Religious leaders sue to block Missouri's abortion ban
By JIM SALTER
Today
ST. LOUIS (AP) — A group of religious leaders who support abortion rights filed a lawsuit Thursday challenging Missouri's abortion ban, saying lawmakers openly invoked their religious beliefs while drafting the measure and thereby imposed those beliefs on others who don't share them.
Since then, religious abortion rights supporters have increasingly used religious freedom lawsuits in seeking to protect abortion access. The religious freedom complaints are among nearly three dozen post-Roe lawsuits that have been filed against 19 states’ abortion bans, according to the Brennan Center for Justice.
The Missouri lawsuit brought on behalf of 13 Christian and Jewish leaders seeks a permanent injunction barring the state from enforcing its abortion law and a declaration that provisions of its law violate the Missouri Constitution.
“What the lawsuit says is that when you legislate your religious beliefs into law, you impose your beliefs on everyone else and force all of us to live by your own narrow beliefs,” said Michelle Banker of the National Women’s Law Center, the lead attorney in the case. “And that hurts us. That denies our basic human rights.”
Missouri Senate President Pro Tem Caleb Rowden, a Republican, called the lawsuit “foolish.”
“We were acting on the belief that life is precious and should be treated as such. I don’t think that’s a religious belief,” Rowden said.
Within minutes of last year's Supreme Court decision, then-Attorney General Eric Schmitt and Gov. Mike Parson, both Republicans, filed paperwork to immediately enact a 2019 law prohibiting abortions “except in cases of medical emergency.” That law contained a provision making it effective only if Roe v. Wade was overturned.
The law makes it a felony punishable by 5 to 15 years in prison to perform or induce an abortion. Medical professionals who do so also could lose their licenses. The law says that women who undergo abortions cannot be prosecuted.
Missouri already had some of the nation’s more restrictive abortion laws and had seen a significant decline in the number of abortions performed, with residents instead traveling to clinics just across the state line in Illinois and Kansas.
The lawsuit, filed on behalf of the faith leaders by Americans United for Separation of Church & State and the National Women’s Law Center, said sponsors and supporters of the Missouri measure “repeatedly emphasized their religious intent in enacting the legislation." It quotes the bill's sponsor, Republican state Rep. Nick Schroer, as saying that “as a Catholic I do believe life begins at conception and that is built into our legislative findings.” A co-sponsor, Republican state Rep. Barry Hovis, said he was motivated “from the Biblical side of it," according to the lawsuit.
“I'm here today because none of our religious views on abortion or anything else should be enshrined into our laws,” Maharat Rori Picker Neiss, executive director of the Jewish Community Relations Council of St. Louis and one of the plaintiffs, said at a news conference.
Lawsuits in several other states take similar approaches.
In Indiana, lawyers for five anonymous women — who are Jewish, Muslim and spiritual — and advocacy group Hoosier Jews for Choice have argued that state’s ban infringes on their beliefs. Their lawsuit specifically highlights the Jewish teaching that a fetus becomes a living person at birth and that Jewish law prioritizes the mother’s life and health.
A court ruling siding with the women was appealed by the Indiana attorney general's office, which is asking the state Supreme Court to consider the case.
In Kentucky, three Jewish women sued, claiming the state’s ban violates their religious rights under the state’s constitution and religious freedom law. They allege that Kentucky’s Republican-dominated legislature “imposed sectarian theology” by prohibiting nearly all abortions. The ban remains in effect while the Kentucky Supreme Court considers a separate case challenging the law.
But Banker said Missouri’s lawsuit is unique because while plaintiffs in other states claimed harm, “we are saying that the whole law violates separation of church and state and we’re seeking to get everything struck down.”
Missouri Republican attorney general, Andrew Bailey, said in a statement that he will “defend the right to life with every tool at my disposal.”
“I want Missouri to be the safest state in the nation for children and that includes unborn children," Bailey said.
___
Associated Press writer David A. Lieb in Jefferson City, Missouri, contributed to this report.
___
This story was updated to correct that the lawsuit was filed on behalf of 13, not 12, Christian and Jewish leaders and to delete a reference to the filing happening on the 50th anniversary of Roe v. Wade. That anniversary is Sunday.
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Religious leaders sue to block Missouri's abortion ban
By JIM SALTER
Today
ST. LOUIS (AP) — A group of religious leaders who support abortion rights filed a lawsuit Thursday challenging Missouri's abortion ban, saying lawmakers openly invoked their religious beliefs while drafting the measure and thereby imposed those beliefs on others who don't share them.
Since then, religious abortion rights supporters have increasingly used religious freedom lawsuits in seeking to protect abortion access. The religious freedom complaints are among nearly three dozen post-Roe lawsuits that have been filed against 19 states’ abortion bans, according to the Brennan Center for Justice.
The Missouri lawsuit brought on behalf of 13 Christian and Jewish leaders seeks a permanent injunction barring the state from enforcing its abortion law and a declaration that provisions of its law violate the Missouri Constitution.
“What the lawsuit says is that when you legislate your religious beliefs into law, you impose your beliefs on everyone else and force all of us to live by your own narrow beliefs,” said Michelle Banker of the National Women’s Law Center, the lead attorney in the case. “And that hurts us. That denies our basic human rights.”
Missouri Senate President Pro Tem Caleb Rowden, a Republican, called the lawsuit “foolish.”
“We were acting on the belief that life is precious and should be treated as such. I don’t think that’s a religious belief,” Rowden said.
Within minutes of last year's Supreme Court decision, then-Attorney General Eric Schmitt and Gov. Mike Parson, both Republicans, filed paperwork to immediately enact a 2019 law prohibiting abortions “except in cases of medical emergency.” That law contained a provision making it effective only if Roe v. Wade was overturned.
The law makes it a felony punishable by 5 to 15 years in prison to perform or induce an abortion. Medical professionals who do so also could lose their licenses. The law says that women who undergo abortions cannot be prosecuted.
Missouri already had some of the nation’s more restrictive abortion laws and had seen a significant decline in the number of abortions performed, with residents instead traveling to clinics just across the state line in Illinois and Kansas.
The lawsuit, filed on behalf of the faith leaders by Americans United for Separation of Church & State and the National Women’s Law Center, said sponsors and supporters of the Missouri measure “repeatedly emphasized their religious intent in enacting the legislation." It quotes the bill's sponsor, Republican state Rep. Nick Schroer, as saying that “as a Catholic I do believe life begins at conception and that is built into our legislative findings.” A co-sponsor, Republican state Rep. Barry Hovis, said he was motivated “from the Biblical side of it," according to the lawsuit.
“I'm here today because none of our religious views on abortion or anything else should be enshrined into our laws,” Maharat Rori Picker Neiss, executive director of the Jewish Community Relations Council of St. Louis and one of the plaintiffs, said at a news conference.
Lawsuits in several other states take similar approaches.
In Indiana, lawyers for five anonymous women — who are Jewish, Muslim and spiritual — and advocacy group Hoosier Jews for Choice have argued that state’s ban infringes on their beliefs. Their lawsuit specifically highlights the Jewish teaching that a fetus becomes a living person at birth and that Jewish law prioritizes the mother’s life and health.
A court ruling siding with the women was appealed by the Indiana attorney general's office, which is asking the state Supreme Court to consider the case.
In Kentucky, three Jewish women sued, claiming the state’s ban violates their religious rights under the state’s constitution and religious freedom law. They allege that Kentucky’s Republican-dominated legislature “imposed sectarian theology” by prohibiting nearly all abortions. The ban remains in effect while the Kentucky Supreme Court considers a separate case challenging the law.
But Banker said Missouri’s lawsuit is unique because while plaintiffs in other states claimed harm, “we are saying that the whole law violates separation of church and state and we’re seeking to get everything struck down.”
Missouri Republican attorney general, Andrew Bailey, said in a statement that he will “defend the right to life with every tool at my disposal.”
“I want Missouri to be the safest state in the nation for children and that includes unborn children," Bailey said.
___
Associated Press writer David A. Lieb in Jefferson City, Missouri, contributed to this report.
___
This story was updated to correct that the lawsuit was filed on behalf of 13, not 12, Christian and Jewish leaders and to delete a reference to the filing happening on the 50th anniversary of Roe v. Wade. That anniversary is Sunday.
yeah i live in missouri. i can promise you a judge will throw this out. its backwards as fuck here.
"You can tell the greatness of a man by what makes him angry." - Lincoln
US states take control of abortion debate with funding focus
By JOHN HANNA and GEOFF MULVIHILL
2 hours ago
LAWRENCE, Kan. (AP) — Though the Insight Women’s Center sits at the epicenter of a reinvigorated battle in the nation’s culture wars, the only hint of its faith-based mission to dissuade people from getting abortions is the jazzy, piano rendition of “Jesus Loves Me” playing in a waiting room.
The Republican-controlled Kansas Legislature is considering allocating millions of dollars in state funds to similar anti-abortion centers that persuade people to bring their pregnancies to term by offering free pregnancy tests and sonograms, as well as counseling and parenting classes taught by volunteers. They're also considering offering millions more in income tax credits for donors supporting what they call “crisis pregnancy centers."
Supporters say the effort shows abortion opponents are addressing families' social and financial needs. But critics say the amount of new funding proposed for organizations like Insight — either in direct funding or tax credits for their donors — fall far short of what’s necessary to improve people’s access to health care and address ongoing poverty.
“You funnel money through a short-term solution that makes it appear as though you are doing something,” said Alesha Doan, a University of Kansas associate professor who has studied and written books about abortion politics.
Legislative committees held hearings Thursday on proposals for a 70% income tax credit to donors who support anti-abortion centers, with a cap of $10 million in total credits. A Senate committee might vote this week.
It's similar to a longstanding Missouri law that provides income tax credits to donors supporting anti-abortion centers. Arizona has such a law, and Mississippi's Republican House speaker is trying to expand a cap on tax credits to $10 million from the $3.5 million authorized last year.
Arkansas and Oklahoma are considering adding similar tax credits, according to the National Right to Life Committee.
In Missouri, donors to anti-abortion centers have received $15 million in total state tax credits over the past five years, and one state analysis estimates the centers served about 43,000 people last year.
Abortion opponents have operated centers like Insight for decades, and the practice of conservative-led states offering financial aid to them predates Dobbs — the decision in June overturning Roe v. Wade.
On the abortion-rights side, Oregon lawmakers last year created a $15 million abortion-access fund, with the first $1 million going to a nonprofit that covers the costs of patients' travel and procedures. California, Connecticut, New Jersey, New York and Washington have also allocated or are considering offering public funding for abortions or related services.
In New Mexico last year, Democratic Gov. Michelle Lujan Grisham pledged $10 million in state funds to the construction of a new abortion clinic.
Morgan Hopkins, president of the abortion-rights advocacy group All(asterisk) Above All praised the funding. “Budgets are a reflection of our values," she said.
Kansas already provides grants to programs that provide prenatal care, and encourage people to carry their pregnancies to term. But it spends less than $339,000 in a state budget of $24 billion on the program — and made only two grants totaling less than $74,000 to anti-abortion centers.
Now, some abortion opponents talk about emulating Missouri's more than $8 million annual funding, plus the income tax credits.
Abortion rights supporters are frustrated that the push for such support is coming so soon after an Aug. 2 statewide vote that decisively rejected a proposed amendment to the Kansas Constitution that would have allowed legislators to greatly restrict or ban abortion.
“I have general concerns that we’re not respecting what was the very clear will of voters,” said state Sen. Ethan Corson, a Kansas City-area Democrat who serves on the Senate tax committee.
Abortion rights advocates say the centers lure patients away from abortion clinics with free services, give them inaccurate medical information and counseling from people who are not trained therapists. Some see funding them as a political gesture designed to make abortion bans look less harsh.
Abortion opponents argue that centers like Insight offer patients a wide range of prenatal and post-birth classes, in addition to other help. They also argue that boosting funding for free services after the August vote is a promise not to abandon parents and families.
In Lawrence, where the nearest abortion clinic is a 40-minute drive away, 28-year-old Korbe Bohac is still visiting the Insight center nearly 8 months after her son Winston was born. She told legislators the classes and counseling make her a better, more confident parent — and helped preserve her mental health. She called it “a safety net.”
