Abortion – Abortion Clinics, Abortion Pill, Abortion Information

Hello, Missouri? Do you mind if I call you Missouri?

It just has a nicer ring than “Missouri State Legislature,” though of course there are plenty of people inside the state working against anti-choice machinations. I’m just going to call you Missouri for short, though. You don’t mind, do you?

I thought it might be nice for us to sit down and catch up. It’s been two years since we last had a chat: In 2015, I wrote you an open letter about your herculean efforts to regulate the last clinic in your state out of existence.

Fortunately, despite your best efforts, clinic access in Missouri is actually getting better. Prior to September of this year, there was only one standalone abortion clinic—the same one you tried for years to shut down. Now, as Rewire reported back in September, Planned Parenthood has opened a second. And according to this report from Christina Cauterucci at Slate, the state might soon have five clinics.

Five! That’s good news for pregnant people that live inside you, Missouri.

But you haven’t given up trying to stick it to them.

During the 2017 regular legislative session, you tried to pass more than 20 bills. All of them failed. And then in June, your Republican governor, Eric Greitens, called a second special session—to focus on cracking down on abortion. It was a Hail Mary attempt to ram through ten more bills restricting abortion access.

All of them failed except one, SB 5—and that one is already in litigation.

SB 5 is an omnibus Frankenbill—pieces of different bills grafted together—that Gov. Greitens signed into law on July 26. It contains pieces of bills that the legislature couldn’t get passed during the regular session.

One provision of SB 5, which gives your attorney general “concurrent original jurisdiction”(legalese for “allows the AG to open independent investigations into alleged clinic violations”) comes from two failed regular session attempts to pass the same policy—one in the house and one in the senate. That section was rammed through out of concerns that local governments—in St. Louis, for example—are run by Democrats and are too progressive, according to GOVERNING. “The prosecuting attorney in St. Louis is a pro-choice Democrat, so we just wanted another set of eyes there,” Andrew Koenig (R-Manchester), the state senator who sponsored SB 5, is reported to have said.

It takes a red-blooded Republican to harass clinics out of existence, I reckon.

Another section of SB 5, meanwhile, comes from a failed regular session bill—HB 989—that purported to prohibit cities or towns from declaring themselves “sanctuaries” for abortion. Some readers may be asking: What the hell is an abortion sanctuary?

Great question. First and foremost, the language is probably a scare tactic that Republicans are using to capitalize on the pervasive, racist, and unwarranted fear of undocumented immigrants, what with cities around the country refusing to kowtow to President Donald Trump by announcing that they would become “sanctuaries” for undocumented immigrants to live without worrying, at least in theory, that any interaction with a public official or agency would result in deportation. The “abortion sanctuary” term is tacky at best, but tackiness is no stranger to you, is it Missouri? (Remember the “All Lives Matter” Act, which your legislature tried to pass in 2016? HB 1794? Exactly. Tacky.)

But aside from that, what is an abortion sanctuary city? Anyone’s guess is as good as mine, although St. Louis is apparently one. This actually gets a little bit weird: St. Louis passed an ordinance in February that prohibits discrimination on the basis of a person’s reproductive health-care decisions. So, for example, an employer couldn’t refuse to hire you because you use birth control, have had an abortion, or are pregnant. Seems pretty straightforward.

Not to Gov. Greitens, though. Apparently, by calling the special session, he intended to make do on his promise at an anti-abortion rally back in March to stop those “crazy liberals and their allies at organizations like NARAL that are trying to create an abortion sanctuary city right here in the state of Missouri.”

Why your governor has his knickers in a twist about St. Louis’ ordinance is anybody’s guess. The “no country for old abortion” provision of SB 5 really has nothing to do with the city’s ordinance.  It bans local governments from enacting laws that would force a person to participate in an abortion if they didn’t want to, or force a property owner to sell or lease property to a clinic, or interfere with the operations or free speech rights of “crisis pregnancy centers.”

