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The Health 202

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

If Roe falls, abortion pills will be the next big fight

The Health 202

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

Good Thursday morning, where we have another fox alert (this time at the National Zoo). Be careful out there, and send fox sightings/news tips to rachel.roubein@washpost.com. 

Today’s edition: A Duke University scientist is under consideration to lead the National Institutes of Health. Republicans don’t really want to talk about abortion. But first … 

Abortion rights supporters are mostly out of options in red states

There’s not much the White House or congressional Democrats can do to immediately blunt the impact of a potential Supreme Court ruling overturning Roe v. Wade.

That’s the overwhelming consensus after a marathon of meetings and calls between White House officials, government lawyers and other outside advisers, The Post’s Yasmeen Abutaleb and Tyler Pager report. 

For months, White House officials had been planning for the possibility that Roe would be struck down, but the leaked document caught the administration off guard. Officials had been talking about whether funding through Medicaid or another mechanism could come online for women to travel to other states for an abortion, but there's some doubt that's feasible, Yasmeen and Tyler report.

Some supporters of the procedure hope abortion pills by mail will help, though Republican-led states are already moving to block access to the medication. And any attempts to circumvent abortion restrictions would likely be litigated by a newly invigorated antiabortion lobby. There’s a chance some may want to use an impending ruling to target emergency contraception as well.

It bears repeating that the decision obtained by Politico was just a draft. But groups are using it as a fire drill, of sorts, gearing up for the very real possibility that women's longstanding right to an abortion could be struck down.

Medication abortion

The next battle over the procedure will likely be over shipping abortion pills by mail.

In December, the Biden administration made permanent a covid-era policy allowing doctors to prescribe the pills via telehealth appointments and mail them to patients in states where it’s permitted to do so. But even before that, medication abortion accounted for roughly 54 percent of all abortions in 2020, according to the Guttmacher Institute, a research organization that supports abortion rights. 

Yet Republican-led states have already pushed to try to stop the medication from being shipped or prescribed. There are roughly 19 states that have banned the use of telehealth for medication abortion, generally requiring the patient and provider to be in the same room, The Post’s Christopher Rowland, Laurie McGinley and Jacob Bogage report.  

But women have found ways to bypass the new rules.

For instance: In places restricting access to pills, some patients are instead turning to overseas online pharmacies selling generic pills manufactured in India and China. The vendors have said the pills are the same quality as those sold in the United States, but the Food and Drug Administration has not signed off on their importation, my colleagues note.

Going further

Tuesday’s leak electrified the antiabortion movement, which has spent nearly 50 years working to reverse Roe’s abortion protections. Prominent groups said they were approaching the draft decision with cautious optimism. 

Some abortion opponents said they’ve been focused on what they perceive as gaps in abortion bans, such as the prevalence of medication abortion, Hannah Knowles, Brittany Shammas and I reported yesterday.  

But some are looking to take the restrictions a step further. Take Lila Rose, founder of the antiabortion group Live Action, known for its massive social media presence and undercover videos of Planned Parenthood clinics. She said she wants to see a ban on the “intentional destruction of human life” from the moment of fertilization, which she believes should block the use of Plan B, also known as the morning-after pill.

  • As Post Politics Now explains, “access to birth control and Plan B is already being targeted by conservative, antiabortion organizations and Republican officials nationwide. For years, some conservative lawmakers have argued that the federal government is wrong to tell employers what health benefits they must cover, fighting provisions outlined in the Affordable Care Act on birth control products.”

Agency alert

🚨 Under consideration: Mary Klotman — a Duke University scientist and senior leader — is a strong contender to helm the National Institutes of Health, the nation’s premier medical research agency.

Klotman has had conversations with several senior administration officials, though the administration is choosing between at least one other contender in a process likely to play out for several weeks, Yasmeen, Dan Diamond and Carolyn Y. Johnson report. 

