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Friday, June 23, 2023 | KFF Health News

Friday, June 23, 2023 | KFF Health News

A Year Without Roe: Cascade Of Bans, Legal Fights Shape Abortion Access

In the year since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization “dropped a nuclear bomb into public health,” as one expert said, the U.S. has become a patchwork of state laws banning or expanding access to abortion. That trend will continue, as will court battles that have extended to abortion medications and fallout at the ballot boxes.


USA Today:
‘Incalculable’ Impact: Three Ways The Supreme Court Abortion Decision Changed The USA


When the Supreme Court handed down its watershed abortion decision last year to overturn Roe v. Wade, the five conservative justices in the majority were not blind to the upheaval the ruling might spark across the nation. But back then, no one knew exactly what the response might look like. “We do not pretend to know how our political system or society will respond to today’s decision,” Justice Samuel Alito wrote for the majority. … Only rarely has a Supreme Court decision had such a profound impact so quickly on the lives of so many people. “The impact has been incalculable,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. “It’s like somebody dropped a nuclear bomb into public health.”(Fritze, 6/22)


Politico:
10 Things We’ve Learned About Abortion In The Year Since Roe Fell


Several developments defied predictions: Conservative lawmakers at the state and federal levels have struggled to agree on the parameters of abortion bans, while progressive groups have clashed over how far to go in expanding access. Doctors in states with bans have reported hesitancy around providing even legal care because of vague new policies and the fear of prosecution. Voters in Kansas, Kentucky and Montana rejected attempts to curtail access, and Democrats held the Senate in part because of their promise to protect abortion rights. With the legal and political landscape still roiling, here are 10 surprises from the past year. (Ollstein and Messerly, 6/22)


The 19th:
Even In States Where It Is Legal, Abortion Isn’t As Accessible As It Seems


The landscape of legal abortion has shifted sharply in the first year since Roe v. Wade was overturned, with some states banning the procedure almost entirely and others passing new, stricter limits. … But in many states without near-total bans, abortion is far less available than the laws may suggest. The 19th examined how accessible abortion really is across the country, looking at how far into pregnancy clinics provide care and how the available methods of abortion can vary by state. The data used was provided by INeedAnA.com, an advocacy group that works to provide the most up-to-date information about abortion options in and around the United States. (Luthra and Mithani, 6/22)


The Wall Street Journal:
What A Year In Post-Roe America Reveals About Abortion


In the first nine months post-Dobbs, there were some 26,000 fewer abortions in the U.S. within the formal medical system, a decrease of about 3%, according to data from WeCount, an abortion-data project sponsored by the Society of Family Planning, which supports abortion rights. That data doesn’t account for an increase in people ordering abortion pills from overseas, a legal gray area. (Kusisto, 6/23)

How things have changed in Mississippi, Texas, Missouri, Illinois, and Florida —


ABC News:
One Year Post-Roe, Crisis Pregnancy Centers Expand Footprint In Mississippi 


For the past year, Michelle Colon, a reproductive health advocate in Jackson, Mississippi, has not been able to bring herself to drive past the Pink House. The state’s lone abortion clinic operated by Jackson Women’s Health Organization had been forced to close its doors last July, just days after losing its legal battle before the Supreme Court and the state’s abortion ban took effect. Now, the building is painted white, the site of an upscale consignment shop – as much a symbol of victory for anti-abortion groups as the Pink House was once a symbol of defiance. (Flaherty and Kindelan, 6/23)


The Texas Tribune:
A Year After Roe V. Wade’s Overturn, Texas Sees Post-Abortion Reality


When the U.S. Supreme Court overturned Roe v. Wade, many in Texas, the largest state in the nation to ban nearly all abortions, began to cycle through the stages of grief. There was denial and anger, as thousands poured into the streets, promising to never stop fighting to turn back the clock and restore abortion access. There was bargaining, in the form of a last-ditch lawsuit to keep clinics open a few weeks longer, and depression, when it failed to change the new legal norm. Now, a year after the Dobbs v. Jackson decision, an uneasy acceptance has settled over Texas, as even the most ardent abortion advocates acknowledge these new laws aren’t changing anytime soon. (Klibanoff, 6/23)


Politico:
Abortion In Florida Remains In Limbo Until Conservative State High Court Ruling


