Analysis Abortion

States Enact 51 Abortion Restrictions in First Half of 2015: Mid-Year Analysis

Elizabeth Nash & Rachel Benson Gold

Through the first six months of 2015, states enacted 51 new abortion restrictions; this brings the number of restrictions enacted since 2010 to 282.

Through the first six months of 2015, states enacted 51 new abortion restrictions; this brings the number of restrictions enacted since 2010 to 282. Although only about a dozen state legislations remained in session as of July 1, these states may well enact additional restrictions before the end of the year.

Following the recent pattern of increased restrictions in odd-numbered years (largely because not all legislatures are in session in even-numbered years), states have enacted more restrictions during the first half of this year than during all of last year (see chart). But nonetheless, the number of new restrictions this year is well below the 70 enacted in 2013, due in part to fewer restrictions being enacted in a handful of states—including Kansas, Oklahoma, and Arizona—that had adopted multiple restrictions between 2011 and 2014.

Abortion Restrictions

 

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Even as states continue to pass new abortion restrictions, the Supreme Court is poised to hear one, and maybe two, major abortion cases in the coming year. The Court might take a case challenging a 2013 Texas law that imposes targeted regulation of abortion providers (TRAP) requirements on abortion clinics in the state, including mandated admitting privileges for abortion providers at a local hospital. The U.S. Fifth Circuit Court of Appeals upheld a provision of the law in May. In June, the Supreme Court granted a request for an emergency stay, blocking enforcement of the provision. Abortion rights supporters are widely expected to file a full appeal to the Supreme Court in the coming months (see The State of Sexual and Reproductive Health and Rights in the State of Texas: A Cautionary Tale). In addition, the Court is weighing whether or not to hear a case in the fall centering on Mississippi’s law requiring abortion providers to have hospital admitting privileges.

Although states have adopted a wide range of restrictions so far this year, much of the attention has focused on four areas: waiting periods, abortions after the first trimester, medication abortion, and TRAP provisions. Even though most action on these issues follows recent trends, some states have charted new directions that may well serve as models for others going forward.

Waiting Periods

Three states moved this year to extend the length of their existing waiting periods, and two additional states adopted new waiting periods. Arkansas and Tennessee mandated a 48-hour wait between counseling and the abortion procedure. North Carolina and Oklahoma enacted measures requiring women to wait at least 72 hours, joining Missouri, South Dakota, and Utah, which also require women to wait at least three full days for an abortion (see Counseling and Waiting Periods for Abortion). A new Florida law, which would establish a 24-hour waiting period, has been challenged and it remains to be seen if enforcement of the law will be blocked during the court case.

Significantly, three of the five states—Arkansas, Tennessee, and Florida—to adopt waiting period requirements this year also require women to receive abortion counseling at the abortion facility, effectively necessitating two trips. Making multiple trips exacts a high toll on women, many of whom have to travel, often at considerable expense, to obtain the care they need (see A Surge of State Abortion Restrictions Puts Providers—and the Women They Serve—in the Crosshairs). Although Florida’s new “two-trip” requirement went into effect on July 1, opponents have asked that it be blocked as the legal proceedings continue; a decision on that request could happen at any time. All in all, 14 states require women to make two trips to obtain an abortion (see map).

 

Two Trips to Abortions

Abortions After the First Trimester

Since 2010, 14 states have adopted measures banning abortion at about 20 weeks post-fertilization (about 22 weeks after the woman’s last menstrual period) and 11 of these states have laws in effect. This includes a new law in West Virginia, which was enacted when the legislature overrode Democratic Gov. Earl Ray Tomblin’s veto (see State Policies on Later Abortions).

For the first time, two states, Kansas and Oklahoma, enacted measures that could ban abortion as early as 14 weeks of pregnancy. These new laws use nonmedical, vague, and inflammatory language to try to ban abortion procedures commonly used in the second trimester. The Kansas law was challenged in early June on the grounds that it violates the state’s constitution by infringing on a woman’s ability to access a safe abortion method and dictating medical practice; the law is not in effect pending resolution of the challenge. Similar measures are likely to be proposed in other states.

Medication Abortion

Including three that enacted measures this year to limit access to medication abortion, 19 states now restrict this commonly used first-trimester abortion method (see Medication Abortion).

