Developments in Abortion, Autonomy, and Access:
This week’s Repro Health Digest discusses a new lawsuit challenging in-person requirements for medication abortion in Alaska, two state court decisions striking down abortion restrictions, a new lawsuit targeting transgender healthcare, and the Supreme Court’s decision not to hear a case involving anti-abortion speech at the high school level. We also examine how abortion bans are impacting the economy, the Trump Administration’s quiet nod to the fetal personhood movement, state-level attacks on mifepristone, and a Texas mural honoring women who lost their lives to the state’s abortion ban. As always, please read on to the end for the news that you need to know.
Legislation & Litigation:
Overview:
Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky has filed a new lawsuit challenging Alaska’s ban on telemedicine abortion;
The Federal Trade Commission and states have filed a lawsuit against the World Professional Association for Transgender Health alleging deceptive claims;
A Missouri Court has struck down a series of anti-abortion restrictions, opening the door for patients to access medication abortion for the first time in years;
The U.S. Supreme Court has declined to hear a case brought by a former high school student challenging her school’s prohibition on flyers with anti-abortion political messaging; and
A Wyoming court has struck down three medically unnecessary abortion restrictions.
Planned Parenthood Sues Alaska Over In-Person Requirements for Medication Abortion:
Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky has filed a lawsuit challenging Alaska's ban on telemedicine abortion. Under current law, abortion is legal in Alaska, but individuals seeking to use medication must have an in-person clinic visit. The newly-filed lawsuit argues that this requirement violates the Alaska Constitution’s guarantee of privacy, which has been interpreted to include a right to abortion. Dr. Colleen McNicholas, the chief medical officer at the Planned Parenthood affiliate, notes that medication abortion is only available to patients under 12 weeks, but in Alaska traveling to access a clinic presents unique challenges that can take patients outside of that window. As explained by The Hill, “more than 60,000 Alaskans live off the road system and can only travel by plane to reach Anchorage or Fairbanks,” where the two in-state Planned Parenthood clinics are located, and “even if someone does live on the road system, they are being forced to drive hundreds of miles round-trip to reach a health center.”
Federal Trade Commission and States Sue the World Professional Association for Transgender Health Over Alleged Deceptive Claims:
Note: this story was originally published in our Trans Rights Digest.
On June 17th, the Federal Trade Commission (FTC), along with Alaska, Iowa, Nebraska, and Texas, filed suit against the World Professional Association for Transgender Health (WPATH) in the U.S. District Court of the Northern District of Texas. The complaint focuses heavily on the ‘market’ for transition services that they allege is created and expanded by WPATH through the self-publication and distribution of its Standards of Care (SOC), which are evidence and consensus based clinical guidelines for medical transition services. The FTC feigns concern for youth by arguing that the latest version of the SOC provides either misleading at best or fraudulent at worst recommendations for medical transition services by omitting age limitations for mastectomies or penectomies. The Nebraskan, Iowan, and Alaskan Attorney Generals all echoed a similar sentiment: that WPATH is not a medical body, but instead advances profit-driven ideology unsupported by science and makes recommendations based on politics rather than science.
Although WPATH has not yet filed its response, on June 17th, it published an organizational statement referencing prior federal court wins against the FTC and a federal court finding that the FTC “is acting out of pure retaliation as a part of the federal government’s relentless and targeted campaign to undermining gender-affirming care.”
The lawsuit will likely prompt statements from organizations and advocates across the nonprofit sphere. The Consumer Federation of America wrote that the FTC could be a “powerful fighter against high prices”, but instead they have chosen to fight a “baseless culture war,” and that American consumers should “question whether this is the best use of public time and resources.”
Missouri Court Strikes Down Anti-Abortion Restrictions:
In Missouri, a state court has struck down a series of abortion restrictions, siding with Planned Parenthood and increasing access to care. Over a year ago, Missourians voted to overturn the state’s total abortion ban and restore pre-viability abortion rights; however, a series of state restrictions have made access difficult. Although procedural abortion has been available since last year, the state’s medically unnecessary requirement of “complication plans” has functionally blocked medication abortions. However, on June 18th, Judge Jerri Zhang issued a ruling finding that a host of abortion restrictions were unconstitutional in light of the amended constitution’s protections for reproductive health. Among the struck laws are reporting requirements, a telemedicine ban, onerous licensing requirements, and the requirement for a state-approved “complication plan” for medication abortions. Planned Parenthood will begin prescribing abortion pills within the week. Missouri Attorney General Catherine Hanaway called the ruling a “radical decision” and vowed to appeal it as soon as possible. Additionally, the state is asking voters to repeal the abortion rights constitutional amendment in November’s election.
Supreme Court Rejects Student Anti-Abortion Speech Case:
The U.S. Supreme Court has declined to hear a case brought by a former student arguing that her Indiana high school violated her constitutional rights by prohibiting the use of a flyer with political speech on it. The case involves a former student - identified as E.D. - who formed a local chapter of Students for Life of America at her school. Although the school permitted her to start the club and advertise it at an activity fair using the slogan “I am the pro-life generation,” she was prohibited from hanging flyers that included political speech such as “Defund Planned Parenthood.” The trial court sided with the school, finding that their policy prohibiting political content on flyers posted on school walls did not violate the student’s rights; the 7th Circuit Court of Appeals later affirmed. The case turns on a 1988 case called Hazelwood School District v. Kuhlmeier, in which the Supreme Court found that schools have some authority to reasonably restrict the content of student speech, particularly where it does not appear in a public forum. Notably, Justice Alito dissented from the Court’s decision not to hear the case, arguing that the court should revisit its precedent in Hazelwood.
