Arkansas governor signs abortion law banning common procedure

By Steve Barnes

LITTLE ROCK, Ark. (Reuters) – Arkansas Governor Asa Hutchinson signed into law on Thursday a bill banning the most common abortion procedure employed in the second trimester of a pregnancy, among the most restrictive abortion legislation in the United States.

The law, which takes effect later this year, prohibits dilation and evacuation, a practice that pro-choice advocates say is the safest method of ending a pregnancy but which supporters of the legislation call “barbaric,” requiring the “dismemberment” of the fetus.

Anti-abortion activists said the bill was their paramount objective in the current legislative session. With conservative Republicans controlling both chambers of the General Assembly, the bill faced little opposition.

Near identical laws have been adopted in Mississippi and Louisiana. Similar bans in Kansas, Oklahoma and Alabama have faced legal challenges and have yet to be implemented, according to the Guttmacher Institute, which tracks abortion legislation.

Opponents of the Arkansas law vowed to fight it in the courts and predicted it would fail.

“The law puts an undue burden on a woman’s constitutional right to obtain a second-trimester abortion, and I think the legislature knows it and doesn’t care,” said Rita Sklar, an attorney for the Arkansas chapter of the American Civil Liberties Union.

Hutchinson, a Republican, had said he believed the U.S. Supreme Court could uphold the law if given the opportunity. He said evolving medical standards of fetal viability could alter the traditional definition of trimester.

The Arkansas health department has said that dilation and extraction was used in 683 of the 3,771 abortions performed in Arkansas in 2015, the most recent year for which it has records.

(Editing by Brendan O’Brien and Hugh Lawson)

Texas Planned Parenthood asks judge to block Medicaid funding cut

Planned Parenthood in Austin, Texas

By Jon Herskovitz

AUSTIN, Texas (Reuters) – The leaders of Texas Planned Parenthood asked a federal judge on Tuesday to block the state’s bid to halt Medicaid funding for the healthcare group, which has long been targeted by Republicans for providing abortions.

Planned Parenthood has said the threatened funding cut, by terminating Planned Parenthood’s enrollment in the state-funded healthcare system for the poor, could affect nearly 11,000 patients across Texas.

It is seeking an injunction from Judge Sam Sparks in federal court in Austin to stop the cutoff, part of a protracted legal and political fight.

Texas and several other Republican-controlled states have pushed to cut the organization’s funding since an anti-abortion group released videos it said showed Planned Parenthood officials negotiating prices for fetal tissue collected from abortions.

The defunding efforts could gain traction now that Republicans, who already control the U.S. House and Senate, are expanding their powers with this week’s inauguration of President-elect Donald Trump.

Ken Lambrecht, chief executive of Planned Parenthood of Greater Texas and a plaintiff, testified his group does not participate in fetal tissue donation for medical research.

Planned Parenthood has denied wrongdoing nationally, saying the videos were heavily edited and misleading.

The Medicaid cut was “unconscionable,” Lambrecht testified, adding it would make it more difficult for some of the state’s poorest people to access services his affiliate provides, such as cancer screenings and HIV testing.

Texas has said other medical facilities could provide similar services as Planned Parenthood.

Planned Parenthood affiliates across Texas received about $4.2 million in Medicaid funding during the 2015 fiscal year, the state’s Health and Human Services Commission said.

None of that money went to abortions, plaintiffs in the lawsuit against Texas and the Medicaid defunding plan have said.

Sparks said he does not see the videos as a central to the hearing, which opened Tuesday and is scheduled to run through Thursday. He called on the state to present evidence to back up its allegations that Planned Parenthood violated the law.

Texas investigated Planned Parenthood over the videos and a grand jury last January cleared it of any wrongdoing. The grand jury indicted two people who made the videos for document fraud but the charges were later dismissed.

The state took no further criminal action against Planned Parenthood after that but has repeated its accusations that the abortion provider may have violated state law.

Planned Parenthood gets about $500 million annually in federal funds across the United States, largely in reimbursements through Medicaid.