The Insight center, which is only a few miles from the University of Kansas, has two sonogram nurses, and a doctor and radiologist sometimes volunteer their time. But services depend mostly on about 50 volunteers. The $340,000 annual budget is mostly supplied by private donations, but the organization received a community development grant in 2014 to launch parent education programs.
Center staff said that although they do not refer clients to abortion providers, they discuss abortion as an option. They said some patients who met with them went on to have abortions, though this is not possible to verify given patients' privacy protocols.
Insight has two separate waiting rooms — one for its educational programs and one for medical services. Executive director Bridgit Smith said one reason is that it keeps pregnant patients from being influenced by seeing babies and toddlers.
Smith said she believes the proposed tax credit would increase donations, helping Insight start a maternity home for people without shelter.
“We’re trying to build strong individuals and strong families. And isn’t that what we all want?” Smith said. “Even for the woman that doesn’t choose to parent, we still want her to be strong and healthy after the decision.”
___
Mulvihill reported from Cherry Hill, New Jersey. Emily Wagster Pettus in Jackson, Mississippi, contributed to this report.
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Abortion pill could be pulled off market by Texas lawsuit
By LINDSAY WHITEHURST
Yesterday
WASHINGTON (AP) — A Texas lawsuit with a key deadline this month is posing a threat to the nationwide availability of medication abortion, which now accounts for the majority of abortions in the U.S.
The case filed by abortion opponents who helped challenge Roe v. Wade seeks to reverse a decades-old approval by the Food and Drug Administration.
If a federal judge appointed by former President Donald Trump sides with them, it could halt the supply of the drug mifepristone in all states, both where abortion is banned and where it remains legal.
“It could have an immediate impact on the country,” said Mini Timmaraju, president of NARAL Pro-Choice America. “In some ways this is a backdoor ban on abortion.”
On Friday, a group of 22 Democratic-led states weighed in, saying the consequences of reversing the approval could be “nothing short of catastrophic. A similar-sized group of Republican states also filed briefs supporting the reversal, saying the ability to order pills by mail undermines their laws banning abortion.
U.S. District Judge Matthew Kacsmaryk has not indicated exactly when or how he will rule, but groups like Timmaraju’s have been preparing for a possible decision shortly after a Feb. 24 filing deadline. There is scant precedent for a lone judge overruling the FDA’s scientific decisions. A swift appeal of any ruling is likely.
The lawsuit was filed by the group Alliance Defending Freedom, which was also involved in the Mississippi case that led to Roe v. Wade being overturned.
“Our representatives in Congress created the FDA and gave the FDA the responsibility to make sure that drugs are safe before they’re allowed on the market … the FDA failed that responsibility,” said Julie Blake, senior counsel for the group.
They argue the FDA overstepped its authority in approving mifepristone by using an accelerated review process reserved for drugs to treat “serious or life-threatening illnesses.”
But in its legal response, the agency said it didn't accelerate the drug’s approval, which came four years after the manufacturer first submitted its application to market the pill.
The FDA approved mifepristone — in combination with a second drug — as a safe and effective method for ending a pregnancy in 2000. Common side effects include cramping and light bleeding. Cases of more severe bleeding requiring emergency care are very rare.
Halting access to the drug more than 20 years after approval would be “extraordinary and unprecedented,” federal attorneys stated in a legal filing.
Kacsmaryk, who previously ruled against a program providing free birth control to minors in Texas, could also issue a ruling rolling back regulators' decisions to ease restrictions on the pill’s availability. Those have been based on scientific studies showing women can safely use the drug at home.
In late 2021, the FDA removed a requirement that women pick up the drug in person. Last month the agency dropped another requirement that prevented most pharmacies from dispensing the pill.
Medication abortion accounted for over half of abortions before Roe v. Wade was overturned, according to research from the Guttmacher Institute. It’s grown more important since then, said Elizabeth Nash, state policy analyst for the science-based research group that supports abortion rights.
“The clinics that are open in the receiving states are stretched thin, they don’t have a lot of give in their capacity and being able to provide medication abortion is very, very important,” she said.
Abortion medication is approved for use up to the 10th week of pregnancy. Mifepristone is taken first, swallowed by mouth. The drug dilates the cervix and blocks the effects of the hormone progesterone, which is needed to sustain a pregnancy.
Misoprostol, a drug also used to treat stomach ulcers, is taken 24 to 48 hours later. It causes the uterus to cramp and contract, causing bleeding and expelling pregnancy tissue. The combination has been shown to be more than 95% effective in ending pregnancies up to 10 weeks.
If mifepristone is pulled, providers could prescribe misoprostol alone instead, an approach that is used in many parts of the world, but would be a big shift in U.S. practice and has not been found to be quite as effective.
Such a ruling could also increase the need for surgical abortion and further increase wait times at clinics, which are already weekslong in some cases after the U.S. Supreme Court ruling overturning Roe, Nash said.
___
Associated Press writer Matthew Perrone contributed to this report.
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North Carolina AG won't defend abortion pill restrictions
By GARY D. ROBERTSON
Today
RALEIGH, N.C. (AP) — North Carolina Attorney General Josh Stein won't defend state restrictions on dispensing abortion pills that are being challenged in a lawsuit and instead will argue the restrictions are preempted by federal regulations protecting access to the pills, Stein's office said Monday.
The decision by Stein, a Democrat, means Republican legislative leaders who want to keep the restrictions would have to seek to formally intervene in the federal lawsuit, which was filed by Amy Bryant, a physician who prescribes the drug mifepristone.
The lawsuit filed in January in U.S. District Court in Durham, and a separate lawsuit challenging limits on abortion pills in West Virginia, are considered the openings of legal battles over access to the medications. A Texas lawsuit poses a threat to the nationwide availability of medication abortion, which now accounts for the majority of abortions in the U.S. The case filed by abortion opponents seeks to reverse FDA approval of mifepristone.
Bryant's lawsuit seeks to block enforcement of state laws and rules that it says interferes with the ability to provide mifepristone to patients. The lawsuit cites the authority that Congress gave to the U.S. Food and Drug Administration to regulate the FDA-approved drug.
North Carolina laws require the pill must be dispensed in person after a 72-hour waiting period, the lawsuit says, and only after patients receive state-mandated counseling and in some cases an ultrasound.
Stein, who supports abortion rights and is running for governor next year, is a defendant in the lawsuit along with a district attorney and state health and medical officials. Stein and state Department of Justice attorneys are tasked with defending state laws in court.
In this case, Bryant's federal preemption arguments "are legally correct,” Sarah Boyce, general counsel at the state Department of Justice, wrote in a letter to legislative lawyers for House Speaker Tim Moore and Senate leader Phil Berger.
“Consistent with its statutory authority, the FDA has determined that restrictions like the ones imposed under North Carolina state law would unduly burden patients’ access to a safe and effective drug,” Boyce wrote. “The department’s filings in the (lawsuit) on behalf of Attorney General Stein will reflect this legal analysis on the merits.”
Spokespeople for Berger and Moore didn’t immediately respond to requests for comment.
The U.S. Supreme Court decision last June that overturned Roe v. Wade — turning decision-making over abortion to the states — has brought renewed focus on medication abortions. Nineteen states — including North Carolina and West Virginia — have laws controlling how, when and where physicians can prescribe and dispense abortion drugs.
The FDA approved mifepristone in 2000 to end pregnancy, when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy. The FDA eliminated an in-person requirement for the pill, which can be shipped by mail-order or picked up at brick-and-mortar pharmacies.
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Post-Roe, Native Americans face even more abortion hurdles
By LAURA UNGAR and HEATHER HOLLINGSWORTH
Yesterday
A few months after South Dakota banned abortion last year, April Matson drove more than nine hours to take a friend to a Colorado clinic to get the procedure.
The trip brought back difficult memories of Matson’s own abortion at the same clinic in 2016. The former grocery store worker and parent of two couldn’t afford a hotel and slept in a tent near a horse pasture — bleeding and in pain.
Getting an abortion has long been extremely difficult for Native Americans like Matson. It has become even tougher since the Supreme Court overturned Roe v. Wade.
New, restrictive state laws add to existing hurdles: a decades-old ban on most abortions at clinics and hospitals run by the federal Indian Health Service, fewer nearby health centers offering abortions, vast rural expanses for many to travel, and poverty afflicting more than a quarter of the Native population.
“That’s a lot of barriers,” said Matson, who lives in Sioux Falls and is Sicangu Lakota. “We’re already an oppressed community, and then we have this oppression on top of that oppression.”
Among the six states with the highest proportion of Native American and Alaska Native residents, four – South Dakota, Oklahoma, Montana and North Dakota – have moved or are poised to further restrict abortion. South Dakota and Oklahoma ban it with few exceptions.
In some communities, the distance to the nearest abortion provider has increased by hundreds of miles, said Lauren van Schilfgaarde, a member of Cochiti Pueblo in New Mexico who directs the tribal legal development clinic at the University of California-Los Angeles.
“Native people are having to cross massive, massive distances and absorb all of the travel costs and child care,” she said.
Experts say the issue should be seen within the larger context of the tortured history between Indigenous people and white society that began with the taking of Native lands and includes coerced sterilization of Native women lasting into the 1970s. Native Americans on both sides of the abortion debate invoke this history — some arguing the procedure reduces the number of potential citizens in a population that has been threatened for centuries, and others saying new restrictions are another attack on Native women's rights.
Many advocates worry that reduced abortion access will make things even worse for women already facing maternal death rates twice as high as their white peers, teen birth rates more than twice as high as whites, and the worst rates of sexual violence.
“Indigenous women don’t have access to reproductive justice in any form, and that includes abortion,” said Natalie Stites Means, a member of the Cheyenne River Sioux Tribe who serves on the board of the Justice Empowerment Network, an abortion fund. “Any limitation on our health care and any limitation on abortion is going to impact our health and well-being.”
DECADES OF RESTRICTIONS
For centuries, experts said, Indigenous people had their own systems of health care, which in some cases included natural abortive practices.
Today, the main source of care for many is the Indian Health Service, which serves 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states. Its clinics and hospitals operate under the Hyde Amendment, which bars them from using federal funds for abortions except in cases of rape, incest or threats to a mother’s life.
Even when an IHS patient falls under one of those exceptions, many facilities "don’t have the materials or staff or the expertise to provide that abortion care," van Schilfgaarde said.
Matson uses the pronoun they and is two-spirit, a term used to describe those who combine traits of both men and women. Matson, who lived in Rapid City at the time, said IHS staff didn't discuss abortion as an option for their unplanned pregnancy. After getting the procedure at 13 weeks in Colorado, they felt uncomfortable returning to IHS despite ongoing bleeding.
While IHS staff can refer people to places that provide abortions, federal funds can only be used for “Hyde-permitted” procedures and related patient travel, agency officials said in a statement. And a federal report shows nearly 1 in 5 American Indians and Alaska Natives are uninsured.
Also, there are often no abortion providers nearby. One reason? The proportion of Catholic health systems, which generally prohibit abortion, has grown significantly. A 2020 report by Community Catalyst, a nonprofit health advocacy organization, found that 1 in 6 acute care hospital beds in the U.S. is in a Catholic system. The share is 40% in South Dakota and 32% in Oklahoma.
SEEKING SOLUTIONS
After Roe fell, restrictive “trigger” laws took effect in more than a dozen states, including South Dakota and Oklahoma, which already had stopped providing most abortions. North Dakota's abortion ban has been blocked in court.
Some Native women were inspired to organize.
Cherokee women in Tahlequah, Oklahoma, gathered over the summer to discuss a possible amendment to the tribe’s constitution protecting reproductive health access for its citizens. They were frustrated that leaders of this tribe with around 450,000 citizens hadn’t addressed the issue.
“Fear was just kind of palpable,” said group leader Alissa Baker, who teaches psychology at Northeastern State University. “We felt a need to protect our community ... and really in some ways reclaim some of those traditional roles of a Cherokee woman, which is effectively being the voice of the community.”