As St. Louis Alderwoman Megan Greene told Missourinet before SB 5 was signed into law, the bill doesn’t even address St. Louis’ nondiscrimination ordinance.

Is there something in the statehouse water? Because Republicans there aren’t make any sense.

Another section of SB 5 requires abortion providers to create a “complication plan” for medical abortions and to get that plan approved by the Missouri Department of Health and Human Services (DHHS). It’s a TRAP law (that’s Targeted Regulation of Abortion Provider, for those who don’t know) that the house tried to pass on its own, to no avail.

In the wake of SB 5’s passage, DHHS issued a memo on October 2 stating that it would be filing emergency rules setting out the standards for complication plans this week, according to St. Louis Public Radio. Doctors who provide medical abortions would be required to contract with an OB/GYN to treat any complications that arise. If that sounds sort of like an admitting privileges law—the kind that the Supreme Court struck down in Whole Woman’s Health v. Hellerstedt because Texas provided no evidence that the law would actually improve women’s health and safety—that’s because it kind of is. And that’s why I’m pretty sure once the DHHS issues standards for these complication plans, Planned Parenthood or another group will file a lawsuit challenging them. (Planned Parenthood has not done so yet, likely because the lawsuit is not “ripe”—in other words, there are no standards yet with which clinics have to comply, so clinics have nothing to sue about. As soon as those standards are issued, however, the lawsuit will become “ripe” and Planned Parenthood will be able to file a lawsuit challenging them.)

And then there’s the provision that has landed SB 5 in court: the “same physician” requirement, which you added to your “informed consent” requirements. This is where it gets truly ridiculous.

You already have a pretty extensive regulatory framework about consent, Missouri. Pregnant people must go to a clinic to receive state-mandated information in a private setting both in writing and orally. And pregnant people have to do all of this 72 hours before the abortion. This means that someone who, say, lives four hours away from a clinic might have to make at least two eight-hour trips in a week to access care. It’s a pain in the ass, is what I’m saying, Missouri.

And now, in addition to all of that, SB 5 requires that the state-mandated information be given by the same physician who is going to perform the abortion. It used to be that the information could be provide by a “qualified professional.” But that wasn’t enough. Now you want to stretch already thinly stretched abortion doctors even further, by forcing them to take on added counseling responsibilities?

What is the health benefit of that, Missouri? Oh, there is none and you know it.

And I’d be willing to bet that your little law doesn’t pass the Whole Woman’s Health v. Hellerstedt smell test, which requires a law that is touted as being for the benefit of women’s health and safety to actually be for the benefit of women’s health. States just can’t claim it is and rest smugly on their laurels. The resident U.S. Supreme Court data nerd—Justice Stephen Breyer—isn’t having any of that. States have to prove it.

And I don’t think you can prove it, Missouri. And neither does Comprehensive Health of Planned Parenthood Great Plains, which is why it sued you in the first place. Sure, the district court judge Monday said that the waiting period is constitutional and that the same-physician requirement is constitutional. Jackson County Circuit Court Judge S. Margene Burnett said that the scarcity of abortion doctors isn’t your fault, Missouri, and that the law doesn’t impose an undue burden on the right to an abortion. Really, Marge?

Pfft. We’ll just have to see what happens when the Supreme Court gets their hands on this one. First, the scarcity of abortion doctors actually is your fault, Missouri: You tried to pass over a hundred bills regulating the one clinic out of existence. And now that you have successfully whittled down the number of abortion doctors in the state—either because they have no practice or because they fear criminalization—suddenly it’s not your fault?

That’s not how this works. At least, that’s certainly not how it should work.

Aside from your looming court battles, let’s chat about some of the other nonsense you tried to pull this year, Missouri.

