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The Health 202

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

Post-Roe, some abortion clinics are moving to more liberal states

The Health 202

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

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Today’s edition: Senate Minority Leader Mitch McConnell (R-Ky.) was released from inpatient physical therapy and is back at home. A deep dive into the impact of an insurer denial of a new obesity drug. But first … 

Some abortion clinics are opening new locations near states with bans

West Virginia’s only abortion clinic wrote on its website that it would no longer perform abortions the morning after state lawmakers passed a near-total ban on the procedure in mid-September.

Now, the clinics’ operators plan to announce today that they’ll soon open a new location in Cumberland, Md., roughly five miles from the West Virginia border. 

“This is a new option for not just Western Marylanders, not just West Virginians, but for people who are living in the abortion desert that is central Appalachia,” said Katie Quiñonez, the executive director of Women's Health Center of West Virginia, which will open Women’s Health Center of Maryland in June.

In the post-Roe era, some abortion providers are rushing to relocate or open in states that are keeping abortion legal, such as New Mexico, Illinois and Minnesota. 

It’s still a relatively small number that have done so, since it takes planning, time and money. But those that have are picking states with strong abortion protections and within striking distance of states with prohibitions on the procedure and abortion pills, an attempt to cut down on travel time. The effort is emblematic of the red-blue divide that has ensued since the Supreme Court overturned Roe v. Wade in June with antiabortion groups celebrating their victory curtailing abortions across various regions of the United States.

  • “Where you see [clinics] opening are states that are as proximate as possible to the ban states, but also relatively safe for the providers who want to know they can stay open for a while,” said Caitlin Myers, an economics professor at Middlebury College who studies abortion. 
The details

There have been several high-profile instances of clinics packing up and moving. For instance: Alan Braid, the abortion provider who defied the Texas abortion ban in fall 2021, shuttered his two clinics in Oklahoma and Texas and headed to Illinois and New Mexico.

Another example: Whole Woman’s Health closed its four locations in Texas, and CEO Amy Hagstrom Miller scouted out a new location. She looked at towns along the Texas-New Mexico border before settling on Albuquerque, believing the abortion provider would have the support of the local community there. 

“Our goal was to try to find a state as close as possible to Texas,” she said. 

The new location officially opened Thursday after three 18-wheelers hauled the clinics’ stuff from Texas to New Mexico. As of late last week, the Albuquerque clinic was scheduled to see a total of 23 patients, and 21 were from Texas. 

And there’s more: The Red River Women’s Clinic moved a five-minute drive away, from Fargo, N.D., to Moorhead, Minn. 

Tammi Kromenaker, the director of the clinic, said the “writing was on the wall.” She began looking for a new location in fall 2021, a process that accelerated after Politico published a leaked draft last spring showing a majority of the justices were poised to overturn Roe. The clinic signed the paperwork for the building in Moorhead the afternoon of June 23, the day before the nation’s highest court declared there was no longer a constitutional right to an abortion. 

Their patient population is similar to what it was before: The vast majority are from North Dakota, with some coming from South Dakota and northwestern Minnesota. (North Dakota has a near-total ban on abortion that the courts have temporarily blocked.)

More changes

Not all clinics located in states with bans on abortions are uprooting. Instead, some are focusing on other services, while also opening new facilities in more liberal states. 

That’s what the Women’s Health Center of West Virginia is doing. The clinic was the state’s first abortion provider in 1976, and continues to provide other sexual and reproductive health care, such as contraception, HIV testing and breast cancer screenings. Across state lines, the upcoming location in Maryland will offer both medication and surgical abortion, according to Quiñonez.

In Memphis, Choices Center for Reproductive Health was founded in 1974 and is continuing to provide midwife, prenatal and other services since the state’s near-total abortion ban went into effect over the summer. At the beginning of October, it opened up a new location to provide abortions in Carbondale, Ill., roughly three hours from both Memphis and Nashville.

  • “Our schedule has stayed pretty full since we've opened in Carbondale,” said Jennifer Pepper, the CEO of Choices. “As we had suspected, we've continued to serve the same communities that we served in Memphis for almost 50 years, folks from Tennessee, Arkansas and Mississippi.”

On the Hill

McConnell out of rehab facility after he fell

Senate Minority Leader Mitch McConnell (R-Ky.) was released from inpatient physical therapy and has returned home over two weeks after a fall that left him with a concussion and a broken rib, our colleague Dan Rosenzweig-Ziff writes. 