It’s been a year since the Supreme Court struck down Roe v. Wade, but Florida’s abortion bans remain in limbo while the state’s highest court weighs what to do. The conservative-leaning Florida Supreme Court, completely overhauled by Gov. Ron DeSantis in the past four years, is poised to decide whether abortions are banned anywhere from six weeks to 24 weeks of pregnancy in the country’s third most populous state, which remains a destination for people seeking the procedure in the South. (Fineout, 6/22)

Also —


CNN:
Abortion Is Ancient History: Long Before Roe, Women Terminated Pregnancies


Abortion today, at least in the United States, is a political, legal and moral powder keg. But for long stretches of history, terminating an unwanted pregnancy, especially in the early stages, was a relatively uncontroversial fact of life, historians say. Egyptian papyrus, Greek plays, Roman coins, the medieval biographies of saints, medical and midwifery manuals, and Victorian newspaper and pamphlets reveal that abortion was more common in premodern times than people might think. This long view of abortion matters, according to Mary Fissell, a professor of the history of medicine at Johns Hopkins University. That’s because assumptions about how abortion was viewed in the past color present-day arguments about abortion rights. (Hunt, 6/23)

White House To Rally With Abortion Rights Groups To Mark Dobbs Anniversary

The Biden administration is holding a series of events over the next two days to spotlight the Supreme Court’s politically controversial decision that overturned abortion rights in the U.S. Groups like Planned Parenthood, EMILY’s List and NARAL-Pro Choice America will join Friday’s White House rally and endorse President Joe Biden for re-election.


AP:
One Year After The Anti-Abortion Ruling, The White House Keeps A Spotlight On The Issue 


Unbowed on Saturday’s anniversary, it’s the White House, not Republicans, calling the most attention to the issue with a cascade of events designed to tap into simmering rage from the overturning of Roe v. Wade. “I don’t think people are tired,” Jennifer Klein, the White House point person on gender policy, said in an interview with The Associated Press. “I think people might be mad. I think there’s a lot of fear out there. But I feel like that turns into power.” (Megerian, 6/22)


The Hill:
Major Reproductive Rights Groups To Back Biden For Reelection 


Three major reproductive rights groups are expected to back President Biden’s reelection bid during a Friday rally to mark one year since the Supreme Court overturned Roe v. Wade. Planned Parenthood Action Fund, NARAL Pro-Choice America and EMILY’s List are each slated to endorse Biden and Vice President Harris during the Friday event in Washington, D.C., which Biden and Harris are both scheduled to attend. While it is not a surprise for abortion-rights groups to support Biden and Harris, the early endorsements underscore how the issue is likely to be central to the president’s campaign heading into 2024. (Samuels, 6/22)


Politico:
Biden Can Barely Say The Word, But ‘Abortion’ Is Set To Define His 2024 Pitch


President Joe Biden has never hidden the fact that his Catholic roots can make it difficult to be a politician in favor of abortion rights. In fact, he still rarely uses the word “abortion” at all. But as the 2024 election comes into focus, Biden is poised to run the most overtly abortion rights platform of any general election candidate in political history as he and his team navigate the first presidential cycle in the post-Roe era. (Otterbein and Ward, 6/22)

In other updates from the Democrats —


Axios:
Scoop: Senate Dems Tie Abortion To Broader Health Care In New Dobbs Push


Medical associations say state abortion restrictions adopted in the wake of the Supreme Court’s Dobbs decision have restricted access not only to reproductive care, but “unrelated” health care treatments as well, according to a report from six Senate Democrats. … Democrats this week have focused on painting Republicans as anti-abortion extremists to appeal to independents and swing voters as the 2024 elections get closer.
The Senate report is led by Sens. Elizabeth Warren (D-Mass.), Tina Smith (D-Minn.), Tammy Duckworth (D-Ill.), Mazie Hirono (D-Hawaii), Maria Cantwell (D-Wash.) and Dianne Feinstein (D-Calif.). (Gonazalez and Solender, 6/23)


The 19th:
Democrats In House, Senate Focus On Abortion


Ahead of the one-year anniversary of the U.S. Supreme Court overturning Roe v. Wade, Congress is seeing a flurry of action on reproductive health as Democrats highlight ongoing concerns over the impact of abortion restrictions and raise the specter of a GOP takeover in 2024. Democratic Rep. Ayanna Pressley and other House Democrats on Thursday plan to introduce new abortion legislation designed to address disparities in reproductive health care access. The bill would guarantee a federal right to abortion and miscarriage care and protect patients and health care providers from criminalization, among other provisions. (Barclay, 6/22)