(Reporting by Jon Herskovitz; Editing by Tom Brown and Lisa Shumaker)

ACLU and Kentucky’s only abortion clinic sue over ultrasound law

By Steve Bittenbender

LOUISVILLE, Ky. (Reuters) – The American Civil Liberties Union sued Kentucky state officials on Monday to block a new law that requires women seeking an abortion to first undergo an ultrasound and hear a description of the embryo or fetus.

ACLU lawyers filed the lawsuit in federal court in Louisville on behalf of EMW Women’s Surgical Center, which the lawsuit said is the sole licensed abortion facility in Kentucky.

The requirement violates the speech rights of doctors and patients by forcing them to deliver and listen to a government-mandated message, the lawsuit argues. The surgical center is asking for a temporary restraining order and a permanent declaration that the law is unconstitutional.

The law is part of a renewed effort by abortion opponents nationwide to restrict the procedure. It was passed on Saturday by the Kentucky General Assembly, where Republicans swept to power after taking the state House for the first time in nearly a century, and signed on Monday by Governor Matt Bevin, also a Republican.

Bevin, in a statement on Monday, defended the law and several other recently passed measures as representing a new day for Kentucky. He said the measures would “protect our most vulnerable.”

The law requires a physician or qualified technician to perform the ultrasound and position the screen so the woman may view the images. The medical staff will also be required to describe what the images show, including the size of the fetus and any organs or appendages visible.

It does not contain exceptions for women who are facing medical complications or are victims of rape or incest. Lawmakers inserted an emergency clause allowing it to take effect immediately upon Bevin’s signature.

The lawsuit accuses lawmakers of “forcibly co-opting and perverting the informed consent process.”

While the bill received overwhelming support in both chambers of Kentucky’s legislature, even some of its supporters questioned whether the state risked a lawsuit.

Some 25 states have laws regarding ultrasounds and abortions, but only three states require medical staff to display and describe the images, according to the Kaiser Family Foundation, a non-profit group focusing on health issues.

Republicans have acted swiftly in their first week with majorities in the Kentucky legislature. Other measures they passed include prohibiting abortions after a pregnancy has reached 20 weeks, making Kentucky the 27th “right-to-work” state and allowing the governor to overhaul the University of Louisville’s board of trustees.

(Reporting by Steve Bittenbender; Editing by David Ingram and Lisa Shumaker)

Kentucky moves toward requiring ultrasound before abortion

ultrasound machine

By Steve Bittenbender

LOUISVILLE, Ky. (Reuters) – Kentucky’s new Republican House majority took the first step on Thursday toward requiring women seeking an abortion to undergo an ultrasound, acting swiftly to capitalize on winning control of the chamber for the first time in almost a century.

The 83-12 vote on the bill came on the third day of the state’s 2017 General Assembly session, the first in which the Republican Party has led the House of Representatives since 1921.

The bill requires a physician or qualified technician to perform the ultrasound and position the screen so the woman may view the images. The medical staff will be required to describe what the images show, including the size of the fetus and any organs or appendages visible.

Sponsors say the bill will better protect the health of women and provide the materials necessary for women to make an informed choice. Abortion rights advocates contend such laws are designed to frighten and shame those seeking an abortion.

Some 25 states have laws regarding ultrasounds and abortions, but only three states require medical staff to display and describe the images, according to the Kaiser Family Foundation, a non-profit group focusing on health issues.

While Kentucky’s bill passed easily, some supporters criticized the new House leadership for pushing the legislation through so quickly that it might open the state to a lawsuit if,

as expected, the bill becomes law.

“I think that had we had a chance to discuss this bill, we might have come up with something that was not going to open this state up to millions of dollars in litigation” costs, said Democratic state Representative Angie Hatton.

The state’s Republican-controlled Senate passed another measure that would outlaw abortions after 20 weeks of pregnancy. After passing the ultrasound bill, the House approved two measures strongly opposed by labor groups. The first was a proposal that would allow workers in union shops to receive union benefits without having to pay dues, The second measure would repeal prevailing wage laws Republicans say add expenses to state and local construction projects.

Leaders in both chambers plan to meet this weekend to pass bills to be sent to Republican Governor Matt Bevin for approval, House Republican Caucus spokeswoman Daisy Olivo said.

