This Week in Sex: Does Game-Changing HIV Prevention Regimen Reduce Condom Use?

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Aussie Study: Condom Use Goes Down When PrEP Use Increases

Pre-exposure prophylaxis (PrEP) has changed the meaning of safe sex—at least as it relates to HIV risk.

Taken by people who are HIV negative but considered at high risk for infection (such as gay men with multiple partners), this pill-a-day regimen is 90 percent effective if taken correctly. While this is excellent news in the fight against the HIV pandemic, public health experts have worried that it will cut down on condom use and therefore make users more susceptible to other sexually transmitted infections (STIs). Now, a new study published in the Lancet shows there may be reason for these concerns.

Between 2013 and 2017, researchers at the University of New South Wales in Sydney, Australia, surveyed almost 17,000 men who said they had recently had casual sex with a male partner. The percentage of HIV-negative men who were taking PrEP rose steadily from 2 percent when the study began to 24 percent at the end. And HIV did, in fact, decline in the region.

At the same time, however, the percentage of men who said they used condoms consistently fell from 46 percent to 31 percent. And this change in behavior seemed to affect men who were not taking PrEP as well; sex without a condom increased 9 percent among this group.

Martin Holt, the lead researcher on the study, told the New York Times, “It’s great that these guys are feeling optimistic about avoiding HIV, but it has disrupted prevention methods at the community level.” The fear is that with lower condom rates, HIV rates will drop but the rates of other STIs—such as chlamydia, gonorrhea, herpes, and syphilis—will go up. While these STIs are often thought of as less serious than HIV, there are long-term health consequences associated with each of them.

This study did not measure rates of STIs in New South Wales, but rates of these infections are rising in various U.S. populations, including men who have sex with men and infants infected congenitally. Dr. Paul Volberding, the director of the AIDS Research Institute at the University of California, San Francisco, asked rhetorically, “Does this mean that pushing PrEP is a bad thing? Of course not. It is preventing HIV which is what it was designed to do. But the challenges posed are no minor issue, and we need to take them seriously.”

HIV can be prevented through use of PrEP, and vaccines can prevent Hepatitis B and human papillomavirus (HPV), the virus that causes genital warts and cervical cancer. But other than abstinence, condoms remain the only form of prevention against our most common STIs.

Japanese Condom Maker Already Preparing for the 2020 Tokyo Olympics

Many records were set at the Olympic Games in Pyeongchang, South Korea, earlier this year. but we here at This Week in Sex only care about one—the unprecedented 110,000 free condoms distributed to athletes. The tradition of distributing condoms to athletes might not date back to the original Greek Games, but it has been a staple of Olympic villages in recent years. And at least some condom companies have been getting ready for the 2020 Tokyo games for longer than some of the athletes who will compete.

“When Tokyo was selected to host the 2020 Olympics, condom distribution at the athlete village immediately came to our minds,” Hiroshi Yamashita, senior manager and spokesperson at Japanese condom maker Sagami Rubber Industries, told French news agency AFP. “The company worked hard to get the 0.01mm products to market well before the Tokyo Olympics.”

Yamashita is referring to the company’s thinnest condom, which is made out of polyurethane, and was introduced in 2013. Rival manufacturer Okamoto Industries introduced one of the same thickness in 2015. Tomonori Hayashi, a marketing manager for Okamoto, explained, “Condoms are an effective means to help people protect themselves from contracting sexually transmitted diseases, and the thinner they are, the more men tend to use them.”

In general, polyurethane condoms are thinner than the more popular latex condoms and conduct heat better. Those qualities make sex with this type of condom feel more like, well, sex without a condom, while still providing STI and pregnancy prevention. But there’s a downside: Polyurethane condoms are not as stretchy as their latex peers and can break more easily. And because they are newer, there is less research about how well they prevent STIs.

Japanese condom companies are not known global household names like industry giants Trojan and Durex, and condom sales in the country have slowed down since 2000 as the country’s population ages and other contraceptive methods have become more available.

Both companies see the Olympics as an international marketing opportunity. Yamashita told AFP: “We see [the Tokyo Games] as an extremely precious opportunity to let the world know about Japan’s high-technology.”

