology — agree that abortion is an essential, time-sensitive health care procedure. The groups note that delaying this care could “profoundly impact a person’s life, health, and well-being.” Delays or additional barriers to care can make it more difficult or even impossible for patients to access safe, legal abortion. For many people of color, who have always faced systemic barriers to health care and are more vulnerable to COVID-19, adding unnecessary restrictions on abortion access poses dangerous risks.

The Texas plaintiff abortion providers are represented by attorneys from Planned Parenthood Federation of America, the Center for Reproductive Rights, the Lawyering Project and the Law Offices of Patrick J. O’Connell PLLC. A copy of the complaint filed last week can be found here.

March 31, 2020: Planned Parenthood posted news titled: “BREAKING: 5th Circuit Allows Gov. Abbott to Block Abortion Procedures During a Pandemic”. From the news:

Today, a three-judge panel of the 5th Circuit Court of Appeals used an extraordinary measure to allow Gov. Greg Abbott to drastically restrict essential, time-sensitive abortion procedures using his COVID-19 executive order. The court issued its stay before the abortion providers — represented by the Center for Reproductive Rights, the Lawyering Project, and Planned Parenthood Federation of America — could even respond to arguments made to the court late yesterday by Gov. Abbott. Today’s order stays Monday’s temporary restraining order granted by a federal district court, which would have helped ensure Texans have access to essential abortion care during the COVID-19 pandemic. This move by the 5th Circuit puts people across Texas in a perilous position, yet again, as they scramble to access care during a public health crisis. The abortion provider plaintiffs will ask the 5th Circuit not to stay the temporary restraining order and to keep the temporary restraining order in place until the district court can hold a hearing — scheduled for April 13 — on their request for a preliminary injunction…

March 31, 2020: KCBX posted an article titled: “As The Pandemic Spreads, Battles over Abortion Play Out in Court”. It was written by Sarah McCammon. From the article:

As reproductive rights activists warn that some patients seeking abortions are being turned away, a federal court has ruled that an order suspending abortions in Texas during the coronavirus pandemic can stand – at least for now.

Republican officials in Texas and several other states have ordered the suspension of most abortions as “elective” or “non-essential” procedures, as part of larger efforts to preserve medical supplies during the pandemic.

In a conference call with reporters this week, Helene Krasnoff of Planned Parenthood said “hundreds of patients” seeking abortions have been turned away in Texas and elsewhere.

On Monday, federal judges blocked orders in Texas, Ohio, and Alabama. A federal judge has now sided with Texas Attorney General Ken Paxton on appeal, lifting a temporary restraining order that had blocked the state directive suspending abortions. Legal challenges remain underway in states including Iowa and Oklahoma…

…Reproductive health groups have weighed in, saying abortion is a time-sensitive procedure and that delaying it can jeopardize women’s health.

“It is an incredibly concerning day when states would impose criminal penalties on physicians and other clinicians that are seeking to deliver care, and that is one of the main concerns that the medical community has about these actions,” said Skye Perryman, an attorney with the American College of Obstetricians and Gynecologists, told reporters.

In Texas, for example, violators would face $1,000 fine or up to 180 days in jail.

Meanwhile, a coalition of 21 Democratic attorneys general is asking the federal government to loosen restrictions on abortion pills, and on the use of telemedicine for abortion and other reproductive health services, in an effort to ease access while the nation’s healthcare system is strained…

March 31, 2020: Politico posted an article titled: “Trump rejects Obamacare special enrollment period amid pandemic”. It was written by Susannah Luthi. From the article:

The Trump administration has decided against reopening Obamacare enrollment to uninsured Americans during the coronavirus pandemic, defying calls from health insurers and Democrats to create a special sign-up window amid the health crisis.

President Donald Trump and administration officials recently said they were considering relaunching HealthCare.gov, the federal enrollment site, and insurers said they privately received assurances from health officials overseeing the law’s marketplace. However, a White House official on Tuesday evening told POLITICO the administration will not reopen the site for a special enrollment period, and that the administration is “exploring other options.”

The annual enrollment period for HealthCare.gov closed months ago, and a special enrollment period for the coronavirus could have extended the opportunity for millions of uninsured Americans to newly seek out coverage. Still, the law already allows a special enrollment for people who have lost their workplace health plans, so the health care law may still serve as a safety net after a record surge in unemployment stemming from the pandemic.

Numerous Democratic-leaning states that run their own insurance markets have already reopened enrollment in recent weeks as the coronavirus threat grew. The Trump administration oversees enrollment for about two-thirds of states.

Insurers said they had expected Trump to announce a special enrollment period last Friday based on conversations they had with officials at the Centers for Medicare and Medicaid Services, which runs HealthCare.gov enrollment. It wasn’t immediately clear why the Trump administration decided against the special enrollment period. CMS deferred comment to the White House…

…Major insurers selling Obamacare plans were initially reluctant to reopen the law’s marketplaces, fearing they would be crushed by a wave of costs from Covid-19, the disease caused by the novel coronavirus. But the main insurance lobby, America’s Health Insurance Plans, endorsed the special enrollment period roughly two weeks ago while also urging lawmakers to expand premium subsidies to make coverage more affordable for middle-income people…

…Democrats pushing for the special enrollment period are also grappling with the high costs facing many people with insurance despite new pledges from plans to waive cost-sharing. Obamacare plans and a growing number of those offered by employers impose hefty cost-sharing and high deductibles that could still burden infected Americans with thousands of dollar in medical bills.

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A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.

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