NBC News:
How A Personal Experience With Abortion Is Guiding The Senate Democrats’ Campaign Chair


It’s still hard for Sen. Gary Peters to talk about. More than 40 years ago, his then-wife’s water broke four months into a very much-wanted pregnancy. Doctors told them “there’s no way” the baby could survive, he recalled in an interview with NBC News; he and Heidi were told they should let a miscarriage happen naturally. After three days of what Peters described as “anguish,” the miscarriage didn’t come — and Heidi’s health deteriorated. But their doctor couldn’t perform an abortion. … The trauma of that moment is still palpable for Peters, now a two-term senator from Michigan and tasked, for the second time, with leading the campaign to help Democrats keep control of the Senate in the 2024 elections. (Vitali and Brown-Kaiser, 6/23)

House Conservatives Want Abortion Bill Vote As GOP Searches For Unified Footing

Republican lawmakers at the state and federal level have struggled in the past year to strike a balance on abortion, which has so far proved to be a defining campaign issue. In the House, conservative caucus members want a vote on the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act, but moderate members worry about the election impact.


Axios:
Exclusive: House Conservatives Challenge Their Leaders On Abortion


The Republican Study Committee is pushing House GOP leadership for a vote on the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act (H.R. 7), Axios has learned. Moderates and some members of GOP leadership are worried the bill could hurt members in swing districts. Frontliners have said they feel bringing H.R. 7 to the floor could hurt their ability to keep their seats, with Rep. Nancy Mace (R-S.C.) recently telling ABC News she believes the party will “lose huge” if they don’t find a “middle ground” on abortion. (Brufke, 6/23)


AP:
Evangelical Leader Hopes Conference Is ‘Testosterone Booster Shot’ For Anti-Abortion 2024 Candidates


A year after the Supreme Court overturned Roe v. Wade, some of the Republican Party’s most powerful evangelical Christian voices are gathering to celebrate a ruling that sent shockwaves through American politics and stripped away a constitutional protection that stood for almost a half century. At the Faith & Freedom Coalition’s annual conference in Washington, GOP presidential candidates will be urged to keep pushing for stronger abortion restrictions, even as Democrats insist the issue will buoy them ahead of the 2024 election. Former President Donald Trump, whose three nominees to the high court allowed for the reversal of nationwide abortion rights, will give the keynote address Saturday night, the anniversary of the court’s Dobbs v. Jackson Women’s Health Organization decision. (Weissert and Price, 6/23)


Los Angeles Times:
‘Just The Beginning.’ An Uncertain Future For Abortion A Year After Roe’s Overturn


Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, a nonprofit group that works to end abortion in the U.S. by electing anti-abortion politicians, said that almost half the states passing “pretty ambitious pro-life legislation” was a “pretty good scorecard for one year.” But Dannenfelser is not done. After playing a key role in 2016 persuading Donald Trump to commit to appointing Supreme Court justices who oppose abortion, she is working to push Republican presidential candidates to support, at the minimum, a 15-week national abortion ban. “The fall of Roe marked the beginning of the race, it’s not the end of anything,” Dannenfelser added. “This is the most motivating moment for the pro-life movement since 1973.” (Jarvie, 6/22)


MPR News:
Abortion Opponents Say They’ll Work To Roll Back Minnesota Law Changes 


Minnesota lawmakers removed abortion restrictions this year and guaranteed access to abortion in state law. Groups opposed to abortion say those changes have energized their members and that they’ll mobilize Minnesotans to roll them back. Lynesha Caron is trying to figure out how to balance the books with a quarter of her annual budget gone. Caron is executive director at Pregnancy Choices in Apple Valley, one of dozens of “crisis pregnancy centers” around the state that works with Minnesotans facing unplanned pregnancies. They don’t provide abortions, nor do they refer clients for abortion services. Instead, they offer pregnancy tests, ultrasounds, counseling and parenting classes. (Ferguson, 6/22)

On Republican presidential candidates —


Politico:
Mike Pence Leans In On Abortion Politics


Saturday marks one year since the Supreme Court overturned Roe v. Wade, revoking the constitutional right to abortion. And ever since, Republicans have been twisting themselves in knots over how to handle the fallout. Former President Donald Trump avoids talking about the matter almost entirely. Florida Gov. Ron DeSantis signed a six-week abortion ban in the middle of the night in April, and has barely spoken about it since. Sen. Tim Scott (R-S.C.) originally waffled on whether he’d support a nationwide abortion ban. And former South Carolina Gov. Nikki Haley has been vague about how she’d handle the issue as president. Then there’s former Vice President Mike Pence. More than any other Republican candidate, the former vice president has staked his pitch to voters on his unabashed “pro-life” stance. (Bade, 6/23)