Luckily for them, figure skater and condom connoisseur/critic Adam Rippon—who told his Instagram followers that the condoms handed out in Pyeongchang were “generic“—won’t be competing in the summer games in Tokyo.

Sex Can Kill You, If You’re an Antechinus

Two species of marsupials, the black-tailed and silver-headed antechinus, were just discovered in Australia in 2013. A few years later, the tiny mouse-like creatures may be on the verge of extinction due to the male’s biological reaction to sex.

During their two-week mating periods, the males try to have sex with as many females as possible while also fending off potential rivals for female attention. They have marathon sex sessions, sometimes lasting as long as 14 hours. These epic sex binges leave the male exhausted, but that’s not what ultimately kills him. The excessive production of testosterone required for all this screwing and sparring causes the body to keep producing a stress hormone that actually destroys their organs.

Andrew Baker, a mammalogist at Queensland University of Technology, compared the dying males to zombies: “They’re honestly like the walking dead towards the end,” he said. “I’ve seen them stumbling around during the day—they are nocturnal mostly—still looking for mates, bleeding from various parts of their body and their hair has fallen out.”

Females live for two years, during which time they have between six and 14 babies. Males only live for about a year.

All of this makes us thankful we’re humans. There’s no such thing as too much sex, and it rarely kills us (except in bad movies where the cheating man dies on top of his mistress). On the plus side, antechinuses sure do make the most of their short lives.

Gavel Drop: Another Woefully Unqualified Judge on His Way to the Federal Bench

Welcome to Gavel Drop, our roundup of legal news, headlines, and head-shaking moments in the courts.

More in “Trump is bad news for the federal judiciary”: At age 37 and with only one year on the bench, Oklahoma Supreme Court Justice Patrick Wyrick is about to become the youngest federal judge confirmed under the Trump administration. He’s white and conservative, which should come as no surprise. What may come as a surprise is that before Scott Pruitt joined the Environmental Protection Agency and blew all our minds with rank corruption, he was Oklahoma’s attorney general and blew Oklahomans’ minds with rank corruption. And guess who his protégé was? If you guessed Patrick Wyrick, give yourself a high five.

Lisa Belkin of Yahoo News writes that the Eighth Circuit Court of Appeals has become a favorite among abortion foes in the states that sit in the Eighth Circuit—Arkansas, Iowa, Minnesota, Missouri, Nebraska, and the Dakotas. Anti-abortion politicians and lobbyists have been introducing abortion restrictions in those states in the hopes that the Eighth Circuit will uphold them—because it is one of the most conservative courts of appeal in the country, especially when it comes to abortion rights—thus provoking a challenge to Roe v. Wade and giving the Supreme Court an opening to reverse the 45-year-old decision.

Demand Justice, a liberal nonprofit founded by Capitol Hill alums, is going on the offensive: Since Republicans have been blocking the appointments of progressive judges such as U.S. Supreme Court nominee Merrick Garland, this Democrat-heavy group is rolling out a digital ad campaign targeting Trump’s Supreme Court shortlist.

In the case of Robert Lewis Dear Jr., the Planned Parenthood shooter who admitted to killing three people in Colorado Springs, the Colorado Supreme Court has upheld two lower court rulings that the state mental institution where Dear is housed can forcibly medicate him in an effort to restore his mental competency so that he can stand trial.

New court documents in a pending criminal case in Kentucky have filled in some details about the September 2017 yard dispute that landed Sen. Rand Paul (R-KY) in the hospital with broken ribs and injured lungs. Paul was reportedly dumping yard debris near a neighbor’s property and said neighbor tackled Paul. Good fences make good neighbors?

New York’s attorney general has filed a lawsuit against the Trump Foundation alleging campaign finance violations and other problems related to the foundation’s dealings with the Trump campaign. If convicted, President Trump won’t be able to pardon his way out of it because he can only pardon federal crimes, not state crimes.

In Minnesota Voters Alliance v. Mansky, the U.S. Supreme Court struck down a Minnesota law barring voters from wearing political apparel at the ballot box. John Roberts, writing for the majority, said that the definition of political apparel was too broad and that the enforcement guidance provided to poll workers was haphazard, rendering the statute unconstitutional.

Crystal Mason, the Texas woman who was sentenced to five years in prison for voter fraud, will not get a new trial.  Mason says she didn’t know that her felony conviction for tax fraud barred her from voting.

