THE PROGNOSIS

Abortion as a voting issue typically motivates its opponents more than its supporters. But Democrats running to defeat President Trump in 2020 are trying to reverse that momentum by harnessing outrage against a slew of new state restrictions.

Last night, Sen. Kamala Harris (D-Calif.) laid out a new proposal requiring states with a history of trying to curb abortion rights to get federal approval being passing such laws. Under the plan she outlined during a MSNBC town hall, states such as South Carolina, Iowa and Georgia — which have all approved bills banning abortions once a fetal heartbeat can be detected — would have to get clearance from the Justice Department for any new abortion laws.

“Women died before we had Roe v. Wade in place, and so I'm going to tell you on this issue I'm done,” Harris said. 

In a crowded Democratic primary in which many candidates are struggling to establish a substantial base of support, Harris is the third presidential candidate to lay out a detailed plan for how she’d enshrine and even expand abortion rights. None of the Democrats vary much in their support for the controversial procedure, but some are seeking to appear especially aggressive on the issue with an eye toward the women voting in their party’s primaries.

“There are ways to be supportive, and there are ways to be more supportive,” said Christina Reynolds, vice president of communications for Emily’s List, a group that works to elect candidates who support abortion rights. “Are you thinking about how to deal with this issue beyond just being supportive of it? Do you have a way to protect Roe?”

In a Medium post earlier this month, Sen. Elizabeth Warren (D-Mass.) laid out a list of specific actions she would like to see from Congress. They include codifying abortion rights in federal statute, banning states from restricting medication abortions or placing extra requirements on abortion providers, and repealing the federal Hyde Amendment, which says taxpayer dollars can’t be used for most abortions.

Sen. Kirsten Gillibrand (D-N.Y.) is also trying to cast herself as the most prominent 2020 candidate on the issue. In an effort to distinguish herself from the pack, she traveled to the Georgia state Capitol earlier this month to protest the antiabortion bills GOP-led states have been passing.

As my Washington Post colleague James Hohmann reported, Gillibrand promised to “make sure every woman in America, no matter what state she lives in or how much money she has in her pocket, can have guaranteed access to safe, legal abortion.” She also suggested requiring private insurance companies to cover abortions, creating a federal authority to oversee state restrictions on the procedure and erasing Hyde.

All three women — along with Sen. Amy Klobuchar (D-Minn.), yet another 2020 presidential candidate — appeared alongside former Georgia gubernatorial candidate Stacey Abrams in a recent video calling for action against the slate of abortion restrictions states have advanced this year.

Historically, Americans who oppose abortion rights have named it as a more important issue than those who think the procedure should remain legal — although the gap is narrowing. Twenty-three percent of voters identifying as “pro-life” said they would only vote for a candidate who shares their views, compared with 19 percent of voters identifying as “pro-choice,” in a 2015 Gallup survey. The gap was 18 points in 2004 and nine points in 2014.

If abortion were to highly motivate Democratic voters, now would certainly be the time. The Trump administration has carried out a number of dearly held priorities for abortion foes, and states are taking unprecedented steps to ban abortions early in pregnancy.

Missouri’s sole remaining abortion clinic could shutter on Friday, when its license is set to expire. Planned Parenthood, which runs the St. Louis clinic, said it is suing the state to allow it to continue offering the procedure. If the clinic closes, Missouri will be the first state in the nation without an abortion provider.

Sen. Bernie Sanders (I-Vt.):

Some Democratic-led states are moving in the opposite direction, repealing long-standing restrictions on abortions performed late in pregnancy. Yesterday the Illinois House passed a bill repealing a 1975 law that calls for spousal consent, waiting periods and criminal penalties for doctors who perform abortions, and states that "a fertilized egg, embryo or fetus does not have independent rights.” It would also repeal the state’s partial-birth abortion ban, although the federal ban still stands, the Chicago Tribune reports.

That charged up abortion opponents. Billy Valentine, vice president of public policy for the antiabortion group Susan B. Anthony List:

The president of Students for Life of America:

The Supreme Court handed a partial victory to abortion opponents yesterday, when it ruled 7 to 2 that Indiana’s requirement for fetal remains to be cremated or buried can go into effect. Liberal justices Stephen Breyer and Elena Kagan sided with the conservative members of the count in a decision saying the law is “rationally related to the state’s interest in proper disposal of fetal remains.”

But the court declined to take up another part of Indiana’s law that prohibits doctors from performing an abortion if the woman is choosing the procedure because of the fetus’s sex, race or disability. Justice Clarence Thomas added his own 20-page statement in which he said the court will eventually have to decide the question of “eugenic abortions,” The Post’s Robert Barnes reports.

“Enshrining a constitutional right to an abortion based solely on the race, sex, or disability of an unborn child, as Planned Parenthood advocates, would constitutionalize the views of the 20th-century eugenics movement,” Thomas wrote.

That ignited more fierce debate on Twitter:

Writer Ernest Owens:

Democratic political operative Ronald Klain:

The National Right to Life Committee:

But one thing’s clear: The new antiabortion laws may help Democrats in their voter turnout efforts next year. And for that, the presidential candidates could be privately grateful.

“I think we’d rather have our rights, but if we don’t have our rights, we are certainly going to remind people elections have consequences,” Reynolds said.