CNN:
Trump Struggles To Navigate Defining 2024 Campaign Issue: Abortion


Donald Trump’s appointment of three conservative justices to the Supreme Court during his time in the White House made him the architect of the post-Dobbs world, a decision that thrilled a huge faction of the Republican Party and many of the evangelical Christian voters Trump has viewed as central to both his 2016 presidential win and his 2024 campaign. Yet even as he wants to take credit for the decision that changed the political and legal landscape of abortion, the former president has privately blamed abortion hard-liners for the party’s lackluster 2022 midterm results and attempted to largely steer clear of the issue on the campaign trail, offering only a series of muddled responses when pressed on whether he would sign a federal abortion bill into law – something many within the conservative movement see as the next frontier in this fight. (Treene and Holmes, 6/22)


Des Moines Register:
Iowa Anti-Abortion Leaders Say GOP Candidates Must Embrace Federal Ban


A panel of anti-abortion advocates sent a message to Republican presidential hopefuls campaigning in Iowa: Embrace a national abortion ban or risk losing in the caucuses. During a town hall at Experience Church in Des Moines, a group that included Iowa’s Bob Vander Plaats of The Family Leader and U.S. Sen. Lindsey Graham of South Carolina called on the growing primary field to face the issue of abortion head-on. (Bacharier, 6/22)

Abortion Providers And Clinics Struggle With Moral, Ethical Choices

Some physicians say the past year has been the toughest of their careers. Dozens of clinics have halted or changed their services in the past year, and many clinics in states where abortion is still legal say they are barely hanging on amid bottlenecks and wait times.


North Carolina Health News:
After The Fall Of Roe, Physicians Confronted Their Toughest Year Working In Reproductive Health Care 


Even for those who have been practicing for years, like OB-GYN Amy Bryant, it’s unquestionable that the past year has been the most challenging and exhausting time to be in the reproductive health care field. … “When I think back to the early days after the Dobbs decision after Roe v. Wade was overturned, I just really think about the chaos and the uncertainty and the difficulties that we confronted, like, almost instantaneously with this new law of the land,” Bryant said. “It was truly just kind of scary.” (Crumpler, 6/23)


AP:
Why Some Doctors Stay In US States With Restrictive Abortion Laws And Others Leave


Dr. Kylie Cooper chokes up thinking about the patients she left behind in Idaho. One who often comes to mind is Kayla Smith. Smith said she chose to end a desperately wanted pregnancy last year after discovering her fetus had potentially deadly heart defects and other problems. But Idaho banned nearly all abortions after the U.S. Supreme Court overturned Roe v. Wade in June, so Smith had to go to Washington state. Cooper felt “deeply saddened” she couldn’t care for her the way she normally would have. And this is one of the reasons Cooper, a maternal-fetal specialist, moved in April to Minnesota, which has broad abortion rights. (Ungar, 6/23)


ABC News:
Termination Boards: How Physicians Are Providing Abortions Within Exceptions Allowed By Bans


Physicians in several states told ABC News that facilities are using termination boards or medical ethics boards to navigate whether they can provide patients with medically necessary abortions in line with exceptions allowed in their states. Dr. Nicole Teal, a maternal fetal medicine specialist, told ABC News that abortions past 20 weeks of pregnancy in the hospital where she works in North Carolina require two physicians to sign off in cases where the mother’s life is at risk. In most cases, both physicians are specialists. In July, North Carolina will start enforcing a ban that prohibits abortions past 12 weeks of pregnancy, with an up to 20-week exception for rape or incest and 24 weeks for fatal fetal anomalies. (El-Bawab, 6/23)

KFF Health News:
Malpractice Lawsuits Over Denied Abortion Care May Be On The Horizon

A year after the overturning of Roe v. Wade, many physicians and hospitals in the states that have restricted abortion reportedly are refusing to end the pregnancies of women facing health-threatening complications out of fear they might face criminal prosecution or loss of their medical license. Some experts predict those providers could soon face a new legal threat: medical malpractice lawsuits alleging they harmed patients by failing to provide timely, necessary abortion care. (Meyer, 6/23)