Wyoming Court Strikes Down Abortion Restrictions:
A Wyoming state court has struck three abortion restrictions, finding that they violate the state’s constitution. Although Wyoming has tried several times to ban or severely restrict abortion, the state’s supreme court has upheld the right to abortion under the Wyoming constitution’s guarantee of autonomy in medical decisionmaking, which was ironically passed in response to the Affordable Care Act. Currently, abortion is legal in the state until viability. The most recent court order found that laws 1) requiring patients to get an ultrasound 48 hours prior to an abortion; 2) mandating that abortion clinics meet the standards of ambulatory surgical centers; and 3) prohibiting the use of abortion pills for off-label uses were unconstitutional. The laws were already temporarily blocked by court order, but the court’s decision cements that ruling. The State may now decide to appeal to the Wyoming Supreme Court.
Trend and Policy Watch:
States Push EPA to Classify Mifepristone as an Environmental Contaminant:
A cohort of 14 state attorneys general and 19 congresspeople are urging the U.S. Environmental Protection Agency (EPA) to include mifepristone in its Contaminant Candidate list on the grounds that its entrance into wastewater could create environmental and health risks. The states and congresspeople sent concurrent letters to the Agency in which they purport to be concerned with environmental safety; however, the letters use highly inflammatory anti-abortion language, including referring to mifepristone as “baby poison” and describing it as “barbarically starv[ing] the unborn baby.” Students for Life of America has also been pushing the narrative that mifepristone is an environmental threat, with their head of policy famously claiming that we are “drinking other people’s abortions.” However, there is no credible evidence that the medication poses any risks to waterways or drinking water. Mifepristone is now used in over 2/3 of abortions in the U.S., - a fact that anti-abortion activists have responded to by attempting to eliminate access through any available means.
Abortion Bans Take an Enormous Toll on the Economy:
New reporting from the Institute for Women’s Policy Research shows that abortion bans and restrictions have resulted in over $140 billion in lost earnings annually. This is in large part because bans can limit pregnant people’s ability to get an education, enter and stay in the workforce, and advance their careers. IWPR’s research shows that states with total or 6-week abortion bans in place account for approximately $68 billion of that economic cost. The total number is up $7 million from last year’s analysis - a number that IWPR notes could fund SNAP benefits for a million Americans for a year. As Melissa Holly Mahoney, the report’s co-author told Rewire, “abortion bans are a drag on the economy by impacting women’s choices about their careers,” and “when women are unable to make choices about when, or if, to start a family, they are less willing to change jobs, to take time out from employment for education or skills training, which could then lead to higher-paying jobs,” or they may end up “leaving the labor force altogether.”
This reporting comes at the same time as new data showing that ACA enrollment fell by more than 5 million people this year, in large part due to the expiration of ACA subsidies and provisions in the “big, beautiful bill.” Experts have indicated that, although some people may be “switching to job-based insurance, [] the scale of the decline suggests many people likely lost their health coverage.” As abortion bans force more people out of the workforce, the numbers of uninsured Americans will only rise, increasing strain on the economy and worsening quality of life for those impacted.
Alabama Attorney General Sends Cease and Desist Letters to Companies Associated with Medication Abortion:
Alabama Attorney General Steve Marshall issued cease-and-desist letters threatening legal action against six companies involved in the provision of medication abortion. The letters were sent to Plan C, Southern Woven, ybycmeds, Abortion Pills in Private, Red State Access, and Cambridge Reproductive Health Consultants. The letters state that abortion is illegal in the state and the companies are breaking the law by providing pills. It also accuses them of misleading Alabamians about the safety of the drugs and trying to “exploit Alabamians for profit” and threatens to prosecute the companies “to the fullest extent permitted by law.” As Robin Marty, executive director of West Alabama Women’s Center explains, by naming the companies, the press release ironically “has now improved the ability for people to find out where they can access abortion in a way that [providers] were never able to actually let people know before.”
Trump Administration Takes Step Toward Enshrining Fetal Personhood:
The Trump Administration has quietly taken a step towards enshrining fetal personhood at the federal level. In a new notice of funding opportunity for the Embryo Adoption Awareness and Services program, which was created in 2002 by President George W. Bush and is administered by HHS, the administration has changed language to refer to embryos as children and refer to unused embryos as “children who already exist and are in need of a family.” As Mother Jones reports, embryo adoption “was the Christian right’s response to the rise in popularity of [IVF] in the early aughts,” and because “the fertility treatment involves generating far more embryos than any prospective parent is likely to use” many IVF patients are left with frozen embryos that will never be used. Recently, opposition to IVF has become more mainstream within the anti-abortion movement, with activists seeking to define and legislate life as beginning at the moment of conception and characterize frozen embryos as unborn children. Several states have used such language in legislation, opening the door to increased restrictions on abortion, the conduct of pregnant people, access to certain kinds of contraception, and access to assisted fertility.
San Antonio Mural Honors Texas Woman Who Died As a Result of the State’s Abortion Ban:
In San Antonio, Texas, artist Ana Hernandez has created a mural honoring the lives of four women lost to Texas’s abortion ban. The women, Josseli Barnica (28), Nevaeh Crain (18), Porsha Ngumezi (35), and Tierra Walker (37) each lost their lives as a direct result of being unable to access the life-saving care that they needed under Texas’s abortion bans. Families of the deceased were present and spoke at the unveiling, sharing their loved ones’ stories and speaking out against the injustices of their deaths. The mural is located in the Southtown Arts District on the side wall of the Mercury Building. May we continue to remember the names and stories of everyone lost to abortion bans as we continue to fight for reproductive freedom for all.