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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Clinics, lawmakers and activists scramble to prep for a post-Roe world

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

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Happy hump day everyone, grab some coffee and let's dive in. ☕

Today's edition: Senate Democrats will soon hold a vote to codify abortion rights into federal law, but it'll almost certainly fail again. Most parents won't rush to vaccinate their littlest kids. But first … 

Trigger laws might soon be…triggered

Lawmakers and abortion clinics are scrambling to gear up for a new reality: Abortion could be banned or closely restricted in roughly half of states in the span of a few weeks. 

A flurry of preparations are underway as the country readies for the red-blue divide of a world without Roe, my colleague Caroline Kitchener and I reported yesterday.

Here’s what we learned: 

  • Antiabortion lawmakers and groups are working to ensure state officials know how to quickly activate prohibitions on the procedure.
  • Abortion clinics and Democrats are wrestling with how to ensure they can welcome patients from conservative states.

Chief Justice John G. Roberts Jr. said the draft opinion wasn’t final, but the document from Justice Samuel A. Alito Jr. offered a legal road map to a divided system of abortion access. The leaked draft opinion obtained by Politico immediately transformed what had been a largely abstract conversation into a visceral reality. 

“We don’t have a plan,” Leilah Zahedi — a high-risk obstetrician who provides abortions in Tennessee, a state with a “trigger law” designed to block abortion as soon as Roe is overturned — told Caroline. “But now I’m in fix-it mode, like: What do we need to do to make sure I can provide as many abortions as I can?”

More from Caroline:

Trigger laws

Antiabortion leaders have been readying for this moment, working to ensure Republican-led states have the strictest possible limits.

That includes so-called trigger laws, which would prohibit most abortions almost immediately if Roe is overturned. They’re already on the books in 13 states, while over a dozen more GOP-led states are also poised to severely restrict the procedure. 

Some trigger laws require quick action from the state attorney general or the governor essentially confirming that Roe has been overturned. In Arkansas, state Sen. Jason Rapert (R) told Caroline he plans to write to the state attorney general and solicitor general to inform them they’ll need to certify the Supreme Court decision in order for the abortion ban to take effect.

  • One thing to note: Rape and incest exceptions have been fading away from Republican-led laws, and most trigger bans don’t include them, said Mary Ziegler, a professor at Florida State University College of Law specializing in the history of abortion law.
  • The majority include exceptions for if the woman's life is endangered, and some include exemptions for being at risk of a severe physical health condition, per a tracker from Elizabeth Nash, an interim associate director at Guttmacher Institute, a research group that supports abortion rights.
What's next

Expect future state action if the draft decision stands — even if such changes won’t be immediate. 

On the left: In Connecticut, the state Senate gave final approval last week for the state to be a place of refuge for women who live in Republican-led states limiting the procedure. (A spokesman for Gov. Ned Lamont (D) confirmed he plans to sign the bill.) 

The effort is aiming to combat what legal experts believe could be the new frontier for antiabortion states: restricting the procedure across state lines. 

  • Will other states follow suit? Connecticut lawmakers have had initial discussions about the legislation with policymakers in California and Massachusetts, as well as advocates and experts across the country, state Rep. Matt Blumenthal (D), one of the sponsors of the Connecticut bill, told The Health 202.

On the right: We’re looking to Florida as a case study. Gov. Ron DeSantis (R), a possible 2024 GOP presidential candidate, recently signed a bill banning abortions after 15 weeks of pregnancy. The legislation was modeled after the Mississippi law at the center of the case before the Supreme Court.

Florida Republicans had previously shrugged off passing a more stringent prohibition, but such limitations could now get a second look. If Roe is overturned, state lawmakers would probably seek to bar the procedure after fetal cardiac activity is detected, per John Stemberger, president of the Florida Family Policy Council, an antiabortion lobbying group. 

  • He anticipates such a bill would gain traction during next year’s legislative session. “I think if Roe v. Wade is overturned, and Justice Alito’s decision is what we think it is, then I think that’s likely to be a next step that you’ll see in Florida,” he said.

Reproductive wars

Blowback from the leaked decision dominated yesterday’s news cycle.

Here’s what you need to know: 

A largely symbolic vote: Senate Majority Leader Chuck Schumer (D-N.Y.) pledged that the chamber would again take up legislation codifying the right to an abortion into federal law. But the legislation is almost certain to fail.  

