Antiabortion advocates want to ensure abortion pill bans are enforced
Good morning! Welcome to Wednesday’s Health 202, which is based off a story out this morning from The Post’s Caroline Kitchener.
Today’s edition: Lawmakers have a real shot at passing new health policies before the end of the year after congressional negotiators announced a framework deal on a broader spending package. The federal health department is proposing to permanently make it easier to access certain opioid addiction treatments. But first …
Abortion foes worry illegal abortion pills will undermine their goals
© Jeffrey McWhorter/for The Washington Post
A yard sign by a driveway in rural Smith County, Tex., reflects the area's conservative stance on abortion.
Antiabortion advocates are concerned that the growing availability of illegal abortion pills is undercutting their biggest victory in nearly 50 years.
That fear has left the movement scrambling to find ways to enforce bans on the medication nearly six months after the Supreme Court struck down Roe v. Wade. And they’re seeking to crack down on those breaking the law, our colleague Caroline Kitchener reports.
“Everyone who is trafficking these pills should be in jail for trafficking,” said Marjorie Dannenfelser, the president of Susan B. Anthony Pro-Life America, who has begun discussing the prevalence of illegal abortion pill networks with GOP governors. “It hasn’t happened, but that doesn’t mean it won’t.”
State abortion bans contain penalties for those involved in facilitating illegal abortions, and don’t penalize the pregnant women themselves. Yet, the push for enforcement from the right underscores how both sides of the debate are reassessing their strategies after a year that’s challenged the assumptions about the politics of abortion.
Caroline interviewed more than 30 influential advocacy group leaders, policymakers and litigators on this next phase of the abortion battle. Here are some of the new efforts she found:
- The largest antiabortion group in Texas has created a team of advocates charged with investigating cases involving citizens who may be distributing abortion pills illegally.
- Students for Life of America, a leading national antiabortion group, is working on a plan to systematically test the groundwater in several large cities. Their aim is to search for contaminants they claim result from medication abortion.
- Republican lawmakers in Texas are prepping legislation requiring internet providers to block abortion pill websites, similar to how they’re able to censor child porn.
The next phase
Leaders on both sides of the debate haven’t heard of instances of people charged for violating abortion bans since the Supreme Court overturned the constitutional right to an abortion in June.
Soon after the ruling came down, Texas antiabortion advocates began searching for local prosecutors willing to enforce antiabortion laws. They zeroed in on Jacob Putman, the prosecutor in Tyler, Tex., a small city that advocates believe has the resources to investigate and prosecute under the state’s near-total abortion ban.
Putman told Caroline he would be “proud” to bring a case against someone caught violating the ban. But he hasn’t had any such cases, and doesn’t expect any soon. That’s because, he said, it’s hard to determine who is breaking the law and where exactly the crimes are committed, highlighting the challenges associated with antiabortion groups’ new strategy.
That’s where Texas Right to Life is hoping to help. It has created a team within the organization searching for an “airtight” case to bring to a district attorney willing to prosecute, per John Seago, the group’s president.
In the meantime, antiabortion legislators and advocates are devising other ways to attempt to restrict medication abortions. Texas lawmakers are drafting legislation to compel internet providers to block state residents from accessing abortion pill websites, like Europe-based Aid Access, even as some antiabortion lawyers say the effort poses free speech concerns.
And Students for Life of America is ramping up its efforts to investigate potential environmental violations they claim may come from medication abortions, specifically flushing fetal remains down the toilet, though there is no direct evidence that abortion pills contaminate the water supply.
Eye on 2024
The renewed rhetoric around enforcement has concerned abortion rights groups, who worry the efforts will exacerbate the fear and isolation of facing an unwanted pregnancy in the states where abortion is banned, Caroline writes.
To protect and restore access, the movement has settled on ballot measures enshrining abortion rights into the constitution as a key strategy, with at least a dozen states exploring whether to launch such an initiative.
Meanwhile, both sides are also gearing up for the 2024 presidential race. President Biden has said he has limited tools to counteract abortion restrictions in conservative states, but a Republican president could alter the post-Roe landscape even further.
Prominent antiabortion leaders are considering potential avenues for a president to restrict illegal pill networks. It’s a question that is top of mind for Dannenfelser, of SBA Pro-Life America, in conversations with Republicans who may run for president.
“We don’t have to dictate their solution,” Dannenfelser said. “But they have to have one.”
Read Caroline’s full story here.
On the Hill
Congressional negotiators clinch ‘framework’ deal on a spending package
Top Democrats and Republicans announced last night that they had reached an early “framework” to fund the government through next September, a key development to passing a broad spending package before the end of the year, our colleague Tony Romm reports.
The details of the agreement weren’t immediately made public, but a longer-term government funding package is the last chance for lawmakers and advocates to notch health policy wins before the next Congress. Passing health-related legislation could get all the more difficult in 2023 amid a divided Congress and ahead of a presidential election year.