In a statement released Saturday, the 81-year-old senator didn’t specify when he will return to his office in Washington, but he said he will spend the coming days working from home. The Senate begins a long Easter recess at the end of the week, so it is unlikely he will return to the chamber for legislative business until lawmakers reconvene on April 17.

Key context: McConnell, the longest-serving Senate leader, was hospitalized for five days after he tripped while attending a private dinner at a Washington hotel March 8. On Tuesday, he spoke directly with members of his leadership team for the first time since the fall. Sen. John Cornyn (R-Tex.) said McConnell sounded “eager” to get back.

Industry RX

Their child’s obesity drug was working. Then their plan refused to pay.

Over the weekend, our colleague Ariana Eunjung Cha published a deep dive into one family’s struggle to pay for Novo Nordisk’s new weight-loss drug Ozempic after their insurer refused to pay for the $1,331-per-month treatment. 

UnitedHealthcare told the Tyler family that it wouldn’t cover the drug prescribed by doctors to manage their daughter’s childhood obesity because it was an off-label use of the medication, which is approved to treat diabetes in adults. UnitedHealthcare declined to comment on the specifics of the case and the company’s approach to covering obesity drugs. 

The bigger picture: Youth obesity is a growing problem in the United States, with more than 14.4 million children having been diagnosed with the chronic disease. Several new medications could be potential game-changers, but drug companies have set their prices beyond reach for most Americans without insurance. 

Even among the insured, just 30 to 40 percent of commercial health plans and 19 Medicaid programs are estimated to cover anti-obesity drugs at some level, according to a 2022 Urban Institute report. Many plans also impose additional barriers to access, such as requiring prior authorization or limiting coverage to adults. The newest of the obesity medications, which were only approved last year and are likely to be used for a lifetime, face especially high coverage barriers because they carry the stigma of being considered “vanity drugs” for some people who don’t have medical conditions, Ariana notes. 

In other health news

  • The Food and Drug Administration is proposing more rigorous clinical trials for cancer drug developers seeking accelerated approval for their treatments, including strongly recommending randomized clinical trials over trials testing the drug without a comparison, Reuters reports. 
  • A bipartisan bill introduced in the House last week seeks to reclassify female service members who participated in secretive missions on the front lines of the Afghanistan war as combat veterans so that they can more easily access health-care benefits to treat their wartime ailments, Hope Hodge Seck reports for The Post. 
  • Florida regulators punished more than a dozen abortion providers in the last year for allegedly violating a newly enforceable law requiring pregnant patients wait 24 hours between clinic visits before getting the procedure, Politico’s Arek Sarkissian reports. 


📅  Welcome back! It’s another jam-packed week in Washington. Here’s what we’ve got our eyes on over the next few days:

On Tuesday: The House select subcommittee on the coronavirus pandemic will examine the consequences of school closures during the pandemic; a House Oversight and Accountability subcommittee will hold its first in a series of hearings on the FDA’s role in the infant formula shortage

Also … Health and Human Services Secretary Xavier Becerra will testify before the House Appropriations Committee and the House Ways and Means Committee on President Biden’s fiscal 2024 budget request.

On Wednesday: A Senate Finance health subcommittee will hold a hearing on the oral health; a House Natural Resources subcommittee will examine how to improve health-care delivery in tribal communities; the House Appropriations Committee will consider the FDA’s fiscal 2024 budget request; a House Veterans Affairs subcommittee will discuss several pieces of health legislation

On Thursday: The Senate Finance Committee will examine pharmacy benefit managers and the prescription drug supply chain; a House Veterans Affairs subcommittee will consider a bill that would protect some benefits for service members who were discharged for failing to comply with the Pentagon’s recently repealed coronavirus vaccine mandate, among other measures. 

Health reads

Irvo Otieno’s last days: How a mental health system ‘completely failed’ (By Justin Jouvenal, Laura Vozzella, Joe Heim and Salvador Rizzo | The Washington Post)

Kyiv doctor killed in Russian airstrike shows war’s fallout far from front (By Missy Ryan, Kostiantyn Khudov and Alice Martins | The Washington Post)

She lost her trans son to suicide. Can a Kentucky lawmaker make her colleagues care? (By William Wan | The Washington Post)

Sugar rush

Thanks for reading! See y'all tomorrow.