But the effort stalled as the school year approached, with members spread across a rural area, busy with jobs and children.
Other activist efforts panned out. D’Arlyn Bell, a doctoral student at the University of Kansas and another member of the Cherokee Nation, joined with other Native activists to help defeat a proposed amendment to the Kansas state constitution that would have cleared the way for tougher abortion restrictions.
“We were doing it not only for the Native women in our own states but Native women from our own home territories, especially Oklahoma,” she said.
Experts stress that abortion views vary among tribal leaders and members – something echoed in a statement from the Cherokee Nation, the only one of the five largest tribes in South Dakota and Oklahoma to respond to a request for comment from The Associated Press.
Opening a clinic on tribal land would be legally challenging, experts said. The Cherokee Nation said it wouldn’t set one up, and there have been no announcements from other tribes since Roe was overturned. History shows the issue is fraught: The first woman president of the Oglala Sioux Tribe in South Dakota was impeached in 2006 after publicly proposing an abortion clinic on the reservation.
Post-Roe, Native Americans on both sides of the issue are taking personal and collective action.
Elizabeth Terrill, a board member for the anti-abortion Native American nonprofit Life is Sacred, said she’s a foster parent, does post-abortion counseling and supports moms. She said extended families on tribal lands historically have banded together when there is an unplanned pregnancy, and most women choose to continue them.
“I think there’s just a different cultural understanding of what life is and when life begins and why life is so sacred,” said Terrill, a mental health therapist near the Navajo Nation in New Mexico and member of the Osage Nation of Oklahoma.
Matson, executive director of the summer camp “Rock the Rez,” said they share their experience, donate money to those in need and tell others about resources like the Justice Empowerment Network, which covered most of their friend’s abortion and travel costs.
“Every time someone is going through this, I offer support,” said Matson, 32. “I’ve helped, I hope, in every way that I can.”
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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Anti-abortion allies change tactics after post-Roe defeats
By MARC LEVY
1 hour ago
HARRISBURG, Pa. (AP) — Republicans and their anti-abortion allies, who suffered a series of defeats in ballot questions in states across the political spectrum last year, are changing tactics as new legislative sessions and the new election season start.
In states where citizens have direct access to the ballot, Republicans are considering ways to prevent another loss in an abortion-rights referendum.
In some states, Republicans are considering exemptions to sweeping bans or looking at ways to prevent abortions besides trying to roll back the number of weeks during which an abortion is allowed.
To be sure, abortion restrictions have seen some success in a few Republican-controlled states.
West Virginia and Indiana passed laws to ban abortion after the U.S. Supreme Court’s June ruling overturning a nationwide constitutional protection for the procedure.
South Carolina and Montana lawmakers are also trying to ban abortion — or more heavily restrict it — despite a court-ordered right to privacy that currently protects a right to abortion in those states.
But in a number of states, the battle over abortion rights is fluid and influenced by what voters had to say last year, when Kentucky, Montana and Kansas rejected anti-abortion measures on ballots and Michigan, California and Vermont approved abortion rights amendments.
In politically divided Pennsylvania, Republican lawmakers have stalled their push for a constitutional amendment that would declare there is no constitutional right to an abortion or for taxpayer support for an abortion.
The wording is nearly identical to a measure that failed in Kentucky, and the experience in Kansas last August told abortion opponents that it would be very difficult to win a statewide referendum, said Michael McMonagle, president of the Pro-Life Coalition of Pennsylvania.
“We realized that if the referendum turns on the left's arguments that ‘these pro-lifers are trying to outlaw abortion,’ we’re going to get slaughtered," McMonagle said. “It will be the mushy middle people who will vote against the pro-life referendum.”
Rather, abortion opponents in Pennsylvania decided to wait to see the outcome of a pending court case where abortion clinics are asking the state Supreme Court to overturn a law that bans taxpayer funding for abortions.
A court decision that overturns the law — and allows the state to use public money for abortions — would give abortion opponents a stronger message and a more persuasive case with voters to help them succeed in a referendum, McMonagle said.
Elizabeth Nash, of the New York-based Guttmacher Institute, which supports abortion rights, sees Republicans changing their approach in some states by trying to put up barriers to abortion pills, fund pregnancy programs or soften strict abortion bans.
As an example, Nash pointed to Tennessee, where a growing number of Republican lawmakers say the state’s abortion ban went too far. A bill to allow an abortion if necessary to save the mother's life passed a Senate subcommittee in February but faces uncertain prospects in the GOP-controlled Legislature, and with Republican Gov. Bill Lee should it reach his desk.
House Speaker Cameron Sexton, a Republican, said polling data and discussions with Republican women persuaded him that the law should, at least, include an exception for the life of the mother.
“It’s a very delicate issue,” Sexton said, “but what you see is Republican women wanting exceptions.”
In Kansas, meanwhile, anti-abortion lawmakers recovering from their referendum defeat last August have dropped the idea of trying to ban abortion earlier in pregnancy. Kansas is one of the more permissive states, barring most abortions after the 22nd week.
For the moment, Kansas Republican legislators are aiming to provide financial help to centers that discourage abortion by offering free pregnancy and post-pregnancy services.
Elsewhere, officials at Planned Parenthood say several Republican-controlled states are taking steps to head off potential ballot questions that ask voters to enshrine abortion rights into state constitutions.
That dynamic is playing out in conservative Missouri.
It is one of 13 states where abortion is banned — largely by “trigger” laws that took effect after the high court overturned its landmark Roe v. Wade decision — and one of 22 where citizens have direct ballot access.
There, Republican state lawmakers are considering a handful of alternatives, including making it more difficult to amend the constitution by raising the threshold for voter approval from 50% to 60% in a referendum.
Republicans also floated their own proposal to amend the constitution to say that no provision in the constitution “shall be construed to secure or protect a right to abortion.”
In Republican-controlled Ohio, abortion opponents are gearing up to try to defeat what is expected to be the nation's next referendum to protect access to abortion.
To fight the referendum, a Republican state lawmaker is sponsoring a resolution to make it more difficult for voters to amend the constitution.
In a memo to colleagues, Rep. Brian Stewart wrote, “after decades of Republicans’ work to make Ohio a pro-life state, the Left intends to write abortion on demand into Ohio’s Constitution.”
Stewart’s measure drew support from Ohio Right to Life, whose leaders met with their philosophical allies in Kentucky, Kansas and Michigan to research why the movement had suffered losses in referendums in those states.
Mike Gonidakis, president of Ohio Right to Life, said he is raising money, hiring campaign staff and intending to get out their message early in the state that just elected a slate of anti-abortion politicians to statewide offices in November.
“What we’re doing now is we’re creating a campaign operation to oppose what Planned Parenthood wants to do,” Gonidakis said. “And we’re going to hire campaign manager, media firms — we’re running this as if it’s a traditional campaign. You have to. They’re going to raise, by their own admission, probably $40 million. We’ve got to match them dollar for dollar. And we’ll do that.”
___
Associated Press writers Kimberlee Kruesi in Nashville, Tennessee; Amy Beth Hanson in Helena, Montana; Julie Carr Smyth in Columbus, Ohio; and John Hanna in Topeka, Kansas, contributed to this report.
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The implications of Walgreens' decision on abortion pills
By TOM MURPHY
1 hour ago
Walgreens says it will not start selling an abortion pill in 20 states that had warned of legal consequences if it did so.
The drugstore chain’s announcement Thursday signals that access to mifepristone may not expand as broadly as federal regulators intended in January, when they finalized a rule change allowing more pharmacies to provide the pill.
Here’s a closer look at the issue.
ABOUT THE ABORTION PILL
The U.S. Food and Drug Administration approved mifepristone in 2000 to end pregnancy, when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy.
Mifepristone is taken first to dilate the cervix and block a hormone needed to sustain a pregnancy. Misoprostol is taken a day or two later, causing contractions to empty the uterus.
More than half of U.S. abortions are now done with pills rather than with a procedure, according to the Guttmacher Institute, a research group that supports abortion rights. In rare cases, the drug combination can cause excess bleeding, requiring emergency care.
WIDENING ACCESS
For more than 20 years, the FDA limited dispensing of mifepristone to a subset of specialty offices and clinics due to safety concerns.
The agency has repeatedly eased restrictions and expanded access, increasing demand even as state laws make the pills harder to get for many women.
In late 2021, the agency eliminated an in-person requirement for getting the pill, saying a new scientific review showed no increase in safety complications if the drug is taken at home. That change also permitted the pill to be prescribed via telehealth and shipped by mail-order pharmacies.
Earlier this year, the FDA further loosened restrictions by allowing pharmacies like Walgreens to start dispensing the drug after they undergo certification. That includes meeting standards for shipping, tracking and confidentially storing prescribing information.
STATES STEP IN
Typically, the FDA’s authority to regulate prescription drug access has gone unchallenged. But more than a dozen states now have laws restricting abortion broadly — and the pills specifically — following last year’s Supreme Court decision overturning the federal right to abortion.
Last month, attorneys general in 20 conservative-led states warned CVS and Walgreens in a letter that they could face legal consequences if they sell abortion pills by mail in their states.
In addition to state laws, attorneys general from conservative states have argued that shipments of mifepristone run afoul of a 19th century law that prohibited sending items used in abortion through the mail.
WALGREENS' REACTION
A spokesman says the company told the attorneys general that it will not dispense mifepristone in their states and it does plan to ship the drug to them as well.
But Walgreens is working to become eligible through the FDA’s certification process. It plans to dispense the pills where it can legally do so.
The company is not currently dispensing the pills anywhere.
OTHER DRUGSTORES
Rite Aid Corp. said it was “monitoring the latest federal, state, legal and regulatory developments” and would keep evaluating its policies. The Associated Press also sought comment from CVS Health Corp., retail giant Walmart and the grocery chain Kroger.
Some independent pharmacists would like to become certified to dispense the pills, said Andrea Pivarunas, a spokeswoman for the National Community Pharmacists Association. She added that this would be a “personal business decision," based partly on state laws. The association has no specifics on how many will do it.
OTHER LEGAL ISSUES
In November, an anti-abortion group filed a federal lawsuit in Texas seeking to revoke mifepristone's approval, claiming the FDA approved the drug 23 years ago without adequate evidence of safety.
A federal judge could rule soon. If he sides with abortion opponents, mifepristone could potentially be removed from the U.S. market.
In January, abortion rights supporters filed separate lawsuits challenging abortion pill restrictions imposed in North Carolina and West Virginia.
Legal experts foresee years of court battles over access to the pills.
___
AP Health Writer Matthew Perrone contributed to this story.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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Ohio Supreme Court to review block of near-ban on abortion
By JULIE CARR SMYTH
34 mins ago
COLUMBUS, Ohio (AP) — The Ohio Supreme Court agreed Tuesday to review a county judge’s order that is blocking enforcement of the state's near-ban on abortions, and to consider whether the clinics challenging the law have legal standing to do so.
In its split decision, the court, however, denied Republican Attorney General Dave Yost's request to launch its own review of the right to an abortion under the Ohio Constitution, leaving those arguments to play out in lower court.
This mean abortions remain legal in the state for now up to 20 weeks' gestation.
Yost appealed Hamilton County Common Pleas Judge Christian Jenkins’ order to the state’s high court in January, after a failed effort to get it overturned by the First District Court of Appeals. The appellate court ruled the appeal premature, as it was only an interim step in the lawsuit challenging the so-called heartbeat law's constitutionality.
Justices will now decide whether such orders are appropriate legal procedure, or attempts by lower courts to block laws they don't like, as Yost has asserted.
Abortion rights organizations want the law to remain blocked, pointing to the chaos inflicted on patients, doctors and clinics during the 66 days that the Ohio ban was in effect last year.
The law signed by Republican Gov. Mike DeWine in April 2019 prohibits most abortions after the first detectable “fetal heartbeat.” Cardiac activity can be detected as early as six weeks into pregnancy, before many women know they’re pregnant. The law had been blocked through a different legal challenge until right after the U.S. Supreme Court overturned its landmark Roe v. Wade decision legalizing abortion.