(Reporting by Steve Bittenbender; Editing by Dan Whitcomb and Peter Cooney)

Texas moves to cut Medicaid funding for Planned Parenthood

Planned Parenthood center

By Jon Herskovitz

AUSTIN, Texas, Dec 21 (Reuters) – Texas plans to block about $3 million in Medicaid funding for Planned Parenthood operations in the state, according to a legal document obtained on Wednesday, a move the reproductive healthcare group said could affect nearly 11,000 low-income people.

Planned Parenthood said it would seek court help to block the funding halt, which would cut cancer screenings, birth control, HIV testing and other programs.

Planned Parenthood gets about $500 million annually in federal funds, largely in reimbursements through Medicaid, which provides health coverage to millions of low-income Americans.

Texas and several other Republican-controlled states have tried to cut the organization’s funding after an anti-abortion group released videos last year that it said showed officials from Planned Parenthood negotiating prices for fetal tissues from abortions it performs.

Texas sent a final termination notice to Planned Parenthood in the state on Tuesday to alert it of the funding cut, the document showed, saying the basis of the termination was the videos.

Planned Parenthood has denied wrongdoing, saying the videos were heavily edited and that it does not profit from fetal tissue donation. It has challenged similar defunding efforts in other states, calling them politically motivated.

Republican President-elect Donald Trump has pledged to defund Planned Parenthood, and at least 14 states have tried to pass legislation or taken administration action to prevent the organization from receiving federal Title X funding.

“Texas is a cautionary tale for the rest of the nation,” Cecile Richards, president of the Planned Parenthood Action Fund, said in a statement. “With this action, the state is doubling down on reckless policies that have been absolutely devastating for women.”

The Texas governor’s office was not immediately available for comment. The state investigated Planned Parenthood over the videos. A grand jury in January cleared Planned Parenthood of any wrongdoing and indicted the anti-abortion activists who made the videos for tampering with government records.

About a year ago, the Texas health department cut funding to a Houston Planned Parenthood affiliate for a nearly three-decade-old HIV prevention program. The contract was federally funded through the Centers for Disease Control and Prevention but managed by the state.

(Reporting by Jon Herskovitz; Editing by Lisa Von Ahn)

Ohio lawmakers pass ‘heartbeat’ abortion legislation

Protesters demonstrate in front of the U.S. Supreme Court on the morning that the court took up a major abortion case focusing on whether a Texas law that imposes strict regulations on abortion doctors and clinic buildings interferes with the constitutional right of a woman to end her pregnancy in Washington

By Kim Palmer

CLEVELAND, Dec 7 (Reuters) – Ohio lawmakers approved a bill that bans abortion once a fetal heartbeat can be detected, as early as six weeks after conception, clearing the way for one of the most stringent abortion restrictions in the United States if it becomes law.

The Republican-led state House of Representatives and Senate passed the so-called “heartbeat” measure late on Tuesday, sending it to be signed into law by Republican Governor John Kasich.

Kasich, an abortion opponent, has in the past questioned whether such legislation would be constitutional.

The U.S. Supreme Court legalized abortion nationwide more than four decades ago, but states were allowed to permit restrictions once a fetus was viable. Some states, particularly those governed by Republicans such as Ohio, have sought to chip away at a woman’s right to end a pregnancy.

Lower courts have struck down similar “heartbeat” laws in North Dakota and Arkansas and the Supreme Court refused to hear appeals on those rulings in January.

But now, with Republican President-elect Donald Trump having the opportunity to fill at least one Supreme Court vacancy, conservatives in Ohio hope that the legislation can withstand a challenge in court.

“A new president, new Supreme Court appointees change the dynamic, and there was consensus in our caucus to move forward,” Senate President Keith Faber told the Columbus Dispatch.

“It has a better chance than it did before,” Faber said of the bill’s chances of surviving a constitutional challenge,
according to the Dispatch.

The heartbeat legislation has been approved twice before by the state’s lower house only to fail in the Senate.

The abortion legislation was part of a wider bill on reporting child abuse. It does not make exceptions for rape and incest, though it does allow for abortions that would save the mother’s life, according to text of the legislation.