Buying time: Congress is slated to pass a temporary measure to keep the government’s lights on through Dec. 23, with the House slated to vote as soon as today. That replaces the existing stopgap bill set to expire at the end of Friday, and extends key health programs — like Medicaid dollars for the territories — another week.
Agency alert
HHS moves to make opioid treatment flexibilities permanent
© Ted S. Warren/AP
A drug user in Olympia, Wash., holds a bottle of buprenorphine, a medicine that prevents withdrawal sickness in people trying to stop using opioids. Though “bupe,” as it's known, has been shown to prevent opioid deaths, many in law enforcement dismiss its use as substituting one drug for another.
The Department of Health and Human Services is proposing to permanently extend certain policies aimed at making it easier to access certain opioid addiction treatments beyond the expiration of the covid-19 public health emergency.
Key details: The proposed rule from the Substance Abuse and Mental Health Services Administration would permanently allow patients to take methadone — a medication used to treat opioid use disorder — at home with their practitioner’s sign-off. Methadone is a tightly controlled treatment, and before the pandemic, patients had to go to a clinic to receive the medication.
Additionally, the rule change would allow doctors to continue initiating treatment with the opioid use disorder drug buprenorphine via telehealth instead of an in-person visit. The draft also would eliminate a requirement that medical professionals who have a waiver to prescribe buprenorphine for up to 275 patients provide annual reports to SAMHSA. The proposed rule will be open for public comment until Feb. 14.
The move comes amid a devastating drug crisis that’s contributed to over 107,000 deaths last year.
Miriam Delphin-Rittmon, assistant secretary for mental health and substance use:
Industry Rx
Experimental skin cancer vaccine shows promising early results
© Dado Ruvic/Reuters
The experimental cancer therapy combined a vaccine created by Moderna using mRNA technology, combined with Merck’s immunotherapy drug, marketed as Keytruda. REUTERS/Dado Ruvic/Illustration/File Photo
For the first time, messenger RNA technology — the scientific advancement used in coronavirus vaccines — was shown to be effective against a deadly form of skin cancer when used in conjunction with another drug, The Post’s Lenny Bernstein reports.
The details: A combination of Moderna’s experimental mRNA cancer vaccine and Merck’s cancer immunotherapy drug Keytruda cut the risk of recurrence or death in patients battling melanoma by 44 percent compared with Keytruda alone. That’s after surgery and as long as the patient has been on the drugs for a year, according to preliminary results released yesterday. The results haven’t been independently reviewed.
Moderna’s proposed vaccine employs a “personalized” approach designed to prompt a patient’s immune system to attack the specific mutations of their tumors.
Next steps: Positive results in a larger Phase 3 trial would be required before the Food and Drug Administration would consider allowing the drug combination on the market. The companies said they hope to begin that trial next year.
Moderna:
Reproductive wars
Indiana AG appealing 2nd court decision blocking abortion ban
© Darron Cummings/AP
Then-Republican attorney general candidate Todd Rokita at a news conference in Indianapolis in September 2020.
Indiana Attorney General Todd Rokita (R) asked the state Supreme Court to review a second legal challenge blocking prosecutors from enforcing the state’s near-total abortion ban, the Associated Press reports.
“Requiring the parties to go through the normal appeals process would only delay final resolution of issues likely headed to this Court anyway,” the latest filing from Rokita’s office argues. The state’s highest court has already agreed to bypass the state appeals court with another judge’s September ruling, which found that the ban violates the Indiana constitution’s individual rights protections. The court is scheduled to hear arguments in that case on Jan. 19.
Meanwhile …
In Montana: The Montana Supreme Court will hear oral arguments today in a case challenging a state law that prevents advanced practice registered nurses from providing abortion services. The state appealed the case to the state Supreme Court after a district court blocked the law earlier this year, finding that the ban violates Montana’s constitution.
In Vermont: Gov. Phil Scott (R) signed the document formally enshrining abortion protections into the state constitution, the VTDigger reports. More than three-fourths of Vermont residents supported the amendment in the November elections.
Coalition behind the Reproductive Liberty Amendment:
In other health news
- Florida Gov. Ron DeSantis (R) petitioned the state Supreme Court yesterday to convene a grand jury to investigate “any and all wrongdoing” connected to coronavirus vaccines despite leading medical societies saying the shots are safe and effective. He also announced the formation of a new state committee to counter policy recommendations from federal health agencies — a decision that medical professionals said will further politicize medicine in the state, The Post’s Lori Rozsa writes.
- The federal government will pay Pfizer nearly $2 billion for an additional 3.7 million courses of its coronavirus treatment Paxlovid, Reuters reports. The Biden administration had previously announced it would stop footing the bill for the antiviral drug next year, per Kaiser Health News.
- The Centers for Medicare and Medicaid Services officially announced the membership list and first public meeting of its new Ground Ambulance and Patient Billing Advisory Committee. The Health 202 first reported the news yesterday.
Health reads
New Biden changes to Obamacare coverage for generics splits the industry (By Sarah Owermohle | Stat)
Sugar rush
Thanks for reading! See y'all tomorrow.