The ruling effectively nullified all abortion-rights lawsuits across the country that had cited the federal constitution, sending the question back to the states.
The lawsuit filed in Jenkins' court argues a similar right exists under the Ohio Constitution.
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Texas judge suspends FDA approval of abortion pill mifepristone By Ann E. Marimow, Caroline Kitchener and Perry Stein April 07, 2023 at 18:46 ET A federal judge in Texas blocked U.S. government approval of a key abortion medication Friday, siding with abortion foes in an unprecedented lawsuit and potentially upending nationwide access to the pill widely used to terminate pregnancies. The highly anticipated ruling puts on hold the Food and Drug Administration’s approval of mifepristone, a medication first cleared for use in the United States in 2000. The ruling will not go into effect for seven days to give the government time to appeal. U.S. District Judge Matthew J. Kacsmaryk, a nominee of President Donald Trump with long-held antiabortion views, agreed with the conservative groups seeking to reverse the FDA’s approval of mifepristone as safe and effective, including in states where abortion rights are protected. The Biden administration will probably appeal to the U.S. Court of Appeals for the 5th Circuit, and the case could make its way to the Supreme Court. The lawsuit followed the Supreme Court’s elimination of the constitutional right to abortion last June, which allowed states to outlaw or sharply restrict the procedure. Medication-induced abortion — the most common method of abortion in the United States — has become increasingly contentious since the high court overturned Roe v. Wade. The lawsuit was brought by the legal group Alliance Defending Freedom on behalf of antiabortion medical organizations and four doctors who say they have treated patients with mifepristone. It claims the FDA did not have the power to approve the drug — one of two medications that are used together to terminate a pregnancy — and takes issue with the agency’s easing of restrictions on the pill through the years.
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I really really fear for women of childbearing age, I am way past that now, but these archaic laws will cause irreparable harm to our young women who are being seen as nothing but baby incubators by the GOP
I really really fear for women of childbearing age, I am way past that now, but these archaic laws will cause irreparable harm to our young women who are being seen as nothing but baby incubators by the GOP
Well said. The extent of control of young women today is a major setback from where we once were. This has to be stopped!
I feel like, while these rulings will make things difficult in the short term, this will backfire in a significant way against hardline conservatives.
Women 60ish and younger are not going to stand for this. They will continue to vote in droves if cons continue to put womens’ rights on the ballot.
I hope that backfire does come. I'm not sure though how that will work out in some of the heavily religious deep red states. I don't have any problem with people of faith in general, but these religious zealots who want to shove their biases and personal agendas on to other people are doggedly relentless. It will be a tough challenge in some places.
“The fear of death follows from the fear of life. A man [or woman] who lives fully is prepared to die at any time.”
I really really fear for women of childbearing age, I am way past that now, but these archaic laws will cause irreparable harm to our young women who are being seen as nothing but baby incubators by the GOP
Well said. The extent of control of young women today is a major setback from where we once were. This has to be stopped!
I feel like, while these rulings will make things difficult in the short term, this will backfire in a significant way against hardline conservatives.
Women 60ish and younger are not going to stand for this. They will continue to vote in droves if cons continue to put womens’ rights on the ballot.
I hope that backfire does come. I'm not sure though how that will work out in some of the heavily religious deep red states. I don't have any problem with people of faith in general, but these religious zealots who want to shove their biases and personal agendas on to other people are doggedly relentless. It will be a tough challenge in some places.
you can't stop progress/evolution. as much as they will fight it, as we can see, they will eventually lose.
Montana Supreme Court decides registered nurses and midwives can continue providing abortion care
By AMY BETH HANSON
Yesterday
HELENA, Mont. (AP) — Montana's Supreme Court ruled unanimously Friday that advanced-practice registered nurses can continue to provide abortion care in the state, likely setting up legal clashes with the 2023 Legislature, which passed restrictive laws saying only physicians can perform abortions.
The state failed to prove that an abortion performed by a family nurse practitioner or certified nurse-midwife presents more risk to the patient than abortions provided by physicians or physician assistants, according to the opinion written by Justice Laurie McKinnon.
“This case was not about the right to abortion — it was about whether women have a right to an elevated standard of care during an abortion,” said Emilee Cantrell, spokeswoman for the Montana Department of Justice. “The Montana Supreme Court said ‘no’ and lowered the standard of care set by the Legislature, effectively constitutionalizing the right of unqualified individuals to perform unregulated abortions.”
Montana is one of at least 19 states that allow advanced-practice registered nurses to provide abortion care. APRNs have at least a master's degree in nursing.
Justices found that a law making it a felony for providers other than physicians and physician assistants to perform abortions violated the patient's fundamental right to privacy to seek a pre-viability abortion from the qualified health care provider of her choosing — a standard set in a 1999 Supreme Court ruling in the Armstrong case.
“Allowing APRNs to perform these services ensures Montanans maintain their constitutional right to access the quality healthcare they need," Alex Rate, ACLU of Montana's interim co-executive director, said in a statement.
The justices said court evidence showed APRNs are capable of providing care for miscarriages or stillbirths, and that early abortion procedures such as medication and aspiration abortions require similar care. The state did not argue that APRNs present a genuine health and safety risk when providing miscarriage care, the justices noted.
Montana's 2023 Legislature passed several bills to restrict abortion access, including provisions to only allow physicians to provide abortion care, to require prior authorization before Medicaid pays for abortions and to prevent the most common abortion procedure used in the second trimester of pregnancy. Also, a bill advanced that seeks to make the court reconsider the Armstrong ruling, by saying that the state's constitutional right to privacy does not include the right to an abortion.
The Montana Supreme Court noted that the state did not ask it to overturn the Armstrong ruling during the course of the case initially brought by Helen Weems, an APRN who owns a sexual and reproductive health clinic in Whitefish.
“Montana lawmakers have been relentless in their efforts to restrict access to essential health care,” Weems said in a statement.
Under earlier rulings in the case, Weems has been allowed to provide abortion care since 2018. Other APRNs, with proper training, were allowed to begin performing abortions after Menahan’s 2022 ruling.
“It is more important than ever to protect our patients and their ability to make decisions about their health and families,” Weems said. “I look forward to continuing to make abortion care more accessible in our state.”
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Clergy: North Carolina's proposed abortion restrictions are another effort to harm the state's poor
Yesterday
RALEIGH, N.C. (AP) — Clergy and other opponents of a bill further restricting abortion in North Carolina that's about to be vetoed by Gov. Roy Cooper said Friday the measure is another effort by the Republican-controlled General Assembly to harm the state's low-income residents.
Civil rights leader the Rev. William Barber of Goldsboro and other ministers gathered inside the Legislative Building to speak against the legislation, which would ban nearly all abortions after 12 weeks of pregnancy. State law currently bans abortions after 20 weeks.
“This bill will hurt the most vulnerable, especially the poor among us,” Barber said. “It is wrong. It is wrong over and over and over again.”
Cooper has said he plans to veto the bill on Saturday, when he'll attend a rally organized by abortion-rights advocates in downtown Raleigh. The state legislature could begin override votes next week. Republicans hold narrow veto-proof seat majorities in the House and Senate. Cooper has held public events this week in hopes of persuading Republican legislators to uphold his anticipated veto.
Critics of the measure say additional rules governing legal abortions will make it harder for women who live in rural areas or work long hours to access abortion services. But bill supporters say the measure will protect life and provide at least $160 million toward services that help mothers, children and families.
Barber, president of the group Repairers of the Breach and co-chair of the national Poor People’s Campaign, said that if GOP legislators were concerned about life they would pass laws tightening gun regulations and raising the minimum wage, among others. Event participants also read from an open letter to legislative leaders that in part highlights other GOP bills they oppose.
Religious leaders participating in the event met later Friday with Cooper, the governor's office said.
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Kansas governor vetoes measures to aid anti-abortion centers, limit health officials' power
By JOHN HANNA
Yesterday
TOPEKA, Kan. (AP) — Kansas' Democratic governor on Friday vetoed Republican legislation that would have provided a financial boost to anti-abortion pregnancy centers and prevented officials fighting outbreaks of contagious diseases from prohibiting public gatherings or ordering infected people to isolate themselves.
The two measures were part of a wave of conservative policies passed by GOP-controlled state legislatures this year, including ones in Kansas rolling back transgender rights and establishing new restrictions on abortion providers. But Gov. Laura Kelly's two vetoes will stand because lawmakers have adjourned for the year, barring any attempt at overriding them.
The anti-abortion measure would have granted up to $10 million a year in new state income tax credits to donors to the more than 50 centers across the state that provide free counseling, classes, supplies and other services to pregnant people and new parents to discourage abortions. Lawmakers included it in a wide-ranging tax bill that also included an expansion of existing tax credits for adoption expenses and purchases from businesses that employ disabled workers. Kelly vetoed the entire bill.
Republican lawmakers pursued anti-abortion measures this year despite a decisive statewide vote in August 2022 affirming abortion rights. Abortion opponents argued that the vote didn't preclude “reasonable” restrictions and other measures, while Democrats argued that GOP legislators were breaking faith with voters.
Kelly supports abortion rights and narrowly won reelection last year. Last month she vetoed $2 million in the next state budget for direct aid to the centers, but the Legislature overrode that action.
In her latest veto message, Kelly didn't point to any individual provision in the tax bill but said bundling so many proposals together made it “impossible to sort out the bad from the good.”
In vetoing direct aid to anti-abortion centers last month, Kelly called them “largely unregulated” and said, “This is not an evidence-based approach or even an effective method for preventing unplanned pregnancies.”
Abortion opponents argued that providing financial aid to their centers would help make sure that people facing unplanned pregnancies have good alternatives if they're unsure about getting abortions.
House Speaker Dan Hawkins, a Wichita Republican, accused Kelly in a statement of a "political bias against helping vulnerable new mothers.”
Even if lawmakers still had a chance to override Kelly's veto, they didn't pass the tax bill initially with the two-thirds majorities required.
The other bill Kelly vetoed was part of an ongoing backlash from conservative lawmakers against how she, other state officials and local officials attempted to check the spread of COVID-19 in 2020 and 2021. They were particularly critical of orders closing schools and businesses during the pandemic's first months and restrictions on businesses' operations and mask mandates later.
“She said no to protecting the health freedom of Kansans and curtailing the powers of unelected bureaucrats,” Senate President Ty Masterson, another Wichita-area Republican, said in a statement.
But Republicans split over the measure because some feared it went too far in curbing state and local officials' powers during outbreaks.
It would have stripped local officials of their authority to prohibit public gatherings and repealed a requirement that local law enforcement officers enforce orders from public health officials. Those officials also would have lost their authority to order quarantines for infected people.
The head of the state health department, appointed by the governor, would have lost the power to issue orders and impose new health rules to prevent the spread of disease or to order people to get tested or seek treatment for infectious diseases.
Kelly's veto message said Kansas has been a pioneer in public health policy. A century ago the state's top health official, Dr. Samuel Crumbine, was known internationally for campaigning against unsanitary, disease-spreading practices such as spitting on sidewalks and having common drinking cups on railroads and in public buildings.
“Yet lawmakers continue trying to undermine the advancements that have saved lives in every corner of our state," Kelly wrote.
The bill also reflected vaccine opponents' influence with conservative Republican lawmakers.
It would have prevented the head of the state health department from requiring COVID-19 vaccinations for children entering school or day care — something Kelly's administration has said it doesn't plan to do. State and local officials also would not have been able to cite a person's lack of vaccination as a reason for recommending that they isolate themselves.
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Indiana doctor's discipline hearing centers on privacy, reporting of Ohio 10-year-old's abortion
By Tom Davies
35 mins ago
INDIANAPOLIS (AP) — A hearing on possible disciplinary action opened Thursday for an Indianapolis doctor who spoke publicly about providing an abortion to a 10-year-old rape victim from Ohio, with finger pointing over how the case became a political flashpoint in the national abortion debate.
Indiana's Republican attorney general has accused Dr. Caitlin Bernard of violating state law by not reporting the girl’s child abuse to Indiana authorities. She's also accused of breaking federal patient privacy laws by telling a newspaper reporter about the girl’s treatment.
