News Law and Policy

Appeals Court Blocks Arizona Medication Abortion Rules, Says Evidence to Justify Them “Non-Existent”

Jessica Mason Pieklo

In a strongly worded opinion, the U.S. Court of Appeals for the Ninth Circuit said attorneys for Arizona failed to offer any evidence supporting the need for restrictions on medication abortions.

The U.S. Court of Appeals for the Ninth Circuit ruled Tuesday the justifications for Arizona’s regulations limiting medication abortions were “non-existent,” and ordered the law blocked and returned to the lower court for a trial on the constitutionality of the restrictions.

The unanimous decision came less than a month after oral arguments were heard in San Francisco over whether or not the regulations should have been blocked while a trial on its the constitutionality proceeds. The regulations, which were issued by the state Department of Health Services on January 27, under the authority of a law signed by Gov. Jan Brewer in April 2012­, restrict the use of medication abortions by requiring providers to follow outdated Food and Drug Administration (FDA) protocol. Advocates argue that, if enacted, the law could end altogether the availability of medication abortions in the state.

Shortly after the regulations were issued, the Center for Reproductive Rights and the Planned Parenthood Federation of America sued to block the new restrictions, but a lower court refused their request and ruled the restrictions could go into effect. Advocates immediately filed an appeal with the Ninth Circuit, which issued a temporary emergency injunction, blocking the lower court order and preventing the regulations from being implemented pending the appeal.

“We are pleased that the Ninth Circuit decided to protect the health and civil rights of Arizona women while this case proceeds to trial and emphasized that the state didn’t provide any evidence to back up their claims,” David Brown, attorney for the Center for Reproductive Rights, told Rewire in an interview following the decision. 

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The court noted several ways in which attorneys for the state failed to show the regulations have any connection to furthering patient health:

On the record before us, Arizona has presented no evidence whatsoever that the law furthers any interest in women’s health. … For example, the Arizona legislature cited the dangerousness of mifepristone in support of requiring the on-label regime, but the on-label regime requires three times more mifepristone than the evidence-based regime. … Arizona argues that the law prohibits not just safe evidence-based regimes for medication but also other, dangerous off-label regimens. But the record contains no evidence that any such dangerous regimen exists or has ever been used by any abortion provider. Therefore, on the current record, the Arizona law appears wholly “unnecessary as a matter of [women’s] health.”

The court also found the law is likely to impose an undue burden on women because it would deny some women the ability to have an abortion, force others to have a surgical procedure instead of a medication abortion, and force women in some parts of the state to make four visits, traveling anywhere between 300 miles to 700 miles each trip, to access a safe and legal medication abortion.

“Evidence in the record shows that women in Arizona will be burdened with a significant increase in the cost of medication, and that many women will be delayed in, or deterred from, seeking an abortion if the evidence-based regimen is foreclosed to them. The availability of on-label medication abortions during the first seven weeks of pregnancy, and of surgical abortions thereafter, does not preclude a finding of undue burden,” the court wrote.

“This decision is a victory for women’s health. This decision assures that Arizona women can access safe, legal abortion following the best, safest medical guidelines while our case challenging this dangerous and misguided law continues,” said Cecile Richards, president of the Planned Parenthood Federation of America, in a statement following the opinion.

In addition to the federal court action challenging Arizona’s medication abortion restrictions, the Center for Reproductive Rights (CRR) also filed a lawsuit in Arizona state court challenging the medication abortion restrictions under state law. According to Brown, the state court lawsuit focuses specifically on Arizona law and claims lawmakers violated the Arizona Constitution by unlawfully delegating their power to regulate mifepristone to the FDA and drug manufacturers. So far, attorneys for the State of Arizona have not responded to the merits of CRR’s state court claim but have instead asked a judge to stay the proceedings while the federal court case works toward resolution. Brown and CRR oppose that request, noting the federal case could take years to resolve and that the state claims could resolve the dispute entirely without having to reach any of the federal constitutional issues.

A trial date in the federal case has not yet been set, and attorneys for the state have the option of asking the Supreme Court to intervene. Meanwhile, the parties are awaiting a ruling on Arizona’s request to postpone the state court proceeding. Additionally, CRR has filed a motion for summary judgment asking the state court to rule on the merits of its claims. Attorneys for the State of Arizona have not yet responded to the summary judgment request.

News Health Systems

The Crackdown on L.A.’s Fake Clinics Is Working

Nicole Knight

"Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options," Feuer said. "And therefore every day is a day that a woman's health could be jeopardized."

Three Los Angeles area fake clinics, which were warned last month they were breaking a new state reproductive transparency law, are now in compliance, the city attorney announced Thursday.

Los Angeles City Attorney Mike Feuer said in a press briefing that two of the fake clinics, also known as crisis pregnancy centers, began complying with the law after his office issued notices of violation last month. But it wasn’t until this week, when Feuer’s office threatened court action against the third facility, that it agreed to display the reproductive health information that the law requires.

“Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options,” Feuer said. “And therefore every day is a day that a woman’s health could be jeopardized.”

The facilities, two unlicensed and one licensed fake clinic, are Harbor Pregnancy Help CenterLos Angeles Pregnancy Services, and Pregnancy Counseling Center.

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Feuer said the lawsuit could have carried fines of up to $2,500 each day the facility continued to break the law.

The Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care. Unlicensed centers must disclose that they are not medical facilities.

Feuer’s office in May launched a campaign to crack down on violators of the law. His action marked a sharp contrast to some jurisdictions, which are reportedly taking a wait-and-see approach as fake clinics’ challenges to the law wind through the courts.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before the U.S. Court of Appeals for the Ninth Circuit.

Some 25 fake clinics operate in Los Angeles County, according to a representative of NARAL Pro-Choice California, though firm numbers are hard to come by. Feuer initially issued notices to six Los Angeles area fake clinics in May. Following an investigation, his office warned three clinics last month that they’re breaking the law.

Those three clinics are now complying, Feuer told reporters Thursday. Feuer said his office is still determining whether another fake clinic, Avenues Pregnancy Clinic, is complying with the law.

Fake clinic owners and staffers have slammed the FACT Act, saying they’d rather shut down than refer clients to services they find “morally and ethically objectionable.”

“If you’re a pro-life organization, you’re offering free healthcare to women so the women have a choice other than abortion,” said Matt Bowman, senior counsel with Alliance Defending Freedom, which represents several Los Angeles fake clinics fighting the law in court.

Asked why the clinics have agreed to comply, Bowman reiterated an earlier statement, saying the FACT Act violates his clients’ free speech rights. Forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs,” Bowman said.

Reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, Googling “abortion clinic” might turn up results for a fake clinic that discourages abortion care.

“Put yourself in the position of a young woman who is going to one of these centers … and she comes into this center and she is less than fully informed … of what her choices are,” Feuer said Thursday. “In that state of mind, is she going to make the kind of choice that you’d want your loved one to make?

Rewire last month visited Lost Angeles area fake clinics that are abiding by the FACT Act. Claris Health in West Los Angeles includes the reproductive notice with patient intake forms, while Open Arms Pregnancy Center in the San Fernando Valley has posted the notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

Culture & Conversation Politics

Latino Votes Count or ‘Why Would They Be Trying to Suppress Them?’: Dolores Huerta on What’s at Stake in 2016

Ally Boguhn

“We know that we’ve had this problem that Latinos sometimes don’t vote—they feel intimidated, they feel like maybe their vote doesn’t matter,” Huerta told Rewire. Huerta encouraged people to consider both what is at stake and why their vote might be suppressed in the first place.

Republican nominee Donald Trump launched his campaign for president in June 2015 with a speech notoriously claiming Mexican immigrants to the United States “are bringing drugs, and bringing crime, and their rapists.”

Since then, both Trump’s campaign and the Republican Party at large have continued to rely upon anti-immigrant and anti-Latino rhetoric to drum up support. Take for example, this year’s Republican National Convention in Cleveland, where Sheriff Joe Arpaio—whose department came under fire earlier this year for racially profiling Latinos—was invited to take the stage to push Trump’s proposed 2,000-mile border wall. Arpaio told the Arizona Republic that Trump’s campaign had worked with the sheriff to finalize his speech.

This June, just a day shy of the anniversary of Trump’s entrance into the presidential race, People for the American Way and CASA in Action hosted an event highlighting what they deemed to be the presumptive Republican nominee’s “Year of Hate.”

Among the advocates speaking at the event was legendary civil rights leader Dolores Huerta, who worked alongside César Chávez in the farm workers’ movement. Speaking by phone the next day with Rewire, Huerta—who has endorsed Democratic nominee Hillary Clinton—detailed the importance of Latinos getting involved in the 2016 election, and what she sees as being at stake for the community.

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The Trump campaign is “promoting a culture of violence,” Huerta told Rewire, adding that it “is not just limited to the rallies,” which have sometimes ended in violent incidents, “but when he is attacking Mexicans, and gays, and women, and making fun of disabled people.”

Huerta didn’t just see this kind of rhetoric as harmful to Latinos. When asked about its effect on the country at large, she suggested it affected not only those who already held racist beliefs, but also people living in the communities of color those people may then target. “For those people who are already racist, it sort of reinforces their racism,” she said. “I think people have their own frustrations in their lives and they take it out on immigrants, they take it out on women. And I think that it really endangers so many people of color.”