A new restriction on medication abortion in Missouri will remain in effect pending the resolution of a lawsuit that will determine whether the restriction is lawful. The regulation requires clinics to adopt a “complication plan” under which the clinic contracts with two OB-GYNs who have admitting privileges at a local hospital and agree to be on call 24/7 in case a complication arises in connection with medication abortion services. Judge Beth Phillips denied Planned Parenthood’s request for an injunction, which means Planned Parenthood clinics in in Columbia and Springfield, Missouri, will not be able to offer medication abortion until the lawsuit is resolved one way or the other.

Virginia GOP Senate Candidate Got Campaign Help From Hate Group in 2017

Virginia Republican U.S. Senate candidate Corey Stewart accepted assistance in his failed 2017 gubernatorial campaign from members of the League of the South, a white supremacist group that has a paramilitary unit. 

A campaign finance report indicates that an in-kind contribution of $474.71 was received on April 12, 2017 from George Randall. The report does not explain what that in-kind contribution consisted of, but George Randall and his brother Gregory Randall frequently attended Stewart’s events around Virginia and appeared to act in a role consistent with providing a personal security detail for Stewart.

In a 2015 Facebook post, Gregory Randall indicated he was a member of the League of the South. George Randall was seen and photographed at the deadly Unite the Right white supremacist rally in Charlottesville, Virginia, in August 2017 wearing an a League of the South patch and standing among members of the League of the South. George Randall received an award signed by Michael Hill, the head of the League of the South, while he was assisting Stewart’s campaign.

George Randall’s wife, Donna Randall, received a $50 payment on April 19, 2017, from the Stewart campaign for work described in the report as “fieldwork consulting.” Stewart’s reports frequently describe paid work by various staffers using the same term.

All three Randalls appeared at many Stewart events, including a visit to Charlottesville in which Stewart conducted a joint press conference with Jason Kessler, a virulently anti-Semitic white supremacist who later organized the Unite the Right rally.

Gregory and George Randall were frequently seen within arm’s reach of Stewart, often with a hand on his shoulder as he moved through a crowd. George and Donna Randall’s son, David Randall, posted a racist screed on Facebook in which he wrote, “i would shoot a nigger deadfor chasing after my daughter no matter how mannerfull he might be… [sic].”

Stewart, a longtime chairman of the Prince William Board of County Supervisors who is challenging Sen. Tim Kaine (D-VA) in November’s midterms, fashions himself as a neo-confederate. He said Paul Nehlen, a congressional candidate from Wisconsin who describes himself as “pro-white,” is “one of my personal heroes,” the Washington Post reports. Stewart later tried to distance himself from Kessler and Nehlen, according to the New York Times

Stewart has seemingly earned the endorsement of President Trump, who declared on Twitter that voters shouldn’t “underestimate” Stewart and that the GOP candidate has “a major chance of winning” in November. Stewart, like Trump, equivocated in his condemnation of white supremacist violence at the Charlottesville hate rally. 

The League of the South advocates for secession of Southern states from the United States and the formation of a white supremacist government. The organization began in 1994 as a group primarily of southern college professors who celebrated southern history while officially rejecting racism. Their leaders became more radical and many original members denounced the direction the group was taking. League of the South formed a paramilitary unit in 2014, according to the Southern Poverty Law Center. 

League of the South has appeared at joint rallies with other hate groups, including the National Socialist Movement, a neo-Nazi party.

Justice Roberts Lands Another Blow in the Fight Against Voters

On Thursday, the U.S. Supreme Court handed down a decision in Minnesota Voters Alliance v. ManskyThe Minnesota Voters Alliance’s ostensible goal in bringing the lawsuit was to be able to wear political apparel at the polls, but the case is really about using that political apparel to intimidate voters.

The split 7-2 decision strikes down a century-old Minnesota law prohibiting the wearing of political apparel to the polls. It’s a disappointing, but not unexpected, victory for the conservative group at the heart of the case, Minnesota Voters Alliance (MVA). It’s also yet another decision from Chief Justice John Roberts that has the net effect of making it harder to vote.