Bernard has consistently defended her actions and told the state Medical Licensing Board Thursday that she followed Indiana’s reporting requirements for child abuse cases to hospital staff — and that the girl’s rape was already being investigated by Ohio authorities. Bernard's lawyers also said that she didn’t released any identifying information about the girl that would break privacy laws.
The Indianapolis Star cited the girl’s case in a July 1 article that sparked a national political uproar in the weeks after the U.S. Supreme Court overturned Roe v. Wade last June, putting into effect an Ohio law that prohibited abortions after six weeks of pregnancy. Some news outlets and Republican politicians falsely suggested Bernard fabricated the story, until a 27-year-old man was charged with the rape in Columbus, Ohio.
Bernard's lawyer Alice Morical told the board Thursday that the doctor reported child abuse of patients many times a year and that a hospital social worker had confirmed with Ohio’s child protection office that it was safe for the girl to leave with her mother.
“Dr. Bernard could not have anticipated the atypical and intense scrutiny that this story received,” Morical said. “She did not expect that politicians would say that she made the story up.”
Indiana Attorney General Todd Rokita’s complaint asked the licensing board to impose “appropriate disciplinary action” but doesn’t specify a requested penalty.
Amid the wave of attention to the girl’s case last summer, Rokita, who is stridently anti-abortion, told Fox News he would investigate Bernard’s actions, calling her an “abortion activist acting as a doctor.”
Deputy Attorney General Cory Voight argued Thursday that the board must address what he called an “egregious violation” of patient privacy and Bernard’s failure to notify Indiana’s Department of Child Services and police about the rape.
“There’s been no case like this before the board,” Voight said. "No physician has been as brazen in pursuit of their own agenda.”
Voight asked Bernard why she discussed the Ohio girl’s case with the newspaper reporter and later in other news media interviews rather than using a hypothetical situation.
“I think that it’s incredibly important for people to understand the real-world impacts of the laws of this country about abortion,” Bernard said. “I think it’s important for people to know what patients will have to go through because of legislation that is being passed and a hypothetical does not make that impact."
The Indiana board — made up of six doctors and one attorney appointed or reappointed by Republican Gov. Eric Holcomb — could vote whether to impose any penalties Thursday after hearing what is expected to be several hours of testimony. State law gives the board wide latitude, allowing it to issue reprimand letters or suspend, revoke or place on probation a doctor’s license.
Bernard unsuccessfully tried to block Rokita’s investigation last fall, although an Indianapolis judge wrote that Rokita made “clearly unlawful breaches” of state confidentiality laws with his public comments about investigating the doctor before filing the medical licensing complaint against her.
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Comments
ST. LOUIS (AP) — A group of religious leaders who support abortion rights filed a lawsuit Thursday challenging Missouri's abortion ban, saying lawmakers openly invoked their religious beliefs while drafting the measure and thereby imposed those beliefs on others who don't share them.
The lawsuit filed in St. Louis is the latest of many to challenge restrictive abortion laws enacted by conservative states after the Supreme Court overturned Roe v. Wade in June. That landmark ruling left abortion rights up to each state to decide.
Since then, religious abortion rights supporters have increasingly used religious freedom lawsuits in seeking to protect abortion access. The religious freedom complaints are among nearly three dozen post-Roe lawsuits that have been filed against 19 states’ abortion bans, according to the Brennan Center for Justice.
The Missouri lawsuit brought on behalf of 13 Christian and Jewish leaders seeks a permanent injunction barring the state from enforcing its abortion law and a declaration that provisions of its law violate the Missouri Constitution.
“What the lawsuit says is that when you legislate your religious beliefs into law, you impose your beliefs on everyone else and force all of us to live by your own narrow beliefs,” said Michelle Banker of the National Women’s Law Center, the lead attorney in the case. “And that hurts us. That denies our basic human rights.”
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Missouri Senate President Pro Tem Caleb Rowden, a Republican, called the lawsuit “foolish.”
“We were acting on the belief that life is precious and should be treated as such. I don’t think that’s a religious belief,” Rowden said.
Within minutes of last year's Supreme Court decision, then-Attorney General Eric Schmitt and Gov. Mike Parson, both Republicans, filed paperwork to immediately enact a 2019 law prohibiting abortions “except in cases of medical emergency.” That law contained a provision making it effective only if Roe v. Wade was overturned.
The law makes it a felony punishable by 5 to 15 years in prison to perform or induce an abortion. Medical professionals who do so also could lose their licenses. The law says that women who undergo abortions cannot be prosecuted.
Missouri already had some of the nation’s more restrictive abortion laws and had seen a significant decline in the number of abortions performed, with residents instead traveling to clinics just across the state line in Illinois and Kansas.
The lawsuit, filed on behalf of the faith leaders by Americans United for Separation of Church & State and the National Women’s Law Center, said sponsors and supporters of the Missouri measure “repeatedly emphasized their religious intent in enacting the legislation." It quotes the bill's sponsor, Republican state Rep. Nick Schroer, as saying that “as a Catholic I do believe life begins at conception and that is built into our legislative findings.” A co-sponsor, Republican state Rep. Barry Hovis, said he was motivated “from the Biblical side of it," according to the lawsuit.
“I'm here today because none of our religious views on abortion or anything else should be enshrined into our laws,” Maharat Rori Picker Neiss, executive director of the Jewish Community Relations Council of St. Louis and one of the plaintiffs, said at a news conference.
Lawsuits in several other states take similar approaches.
In Indiana, lawyers for five anonymous women — who are Jewish, Muslim and spiritual — and advocacy group Hoosier Jews for Choice have argued that state’s ban infringes on their beliefs. Their lawsuit specifically highlights the Jewish teaching that a fetus becomes a living person at birth and that Jewish law prioritizes the mother’s life and health.
A court ruling siding with the women was appealed by the Indiana attorney general's office, which is asking the state Supreme Court to consider the case.
In Kentucky, three Jewish women sued, claiming the state’s ban violates their religious rights under the state’s constitution and religious freedom law. They allege that Kentucky’s Republican-dominated legislature “imposed sectarian theology” by prohibiting nearly all abortions. The ban remains in effect while the Kentucky Supreme Court considers a separate case challenging the law.
But Banker said Missouri’s lawsuit is unique because while plaintiffs in other states claimed harm, “we are saying that the whole law violates separation of church and state and we’re seeking to get everything struck down.”
Missouri Republican attorney general, Andrew Bailey, said in a statement that he will “defend the right to life with every tool at my disposal.”
“I want Missouri to be the safest state in the nation for children and that includes unborn children," Bailey said.
___
Associated Press writer David A. Lieb in Jefferson City, Missouri, contributed to this report.
___
This story was updated to correct that the lawsuit was filed on behalf of 13, not 12, Christian and Jewish leaders and to delete a reference to the filing happening on the 50th anniversary of Roe v. Wade. That anniversary is Sunday.
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"Well, you tell him that I don't talk to suckas."
LAWRENCE, Kan. (AP) — Though the Insight Women’s Center sits at the epicenter of a reinvigorated battle in the nation’s culture wars, the only hint of its faith-based mission to dissuade people from getting abortions is the jazzy, piano rendition of “Jesus Loves Me” playing in a waiting room.
The Republican-controlled Kansas Legislature is considering allocating millions of dollars in state funds to similar anti-abortion centers that persuade people to bring their pregnancies to term by offering free pregnancy tests and sonograms, as well as counseling and parenting classes taught by volunteers. They're also considering offering millions more in income tax credits for donors supporting what they call “crisis pregnancy centers."
When the U.S. Supreme Court overturned Roe v. Wade last year and gave control of abortion policy to the states, it led to bans and restrictions in some states, and executive orders and laws protecting access in others. Those debates continue, but perhaps less noticed is how this change refueled the renewed battle over taxpayer money.
Supporters say the effort shows abortion opponents are addressing families' social and financial needs. But critics say the amount of new funding proposed for organizations like Insight — either in direct funding or tax credits for their donors — fall far short of what’s necessary to improve people’s access to health care and address ongoing poverty.
ABORTION
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“You funnel money through a short-term solution that makes it appear as though you are doing something,” said Alesha Doan, a University of Kansas associate professor who has studied and written books about abortion politics.
Increasingly, liberal cities and states are funding access to abortion, including telemedicine, which has seen a notable rise with more than half of U.S. abortions now done with pills rather than surgery. Meanwhile, states with GOP legislatures and governors are looking to put more taxpayer money into organizations that talk people out of ending their pregnancies.
Legislative committees held hearings Thursday on proposals for a 70% income tax credit to donors who support anti-abortion centers, with a cap of $10 million in total credits. A Senate committee might vote this week.
It's similar to a longstanding Missouri law that provides income tax credits to donors supporting anti-abortion centers. Arizona has such a law, and Mississippi's Republican House speaker is trying to expand a cap on tax credits to $10 million from the $3.5 million authorized last year.
Arkansas and Oklahoma are considering adding similar tax credits, according to the National Right to Life Committee.
In Missouri, donors to anti-abortion centers have received $15 million in total state tax credits over the past five years, and one state analysis estimates the centers served about 43,000 people last year.
Abortion opponents have operated centers like Insight for decades, and the practice of conservative-led states offering financial aid to them predates Dobbs — the decision in June overturning Roe v. Wade.
On the abortion-rights side, Oregon lawmakers last year created a $15 million abortion-access fund, with the first $1 million going to a nonprofit that covers the costs of patients' travel and procedures. California, Connecticut, New Jersey, New York and Washington have also allocated or are considering offering public funding for abortions or related services.
In New Mexico last year, Democratic Gov. Michelle Lujan Grisham pledged $10 million in state funds to the construction of a new abortion clinic.
Morgan Hopkins, president of the abortion-rights advocacy group All(asterisk) Above All praised the funding. “Budgets are a reflection of our values," she said.
Kansas already provides grants to programs that provide prenatal care, and encourage people to carry their pregnancies to term. But it spends less than $339,000 in a state budget of $24 billion on the program — and made only two grants totaling less than $74,000 to anti-abortion centers.
Now, some abortion opponents talk about emulating Missouri's more than $8 million annual funding, plus the income tax credits.
Abortion rights supporters are frustrated that the push for such support is coming so soon after an Aug. 2 statewide vote that decisively rejected a proposed amendment to the Kansas Constitution that would have allowed legislators to greatly restrict or ban abortion.
“I have general concerns that we’re not respecting what was the very clear will of voters,” said state Sen. Ethan Corson, a Kansas City-area Democrat who serves on the Senate tax committee.
Abortion rights advocates say the centers lure patients away from abortion clinics with free services, give them inaccurate medical information and counseling from people who are not trained therapists. Some see funding them as a political gesture designed to make abortion bans look less harsh.
Abortion opponents argue that centers like Insight offer patients a wide range of prenatal and post-birth classes, in addition to other help. They also argue that boosting funding for free services after the August vote is a promise not to abandon parents and families.
In Lawrence, where the nearest abortion clinic is a 40-minute drive away, 28-year-old Korbe Bohac is still visiting the Insight center nearly 8 months after her son Winston was born. She told legislators the classes and counseling make her a better, more confident parent — and helped preserve her mental health. She called it “a safety net.”
The Insight center, which is only a few miles from the University of Kansas, has two sonogram nurses, and a doctor and radiologist sometimes volunteer their time. But services depend mostly on about 50 volunteers. The $340,000 annual budget is mostly supplied by private donations, but the organization received a community development grant in 2014 to launch parent education programs.
Center staff said that although they do not refer clients to abortion providers, they discuss abortion as an option. They said some patients who met with them went on to have abortions, though this is not possible to verify given patients' privacy protocols.
Insight has two separate waiting rooms — one for its educational programs and one for medical services. Executive director Bridgit Smith said one reason is that it keeps pregnant patients from being influenced by seeing babies and toddlers.
Smith said she believes the proposed tax credit would increase donations, helping Insight start a maternity home for people without shelter.
“We’re trying to build strong individuals and strong families. And isn’t that what we all want?” Smith said. “Even for the woman that doesn’t choose to parent, we still want her to be strong and healthy after the decision.”