The inflammatory rhetoric toward people of color by presidential candidates has led to “an alarming level of fear and anxiety among children of color and inflaming racial and ethnic tensions in the classroom,” according to an April report by the Southern Poverty Law Center (SPLC). The organization’s analysis of the impact of the 2016 presidential election on classrooms across the country found “an increase in bullying, harassment and intimidation of students whose races, religions or nationalities have been the verbal targets of candidates on the campaign trail.” Though the SPLC did not name Trump in its questions, its survey of about 2,000 K-12 educators elicited up more than 1,000 comments about the Republican nominee, compared to less than 200 comments mentioning other presidential candidates still in the race at that time.

But the 2016 election presents an opportunity for those affected by that violent rhetoric to make their voices heard, said Huerta. “The Latino vote is going to be the decisive vote in terms of who is going to be elected the president of the United States,” she continued, later noting that “we’ve actually seen a resurgence right now of Latinos registering to vote and Latinos becoming citizens.”

However, a desire to vote may not always be enough. Latinos, along with other marginalized groups, face many barriers when it comes to voting due to the onslaught of voter restrictions pushed by conservative lawmakers across the country—a problem only exacerbated by the Supreme Court’s 2013 ruling gutting portions of the Voting Rights Act (VRA) meant to safeguard against voter suppression efforts. The 2016 election season will be the first presidential election without those protections.

As many as 875,000 eligible Latino voters could face difficulty voting thanks to new restrictions—such as voter ID laws, proof of citizenship requirements, and shortened early voting periods—put into place since the 2012 elections, a May analysis from the National Association of Elected and Appointed Officials found.

When it comes to restrictions like this, Huerta “absolutely” saw how they could create barriers for those hoping to cast their ballot this year. “They’ve made all of these restrictions that keep especially the Latino population from voting. So it’s very scary,” said Huerta, pointing to laws in states like Texas, which previously had one of the strictest voter ID laws in the country. (The state has since agreed to weaken its law following a judge’s order).

“We know that we’ve had this problem that Latinos sometimes don’t vote—they feel intimidated, they feel like maybe their vote doesn’t matter,” Huerta went on.

Huerta encouraged people to consider both what is at stake and why their voting rights might be targeted in the first place. “What we have to think about is, if they’re doing so much to suppress the vote of the Latino and the African-American community, that means that that vote really counts. It really matters or else why would they be trying to suppress them?”

Appealing to those voters means tapping into the issues Latinos care about. “I think the issues [Latinos care about] are very, very clear,” said Huerta when asked how a presidential candidate could best appeal to the demographic. “I mean, immigration of course is one of the issues that we have, but then education is another one, and health care.”

A February survey conducted jointly by the Washington Post and Univision found that the top five issues Latino voters cared about in the 2016 election cycle were jobs and the economy (33 percent), immigration (17 percent), education (16 percent), health care (11 percent), and terrorism (9 percent).

Another election-year issue that could affect voters is the nomination of a U.S. Supreme Court justice, Huerta added. She pointed out the effect justices have on our society by using the now-decided Whole Woman’s Health v. Hellerstedt case as an example. “You know, again, when we think of the presidents, and we think of the Supreme Court and we know that [was] one of the issues that [was] pending in the Supreme Court … whether what they did in Texas … was constitutional or not with all of the restrictions they put on the health clinics,” she said.

Latinas disproportionately face large barriers to reproductive health care. According to Planned Parenthood, they “experience higher rates of reproductive cancers, unintended pregnancy, and sexually transmitted infections than most other groups of people.” Those barriers are only exacerbated by laws like Texas’ HB 2, as the National Latina Institute for Reproductive Health explained in its amicus brief in the Whole Woman’s Health case prior to the decision: “Texas Latinas already face significant geographic, transportation, infrastructure, and cost challenges in accessing health services.”

“H.B. 2’s impact is acute because of the day-to-day struggles many Latinas encounter when seeking to exercise their reproductive rights,” wrote the organization in its brief. “In Texas, there is a dire shortage of healthcare facilities and providers in predominantly Latino communities. Texas has the highest percentage of uninsured adults in the country, and Texas Latinos are more than twice as likely as whites to be uninsured …. Additionally, the lack of public and private transportation creates a major barrier to accessing health services, especially in rural areas.”

As Rewire’s Tina Vasquez has reported, for undocumented women, the struggle to access care can be even greater.

Given the threats cases like Whole Woman’s Health have posed to reproductive rights, Huerta noted that “Trump’s constant attacks and misogynist statements” should be taken with caution. Trump has repeatedly vowed to appoint anti-choice justices to the Supreme Court if elected.

“The things he says without even thinking about it … it shows what a dangerous individual he can be when it comes to women’s rights and women’s reproductive rights,” said Huerta.

Though the race for the White House was a top concern of Huerta’s, she concluded by noting that it is hardly the only election that matters this year. “I think the other thing is we have to really talk about is, the presidency is really important, but so is the Senate and the Congress,” said Huerta.

“We’ve got to make sure we get good people elected at every level, starting at school board level, city council, supervisors, commissioners, etc. state legislatures …. We’ve got to make sure reasonable people will be elected, and reasonable people are voted into office.”

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