The case came about when MVA Executive Director Andrew Cilek deliberately wore two items while casting his vote in 2010 in Minnesota—a “Don’t Tread On Me” t-shirt and a button that said “Please ID Me”—and was subsequently turned away. Both of these items were designed to provoke people. The former is inextricably associated with the conservative Tea Party and the latter was seemingly designed to sow confusion in a state that doesn’t have voter ID requirements. They were also both designed to provoke a lawsuit: MVA had already tried to have Minnesota enjoined from enforcing its ban on political apparel for the 2010 election and been denied.

Roberts’ opinion explains this in the most cursory terms, noting only that Cilek wore the two items of clothing. He gives no context to the meaning of that clothing, and he takes at face value MVA’s assertion that it is simply a non-profit that “seeks better government through election reforms.” In reality, MVA is a voter suppression group. They’re deeply committed to restricting the franchise of voting and creating barriers for people of color, people with low incomes, re-enfranchised ex-felons, and people whose living situation is in flux.

Unfortunately for MVA, their members live in Minnesota, a state that is known for fiercely protecting the right to vote. In 2012, MVA sued the state to try to limit its same-day voting registration system, but lost that lawsuit. Same-day voting registration improves turnout, and, in fact, Minnesota consistently has the highest voter turnout in the nation. Same-day voting registration also allows people to update their registration as late as Election Day, which is key for individuals who have transient living situations and relocate during election season.

In 2016, MVA brought another lawsuit to try to make voting harder for people who had been convicted of a felony but had their voting rights restored.

Minnesota’s citizens have made clear they don’t endorse the views of groups like MVA by resoundingly rejected a ballot initiative for a voter ID constitutional amendment back in 2012.

Roberts ignored all of this in his opinion in favor of an oddly misplaced discussion of the history of voting in the United States, noting that it used to be much more chaotic, with groups forming to harass people they perceived to be voting for the other side. Over time, all 50 states passed laws to restrict that sort of behavior, and back in 1992, the Supreme Court upheld a Tennessee law that barred the display or distribution of campaign materials within 100 feet of the entrance of a polling place. Because of that decision, any state with a similar restriction should not run afoul of the law.

Minnesota’s law is somewhat broader than Tennessee’s. It bars the wearing of a “political badge, political button, or other political insignia” at or near the polling place on Election Day. Though Roberts agreed that it was permissible for Minnesota to decide that the interior of a polling place should be an “island of calm” where voters can contemplate their voting choices in an undisturbed fashion, he found that Minnesota’s law went too far and barred too much speech. The Court said that, by interpreting the ban to cover issue-oriented material designed to affect voting, Minnesota state officials could end up stopping people from wearing any number of things. For example, the Court said, someone wearing an ACLU shirt, Chamber of Commerce apparel, or even Boy Scout gear, could be prohibited if any of those groups had taken a position on something during the election.

It’s likely true that Minnesota’s voting law could be better written and more narrowly tailored. In fact, in striking down the law, that’s what the Supreme Court is really supposed to do: provide guidance on how the law could be made better. Alternatively, it could just tell Minnesota that it can’t ever have a law that prohibits anything other than actual campaign slogans, insignias, and candidate names. However, the Court here tried to thread a needle and failed.

The opinion praises the more narrowly-written laws of other states, such as California—which prohibits the display of information advocating for or against any candidate or measure—or Texas—which prohibits wearing anything related to a candidate, measure, or political party appearing on the ballot. However, neither of those actually get at Minnesota’s concern: stopping groups like MVA from sowing discord and confusion at the polling place. Cilek’s display of the “Please ID Me” button was specifically designed to imply, particularly to new or infrequent voters, that Minnesota had a voter ID requirement and that they would be asked for their ID as well. Or Cilek was staking out a political position: Minnesota should have voter ID. 

The Court tries to address this, dropping in a small footnote to say that Minnesota can prohibit messages that are intended to mislead voters about voting requirements or procedures. Some have praised this as a victory, reaffirming that states could indeed bar misleading messages at the polls. However, the rest of the opinion chastises Minnesota for giving too much discretion to its election judges to decide what sort of message is appropriate or inappropriate. It’s unclear how those same judges are not properly equipped to decide if a message is political but are properly equipped to decide if something is designed to mislead voters.