You tried four times to make 20-week abortion bans happen. Like so much “fetch,” it didn’t. You also took several stabs at trying to make personhood happen. That didn’t happen either. You tried to ban abortion outright (HB 1177) and also tried to ban it at six weeks (SB 408), which is when a heartbeat can be detected. Neither of those laws is constitutional, Missouri. You know better.

You introduced several bills that regulated or banned fetal tissue donation, several bills dedicated to making it more difficult for pregnant teens to obtain abortion care, and a couple bills that criminalize prenatal drug and alcohol use, virtually ensuring that pregnant people who happen to be addicted to drugs won’t seek care out of fear of imprisonment.

And you also tried to pass several bills that would let CPCs continue to prey on pregnant people, by prohibiting local governments from regulating them.

Plus, there were a couple of bills that defy logic and categorization: laws that seem designed just to piss me off. Yes, me, specifically. A bill requiring that the state museum include an abortion exhibit? And that the abortion exhibit must be near the exhibit on slavery? (This, of course, was introduced by the same guy who introduced the All Lives Matter Act personhood bill.)

You’re out of control, Missouri. More than 35 bills and you managed only to pass one, which is already in court.

You’re like one of those unmoored oversized floats you see at the Thanksgiving Day parade in New York City—you know the one that gets loose because it was manned by a dude who accidentally put too much whisky in his coffee?

You’re off your tether, Missouri, and you’re lumbering around knocking over telephone poles and stripping pregnant people of their human rights.

And let’s face it, you’re probably going to get your ass handed to you by Planned Parenthood, and then your taxpayers are going to have to pay Planned Parenthood’s attorneys’ fees, and it seems that money could be better spent on—I don’t know—expanding Medicaid?

Look, Missouri, I know it’s not the entire state that has been making some questionable decisions. There are plenty of lawmakers and grassroots activists working hard to make life better for pregnant people in Missouri. Many Missourians love their state and just want to be healthy and to prosper. That doesn’t seem to be Republicans’ bag, though.

So I don’t know what to tell you, Missouri.

You’re the “show me” state, right? So show me some thing good. Show me that people in Missouri can rest assured that they will have access to affordable health care, including abortion. Maybe show Republicans the door. Otherwise you’ll remain—as a friend from Missouri once told me—the “show me the way out” state. And you don’t want that, do you?

Of course not.

Good walk and talk Missouri. Let’s not have this conversation again. It’s exhausting.

https://rewire.news/ablc/2017/10/24/hi-missouri-can-talk-abortion-minute/

A teenage immigrant who had been barred by federal officials from accessing abortion care can now have the medical procedure after the full U.S. Court of Appeals for the D.C. Circuit on Tuesday overruled a three-judge panel of the court that had temporarily blocked the teen from having an abortion.

It has been an arduous legal battle for the unaccompanied 17-year-old from Central America, who has been “held hostage” by the Office of Refugee Resettlement (ORR), the agency that oversees unaccompanied immigrant minors. Advocates told Rewire that ORR Director Scott Lloyd, who is vehemently anti-choice and refuses to allow the teen to access abortion care, is a sign of “anti-choice fanaticism” making its way into the federal immigration system.

After having an initial emergency order denied that would have allowed the teen to access abortion care, the American Civil Liberties Union (ACLU), acting on behalf of Jane Doe, sought a second emergency order last week. U.S. District Court Judge Tanya S. Chutkan on Wednesday ordered the federal government to allow the teenager to have the medical procedure, but the Trump administration late Wednesday filed an appeal with the D.C. Court of Appeals asking for an emergency ruling to block the ruling recognizing Jane Doe’s right to abortion care. The circuit court on Thursday issued an administrative stay, which delayed abortion care for the undocumented teenager. A three-judge panel heard arguments from the government and ACLU attorney Brigitte Amiri on Friday, later issuing a 2-1 decision on Jane Doe’s case, giving the undocumented teen until October 31 to secure a sponsor. Once a sponsor is secured, Jane Doe would be released from the custody of Health and Human Services (HHS), which oversees ORR, and she could access the medical procedure.