___
Mulvihill reported from Cherry Hill, New Jersey. Emily Wagster Pettus in Jackson, Mississippi, contributed to this report.
___
Follow John Hanna on Twitter at https://twitter.com/apjdhanna.
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WASHINGTON (AP) — A Texas lawsuit with a key deadline this month is posing a threat to the nationwide availability of medication abortion, which now accounts for the majority of abortions in the U.S.
The case filed by abortion opponents who helped challenge Roe v. Wade seeks to reverse a decades-old approval by the Food and Drug Administration.
If a federal judge appointed by former President Donald Trump sides with them, it could halt the supply of the drug mifepristone in all states, both where abortion is banned and where it remains legal.
“It could have an immediate impact on the country,” said Mini Timmaraju, president of NARAL Pro-Choice America. “In some ways this is a backdoor ban on abortion.”
On Friday, a group of 22 Democratic-led states weighed in, saying the consequences of reversing the approval could be “nothing short of catastrophic. A similar-sized group of Republican states also filed briefs supporting the reversal, saying the ability to order pills by mail undermines their laws banning abortion.
U.S. District Judge Matthew Kacsmaryk has not indicated exactly when or how he will rule, but groups like Timmaraju’s have been preparing for a possible decision shortly after a Feb. 24 filing deadline. There is scant precedent for a lone judge overruling the FDA’s scientific decisions. A swift appeal of any ruling is likely.
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The lawsuit was filed by the group Alliance Defending Freedom, which was also involved in the Mississippi case that led to Roe v. Wade being overturned.
“Our representatives in Congress created the FDA and gave the FDA the responsibility to make sure that drugs are safe before they’re allowed on the market … the FDA failed that responsibility,” said Julie Blake, senior counsel for the group.
They argue the FDA overstepped its authority in approving mifepristone by using an accelerated review process reserved for drugs to treat “serious or life-threatening illnesses.”
But in its legal response, the agency said it didn't accelerate the drug’s approval, which came four years after the manufacturer first submitted its application to market the pill.
The FDA approved mifepristone — in combination with a second drug — as a safe and effective method for ending a pregnancy in 2000. Common side effects include cramping and light bleeding. Cases of more severe bleeding requiring emergency care are very rare.
Halting access to the drug more than 20 years after approval would be “extraordinary and unprecedented,” federal attorneys stated in a legal filing.
Kacsmaryk, who previously ruled against a program providing free birth control to minors in Texas, could also issue a ruling rolling back regulators' decisions to ease restrictions on the pill’s availability. Those have been based on scientific studies showing women can safely use the drug at home.
In late 2021, the FDA removed a requirement that women pick up the drug in person. Last month the agency dropped another requirement that prevented most pharmacies from dispensing the pill.
Medication abortion accounted for over half of abortions before Roe v. Wade was overturned, according to research from the Guttmacher Institute. It’s grown more important since then, said Elizabeth Nash, state policy analyst for the science-based research group that supports abortion rights.
“The clinics that are open in the receiving states are stretched thin, they don’t have a lot of give in their capacity and being able to provide medication abortion is very, very important,” she said.
Abortion medication is approved for use up to the 10th week of pregnancy. Mifepristone is taken first, swallowed by mouth. The drug dilates the cervix and blocks the effects of the hormone progesterone, which is needed to sustain a pregnancy.
Misoprostol, a drug also used to treat stomach ulcers, is taken 24 to 48 hours later. It causes the uterus to cramp and contract, causing bleeding and expelling pregnancy tissue. The combination has been shown to be more than 95% effective in ending pregnancies up to 10 weeks.
If mifepristone is pulled, providers could prescribe misoprostol alone instead, an approach that is used in many parts of the world, but would be a big shift in U.S. practice and has not been found to be quite as effective.
Such a ruling could also increase the need for surgical abortion and further increase wait times at clinics, which are already weekslong in some cases after the U.S. Supreme Court ruling overturning Roe, Nash said.
___
Associated Press writer Matthew Perrone contributed to this report.
___
Find AP’s full coverage of the overturning of Roe v. Wade at: https://apnews.com/hub/abortion
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RALEIGH, N.C. (AP) — North Carolina Attorney General Josh Stein won't defend state restrictions on dispensing abortion pills that are being challenged in a lawsuit and instead will argue the restrictions are preempted by federal regulations protecting access to the pills, Stein's office said Monday.
The decision by Stein, a Democrat, means Republican legislative leaders who want to keep the restrictions would have to seek to formally intervene in the federal lawsuit, which was filed by Amy Bryant, a physician who prescribes the drug mifepristone.
The lawsuit filed in January in U.S. District Court in Durham, and a separate lawsuit challenging limits on abortion pills in West Virginia, are considered the openings of legal battles over access to the medications. A Texas lawsuit poses a threat to the nationwide availability of medication abortion, which now accounts for the majority of abortions in the U.S. The case filed by abortion opponents seeks to reverse FDA approval of mifepristone.
Bryant's lawsuit seeks to block enforcement of state laws and rules that it says interferes with the ability to provide mifepristone to patients. The lawsuit cites the authority that Congress gave to the U.S. Food and Drug Administration to regulate the FDA-approved drug.
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North Carolina laws require the pill must be dispensed in person after a 72-hour waiting period, the lawsuit says, and only after patients receive state-mandated counseling and in some cases an ultrasound.
Stein, who supports abortion rights and is running for governor next year, is a defendant in the lawsuit along with a district attorney and state health and medical officials. Stein and state Department of Justice attorneys are tasked with defending state laws in court.
In this case, Bryant's federal preemption arguments "are legally correct,” Sarah Boyce, general counsel at the state Department of Justice, wrote in a letter to legislative lawyers for House Speaker Tim Moore and Senate leader Phil Berger.
“Consistent with its statutory authority, the FDA has determined that restrictions like the ones imposed under North Carolina state law would unduly burden patients’ access to a safe and effective drug,” Boyce wrote. “The department’s filings in the (lawsuit) on behalf of Attorney General Stein will reflect this legal analysis on the merits.”
Spokespeople for Berger and Moore didn’t immediately respond to requests for comment.
The U.S. Supreme Court decision last June that overturned Roe v. Wade — turning decision-making over abortion to the states — has brought renewed focus on medication abortions. Nineteen states — including North Carolina and West Virginia — have laws controlling how, when and where physicians can prescribe and dispense abortion drugs.
The FDA approved mifepristone in 2000 to end pregnancy, when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy. The FDA eliminated an in-person requirement for the pill, which can be shipped by mail-order or picked up at brick-and-mortar pharmacies.
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A few months after South Dakota banned abortion last year, April Matson drove more than nine hours to take a friend to a Colorado clinic to get the procedure.
The trip brought back difficult memories of Matson’s own abortion at the same clinic in 2016. The former grocery store worker and parent of two couldn’t afford a hotel and slept in a tent near a horse pasture — bleeding and in pain.
Getting an abortion has long been extremely difficult for Native Americans like Matson. It has become even tougher since the Supreme Court overturned Roe v. Wade.
New, restrictive state laws add to existing hurdles: a decades-old ban on most abortions at clinics and hospitals run by the federal Indian Health Service, fewer nearby health centers offering abortions, vast rural expanses for many to travel, and poverty afflicting more than a quarter of the Native population.
“That’s a lot of barriers,” said Matson, who lives in Sioux Falls and is Sicangu Lakota. “We’re already an oppressed community, and then we have this oppression on top of that oppression.”
Among the six states with the highest proportion of Native American and Alaska Native residents, four – South Dakota, Oklahoma, Montana and North Dakota – have moved or are poised to further restrict abortion. South Dakota and Oklahoma ban it with few exceptions.
In some communities, the distance to the nearest abortion provider has increased by hundreds of miles, said Lauren van Schilfgaarde, a member of Cochiti Pueblo in New Mexico who directs the tribal legal development clinic at the University of California-Los Angeles.
“Native people are having to cross massive, massive distances and absorb all of the travel costs and child care,” she said.
Experts say the issue should be seen within the larger context of the tortured history between Indigenous people and white society that began with the taking of Native lands and includes coerced sterilization of Native women lasting into the 1970s. Native Americans on both sides of the abortion debate invoke this history — some arguing the procedure reduces the number of potential citizens in a population that has been threatened for centuries, and others saying new restrictions are another attack on Native women's rights.
Many advocates worry that reduced abortion access will make things even worse for women already facing maternal death rates twice as high as their white peers, teen birth rates more than twice as high as whites, and the worst rates of sexual violence.
“Indigenous women don’t have access to reproductive justice in any form, and that includes abortion,” said Natalie Stites Means, a member of the Cheyenne River Sioux Tribe who serves on the board of the Justice Empowerment Network, an abortion fund. “Any limitation on our health care and any limitation on abortion is going to impact our health and well-being.”
DECADES OF RESTRICTIONS
For centuries, experts said, Indigenous people had their own systems of health care, which in some cases included natural abortive practices.
Today, the main source of care for many is the Indian Health Service, which serves 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states. Its clinics and hospitals operate under the Hyde Amendment, which bars them from using federal funds for abortions except in cases of rape, incest or threats to a mother’s life.
Even when an IHS patient falls under one of those exceptions, many facilities "don’t have the materials or staff or the expertise to provide that abortion care," van Schilfgaarde said.
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Matson uses the pronoun they and is two-spirit, a term used to describe those who combine traits of both men and women. Matson, who lived in Rapid City at the time, said IHS staff didn't discuss abortion as an option for their unplanned pregnancy. After getting the procedure at 13 weeks in Colorado, they felt uncomfortable returning to IHS despite ongoing bleeding.
While IHS staff can refer people to places that provide abortions, federal funds can only be used for “Hyde-permitted” procedures and related patient travel, agency officials said in a statement. And a federal report shows nearly 1 in 5 American Indians and Alaska Natives are uninsured.
Also, there are often no abortion providers nearby. One reason? The proportion of Catholic health systems, which generally prohibit abortion, has grown significantly. A 2020 report by Community Catalyst, a nonprofit health advocacy organization, found that 1 in 6 acute care hospital beds in the U.S. is in a Catholic system. The share is 40% in South Dakota and 32% in Oklahoma.
SEEKING SOLUTIONS
After Roe fell, restrictive “trigger” laws took effect in more than a dozen states, including South Dakota and Oklahoma, which already had stopped providing most abortions. North Dakota's abortion ban has been blocked in court.
Some Native women were inspired to organize.
Cherokee women in Tahlequah, Oklahoma, gathered over the summer to discuss a possible amendment to the tribe’s constitution protecting reproductive health access for its citizens. They were frustrated that leaders of this tribe with around 450,000 citizens hadn’t addressed the issue.
“Fear was just kind of palpable,” said group leader Alissa Baker, who teaches psychology at Northeastern State University. “We felt a need to protect our community ... and really in some ways reclaim some of those traditional roles of a Cherokee woman, which is effectively being the voice of the community.”
But the effort stalled as the school year approached, with members spread across a rural area, busy with jobs and children.
Other activist efforts panned out. D’Arlyn Bell, a doctoral student at the University of Kansas and another member of the Cherokee Nation, joined with other Native activists to help defeat a proposed amendment to the Kansas state constitution that would have cleared the way for tougher abortion restrictions.
“We were doing it not only for the Native women in our own states but Native women from our own home territories, especially Oklahoma,” she said.
Experts stress that abortion views vary among tribal leaders and members – something echoed in a statement from the Cherokee Nation, the only one of the five largest tribes in South Dakota and Oklahoma to respond to a request for comment from The Associated Press.
Opening a clinic on tribal land would be legally challenging, experts said. The Cherokee Nation said it wouldn’t set one up, and there have been no announcements from other tribes since Roe was overturned. History shows the issue is fraught: The first woman president of the Oglala Sioux Tribe in South Dakota was impeached in 2006 after publicly proposing an abortion clinic on the reservation.
Post-Roe, Native Americans on both sides of the issue are taking personal and collective action.
Elizabeth Terrill, a board member for the anti-abortion Native American nonprofit Life is Sacred, said she’s a foster parent, does post-abortion counseling and supports moms. She said extended families on tribal lands historically have banded together when there is an unplanned pregnancy, and most women choose to continue them.