Roberts’ decision also ignores the real goal of groups like MVA: to simply cause enough disruption, confusion, and fear that voters leave the polls. Imagine being an immigrant, newly enfranchised to vote in the 2018 elections after seeing immigrants routinely harassed, arrested, and deported, and seeing an “Immigrants Go Home” shirt at the voting booth. Imagine being a new resident to Minnesota and seeing a “Please ID Me” button and accidentally believing such a thing is required.

MVA’s goal wasn’t to wear political apparel as such; it was to use political apparel to intimidate voters.   

Perhaps the most wrong-headed part of this decision is that there was a much easier—and fairer—way to resolve this, as Justice Sonia Sotomayor’s dissent points out. Usually, when a state statute is challenged in this fashion, the Supreme Court can decline to decide the matter. Instead, they certify, or refer, the case to that state’s supreme court so that the state can provide a definitive interpretation of the statute. That’s because the U.S. Supreme Court has held that state courts should have a reasonable opportunity to construe a state statute.

The dissent notes that federal courts such as the U.S. Supreme Court should always be hesitant to speculate about how to construe a state law if the state court is ready and able to address the construction of that law. The majority opinion dismissed this idea, saying that the case had dragged on for seven years and no request for a referral certification action to the state court had been brought, but Justice Sotomayor’s dissent properly notes that there is no time limit on requesting or receiving certification. By deciding as it did, the Court overstepped and instructed Minnesota on how to interpret its own state law, rather than properly allowing the state to do so.

Worst of all, Minnesota itself has no way to fix this statute prior to the 2018 midterm elections, as Minnesota’s legislature isn’t in session again until January 2019. The law banning political apparel was struck down, but nothing replaces it at this time. Groups like MVA will be free to wear whatever they want to the polls, as long as it doesn’t refer to a specific candidate.

At its root, this decision is yet another instance of Justice Roberts’ utter dismissal of the importance of voting. Even as a young attorney in the U.S. Department of Justice’s Civil Rights Division, he suggested a very narrow interpretation of the Voting Rights Act (VRA). In the early 1980s, as parts of the VRA were about to expire, there was a dispute between Democrats and Republicans about how to extend the act. Democrats favored an interpretation where evidence of the effects of discrimination was sufficient to prove discrimination, where Republicans like Roberts favored a narrower interpretation that required intent. In other words, Roberts’ view would allow a state to engage in a widespread act of discrimination against Black voters as long as there was no obvious statement of intent to discriminate. It was the reading favored by people like Strom Thurmond and think tanks like the Heritage Foundation.

In 2013, he authored the majority opinion in Shelby v. Holder, which functionally killed a key part of the VRA—the provision that required Southern states with a history of discrimination to get federal approval, known as “preclearance,” before changing their election laws. That preclearance review ensured that marginalized communities, including Black, Latino, Asian, Native American, and Alaskan Native voters were protected from discrimination because potentially harmful voting changes were blocked from going into effect. Almost immediately after the decision in Shelby, Southern states began to do things like close early voting locations and move primaries to earlier months, moves which would have needed preclearance prior to the decision. Roberts thinks data on partisan gerrymandering is “sociological gobbledygook.” And of course, he enthusiastically joined the Citizens United decision, which paved the way for letting big money influence elections to the point of incoherence.

Things like the VRA, keeping dark money out of politics, rejecting voter ID laws, and respecting the integrity and sanctity of the polling place are designed to protect all voters. And frankly, the voters that most need protection are people of color and people otherwise marginalized by the political process, such as people with low incomes and re-enfranchised people with a felony conviction.

Justice Roberts is no friend to people of color or people on the margins, and has made clear that he thinks white people and people with money are the ones that should direct elections and vote in elections. This decision is yet another step in executing that vision.

There’s No Evidence That Abortion Is Dangerous. This Study Proves It.

Cases of women visiting emergency rooms for complications related to abortion care are extremely rare, and the rate of major medical complications resulting from abortion are almost nonexistent, according to a new study.

The authors of the study, published on Thursday in the journal BMC Medicine, concluded that regulation of abortion care is unlikely to have any impact on pregnant people’s health outcomes, and that “perceptions that abortion is unsafe are not based on evidence.”

The study is the latest piece of mounting evidence that demonstrates that abortion is a safe and well-regulated procedure. This flies in the face of evidence-free claims from abortion rights foes that the common medical procedure is dangerous, requiring stringent regulations. 