On Sunday night, the teen’s attorneys petitioned for en banc review, “asking the full bench of a federal appeals court in Washington to permit her to have an abortion immediately,” Politico reported.

Jane Doe, who is being detained at a shelter in Texas, has complied with all of the state laws required to access abortion care, including obtaining a judicial bypass when she was nine weeks pregnant. This week she will be 16 weeks pregnant. The state of Texas bans abortion after 20 weeks and in the Rio Grande Valley, where Jane Doe is detained, there is only one clinic.

“Every additional day she must remain pregnant against her will places a severe strain on [Jane Doe], both physically and emotionally. Every additional week the government delays her abortion increases the risks associated with the procedure,” the teen’s attorneys wrote in the petition for en banc review. “In a matter of weeks, J.D. will no longer be able to get an abortion at all, and the government will have forced [Jane Doe] to have a child against her will.”

Source: Jane’s Due Process

Jane’s Due Process outlined how as ORR forces Jane Doe to carry an unwanted pregnancy, not only do her chances of accessing abortion care become slimmer, but the procedure becomes more complicated. If the undocumented teen would have been granted access to abortion care when she initially requested it, the procedure would have taken ten minutes.

There are far-reaching concerns for Jane Doe’s case, including whether ORR will now make a practice of attempting to veto or block teens in its care who are granted judicial waivers to access abortion care.

The government’s stance is that its refusal to facilitate transportation for Jane Doe’s abortion care, meaning its refusal to provide transportation and its refusal to allow her guardian to provide transportation, does not constitute an undue burden.

Jane Doe could have accessed an abortion by now if she were an adult in an immigrant detention center overseen by Immigration and Customs Enforcement or as an undocumented adult in prison for committing a crime. But because she is a minor in legal custody of ORR—and ORR maintains an interest in “fetal life and child birth,” as it made clear in Friday’s arguments—the teen is being forced to carry an unwanted pregnancy.

Alex Azar, whose resume includes stints as a pharmaceutical executive, working in George W. Bush’s Department of Health and Human Services (HHS), and clerking for the late Supreme Court Justice Antonin Scalia, is reportedly being considered by the Trump administration to lead HHS.

Trump “is leaning towards” nominating Azar to replace Tom Price after the HHS secretary resigned last month, according to a Tuesday report from Politico.

Azar worked from 2001 to 2007 at HHS under the Bush administration, first as general counsel and later as its deputy secretary. During his tenure at the agency, Azar worked on stem-cell research policy, among other areas. After departing HHS, Azar moved to pharmaceutical company Eli Lilly and Company from 2007 until January 2017, the last five years of which he spent as president of its U.S. affiliate, Lilly USA, LLC.

Lilly and Company is listed as a corporate sponsor of Population Services International (PSI), whose work includes training abortion providers and providing supplies for medical abortions. The pharmaceutical company worked with PSI on its diabetes prevention and management program in India. Lilly and Company’s CEO also signed onto a 2015 letter opposing then-Indiana Gov. Mike Pence’s signature religious imposition law, which gave businesses the green light to discriminate against LGBTQ people.

The company also gave money to the Republican Governors Association.

Data accessed through the National Institute on Money in State Politics reveals that Azar has donated to Vice President Mike Pence’s campaigns, including a $2,950 donation to his 2012 gubernatorial campaign, $1,000 to his gubernatorial re-election efforts in 2016 prior to becoming the nominee for vice president, and another $500 to Pence’s successful 2010 bid for the U.S. House of Representatives.

Pence is hardly the only Republican to have received campaign funds from Azar. In July 2016, he gave $2,700 to the Trump Victory fund, a joint fundraising venture between the Trump campaign and the Republican National Committee, campaign finance records show. Other members of the party who have received donations from Azar include former U.S. senator and current Director of National Intelligence Dan Coats, Sens. Todd Young (IN), Mitch McConnell (KY), and Orrin Hatch (UT), along with failed presidential candidate Jeb Bush.

