Anti-abortion activists looking beyond SCOTUS case

Mar 27, 2024

Driving the Day

An anti-abortion activist and other demonstrators are seen outside the U.S. Supreme Court.

Anti-abortion activists rallied outside the Supreme Court where FDA v. Alliance for Hippocratic Medicine was being argued. | Francis Chung/POLITICO

BACKUP PLANS — The Supreme Court seemed skeptical Tuesday of a lawsuit challenging FDA decisions loosening access to abortion pills — so the anti-abortion movement is staking out some new approaches.

Plans from anti-abortion activists and others include more legal challenges, executive orders, pressure campaigns and the use of environmental and wildlife laws, POLITICO’s Alice Miranda Ollstein and Josh Gerstein report. A SCOTUS decision is expected in June.

“We’re not putting all our chips on this one case,” said Jesse Southerland, federal policy director for Americans United for Life.

What the plans include:

— Protests: On Tuesday, the anti-abortion group Students for Life of America held simultaneous rallies outside the Supreme Court, where FDA v. Alliance for Hippocratic Medicine was being argued, and Walgreens headquarters in Chicago — part of a bigger campaign to boycott and picket pharmacy chains that have agreed to dispense mifepristone in some states.

— Executive orders: Students for Life is also part of a coalition of conservative organizations, led by the Heritage Foundation, preparing executive actions for a potential second Trump administration. Heritage’s Project 2025 manifesto suggests ways to “institutionalize the post-Dobbs environment,” including directing the FDA to rescind its two-decade-old approval of mifepristone.

— Comstock Act enforcement: The 151-year-old, long-dormant federal law bans mail delivery of any “lewd or lascivious material,” including any “instrument, substance, drug, medicine, or thing” that could be used for an abortion. Legal experts say the law would cut off access to medical equipment used for surgical abortions and other procedures — creating a de facto national ban and potential disruptions to routine care.

— State action: Americans United for Life and other anti-abortion groups are drafting model legislation for states they hope will join the ranks of 14 others that have near-total abortion bans, including policies like ultrasound requirements, mandatory waiting periods and specific scripts doctors would be required to read to patients seeking the pills.

Democrats and abortion-rights advocates, well aware of the efforts to target abortion pills, are making contingency plans.

A growing number of blue states are passing “shield laws” protecting doctors from prosecution if they prescribe mifepristone to a patient in a red state via telemedicine, and several have stockpiled misoprostol — the second drug in the two-pill regimen — in case mifepristone is cut off.

But many Democratic groups see winning the presidential election — and preventing a GOP takeover of the Senate — as the strongest safeguard for the pills, regardless of what ruling the Supreme Court decides.

WELCOME TO WEDNESDAY PULSE. A team of researchers from Cornell, Oxford and other universities says one way to prevent the next pandemic is to restore bats’ habitats. This prevents them from scavenging for food in heavily populated areas, potentially infecting people and animals with diseases.

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Opioids

A urine sample is pictured in a lab.

Democrats propose that people receiving government assistance be required to be screened for drugs — a measure similar to requirements in many Republican-leaning states. | Damian Dovarganes/AP Photo

A SCREENING CASE — Democrats are embracing a concept approved by San Francisco voters last month: requiring people on government assistance to submit to regular drug screenings and mandatory treatment if they show signs of addiction, POLITICO’s Dustin Gardiner and Maya Kaufman report.

The measure has stunned drug-policy reformers who see it as a Republican talking point. Democrats, however, say it’s about preserving lives as overdose deaths skyrocket.

Their position is a sharp change of course after years of liberal cities supporting harm-reduction drug policies like clean-needle exchanges and safe injection sites. The move in San Francisco comes amid a larger shift toward tough-on-drugs and crime policies in blue cities, where Democrats are exasperated by urban challenges in the pandemic’s wake.

HHS Secretary Xavier Becerra, a California Democrat whose department oversees much of the administration’s addiction-response efforts, seemed open to the idea.

“Knowing San Francisco well, we should be willing to consider anything that helps us tackle this drug addiction crisis because so many people are dying today,” Becerra said at POLITICO’s Health Care Summit this month. “We need to get a grip on this.”