Researchers analyzed data from nearly 190 million emergency rooms visits by women of reproductive age between 2009 and 2013, and found that about 0.01 percent were related to abortion.

Ushma Upadhyay, associate professor at the University of California, San Francisco (UCSF) and lead author of the study, said in a statement that lawmakers in several states have used alleged safety concerns to justify the passage of laws creating burdensome regulations for abortion providers.

“However, this research directly combats the presumption that abortion is unsafe, and therefore, laws implemented or being considered for safety reasons are not actually founded in science,” Upadhyay said. “Lawmakers should reference these data when drafting policy in the future, relying on science rather than misconceptions to protect women’s health.”

Lawmakers in states across the United States over the past decade have passed hundreds of laws restricting access to abortion care with policies that are not based on scientific evidence, and often written by anti-choice legislative mills.

A study published in May concluded there’s no evidence people who receive abortion care are at higher risk of developing suicidal ideation than those who were unable to obtain abortion services. A study published in 2014 found that “major complications” after legal abortion care are extremely rare, and that legal abortion care has a “very low complication rate.”

Alyson McGregor, director for the Division of Sex and Gender in Emergency Medicine at Brown University’s Alpert Medical School Department of Emergency Medicine and co-author of the study, said it’s not unusual for patients to seek follow-up care in an emergency room. They’re typically sent home with no need for further care.

“Nothing about that practice suggests any need for increased or particular regulation of abortion, especially given all the data demonstrating its safety,” McGregor said in a statement.

The study was conducted by researchers at Advancing New Standards in Reproductive Health at UCSF, and Brown University’s Alpert Medical School, Department of Emergency Medicine.

Legislative Lowlights: Backroom Dealing Gives Pennsylvania Anti-Choice Measure a Boost

Rewire.News tracks anti-choice and anti-LGBTQ legislation as it works its way through the states. Here’s an overview of bills we’re watching.

Sneaky backroom maneuvering advanced a Down syndrome abortion ban in Pennsylvania, Republican lawmakers in Michigan found a new way to attack vaccines and fetal tissue research, and lawmakers in Delaware seem to think pregnant people can’t make informed decisions when it comes to abortion unless they see and hear from the fetus first.

Pennsylvania

The state senate Judiciary Committee on Wednesday advanced HB 2050, a bill that would ban abortion care solely due to a prenatal diagnosis of, or belief that the fetus has, Down syndrome. The legislation passed the house in April by a 139-56 vote.

The bill, which had languished in committee, was revived this week after its sponsor, state house Speaker Mike Turzai (R-Allegheny)attached his proposal to a human-trafficking bill sponsored by state senate Judiciary Committee Chair Stewart J. Greenleaf (R-Montgomery). The amendment threatened to derail the human-trafficking bill, which appeared on track to pass and be signed by Gov. Tom Wolf (D). Once Greenleaf pushed forward Turzai’s bill from committee, Turzai removed his amendment from Greenleaf’s human-trafficking bill. Regardless of the backroom politics, even if the senate votes to pass the abortion ban, it most likely won’t become law. The governor is expected to veto the measure, and a similar law in Ohio was recently ruled unconstitutional.

Michigan

State senate Republicans last week introduced legislation requiring so-called informed consent for vaccinations containing aborted fetal tissue. When providing vaccines, health-care providers would be required to notify patients if the immunizing agent is derived from aborted fetal tissue, and if available, offer an alternative vaccine which is not derived from aborted fetal tissue.

The bill, SB 1055, defines “immunizing agent derived from aborted fetal tissue” to mean:

An immunizing agent that is manufactured using a human fetal or embryonic cell line, protein, deoxyribonucleic acid, recombinant deoxyribonucleic acid, monoclonal antibody, or any other component derived from an elective abortion or using a cell line derived from the tissue of a fetus that was electively aborted.

Right to Life of Michigan, an anti-choice organization and proponent of the bill, maintains its own list of vaccines it describes as “abortion-tainted.” The vaccines in question were legally derived from human fetal lung cell lines in the 1960s. This bill is the latest attempt by anti-choice forces to co-opt anti-vaccination tactics in order to attack fetal tissue research.