“I think there’s just a different cultural understanding of what life is and when life begins and why life is so sacred,” said Terrill, a mental health therapist near the Navajo Nation in New Mexico and member of the Osage Nation of Oklahoma.
Matson, executive director of the summer camp “Rock the Rez,” said they share their experience, donate money to those in need and tell others about resources like the Justice Empowerment Network, which covered most of their friend’s abortion and travel costs.
“Every time someone is going through this, I offer support,” said Matson, 32. “I’ve helped, I hope, in every way that I can.”
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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HARRISBURG, Pa. (AP) — Republicans and their anti-abortion allies, who suffered a series of defeats in ballot questions in states across the political spectrum last year, are changing tactics as new legislative sessions and the new election season start.
In states where citizens have direct access to the ballot, Republicans are considering ways to prevent another loss in an abortion-rights referendum.
In some states, Republicans are considering exemptions to sweeping bans or looking at ways to prevent abortions besides trying to roll back the number of weeks during which an abortion is allowed.
To be sure, abortion restrictions have seen some success in a few Republican-controlled states.
West Virginia and Indiana passed laws to ban abortion after the U.S. Supreme Court’s June ruling overturning a nationwide constitutional protection for the procedure.
South Carolina and Montana lawmakers are also trying to ban abortion — or more heavily restrict it — despite a court-ordered right to privacy that currently protects a right to abortion in those states.
But in a number of states, the battle over abortion rights is fluid and influenced by what voters had to say last year, when Kentucky, Montana and Kansas rejected anti-abortion measures on ballots and Michigan, California and Vermont approved abortion rights amendments.
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In politically divided Pennsylvania, Republican lawmakers have stalled their push for a constitutional amendment that would declare there is no constitutional right to an abortion or for taxpayer support for an abortion.
The wording is nearly identical to a measure that failed in Kentucky, and the experience in Kansas last August told abortion opponents that it would be very difficult to win a statewide referendum, said Michael McMonagle, president of the Pro-Life Coalition of Pennsylvania.
“We realized that if the referendum turns on the left's arguments that ‘these pro-lifers are trying to outlaw abortion,’ we’re going to get slaughtered," McMonagle said. “It will be the mushy middle people who will vote against the pro-life referendum.”
Rather, abortion opponents in Pennsylvania decided to wait to see the outcome of a pending court case where abortion clinics are asking the state Supreme Court to overturn a law that bans taxpayer funding for abortions.
A court decision that overturns the law — and allows the state to use public money for abortions — would give abortion opponents a stronger message and a more persuasive case with voters to help them succeed in a referendum, McMonagle said.
Elizabeth Nash, of the New York-based Guttmacher Institute, which supports abortion rights, sees Republicans changing their approach in some states by trying to put up barriers to abortion pills, fund pregnancy programs or soften strict abortion bans.
As an example, Nash pointed to Tennessee, where a growing number of Republican lawmakers say the state’s abortion ban went too far. A bill to allow an abortion if necessary to save the mother's life passed a Senate subcommittee in February but faces uncertain prospects in the GOP-controlled Legislature, and with Republican Gov. Bill Lee should it reach his desk.
House Speaker Cameron Sexton, a Republican, said polling data and discussions with Republican women persuaded him that the law should, at least, include an exception for the life of the mother.
“It’s a very delicate issue,” Sexton said, “but what you see is Republican women wanting exceptions.”
In Kansas, meanwhile, anti-abortion lawmakers recovering from their referendum defeat last August have dropped the idea of trying to ban abortion earlier in pregnancy. Kansas is one of the more permissive states, barring most abortions after the 22nd week.
For the moment, Kansas Republican legislators are aiming to provide financial help to centers that discourage abortion by offering free pregnancy and post-pregnancy services.
Elsewhere, officials at Planned Parenthood say several Republican-controlled states are taking steps to head off potential ballot questions that ask voters to enshrine abortion rights into state constitutions.
That dynamic is playing out in conservative Missouri.
It is one of 13 states where abortion is banned — largely by “trigger” laws that took effect after the high court overturned its landmark Roe v. Wade decision — and one of 22 where citizens have direct ballot access.
There, Republican state lawmakers are considering a handful of alternatives, including making it more difficult to amend the constitution by raising the threshold for voter approval from 50% to 60% in a referendum.
Republicans also floated their own proposal to amend the constitution to say that no provision in the constitution “shall be construed to secure or protect a right to abortion.”
In Republican-controlled Ohio, abortion opponents are gearing up to try to defeat what is expected to be the nation's next referendum to protect access to abortion.
Abortion remains legal in Ohio through 20 weeks, but courts may allow a near-complete ban on abortion approved by lawmakers in 2019.
To fight the referendum, a Republican state lawmaker is sponsoring a resolution to make it more difficult for voters to amend the constitution.
In a memo to colleagues, Rep. Brian Stewart wrote, “after decades of Republicans’ work to make Ohio a pro-life state, the Left intends to write abortion on demand into Ohio’s Constitution.”
Stewart’s measure drew support from Ohio Right to Life, whose leaders met with their philosophical allies in Kentucky, Kansas and Michigan to research why the movement had suffered losses in referendums in those states.
Mike Gonidakis, president of Ohio Right to Life, said he is raising money, hiring campaign staff and intending to get out their message early in the state that just elected a slate of anti-abortion politicians to statewide offices in November.
“What we’re doing now is we’re creating a campaign operation to oppose what Planned Parenthood wants to do,” Gonidakis said. “And we’re going to hire campaign manager, media firms — we’re running this as if it’s a traditional campaign. You have to. They’re going to raise, by their own admission, probably $40 million. We’ve got to match them dollar for dollar. And we’ll do that.”
___
Associated Press writers Kimberlee Kruesi in Nashville, Tennessee; Amy Beth Hanson in Helena, Montana; Julie Carr Smyth in Columbus, Ohio; and John Hanna in Topeka, Kansas, contributed to this report.
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Walgreens says it will not start selling an abortion pill in 20 states that had warned of legal consequences if it did so.
The drugstore chain’s announcement Thursday signals that access to mifepristone may not expand as broadly as federal regulators intended in January, when they finalized a rule change allowing more pharmacies to provide the pill.
Here’s a closer look at the issue.
ABOUT THE ABORTION PILL
The U.S. Food and Drug Administration approved mifepristone in 2000 to end pregnancy, when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy.
Mifepristone is taken first to dilate the cervix and block a hormone needed to sustain a pregnancy. Misoprostol is taken a day or two later, causing contractions to empty the uterus.
More than half of U.S. abortions are now done with pills rather than with a procedure, according to the Guttmacher Institute, a research group that supports abortion rights. In rare cases, the drug combination can cause excess bleeding, requiring emergency care.
WIDENING ACCESS
For more than 20 years, the FDA limited dispensing of mifepristone to a subset of specialty offices and clinics due to safety concerns.
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The agency has repeatedly eased restrictions and expanded access, increasing demand even as state laws make the pills harder to get for many women.
In late 2021, the agency eliminated an in-person requirement for getting the pill, saying a new scientific review showed no increase in safety complications if the drug is taken at home. That change also permitted the pill to be prescribed via telehealth and shipped by mail-order pharmacies.
Earlier this year, the FDA further loosened restrictions by allowing pharmacies like Walgreens to start dispensing the drug after they undergo certification. That includes meeting standards for shipping, tracking and confidentially storing prescribing information.
STATES STEP IN
Typically, the FDA’s authority to regulate prescription drug access has gone unchallenged. But more than a dozen states now have laws restricting abortion broadly — and the pills specifically — following last year’s Supreme Court decision overturning the federal right to abortion.
Last month, attorneys general in 20 conservative-led states warned CVS and Walgreens in a letter that they could face legal consequences if they sell abortion pills by mail in their states.
In addition to state laws, attorneys general from conservative states have argued that shipments of mifepristone run afoul of a 19th century law that prohibited sending items used in abortion through the mail.
WALGREENS' REACTION
A spokesman says the company told the attorneys general that it will not dispense mifepristone in their states and it does plan to ship the drug to them as well.
But Walgreens is working to become eligible through the FDA’s certification process. It plans to dispense the pills where it can legally do so.
The company is not currently dispensing the pills anywhere.
OTHER DRUGSTORES
Rite Aid Corp. said it was “monitoring the latest federal, state, legal and regulatory developments” and would keep evaluating its policies. The Associated Press also sought comment from CVS Health Corp., retail giant Walmart and the grocery chain Kroger.
Some independent pharmacists would like to become certified to dispense the pills, said Andrea Pivarunas, a spokeswoman for the National Community Pharmacists Association. She added that this would be a “personal business decision," based partly on state laws. The association has no specifics on how many will do it.
OTHER LEGAL ISSUES
In November, an anti-abortion group filed a federal lawsuit in Texas seeking to revoke mifepristone's approval, claiming the FDA approved the drug 23 years ago without adequate evidence of safety.
A federal judge could rule soon. If he sides with abortion opponents, mifepristone could potentially be removed from the U.S. market.
In January, abortion rights supporters filed separate lawsuits challenging abortion pill restrictions imposed in North Carolina and West Virginia.
Legal experts foresee years of court battles over access to the pills.
___
AP Health Writer Matthew Perrone contributed to this story.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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COLUMBUS, Ohio (AP) — The Ohio Supreme Court agreed Tuesday to review a county judge’s order that is blocking enforcement of the state's near-ban on abortions, and to consider whether the clinics challenging the law have legal standing to do so.
In its split decision, the court, however, denied Republican Attorney General Dave Yost's request to launch its own review of the right to an abortion under the Ohio Constitution, leaving those arguments to play out in lower court.
This mean abortions remain legal in the state for now up to 20 weeks' gestation.
Yost appealed Hamilton County Common Pleas Judge Christian Jenkins’ order to the state’s high court in January, after a failed effort to get it overturned by the First District Court of Appeals. The appellate court ruled the appeal premature, as it was only an interim step in the lawsuit challenging the so-called heartbeat law's constitutionality.
Justices will now decide whether such orders are appropriate legal procedure, or attempts by lower courts to block laws they don't like, as Yost has asserted.
Abortion rights organizations want the law to remain blocked, pointing to the chaos inflicted on patients, doctors and clinics during the 66 days that the Ohio ban was in effect last year.
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The law signed by Republican Gov. Mike DeWine in April 2019 prohibits most abortions after the first detectable “fetal heartbeat.” Cardiac activity can be detected as early as six weeks into pregnancy, before many women know they’re pregnant. The law had been blocked through a different legal challenge until right after the U.S. Supreme Court overturned its landmark Roe v. Wade decision legalizing abortion.
The ruling effectively nullified all abortion-rights lawsuits across the country that had cited the federal constitution, sending the question back to the states.
The lawsuit filed in Jenkins' court argues a similar right exists under the Ohio Constitution.
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By Ann E. Marimow, Caroline Kitchener and Perry Stein
April 07, 2023 at 18:46 ET
A federal judge in Texas blocked U.S. government approval of a key abortion medication Friday, siding with abortion foes in an unprecedented lawsuit and potentially upending nationwide access to the pill widely used to terminate pregnancies.
The highly anticipated ruling puts on hold the Food and Drug Administration’s approval of mifepristone, a medication first cleared for use in the United States in 2000. The ruling will not go into effect for seven days to give the government time to appeal.
U.S. District Judge Matthew J. Kacsmaryk, a nominee of President Donald Trump with long-held antiabortion views, agreed with the conservative groups seeking to reverse the FDA’s approval of mifepristone as safe and effective, including in states where abortion rights are protected.
The Biden administration will probably appeal to the U.S. Court of Appeals for the 5th Circuit, and the case could make its way to the Supreme Court. The lawsuit followed the Supreme Court’s elimination of the constitutional right to abortion last June, which allowed states to outlaw or sharply restrict the procedure.
Medication-induced abortion — the most common method of abortion in the United States — has become increasingly contentious since the high court overturned Roe v. Wade.