Some women’s rights groups were swift to condemn the approval of the bill. The Guttmacher Institute, a nonprofit research organization that supports abortion rights and tracks abortion legislation, said it would be one of the most restrictive abortion laws if enacted.

“Banning women from getting a medical procedure is out of touch with Ohio values and is completely unacceptable,” abortion-rights advocacy group NARAL Pro-Choice Ohio said in a statement.

(Additional reporting by Brendan O’Brien in Milwaukee; editing
by Richard Lough)

Exclusive: Abortion by prescription now rivals surgery for U.S. women

By Jilian Mincer

NEW YORK (Reuters) – American women are ending pregnancies with medication almost as often as with surgery, marking a turning point for abortion in the United States, data reviewed by Reuters shows.

The watershed comes amid an overall decline in abortion, a choice that remains politically charged in the United States, sparking a fiery exchange in the final debate between presidential nominees Hillary Clinton and Donald Trump.

When the two medications used to induce abortion won U.S. approval 16 years ago, the method was expected to quickly overtake the surgical option, as it has in much of Europe. But U.S. abortion opponents persuaded lawmakers in many states to put restrictions on their use.

Although many limitations remain, innovative dispensing efforts in some states, restricted access to surgical abortions in others and greater awareness boosted medication abortions to 43 percent of pregnancy terminations at Planned Parenthood clinics, the nation’s single largest provider, in 2014, up from 35 percent in 2010, according to previously unreported figures from the nonprofit.

The national rate is likely even higher now because of new federal prescribing guidelines that took effect in March. In three states most impacted by that change – Ohio, Texas and North Dakota – demand for medication abortions tripled in the last several months to as much as 30 percent of all procedures in some clinics, according to data gathered by Reuters from clinics, state health departments and Planned Parenthood affiliates.

Among states with few or no restrictions, medication abortions comprise a greater share, up to 55 percent in Michigan and 64 percent in Iowa.

Denise Hill, an Ohio mother who works full time and is pursuing a college degree, is part of the shift.

Hill, 26, became extremely ill with her third pregnancy, sidelined by low blood pressure that made it challenging to care for her son and daughter. In July, eight weeks in, she said she made the difficult decision to have a medication abortion. She called the option that was not available in her state four months earlier “a blessing.”

The new prescribing guidelines were sought by privately-held Danco Laboratories, the sole maker of the pills for the U.S. market. Spokeswoman Abby Long said sales have since surged to the extent that medication abortion now is “a second option and fairly equal” to the surgical procedure.

“We have been growing steadily year over year, and definitely the growth is larger this year,” Long said.

Women who ask for the medication prefer it because they can end a pregnancy at home, with a partner, in a manner more like a miscarriage, said Tammi Kromenaker, director of the Red River Women’s Clinic in Fargo, North Dakota.

GAME CHANGER

Medication abortion involves two drugs, taken over a day or two. The first, mifepristone, blocks the pregnancy sustaining hormone progesterone. The second, misoprostol, induces uterine contractions. Studies have shown medical abortions are effective up to 95 percent of the time.

Approved in France in 1988, the abortion pill was supposed to be a game changer, a convenient and private way to end pregnancy. In Western Europe, medication abortion is more common, accounting for 91 percent of pregnancy terminations in Finland, the highest rate, followed by Scotland at 80 percent, according to the Guttmacher Institute, a nonprofit research organization that supports abortion rights.

In the United States, proponents had hoped the medication would allow women to avoid the clinics that had long been targets of protests and sometimes violence.

But Planned Parenthood and other clinics remain key venues for the medication option. Of the more than 2.75 million U.S. women who have used abortion pills since they were approved in 2000, at least 1 million got them at Planned Parenthood.

Many private physicians have avoided prescribing the pills, in part out of concern that it would expose their practices to the type of protests clinics experienced, say doctors, abortion providers and healthcare organizations.

At the same time, the overall U.S. abortion rate has dropped to a low of 16.9 terminations per 1,000 women aged 15-44 in 2011, down from 19.4 per 1,000 in 2008, according to federal data. The decline has been driven in part by wider use of birth control, including long lasting IUDs.