Delaware

Over the weekend, state senate Republicans introduced the “Women’s Ultrasound Right to Know Act” (SB 240). The bill would require a physician to offer a patient ultrasound imaging and the opportunity to listen to a fetal heart tone before terminating a pregnancy, except in the case of an emergency. A physician who fails to offer these services would be guilty of a class A misdemeanor and be subject to civil malpractice and professional disciplinary action. The pregnant person would not be required to actually view the ultrasound or listen to the heartbeat. The bill is based on copycat legislation drafted by Americans United for Life (AUL), an anti-choice legislation mill. The bill was assigned to the state senate Sunset Committee and is awaiting consideration.

The state senate Health Committee on Wednesday held a hearing to consider SB 205, a bill banning abortion at 20 weeks. In yet another example of copycat legislation, this time drafted by the National Right to Life Committee, the bill uses junk science to claim a fetus is capable of feeling pain at 20 weeks (it isn’t). Not only are 20-week abortion bans based on false information, they’re also unconstitutional, so it’s a good thing the bill failed to advance out of committee.

Looking Ahead…

Several states will wrap up their legislative sessions by the end of the month. Delaware, New Hampshire, North Carolina, Rhode Island, and South Carolina are all expected to conclude their regular or special legislative sessions by July 1. In addition to Delaware’s ultrasound bill, another bill to keep an eye on is South Carolina’s budget bill.

While South Carolina’s regular legislative session ended in early May, at least two special sessions were scheduled: one at the end of May and one at the end of June. As Rewire.News mentioned last month, the budget bill contains a provision that would allow child-placement agencies to refuse to provide services that conflict with a “sincerely-held religious belief or moral conviction.” If the budget bill passes with the provision still in place, South Carolina would become the tenth state to allow child-placement agencies to discriminate against same-sex couples or LGBTQ individuals looking to adopt.

Anti-Choice Lawmakers Use Federal Budget Bills to Launch All-Out Assault on Reproductive Rights

A series of House Appropriations Committee bills at various stages of approval include anti-choice provisions seeking to restrict access to reproductive health care and contraception both domestically and across the globe.

Most critically, the House Appropriations subcommittee for Labor, Health and Human Services, and Education released its draft of the agencies’ budgets for fiscal year 2019, which begins Oct. 1. The bill includes provisions that would cut all Title X family planning and Teen Pregnancy Prevention Program funding from the 2019 budget. The bill passed through subcommittee markup Friday morning, however, committee Democrats have labeled the anti-choice provisions “riders” and “poison pills” and promised to introduce amendments during full committee markups to drop them from the version of the bill that would be sent to the House floor.

Congress decides how to fund the government through twelve separate appropriations bills from both the House and Senate, which are eventually rolled into a budget bill requiring approval from each chamber of the U.S. Congress. The House and Senate budget differences are then reconciled before forming a single bill which must be approved by each chamber. The House and Senate each have their own appropriations committees, and each of those are divided into 12 subcommittees which work together to create a draft of the bill. From there, the drafts get sent to full committee for markups, when members of the full appropriations committee have a chance to offer amendments and make changes before voting on whether to send the bill for a vote in the full chamber.

“To add insult to injury, there are an abundance of poison pills in this bill. Yet again, the majority is trying to block funding for the Affordable Care Act. They also want to eliminate and block funding for family planning, teen pregnancy prevention, and abortion coverage,” said Rep. Rosa DeLauro (D-CT) in a statement regarding the bill. “[W]e should not be playing ideological games with people’s health.”

On Wednesday evening, the full House Appropriations Committee approved the fiscal year 2019 Financial Services and General Government Appropriations Bill, which includes a ban on abortion coverage by multi-state Affordable Care Act (ACA) insurance plans as well as a ban on abortion coverage in insurance plans for federal employees. The bill also renews a policy banning the District of Columbia from using its own tax dollars to cover abortion care for Medicaid recipients.

The Financial Services and General Government Appropriations bill now heads to the full House for debate and a possible vote.

Rep. Nita Lowey (D-NY) introduced an amendment during markups yesterday which would have struck section 631 of the financial services appropriations bill, the aforementioned multi-state ACA abortion care coverage ban. “Section 631 is designed to make it more difficult for a woman to purchase the health insurance she wants with the ultimate goal of restricting a woman’s ability to access a safe and legal medical procedure,” said Rep. Lowey in her remarks introducing the amendment in committee. “As we all know, current law already prohibits federal funds from being used to pay for abortion services,” she said, referring to the Hyde Amendment.