The lawsuit was brought by the legal group Alliance Defending Freedom on behalf of antiabortion medical organizations and four doctors who say they have treated patients with mifepristone. It claims the FDA did not have the power to approve the drug — one of two medications that are used together to terminate a pregnancy — and takes issue with the agency’s easing of restrictions on the pill through the years.
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Women 60ish and younger are not going to stand for this. They will continue to vote in droves if cons continue to put womens’ rights on the ballot.
www.headstonesband.com
I hope that backfire does come. I'm not sure though how that will work out in some of the heavily religious deep red states. I don't have any problem with people of faith in general, but these religious zealots who want to shove their biases and personal agendas on to other people are doggedly relentless. It will be a tough challenge in some places.
www.headstonesband.com
HELENA, Mont. (AP) — Montana's Supreme Court ruled unanimously Friday that advanced-practice registered nurses can continue to provide abortion care in the state, likely setting up legal clashes with the 2023 Legislature, which passed restrictive laws saying only physicians can perform abortions.
The state failed to prove that an abortion performed by a family nurse practitioner or certified nurse-midwife presents more risk to the patient than abortions provided by physicians or physician assistants, according to the opinion written by Justice Laurie McKinnon.
“This case was not about the right to abortion — it was about whether women have a right to an elevated standard of care during an abortion,” said Emilee Cantrell, spokeswoman for the Montana Department of Justice. “The Montana Supreme Court said ‘no’ and lowered the standard of care set by the Legislature, effectively constitutionalizing the right of unqualified individuals to perform unregulated abortions.”
Montana is one of at least 19 states that allow advanced-practice registered nurses to provide abortion care. APRNs have at least a master's degree in nursing.
Justices found that a law making it a felony for providers other than physicians and physician assistants to perform abortions violated the patient's fundamental right to privacy to seek a pre-viability abortion from the qualified health care provider of her choosing — a standard set in a 1999 Supreme Court ruling in the Armstrong case.
“Allowing APRNs to perform these services ensures Montanans maintain their constitutional right to access the quality healthcare they need," Alex Rate, ACLU of Montana's interim co-executive director, said in a statement.
Friday's opinion upholds a February 2022 ruling by District Court Judge Mike Menahan, who found that a 2005 law that implemented the Armstrong ruling by also allowing physician assistants to provide abortion care was unconstitutional because it did not include properly trained APRNs.
The justices said court evidence showed APRNs are capable of providing care for miscarriages or stillbirths, and that early abortion procedures such as medication and aspiration abortions require similar care. The state did not argue that APRNs present a genuine health and safety risk when providing miscarriage care, the justices noted.
Montana's 2023 Legislature passed several bills to restrict abortion access, including provisions to only allow physicians to provide abortion care, to require prior authorization before Medicaid pays for abortions and to prevent the most common abortion procedure used in the second trimester of pregnancy. Also, a bill advanced that seeks to make the court reconsider the Armstrong ruling, by saying that the state's constitutional right to privacy does not include the right to an abortion.
The Montana Supreme Court noted that the state did not ask it to overturn the Armstrong ruling during the course of the case initially brought by Helen Weems, an APRN who owns a sexual and reproductive health clinic in Whitefish.
“Montana lawmakers have been relentless in their efforts to restrict access to essential health care,” Weems said in a statement.
Under earlier rulings in the case, Weems has been allowed to provide abortion care since 2018. Other APRNs, with proper training, were allowed to begin performing abortions after Menahan’s 2022 ruling.
“It is more important than ever to protect our patients and their ability to make decisions about their health and families,” Weems said. “I look forward to continuing to make abortion care more accessible in our state.”
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RALEIGH, N.C. (AP) — Clergy and other opponents of a bill further restricting abortion in North Carolina that's about to be vetoed by Gov. Roy Cooper said Friday the measure is another effort by the Republican-controlled General Assembly to harm the state's low-income residents.
Civil rights leader the Rev. William Barber of Goldsboro and other ministers gathered inside the Legislative Building to speak against the legislation, which would ban nearly all abortions after 12 weeks of pregnancy. State law currently bans abortions after 20 weeks.
“This bill will hurt the most vulnerable, especially the poor among us,” Barber said. “It is wrong. It is wrong over and over and over again.”
Cooper has said he plans to veto the bill on Saturday, when he'll attend a rally organized by abortion-rights advocates in downtown Raleigh. The state legislature could begin override votes next week. Republicans hold narrow veto-proof seat majorities in the House and Senate. Cooper has held public events this week in hopes of persuading Republican legislators to uphold his anticipated veto.
Critics of the measure say additional rules governing legal abortions will make it harder for women who live in rural areas or work long hours to access abortion services. But bill supporters say the measure will protect life and provide at least $160 million toward services that help mothers, children and families.
Barber, president of the group Repairers of the Breach and co-chair of the national Poor People’s Campaign, said that if GOP legislators were concerned about life they would pass laws tightening gun regulations and raising the minimum wage, among others. Event participants also read from an open letter to legislative leaders that in part highlights other GOP bills they oppose.
Religious leaders participating in the event met later Friday with Cooper, the governor's office said.
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TOPEKA, Kan. (AP) — Kansas' Democratic governor on Friday vetoed Republican legislation that would have provided a financial boost to anti-abortion pregnancy centers and prevented officials fighting outbreaks of contagious diseases from prohibiting public gatherings or ordering infected people to isolate themselves.
The two measures were part of a wave of conservative policies passed by GOP-controlled state legislatures this year, including ones in Kansas rolling back transgender rights and establishing new restrictions on abortion providers. But Gov. Laura Kelly's two vetoes will stand because lawmakers have adjourned for the year, barring any attempt at overriding them.
The anti-abortion measure would have granted up to $10 million a year in new state income tax credits to donors to the more than 50 centers across the state that provide free counseling, classes, supplies and other services to pregnant people and new parents to discourage abortions. Lawmakers included it in a wide-ranging tax bill that also included an expansion of existing tax credits for adoption expenses and purchases from businesses that employ disabled workers. Kelly vetoed the entire bill.
Republican lawmakers pursued anti-abortion measures this year despite a decisive statewide vote in August 2022 affirming abortion rights. Abortion opponents argued that the vote didn't preclude “reasonable” restrictions and other measures, while Democrats argued that GOP legislators were breaking faith with voters.
Kelly supports abortion rights and narrowly won reelection last year. Last month she vetoed $2 million in the next state budget for direct aid to the centers, but the Legislature overrode that action.
In her latest veto message, Kelly didn't point to any individual provision in the tax bill but said bundling so many proposals together made it “impossible to sort out the bad from the good.”
In vetoing direct aid to anti-abortion centers last month, Kelly called them “largely unregulated” and said, “This is not an evidence-based approach or even an effective method for preventing unplanned pregnancies.”
Abortion opponents argued that providing financial aid to their centers would help make sure that people facing unplanned pregnancies have good alternatives if they're unsure about getting abortions.
House Speaker Dan Hawkins, a Wichita Republican, accused Kelly in a statement of a "political bias against helping vulnerable new mothers.”
Even if lawmakers still had a chance to override Kelly's veto, they didn't pass the tax bill initially with the two-thirds majorities required.
The other bill Kelly vetoed was part of an ongoing backlash from conservative lawmakers against how she, other state officials and local officials attempted to check the spread of COVID-19 in 2020 and 2021. They were particularly critical of orders closing schools and businesses during the pandemic's first months and restrictions on businesses' operations and mask mandates later.
“She said no to protecting the health freedom of Kansans and curtailing the powers of unelected bureaucrats,” Senate President Ty Masterson, another Wichita-area Republican, said in a statement.
But Republicans split over the measure because some feared it went too far in curbing state and local officials' powers during outbreaks.
It would have stripped local officials of their authority to prohibit public gatherings and repealed a requirement that local law enforcement officers enforce orders from public health officials. Those officials also would have lost their authority to order quarantines for infected people.
The head of the state health department, appointed by the governor, would have lost the power to issue orders and impose new health rules to prevent the spread of disease or to order people to get tested or seek treatment for infectious diseases.
Kelly's veto message said Kansas has been a pioneer in public health policy. A century ago the state's top health official, Dr. Samuel Crumbine, was known internationally for campaigning against unsanitary, disease-spreading practices such as spitting on sidewalks and having common drinking cups on railroads and in public buildings.
“Yet lawmakers continue trying to undermine the advancements that have saved lives in every corner of our state," Kelly wrote.
The bill also reflected vaccine opponents' influence with conservative Republican lawmakers.
It would have prevented the head of the state health department from requiring COVID-19 vaccinations for children entering school or day care — something Kelly's administration has said it doesn't plan to do. State and local officials also would not have been able to cite a person's lack of vaccination as a reason for recommending that they isolate themselves.
___
Follow John Hanna on Twitter: https://twitter.com/apjdhanna
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INDIANAPOLIS (AP) — A hearing on possible disciplinary action opened Thursday for an Indianapolis doctor who spoke publicly about providing an abortion to a 10-year-old rape victim from Ohio, with finger pointing over how the case became a political flashpoint in the national abortion debate.
Indiana's Republican attorney general has accused Dr. Caitlin Bernard of violating state law by not reporting the girl’s child abuse to Indiana authorities. She's also accused of breaking federal patient privacy laws by telling a newspaper reporter about the girl’s treatment.
Bernard has consistently defended her actions and told the state Medical Licensing Board Thursday that she followed Indiana’s reporting requirements for child abuse cases to hospital staff — and that the girl’s rape was already being investigated by Ohio authorities. Bernard's lawyers also said that she didn’t released any identifying information about the girl that would break privacy laws.
The Indianapolis Star cited the girl’s case in a July 1 article that sparked a national political uproar in the weeks after the U.S. Supreme Court overturned Roe v. Wade last June, putting into effect an Ohio law that prohibited abortions after six weeks of pregnancy. Some news outlets and Republican politicians falsely suggested Bernard fabricated the story, until a 27-year-old man was charged with the rape in Columbus, Ohio.
Bernard's lawyer Alice Morical told the board Thursday that the doctor reported child abuse of patients many times a year and that a hospital social worker had confirmed with Ohio’s child protection office that it was safe for the girl to leave with her mother.
“Dr. Bernard could not have anticipated the atypical and intense scrutiny that this story received,” Morical said. “She did not expect that politicians would say that she made the story up.”
Indiana Attorney General Todd Rokita’s complaint asked the licensing board to impose “appropriate disciplinary action” but doesn’t specify a requested penalty.
Amid the wave of attention to the girl’s case last summer, Rokita, who is stridently anti-abortion, told Fox News he would investigate Bernard’s actions, calling her an “abortion activist acting as a doctor.”
Deputy Attorney General Cory Voight argued Thursday that the board must address what he called an “egregious violation” of patient privacy and Bernard’s failure to notify Indiana’s Department of Child Services and police about the rape.
“There’s been no case like this before the board,” Voight said. "No physician has been as brazen in pursuit of their own agenda.”
Voight asked Bernard why she discussed the Ohio girl’s case with the newspaper reporter and later in other news media interviews rather than using a hypothetical situation.
“I think that it’s incredibly important for people to understand the real-world impacts of the laws of this country about abortion,” Bernard said. “I think it’s important for people to know what patients will have to go through because of legislation that is being passed and a hypothetical does not make that impact."
The Indiana board — made up of six doctors and one attorney appointed or reappointed by Republican Gov. Eric Holcomb — could vote whether to impose any penalties Thursday after hearing what is expected to be several hours of testimony. State law gives the board wide latitude, allowing it to issue reprimand letters or suspend, revoke or place on probation a doctor’s license.
Ohio’s law imposing a near-ban on abortion was in effect for about two months, before being put on hold as a lawsuit against it plays out. Indiana’s Republican-dominated Legislature approved a statewide abortion ban weeks after the Ohio girl’s case drew attention, but abortions have continued to be permitted in the state while awaiting an Indiana Supreme Court decision on the ban’s constitutionality.
Bernard unsuccessfully tried to block Rokita’s investigation last fall, although an Indianapolis judge wrote that Rokita made “clearly unlawful breaches” of state confidentiality laws with his public comments about investigating the doctor before filing the medical licensing complaint against her.
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