  • Banning telemedicine. Although telemedicine is increasingly used to expand access to health care in underserved areas, states have moved aggressively in recent years to ban its use for medication abortion. This year, Arkansas and Idaho adopted new restrictions, joining 16 other states in barring this use of telemedicine. In mid-June, the Iowa State Supreme Court struck down a regulation banning the use of telemedicine for medication abortion, saying that no evidence supported the imposition of such an undue burden on women; the regulation had not been in effect pending the court decision.
  • Requiring FDA protocol. Arkansas enacted a measure requiring use of the outdated protocol, approved in 2000, that appears on the FDA label for mifepristone. The newer evidence-based regimen uses less medication, involves fewer side effects and visits to the provider, and is less expensive; this new regimen is routinely used and is widely recognized as the standard of care for performing medication abortion. Including Arkansas, four states nonetheless require the use of the outdated FDA protocol.
  • Counseling on reversing medication abortion. Arizona and Arkansas adopted a new type of medication abortion restriction: Under these laws, abortion providers are required to inform women that it is possible to stop a medication abortion by giving the woman a large dose of hormones after the mifepristone has been administered, but before the woman takes the misoprostol. However, very little evidence indicates that this works to stop the abortion procedure or that it does not entail medical risks. The Arizona law has been challenged in federal court and is not being enforced.

Targeted Regulation of Abortion Providers (TRAP)

Four states enacted measures that impose restrictions on abortion providers beyond what is necessary to ensure patients’ safety. Typically, these laws take two approaches: establishing physical facility and staffing standards, and requiring abortion providers to have a formal relationship with a hospital (see TRAP Laws Gain Political Traction While Abortion Clinics—and the Women They Serve—Pay the Price). Including the new measures enacted this year, 25 states have some form of TRAP law (see Targeted Regulation of Abortion Providers).

  • Admitting privileges. Five states require providers of either medication or surgical abortion services to have admitting privileges at a local hospital. Another ten require the provider to have either admitting privileges or another type of relationship with a hospital (such as an agreement with a physician who has privileges). This year, Arkansas adopted a new restriction that requires only medication abortion providers to have an agreement with a physician who has admitting privileges; the law does not include a parallel requirement for surgical abortion providers. Arkansas is the only state to have such a requirement. Continuing its longstanding effort to require abortion providers to have a relationship with a hospital, the state adopted a new law that requires proof of such a relationship as a condition of obtaining a license to operate in the state.
  • Physical plant standards. Legislation adopted by Tennessee in May would require surgical abortion facilities to meet all the requirements for licensure as an ambulatory surgical center; implementation of the law is blocked pending resolution of a legal challenge. Twenty-two states impose standards on abortion providers that are comparable to those for ambulatory surgical centers.
  • Disposal of fetal remains. Arkansas and Indiana now require abortion providers to either incinerate or bury fetal remains.

Editor’s note: Gwen Rathbun and Yana Vierboom also contributed to this analysis.

News Politics

Missouri ‘Witch Hunt Hearings’ Modeled on Anti-Choice Congressional Crusade

Christine Grimaldi

Missouri state Rep. Stacey Newman (D) said the Missouri General Assembly's "witch hunt hearings" were "closely modeled" on those in the U.S. Congress. Specifically, she drew parallels between Republicans' special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life.

Congressional Republicans are responsible for perpetuating widely discredited and often inflammatory allegations about fetal tissue and abortion care practices for a year and counting. Their actions may have charted the course for at least one Republican-controlled state legislature to advance an anti-choice agenda based on a fabricated market in aborted “baby body parts.”

“They say that a lot in Missouri,” state Rep. Stacey Newman (D) told Rewire in an interview at the Democratic National Convention last month.

Newman is a longtime abortion rights advocate who proposed legislation that would subject firearms purchases to the same types of restrictions, including mandatory waiting periods, as abortion care. Her district includes the University of Missouri, which ended a 26-year relationship with Planned Parenthood as anti-choice state lawmakers ramped up their inquiries in the legislature.

Newman said the Missouri General Assembly’s “witch hunt hearings” were “closely modeled” on those in the U.S. Congress. Specifically, she drew parallels between Republicans’ special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life. Both formed last year in response to videos from the anti-choice front group the Center for Medical Progress (CMP) accusing Planned Parenthood of profiting from fetal tissue donations. Both released reports last month condemning the reproductive health-care provider even though Missouri’s attorney general, among officials in 13 states to date, and three congressional investigations all previously found no evidence of wrongdoing.