In March, the U.S. Food and Drug Administration changed its prescribing guidelines for medication abortion. The agency now allows the pills to be prescribed as far as 10 weeks into pregnancy, up from seven. It cut the number of required medical visits and allowed trained professionals other than physicians, including nurse practitioners, to dispense the pills. It also changed dosing guidelines.

The changes were supported by years of prescribing data and reflect practices already common in most states where doctors are free to prescribe as they deem best.

Ohio, Texas and North Dakota took the unusual step of requiring physicians to strictly adhere to the original guidelines. Many abortion providers were reluctant to prescribe the pills under the older guidelines, which no longer reflected current medical knowledge, said Vicki Saporta, President and CEO of the National Abortion Federation.

Randall K. O’Bannon, a director at the anti-abortion National Right to Life organization, criticized the new guidelines but said his organization had no plans to fight them.

“What they did was make it more profitable,” O’Bannon said. “It will increase the pool of potential customers.”

Planned Parenthood said both types of abortion typically cost from $300 to $1,000, including tests and examinations. The group charges a sliding fee based on a patient’s ability to pay, regardless of which type of abortion they choose.

VARIED ACCESS

Despite a landmark U.S. Supreme Court ruling that abortion is a woman’s right, access varies widely by state. Some states maintain restrictions on both surgical and medication abortions; others have worked to increase access.

In rural Iowa, where clinics are few and far between, Planned Parenthood is using video conferencing, known as telemedicine, to expand access.

The way it works is, a woman is examined in her community by a trained medical professional, who checks vital signs and blood pressure and performs an ultrasound. The information is sent to an off-site doctor, who talks with the woman via video conference and authorizes the medications.

Since the telemedicine program began in Iowa in 2008, medication abortions increased to 64 percent of all pregnancy terminations, the highest U.S. rate.

In New York, Hawaii, Washington and Oregon, a private research institute, Gynuity Health Projects, works with clinics to send abortion pills by mail to pre-screened women.

“Medication abortion is definitely the next frontier,” said Gloria Totten, president of the Public Leadership Institute, a nonprofit that advises advocates.

And in Maryland and Atlanta, the nonprofit organization Carafem opened centers in the last 18 months that offer birth control and medication, but not surgical, abortions. It promotes its services with ads that read: “Abortion. Yeah, we do that.”

(Reporting By Jilian Mincer; Editing by Michele Gershberg and Lisa Girion)

Judge sides with Planned Parenthood over Mississippi abortion law

Boston Planned Parenthood

(Reuters) – A federal judge on Thursday sided with women’s health provider Planned Parenthood in a lawsuit aiming to block a Mississippi law that barred medical providers that perform abortions from participating in the state’s Medicaid program.

The decision by U.S. District Judge Daniel Jordan III is the latest in a string of rulings striking down similar laws elsewhere in the country against the women’s health provider.

Jordan’s two page order noted a ruling from the 5th U.S. District Court of Appeals that rejected a similar law in Louisiana, saying “essentially every court to consider similar laws has found that they violate” federal law.

Medicaid is a health insurance program for the poor run jointly by the federal government and individual states.

Planned Parenthood said in its complaint that the law, which went into effect in July, unconstitutionally limited patients’ rights to choose the healthcare provider of their choice and would have stopped it from serving low-income patients.

“Yet another court has said it is unacceptable for politicians to dictate where women can go for their health care,” Planned Parenthood Federation of America President Cecile Richards said in a statement. “Planned Parenthood will fight for our patients at every turn.”

Mississippi’s Republican Governor, Phil Bryant, expressed disappointment with the ruling, saying in a statement on Facebook: “I believe the law was the right thing to do and I will continue to stand with the legislature and people of Mississippi who do not want their hard-earned money going to the largest abortion provider in the nation.”

Mississippi was among many states adopting new abortion laws as conservatives have sought to chip away at the U.S. Supreme Court’s landmark 1973 Roe v. Wade decision legalizing abortion.

In August, a federal judge prevented Ohio from cutting federal taxpayer funding from 28 Planned Parenthood clinics in the state, setting back the governor’s hopes of stopping the women’s health services group from providing abortions.

(Reporting by Curtis Skinner in San Francisco; Editing by Simon Cameron-Moore)