Such a vote could come as soon as next week, Sen. Patty Murray (D-Wash.) told PBS NewsHour. Back in February, the Senate tried to muscle similar legislation through, but it failed due to opposition from all Republicans and Sen. Joe Manchin (D-W.Va.). The measure would need to garner 60 votes, and that is extremely unlikely. 

Our colleague Mike DeBonis flagged the draft text. Read his 🧵:

The midterm effect: The possible overturning of Roe threatens to upend the midterms and transform the campaign into a “massive mobilizing effort” over abortion, individual rights and the two parties’ differing philosophies, The Post’s Dan Balz, Colby Itkowitz and Caroline report.

That could transition the election away from being a referendum on President Biden and his party into a choice between how Democrats and Republicans governor. This could narrow the enthusiasm gap and boost Democrats. Yet, Republicans argue their base will be energized as well, and contend issues like inflation and crime aren’t going away. 

Where Americans stand: A majority of Americans say the Supreme Court should uphold Roe, a new Washington Post-ABC News poll conducted last week finds. 

According to the survey, 54 percent of Americans think the Roe decision should remain intact, while 28 percent believe it should be overturned, our colleagues Emily Guskin and Scott Clement write. 

The poll also finds that 58 percent of Americans say abortion should be legal in “most cases” or “all case,” while 37 percent say it should be illegal in “most cases” or “all cases.”

More from Scott:

Tricky politics: Abortion has long been complicated for Biden, a practicing Catholic, whose views have shifted throughout his time in politics to bring him in line with Democrats but at odds with the church, The Post’s Matt Viser reports. Two striking quotes reflect the change. 

  • Biden in 1974: “I don’t like the Supreme Court decision on abortion. I think it went too far,” he said. “I don’t think that a woman has the sole right to say what should happen to her body.”
  • Biden yesterday: “The idea that we’re going to make a judgment that is going to say that no one can make the judgment to choose to abort a child, based on a decision by the Supreme Court, I think, goes way overboard,” he said.

On the Hill

Dems launch probe to ensure women get free birth control

Senate Democrats are pushing to make sure women can obtain free birth control required by Obamacare, arguing the policy is critical if the high court strikes down abortion rights, our colleague Dan Diamond reports.

The details: Murray and Sen. Ron Wyden (D-Ore.) — who chair the powerful health and finance panels, respectively — opened an investigation into complaints that health insurers are denying patients no-cost birth control. 

The pair, along with Democratic Sens. Bob Casey (Pa.) and Maggie Hassan (N.H.), sent letters to OptumRx, CVS Caremark and Express Scripts — which help insurance companies oversee pharmacy benefits for millions of Americans. They’re demanding information from the companies on their policies, how often they deny patients’ requests and more within two weeks. Spokespeople for the companies told Dan they’re reviewing the request.

Agency alert

Keep wearing masks on public transit, CDC urges

This week would have been the expiration of the federal mandate to wear masks on airplanes, buses and other public transportation, if not for a federal judge’s recent ruling striking down the requirement. But while that mandate is gone, the Centers for Disease Control and Prevention is still reiterating its recommendation that people choose to mask up on public transit, our colleague Lori Aratani reports.

  • CDC continues to recommend that all people — passengers and workers, alike — properly wear a well-fitting mask or respirator in indoor public transportation conveyances and transportation hubs to provide protection for themselves and other travelers in these high volume, mixed population settings,” CDC Director Rochelle Walensky said in a statement.

The backstory: Before the ruling striking the mandate, the CDC had extended the mandate several times under the Biden administration. “When they announced the most recent extension, federal health officials said they had hoped to use the additional time to assess the need for a mask requirement in transportation settings based on factors such as the risk of virus variants and trends in caseloads,” Lori writes.

Most parents won't rush to get their young kids vaccinated

That’s from a new Kaiser Family Foundation poll, which finds little change in coronavirus vaccine hesitancy among parents of children under 5. A majority of these parents feel there’s still too little information about the effects of the vaccines on young kids and want to wait longer, even as Moderna pursues authorization of its shots for this age group. 

Some of the takeaways:

  • 18 percent of parents are eager to vaccinate their child under 5
  • 38 percent say they want to “wait and see” before vaccination
  • 11 percent say they’ll only get their child vaccinated if required to do so
  • 27 percent say they will “definitely not” get their child under 5 vaccinated

Sugar rush

Thanks for reading! See y'all tomorrow.

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