How clinics are faring —


The New York Times:
Dozens Of Clinics Have Closed Or Halted Abortions Since The Supreme Court’s Decision To Overturn Roe V. Wade


In the year since Roe fell, 20 states enacted laws banning or restricting abortion, forcing a rapid shift in the country’s patchwork of abortion access. Clinic owners scrambled to adjust, canceling appointments and helping patients travel elsewhere. Some clinics relocated, while others stayed open to provide the services they still could. Many simply closed, leaving behind empty buildings. In Milwaukee, this former clinic is for sale for $1 million. The real estate agent says he’s had a hard time finding buyers. (McCann and Walker, 6/23)


The Texas Tribune:
A Year After Roe V. Wade’s Overturn, Texas Sees Post-Abortion Reality


Dr. Alan Braid first started performing abortions in Texas shortly after Roe v. Wade was decided in 1973. Over the last 50 years, he built two clinics, raised a family and merged the two after his daughter, Andrea Gallegos, came in to help run Alamo Women’s Reproductive Services in San Antonio and Tulsa. Together, this multigenerational Texas family business weathered protesters and lawsuits and ever-increasing restrictions from the Legislature. But on June 24, 2022, that all came to an end. Immediately, the clinic stopped performing abortions. A few weeks later, they closed their doors for good. And one year later, Braid has moved to Albuquerque, New Mexico, and Gallegos is preparing to move her family to Carbondale, Illinois, each to run one of the two new Alamo clinics. (Klibanoff, 6/23)


The Boston Globe:
One Year After Roe V. Wade Was Overturned, N.H. Abortion Providers Say They Feel The Effects 


Saturday marks one year since the US Supreme Court overturned the constitutional right to abortion, striking down Roe v. Wade. Abortion providers in New Hampshire say they’ve been feeling the effect of the decision, from more people coming from out of state for abortion care to more protests outside of the Equality Health Center in Concord. And, on the eve of the anniversary, the state’s two Democratic US Senators say they’re going to keep pushing to ensure people have access to reproductive health care. (Gokee, 6/22)


Politico:
Inside An Abortion Clinic That Fled A Red State


When you drive up to the Red River Women’s Clinic, you’ll see John Gaffrey on the street corner, perched in between two signs depicting aborted fetuses, his arms draping over the large pieces of cardboard like a scarecrow. Then there’s Bonnie Spies, who sways back and forth holding her rosary, murmuring prayers. Nick is so quiet, you wouldn’t know a loud yell could come out of him. Until you hear his booming voice carry over the lot as a patient walks through the clinic’s front door. “We’re here to help!” yells Nick, who’s reluctant to give his last name. (Ward, 6/23)

Denied Care, Distant Travel: Women Tell Their Stories Of A Post-Roe US

Many women of reproductive age in the U.S. have been impacted over the last year as new state laws and court decision quickly shifted how pregnant women are treated. Some tell news outlets about their personal stories of fear and uncertainty, difficulty in getting care, and dangerous outcomes.


CNN:
One Year After Dobbs Decision, Families Describe Terror, Trauma And Putting ‘Pain To Purpose’


“No one can tell me that my experience is wrong,” said Jill Hartle, a hair salon owner who had to travel out of her home state of South Carolina to terminate a pregnancy after learning that her fetus had a severe heart defect. “They can’t tell me my feelings are wrong. They can’t tell me the trauma is not valid. Nobody can take that away from me. I feel so confident in what I’m speaking to, because I’ve experienced it.” (Cohen, 6/22)


NPR:
8 Very Personal Stories About New Abortion Laws 


Last fall, NPR asked people to tell us how abortion laws in their states had affected their own lives. The response was striking — more than 350 people responded, and we featured several of their stories in a series entitled Days & Weeks. Their stories are not simple. The impacts of the new laws are surprising and varied. Here are excerpts from personal accounts sent to NPR from around the country describing how abortion laws changed their lives in the past year. (6/23)


Dallas Morning News:
Dallas Mom Tells First Lady Of ‘Demeaning’ Ordeal With Doomed Fetus, Texas Abortion Ban


Two Texas women whose doctors refused to perform legal and medically urgent abortions met Tuesday with first lady Jill Biden, recounting their ordeals as the White House pressures Congress to codify rights the Supreme Court erased nearly a year ago. “Even prayed-for, planned pregnancies can end in abortion,” said one of the women, Austin Dennard, a Dallas physician with two kids and a third due in August. “The state of Texas should not be making these decisions for me or for anybody else.” (Gillman, 6/20)