News Abortion

Mississippi’s Last Abortion Clinic Still Struggling To Get Admitting Privileges

Robin Marty

If they do not receive privileges by July 1st when the state's new law goes into effect, they will no longer be allowed to perform abortions.

Jackson Women’s Health Organization has less than three weeks to obtain hospital admitting privileges before Mississippi’s new TRAP law goes into effect on July 1st, and the group says they are leaving “no stone unturned.” They have now applied at every hospital in the region, but have yet to receive a positive response from any of them.

Even worse, it’s a long and detailed process.

Via The Clarion-Ledger:

Admitting privileges at local hospitals may be difficult to obtain. Many religious-affiliated hospitals do not allow abortions to be performed at their facilities and some will not affiliate with doctors who perform abortions at other hospitals or clinics.But even public hospitals like the University of Mississippi Medical Center have strict guidelines.

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At UMC, doctors must apply with the appropriate clinical department, where officials determine whether applicants meet basic qualifications, spokesman Tom Fortner said. Then, the executive committee of the medical staff and the dean of medicine must approve the application.

Additionally, since UMC operates with a closed medical staff, only faculty usually have admitting privileges. There must be a need to obtain an exception – known as affiliate faculty – and those physicians must practice exclusively at UMC. The only exception is Blair E. Batson Hospital for Children, as it is the only children’s hospital in the state.As at UMC, doctors seeking privileges at a hospital within Baptist Health Systems would need to demonstrate they’re qualified, certified and covered by insurance in Mississippi. Then, physicians would undergo a review process, requiring approval from the board of directors and other appropriate committees.

According to the clinic spokesperson, it could take up to three months to be credentialed, if approved, and the process didn’t begin until mid-May. Should they not have privileges by the deadline, they will likely to take the state to court.

News Abortion

Abortion Providers Could Recoup Millions From Wisconsin After Fighting Unconstitutional Anti-Choice Law

Michelle D. Anderson

The providers seeking money include Planned Parenthood of Wisconsin, Inc., Planned Parenthood Federation of America, and Milwaukee Women's Medical Services, which conducts business as Affiliated Medical Services.

Abortion providers serving Wisconsin residents could recoup nearly $1.8 million in legal fees they amassed while fighting an anti-choice law that was first blocked in 2013. However, spokespeople for the State of Wisconsin have raised the possibility of an undisclosed settlement.

In a U.S. District Court filing dated July 28, the providers requested an award of “attorneys’ fees, costs and expenses” that could be recouped under the Civil Rights Attorneys’ Fee Awards Act of 1976. On Wednesday in response, Wisconsin Attorney General Brad Schimel asked the court to extend the due date for the state to respond from August 18 to September 1. The request was granted, according to court documents.

“The parties are currently discussing settlement of the plaintiffs’ motion. An extension of the briefing schedule would allow the parties the opportunity to explore the possibility of a settlement of this issue,” Schimel said in the court filing.

The providers seeking money include Planned Parenthood of Wisconsin, Inc., Planned Parenthood Federation of America, and Milwaukee Women’s Medical Services, which conducts business as Affiliated Medical Services. The sum requested includes $1.7 million in attorneys’ fees, $44,253 in billable costs and $22,545 in out-of-pocket expenses, according to the court filing.

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The providers amassed the fees fighting Wisconsin Act 37 of 2013, a Republican-initiated law that required doctors to have hospital admitting privileges within 30 miles of the location where an abortion was to be performed.

U.S. District Judge William Conley of the Western District of Wisconsin blocked the law’s enforcement soon after Republican Gov. Scott Walker signed it in 2013.

The state attorney general twice appealed to the Seventh Circuit U.S. Court of Appeals, which affirmed the lower court’s decision both times; the U.S. Supreme Court also declined to take the case a day after overturning a similar provision in Whole Woman’s Health v. Hellerstedt.

In a Court of Appeals opinion issued in November 2015, the court said there was no evidence that “transfer agreements provide inferior protection to the health of women undergoing abortion compared to admitting privileges.” The opinion concluded by saying the unconstitutional statute was burdensome and curtailed citizens’ constitutional right to an abortion.

“The statute may not be irrational, yet may still impose an undue burden—a burden excessive in relation to the aims of the statute and the benefits likely to be conferred by it— and if so it is unconstitutional,” the court said.

If not blocked, the law would have forced pregnant people in various parts of the state to travel at least an extra 200 miles round trip to access legal abortion, according to a previous Rewire report.

Johnny Koremenos, a spokesperson for Schimel, had indicated in statements to the Journal Sentinel and the Wisconsin State Journal earlier this month that the state would fight the charges for legal fees. He said Schimel would challenge the providers’ request “to ensure that the state is not paying more than it should be for those fees,” according to local news reports.

Koremenos did not respond to Rewire’s request for comment.

Walker also supported fighting the fees, his spokesperson told the Journal Sentinel.

Ismael Ozanne, the district attorney for Dane County, was also named as a defendant in the providers’ lawsuit, along with several state medical examining board members.

Planned Parenthood of Wisconsin spokeswoman Iris Riis told Rewire the money Planned Parenthood is seeking in this case is only a recoup of the legal fees already spent fighting the unconstitutional admitting privileges law.

“There would not be any leftover money to allocate to services or any fund. It would just cover what was already spent. Governor Walker’s administration appealed multiple definitive rulings, wasting countless taxpayer dollars in the process. That action also drove up our legal costs,” Riis said.

Riis said the plaintiffs do not know when Conley will issue the ruling that will determine whether Schimel will have to compensate them for legal fees.

Andrew Wiseman, a deputy clerk in the U.S. District Court, Western District of Wisconsin, told Rewire the court could not offer a prediction about the date of Conley’s ruling.

Affiliated Medical Services, which operates a clinic in Milwaukee, is being represented by the American Civil Liberties Union of Wisconsin, while private attorneys are representing Planned Parenthood.

Analysis Abortion

Legislators Have Introduced 445 Provisions to Restrict Abortion So Far This Year

Elizabeth Nash & Rachel Benson Gold

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

Mid year state restrictions

 

Signs of Progress

The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedt struck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear. 

Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.

More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.

As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.

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But the Assault Continues

Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:

  • Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
  • Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
  • Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.

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The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:

  • By the end of June, four states enacted legislation to ban the most common method used to perform abortions during the second trimester. The Mississippi and West Virginia laws are in effect; the other two have been challenged in court. (Similar provisions enacted last year in Kansas and Oklahoma are also blocked pending legal action.)
  • South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
  • Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
  • Oklahoma Gov. Mary Fallin (R) vetoed a sweeping measure that would have banned all abortions except those necessary to protect the woman’s life.

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In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.

Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.

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