Azar didn’t just support Jeb Bush’s 2016 presidential campaign financially, he served on his campaign’s Indiana steering committee, according to a report from the Indy Star. Bush was a vocal opponent of abortion rights and repeatedly pushed his anti-choice record as Florida governor. He told the Associated Press in January 2016 that he would like to see Roe. v. Wade overturned and vowed to expand funding for anti-choice crisis pregnancy centers if elected—something he did in his home state.

Health Care in Azar’s Own Words

In a video published on YouTube by the Zetema Project, a group of health-care stakeholders that meet to discuss the industry, Alzar spoke positively of block granting Medicaid. “I think there’s a lot to commend a block grant approach because the states are the laboratory for experimentation,” he says. “Block granting really says … ‘Here’s an amount of money, you figure out the best way to provide insurance to those who are unable to afford it in your state.’ It makes them better stewards of the money. It becomes their money again to make the choices.”

But converting Medicaid to block grants “would do irreparable damage to the safety net at a time when demand for publicly funded family planning continues to grow,” Audrey Sandusky, the director of advocacy and communications at the National Family Planning & Reproductive Health Association, toldRewire in March. The increased flexibility given to states through block grants could also open the door for some to restrict access to certain kinds of reproductive health care and restrict access to some providers. It could also hamper states’ ability to deal with public health crises and economic downturns by capping how much the government allots to states annually.

Though Medicaid expansion has drastically improved access to health care for people with low incomes, in another video for the Zetema Project, Azar said he didn’t believe that the expansion under the Affordable Care Act (ACA) had been successful though he did not say why. Instead, he said, expansion efforts should have instead “chosen vehicles that actually harnessed the private sector.”

An analysis from the nonpartisan Kaiser Family Foundation released last month overviewing findings from 153 studies on Medicaid expansion found that, “the large body of research on the effects of Medicaid expansion under the ACA suggests that expansion has had largely positive impacts on coverage; access to care, utilization, and affordability; and economic outcomes, including impacts on state budgets, uncompensated care costs for hospitals and clinics, and employment and the labor market.”

Azar, since departing from Lilly, has appeared on Fox Business Network to discuss health care. When Congressional Republicans continued their efforts to repeal the ACA despite warnings from the Congressional Budget Office (CBO) that the House version of the bill could leave as many as 23 million more people uninsured, Azar defended the legislation during a July appearance on Fox Business Network and claimed it would leave the country “better than where we are under Obamacare now.”

During the interview, he chided Republicans for not speaking enough about what he called the “benefits” of the legislation and joined the conservative media network in its crusade to cast doubt on the nonpartisan CBO. Though Fox News host Stuart Varney and Azar alluded to the GOP talking point that CBO estimates for the ACA were off, as media watchdog Media Matters for America noted in March, “According to an independent analysis of the CBO’s Affordable Care Act estimates from the Commonwealth Fund, the office’s health care policy analysis regarding the ACA actually ‘proved to be reasonably accurate’ and was thrown off by Supreme Court decisions and GOP political obstruction that it had no way to forecast.”

Azar appeared in July on Neil Cavuto’s Fox show, when he discussed what then-HHS Secretary Price could legally do to address problems with the ACA. He said that if he were head of HHS, he would “grant waivers to states to create much more flexibility in his exchanges.”

“I would do a top to bottom comprehensive rewrite of the regulations of Obamacare, imposing as much free market, localized flexibility as humanly possible,” said Azar.

Azar also appeared on the network’s Mornings with Maria program in June. He confirmed that he had been at the White House that week and had discussed ACA repeal efforts with Pence, according to transcript of the segment.

https://rewire.news/article/2017/10/19/meet-trumps-reported-top-choice-health-human-services-secretary/