Many Republican-leaning states require welfare applicants to complete a questionnaire about their substance use and, depending on their answers, pass a drug test as a condition of eligibility.

Public health experts worry, however, that the San Francisco initiative will fail because drug-screening policies aren’t shown to be effective in decreasing addiction and could perpetuate stereotypes about welfare recipients. Between 5 and 10 percent of welfare recipients struggle with substance abuse, a slightly higher rate than among the general population, according to HHS.

2024 Elections

TRUMP WANTS ‘MUCH BETTER’ ACA — Former President Donald Trump said in a social media post Tuesday that he’s “not running to terminate” the Affordable Care Act but to make it “much, much better."

Trump’s post is a shift from November: On his social site Truth Social, he hit his own party for failing to overturn the ACA and said he was “seriously looking at alternatives.” Trump hasn’t yet been clear on what that alternative would be, and Republicans have largely shrugged off the idea.

In the new post, Trump promised to make the ACA stronger and “far less expensive” instead of outright repealing it. On Tuesday, Trump’s campaign also attacked the Biden campaign, which is prepping to go after Trump on health care, particularly accusing the former president of harboring a vendetta against the ACA.

President Joe Biden and Vice President Kamala Harris went to North Carolina on Tuesday to tout the president’s record on health care. The ACA hit a milestone this year with more than 20 million people enrolled in marketplace plans.

In a campaign email, the Trump team accused Biden of lying about his health care record, pointing to rising health care costs.

Providers

DOCS: DATA-SHARING SATISFYING, NOT EASY — Most primary care doctors appreciate being able to access health information from outside organizations, but less than a quarter find the exchange network user-friendly, according to a new study published in JAMA Network Open.

Why it matters: The 21st Century Cures Act — signed into law in 2016 and finalized as a rule in 2020 — sought to allow health information to flow between systems more easily. The survey of more than 2,000 physicians nationwide, taken between December 2021 and October 2022, found that six years after the law passed, doctors were still struggling to use information from different electronic health record systems.

According to the survey, 70 percent were “somewhat satisfied” with access to outside information. Twenty-three percent said it was “very easy” to use outside information, and 8 percent said it was “very easy” to use information from different electronic health systems.

Doctors reported barriers to outside information that impacted their satisfaction, from missing key data in a patient’s record to difficulty finding information at all.

In Congress

GOP WARNS ABOUT CANNABIS PSYCHOSIS — Some House Republicans are concerned about the impact of cannabis on developing brains, POLITICO’s Natalie Fertig reports.

The House Republican Policy Committee is imploring Republicans in a new report to vote against the cannabis banking bill and legislation that would prohibit federal agencies from refusing to hire someone or denying a security clearance due to cannabis use.

The report points out that cannabis potency has increased dramatically over recent decades. It also cites a recent Wall Street Journal article regarding a rise in cases of cannabis use disorder, as well as reports that draw connections between prolonged cannabis use and violent behavior and indicate that cannabis interferes with brain development.

The impact of cannabis on adolescent brains is one of the biggest public health concerns raised by legalization. Yale scientist Deepak D’Souza told POLITICO in 2021 that scientific data suggests exposure to high-potency THC can increase the potential in adolescents for schizophrenia. He added that cannabis is “neither necessary, nor sufficient” to cause psychosis on its own but can be a component that interacts with other factors to contribute to psychosis.

Not all House Republicans agree with the RPC’s position on cannabis policy. Rep. Dave Joyce (R-Ohio), a co-chair of the Congressional Cannabis Caucus, pointed out via a spokesperson that “over 100 House Republicans support [SAFE].”

The RPC did not respond to requests for comment.

Names in the News

Heather Aaron is now CEO of Whitman-Walker Health System. She previously was a deputy commissioner for the Connecticut Department of Public Health.

WHAT WE'RE READING

The New York Times reports on how popular weight-loss drugs may change patient resistance to “forever drugs.”

STAT reports on a European antitrust inquiry into a drugmaker of pain medication for dogs.

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