Klotman is a physician known for her research into HIV, and she and her husband, Paul, worked as NIH scientists earlier in their careers. If chosen — and confirmed by the Senate — she’d step into a position last filled by Francis Collins, who stepped down last year as NIH director. Lawrence Tabak has been serving as the interim head since Collins’s departure. 

The agency’s work has been catapulted into the spotlight amid the pandemic. It played a critical role in developing coronavirus vaccines and therapeutics, and its leaders — Collins and Anthony Fauci, the chief medical adviser to President Biden — have been major players in the pandemic response. 

On the Hill

Republicans are on the precipice of an abortion win. But they don’t want to talk about it.

Congressional Republicans participate in the annual March for Life. They give speeches opposing abortion on the Senate and House floors. And if they win back Congress, they’ve pledged to hold votes to restrict the procedure.

But yet … Few Republicans have openly celebrated, even though Justice Samuel A. Alito Jr.’s opinion would, if adopted by the court, fulfill what is perhaps the conservative movement’s single most enduring policy goal,” The Post’s Mike DeBonis reports.

Instead, GOP lawmakers are expressing concerns over the leak. Some attributed the subdued reaction to a desire to wait until there’s actually a decision. But there are signals that Republicans may not be ready for the ramifications of a post-Roe world.

  • For instance: The National Republican Senatorial Committee issued a memo Tuesday that counseled Republican candidates to be “compassionate, consensus builders,” and to attack the other side for its support of late-term abortions and taxpayer funding of the procedure. But the document also advised them to steer away from the issue.

From our notebook

30 million Americans still don’t have health insurance

The number of uninsured Americans decreased slightly last year, dropping from 9.7 percent in 2020 to 9.2 percent in 2021. That amounts to 30 million people without health coverage, according to new data released today from the CDC’s National Center for Health Statistics.

Increasing access and making health coverage more affordable has been a key priority of the Biden administration. But yet, millions still lack health insurance, a gap in care that comes as the administration’s health agenda is stalled on Capitol Hill.

Here’s what else we learned from the new data:

  • Roughly 13.5 percent of adults ages 18 to 64 didn’t have health insurance last year.
  • Far fewer children were uninsured, with just 4.1 percent of those 17 and under lacking health coverage.
  • The percentage of people under age 65 with coverage through Obamacare’s insurance marketplaces increased from 3.7 percent in 2019 to 4.3 percent last year.

Coronavirus

Blinken tests positive for the coronavirus

Secretary of State Antony Blinken became the latest member of Biden’s Cabinet to contract the coronavirus, the State Department announced yesterday.

He’s experiencing mild symptoms and has been vaccinated and boosted. White House press secretary Jen Psaki told reporters that he’s not considered a close contact of Biden according to guidelines from the CDC, per my colleagues Felicia Sonmez and John Hudson

Blinken was among the over 2,000 attendees at the White House Correspondents’ Association dinner last weekend, which Biden also attended. Yet, it’s not clear where Blinken caught the virus, since he’s often in face-to-face meetings with a broad array of officials, lawmakers and journalists.

Meanwhile … In the days after the weekend of the correspondents' dinner, reporters and staffers from various news outlets have tested positive for the coronavirus. This includes reporters and staffers from CNN, ABC News, NBC News, CBS News and Politico, CNN reports. Jonathan Karl, ABC News’ chief Washington correspondent, tested positive for the virus days after shaking hands with Biden, Politico reported.

In other health news

  • Mississippi’s last abortion clinic — which is at the heart of the Supreme Court case that could overturn Roe may move to Mexico if the abortion protections are struck down, our colleague Timothy Bella writes.
  • Stacey Abrams is pausing fundraising for her Georgia gubernatorial race to instead redirect funds to abortion rights groups, The Post’s Eugene Scott writes.
  • Three Republican governors in New England are vowing to protect abortion rights in the states they lead: Massachusetts, Vermont and New Hampshire, per the New York Times.

Sugar rush

Thanks for reading! See y'all tomorrow.

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