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Missouri state Sen. Kurt Schaefer (R), the chair of the committee, and his colleagues alleged that the report potentially contradicted the attorney general’s findings. Schaefer’s refusal to confront evidence to the contrary aligned with how Newman described his leadership of the committee.

“It was based on what was going on in Congress, but then Kurt Schaefer took it a step further,” Newman said.

As Schaefer waged an ultimately unsuccessful campaign in the Missouri Republican attorney general primary, the once moderate Republican “felt he needed to jump on the extreme [anti-choice] bandwagon,” she said.

Schaefer in April sought to punish the head of Planned Parenthood’s St. Louis affiliate with fines and jail time for protecting patient documents he had subpoenaed. The state senate suspended contempt proceedings against Mary Kogut, the CEO of Planned Parenthood of St. Louis Region and Southwest Missouri, reaching an agreement before the end of the month, according to news reports.

Newman speculated that Schaefer’s threats thwarted an omnibus abortion bill (HB 1953, SB 644) from proceeding before the end of the 2016 legislative session in May, despite Republican majorities in the Missouri house and senate.

“I think it was part of the compromise that they came up with Planned Parenthood, when they realized their backs [were] against the wall, because she was not, obviously, going to illegally turn over medical records.” Newman said of her Republican colleagues.

Republicans on the select panel in Washington have frequently made similar complaints, and threats, in their pursuit of subpoenas.

Rep. Marsha Blackburn (R-TN), the chair of the select panel, in May pledged “to pursue all means necessary” to obtain documents from the tissue procurement company targeted in the CMP videos. In June, she told a conservative crowd at the faith-based Road to Majority conference that she planned to start contempt of Congress proceedings after little cooperation from “middle men” and their suppliers—“big abortion.” By July, Blackburn seemingly walked back that pledge in front of reporters at a press conference where she unveiled the select panel’s interim report.

The investigations share another common denominator: a lack of transparency about how much money they have cost taxpayers.

“The excuse that’s come back from leadership, both [in the] House and the Senate, is that not everybody has turned in their expense reports,” Newman said. Republicans have used “every stalling tactic” to rebuff inquiries from her and reporters in the state, she said.

Congressional Republicans with varying degrees of oversight over the select panel—Blackburn, House Speaker Paul Ryan (WI), and House Energy and Commerce Committee Chair Fred Upton (MI)—all declined to answer Rewire’s funding questions. Rewire confirmed with a high-ranking GOP aide that Republicans budgeted $1.2 million for the investigation through the end of the year.

Blackburn is expected to resume the panel’s activities after Congress returns from recess in early September. Schaeffer and his fellow Republicans on the committee indicated in their report that an investigation could continue in the 2017 legislative session, which begins in January.

Roundups Politics

Campaign Week in Review: Tim Kaine Outlines Plan to ‘Make Housing Fair’

Ally Boguhn

“A house is more than just a place to sleep. It's part of the foundation on which a family can build a life,” wrote Sen. Tim Kaine (D-VA). “Where you live determines the jobs you can find, the schools your children can attend, the air you breathe and the opportunities you have. And when you are blocked from living where you want, it cuts to the core of who you are.”

Donald Trump made some controversial changes to his campaign staff this week, and Sen. Tim Kaine (D-VA) noted his commitment to better housing policies.

Trump Hires Controversial Conservative Media Figure

Republican presidential nominee Trump made two notable additions to his campaign staff this week, hiring Breitbart News’ Stephen Bannon as CEO and GOP pollster Kellyanne Conway as campaign manager.

“I have known Steve and Kellyanne both for many years. They are extremely capable, highly qualified people who love to win and know how to win,” said Trump in a Wednesday statement announcing the hires. “I believe we’re adding some of the best talents in politics, with the experience and expertise needed to defeat Hillary Clinton in November and continue to share my message and vision to Make America Great Again.”

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Both have been criticized as being divisive figures.

Conway, for example, previously advised then-client Todd Akin to wait out the backlash after his notorious “legitimate rape” comments, comparing the controversy to “the Waco with David Koresh situation where they’re trying to smoke him out with the SWAT teams.” According to the Southern Poverty Law Center (SPLC), Conway is also “often cited by anti-immigrant and anti-Muslim organizations such as the think tank Center for Security Policy and NumbersUSA.”