AHH, OOF and OUCH

AHH: Lawyer for the state of Oklahoma argued that Johnson & Johnson and its subsidiaries deliberately flooded the market with prescription painkillers, deceptively promoted them and stood by as the opioid epidemic flourished, The Post's Lenny Bernstein reports from Norman, Okla., where a trial examining the company’s role in the drug crisis began yesterday.

“The company countered that its products make up just a tiny portion of the painkillers that have been consumed in Oklahoma, and it said its business — from the poppy farms of Tasmania to its products in U.S. drugstores — is closely regulated by federal and state agencies,” Lenny writes. “With manufacturers, distributors, doctors and pharmacists all involved in bringing painkillers to patients, the state cannot prove that Johnson & Johnson caused rampant addiction and overdose deaths, its attorney said.”

Yesterday's legal arguments unfolded before a packed gallery of lawyers, experts, media and the public are expected to be echoed at future trials. “The health-care conglomerate’s conduct has emerged as an early test of whether the pharmaceutical industry will be forced to pay billions of dollars to more than 1,600 cities, counties, states, Native American tribes and others across the United States that have sued to recover the costs of coping with the crisis,” Lenny notes.

OOF: My fact-checking colleague Glenn Kessler gives Planned Parenthood President Leana Wen four "Pinocchios" for repeatedly claiming that "thousands of women died every year" before the 1973 Roe v. Wade ruling legalizing abortion. These numbers were debunked in 1969 — 50 years ago — by a statistician celebrated by Planned Parenthood.

When Glenn asked Planned Parenthood for data showing "thousands" of women died from botched abortions, the group pointed him to this 2014 policy statement issued by the American College of Obstetricians and Gynecologists (ACOG): “It is estimated that before 1973, 1.2 million U.S. women resorted to illegal abortion each year and that unsafe abortions caused as many as 5,000 annual deaths.”

An ACOG spokeswoman then referred Glenn to a 1958 report that said “a plausible estimate of the frequency of induced abortion in the United States could be as low as 200,000 and as high as 1,200,000 per year," but this report contained no mortality rates or an explanation of the 5,000-death estimate.

In literature from NARAL Pro-Choice America, Glenn found the 5,000 figured cited in 1942 by Frederick Taussig, a gynecologist and influential advocate of legalized abortion. Taussig had originally concluded it was "no more than 10,000" in a 1936 study, but that wasn't a very rigorous calculation, based on a mix of theory and data from the United States and Germany. He admitted that just five years earlier, he had estimated 15,000 deaths in another paper and few years later, in 1942, he revised the figure yet again, down to 5,000.

The advent of antibiotics such as penicillin and improved medical procedures suddenly made abortion less risky, Glenn writes. "Another prominent researcher, Christopher Tietze, argued in a 1948 paperthat the number of deaths from abortion was rapidly declining because of three reasons: contraceptive methods had improved so fewer women were getting pregnant, abortion providers were getting better at avoiding infections, and many lives had been saved because of the introduction of sulfa drugs and penicillin." 

Data collected by Tietze showed 888 deaths from abortion in 1945, down from 2,677 in 1933. Then in 1959, Mary Steichen Calderone, medical director of Planned Parenthood, wrote this: “Abortion is no longer a dangerous procedure. This applies not just to therapeutic abortions as performed in hospitals but also to so-called illegal abortions as done by physicians. In 1957, there were only 260 deaths in the whole country attributed to abortions of any kind. In New York City in 1921, there were 144 abortion deaths, in 1951 there were only 15.”

"Wen is a doctor, and the ACOG is made up of doctors," Glenn concludes. "They should know better than to peddle statistics based on data that predates the advent of antibiotics. Even given the fuzzy nature of the data and estimates, there is no evidence that in the years immediately preceding the Supreme Court’s decision, thousands of women died every year in the United States from illegal abortions."

OUCH: Lambda Legal and other civil rights groups are asking a federal court to strike down a Health and Human Services Department rule giving health providers, insurers and others more leeway in refusing services they say violates their religious or moral beliefs, The Post's Ariana Eunjung Cha reports. The lawsuit filed yesterday claims the policy, which was published May 21, is unconstitutional and exceeds HHS’s statutory authority.

"President Trump personally announced the rule during a speech before faith leaders who say the protections are necessary because of ineffectual enforcement of existing statutes protecting such decisions," Ariana writes. (Health 202 wrote about the rule here.) "The plaintiffs represent a diverse group of health-care providers, community centers and LGBTQ and women’s rights groups....they emphasized that while transgender individuals may be most vulnerable to discrimination under the rule, it would affect all Americans."

“This rule erodes trust between patients and providers,” said Jamie Gliksberg, senior attorney at Lambda Legal. Gliksberg said there has always been a balance between patients’ right to care and providers’ right to decline services such as abortion, assisted suicide and sterilization.

— A few more good reads from The Post and beyond:

AGENCY ALERT
Immigration
Nearly 169,000 children have arrived at the U.S. border in the first seven months of the fiscal year, and the government is struggling to deal with them.
Maria Sacchetti
MEDICAL MISSIVES
STATE SCAN
REPRODUCTIVE WARS
Pop Culture
Chief Content Officer Ted Sarandos said the company would work with the ACLU to fight the legislation in court.
Sonia Rao