Under Bannon’s leadership, “mainstream conservative website” Breitbart.com changed “into a cesspool of the alt-right,” suggested the publication’s former editor at large, Ben Shapiro, in a piece for the Washington Post‘s PostEverything. “It’s a movement shot through with racism and anti-Semitism.”

Speaking with ABC News this week, Kurt Bardella, who also previously worked with Bannon at Breitbart, alleged that Bannon had exhibited “nationalism and hatred for immigrants, people coming into this country to try to get a better life for themselves” during editorial calls.

“If anyone sat there and listened to that call, you’d think that you were attending a white supremacist rally,” said Bardella.

Trump’s new hire drew heated criticism from the Clinton campaign in a Wednesday press call. “The Breitbart organization has been known to defend white supremacists,” said Robby Mook, Clinton’s campaign manager. After pointing to an analysis from the SPLC linking Breitbart to the extremist alt-right movement, Mook listed a number of other controversial positions pushed by the site.

“Breitbart has compared the work of Planned Parenthood to the Holocaust. They’ve also repeatedly used anti-LGBT slurs in their coverage. And finally, like Trump himself, Breitbart and Bannon have frequently trafficked in all sorts of deranged conspiracy theories from touting that President Obama was not born in America to claiming that the Obama Administration was ‘importing more hating Muslims.’”

“It’s clear that [Trump’s] divisive, erratic, and dangerous rhetoric simply represents who he really is,” continued Mook.

Kaine Outlines Plan to “Make Housing Fair”

Clinton’s vice presidential nominee Kaine wrote an essay for CNN late last week explaining how the Clinton-Kaine ticket can “make housing fair” in the United States.

“A house is more than just a place to sleep. It’s part of the foundation on which a family can build a life,” wrote Kaine. “Where you live determines the jobs you can find, the schools your children can attend, the air you breathe and the opportunities you have. And when you are blocked from living where you want, it cuts to the core of who you are.”

Kaine shared the story of Lorraine, a young Black woman who had experienced housing discrimination, whom Kaine had represented pro bono just after completing law school.

“This is one issue that shows the essential role government can play in creating a fairer society. Sen. Ed Brooke, an African-American Republican from Massachusetts, and Sen. Walter Mondale, a white Democrat from Minnesota, came together to draft the Fair Housing Act, which protects people from discrimination in the housing market,” noted Kaine, pointing to the 1968 law.

“Today, more action is still needed. That’s why Hillary Clinton and I have a bold, progressive plan to fight housing inequities across Americaespecially in communities that have been left out or left behind,” Kaine continued.

The Virginia senator outlined some of the key related components of Clinton’s “Breaking Every Barrier Agenda,” including an initiative to offer $10,000 in down payment assistance to new homebuyers that earn less than the median income in a given area, and plans to “bolster resources to enforce Fair Housing laws and fight housing discrimination in all its forms.”

The need for fair and affordable housing is a pressing issue for people throughout the country.

“It is estimated that each year more than four million acts of [housing] discrimination occur in the rental market alone,” found a 2015 analysis by the National Fair Housing Alliance.

No county in the United States has enough affordable housing to accommodate the needs of those with low incomes, according to a 2015 report released by the Urban Institute. “Since 2000, rents have risen while the number of renters who need low-priced housing has increased,” explained the report. “Nationwide, only 28 adequate and affordable units are available for every 100 renter households with incomes at or below 30 percent of the area median income.”

What Else We’re Reading

CBS News’ Will Rahn penned a primer explaining Trump campaign CEO Bannon’s relationship to the alt-right.

White supremacists and the alt-right “rejoice[d]” after Trump hired Bannon, reported Betsy Woodruff and Gideon Resnick for the Daily Beast.

Clinton published an essay in Teen Vogue this week encouraging young people to fight for what they care about, learn from those with whom they disagree, and get out the vote.

“In calling for ‘extreme vetting’ of foreigners entering the United States, Republican presidential nominee Donald Trump suggested a return to a 1950s-era immigration standard—since abandoned—that barred entry to people based on their political beliefs,” explained USA Today.

Trump wants to cut a visa program “his own companies have used … to bring in hundreds of foreign workers, including fashion models for his modeling agency who need exhibit no special skills,” according to a report by the New York Times.

A Koch-backed group “has unleashed an aggressive campaign to kill a ballot measure in South Dakota that would require Koch-affiliated groups and others like them to reveal their donors’ identities.”

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