Rep. Lowey went on to explain that the ACA already restricts access to coverage for abortion care and includes a provision that at least one multi-state plan to not provide coverage for such services. “Those provisions [in the ACA] were written by anti-choice legislators [and] are apparently not enough for those who are laser focused on denying safe, legal, and even private health services to women,” she said. Rep. Lowey’s amendment ultimately failed in a committee vote, 21-31.

Later on Wednesday, Rep. Barbara Lee (D-CA) introduced an amendment to lift a bill rider that restricts how D.C. administers its Medicaid coverage for abortion care. In remarks introducing her amendment, Rep. Lee pointed out what she suggested was GOP hypocrisy on the issue. “No other jurisdiction or state is told how to use its own locally raised revenue, yet this committee is preparing to once again vote to force Congress’ view on the District of Columbia,” she said.

Rep. Lee went on to explain that people who seek an abortion and are denied are more likely to fall into poverty. For all but two years since 1989, Congress also has restricted the District’s ability to use its own locally raised revenue for abortion services. Rep. Tom Graves (R-GA), chairperson of the Financial Services and General Government subcommittee which wrote the initial draft of the bill, noted that Rep. Lee puts forward this amendment every year while voicing his opposition.

“Federal politicians have no place interfering in women’s reproductive health decisions. Policies like these are crafted to deny women the right to make decisions over their own lives, and often drive low-income women and women of color into poverty” said Rep. Lee in a statement to Rewire.News. “I’ll keep fighting against these ideological riders in the Appropriations Committee.”

Dana Singiser, vice president of public policy and government affairs at Planned Parenthood Federation of America, addressed both bill riders in a statement. “Every woman deserves access to basic health care, including abortion, no matter where she lives or how much money she makes,” said Singiser. “Our elected representatives should focus on expanding access to reproductive health care, not taking it away.”

Rep. Lee’s amendment to strike the DC rider from the bill was defeated in committee vote.

A separate draft-measure including anti-choice provisions in the FY 2019 State and Foreign Operations Appropriations Bill, which funds the State Department and foreign aid, was released by the House State and Foreign Operations Appropriations subcommittee. The bill would significantly cut global funding of contraceptive and reproductive care by including President’s Trump’s “Protecting Life in Global Health Assistance” policy prohibiting all global health assistance to foreign nongovernmental organizations that promote or perform abortions, commonly known as the global gag rule—a move that upset pro-choice Democrats on the House Appropriations Committee.

“In 2018, I find it hard to believe we are still arguing over the importance of international family planning and reproductive health programs,” Rep. Lowey said in a statement, before promising to introduce an amendment during full committee to exclude the cuts. “But the mark would slash investments in bilateral family planning, codify the global gag rule and its expansion into all global health, and prohibit U.S. contributions to [the United Nations Population Fund]. These policies would hurt vulnerable women and severely decrease the efficiency of U.S. aid programs.”

These Numbers Show Why Florida Democrats Are Running on Medicaid Expansion

Years of Republican refusal to expand Medicaid access in Florida hasn’t diminished the electorate’s appetite for making the health-care program more widely available, and the state’s Democratic candidates seem to have gotten the message.

Florida Democrats this week launched a Medicaid expansion tour as they try to loosen the GOP’s grip on both chambers of the state legislature and the governor’s office. The tour highlights the benefits of expanding Medicaid under the Affordable Care Act (ACA), or Obamacare, which would add almost a million people to Medicaid rolls in Florida. Expansion of Medicaid would drop Florida’s uninsured rate from 15.7 percent to 11.1 percent, according to the Robert Wood Johnson Foundation and the Urban Institute.

Recent data seems to validate Democrats’ focus on Medicaid expansion in the run-up to November’s elections: The policy has majority support in every one of the state’s congressional and state legislative districts, according to Data for Progress, a left-leaning think tank using data science to analyze political issues. Expansion likely enjoys high levels of support among people of color, women, and those with low incomes. Even 53 percent of white males support the move.

Expanding access to Medicaid has higher approval in Florida than Gov. Rick Scott (R), Sen. Marco Rubio (R), and Sen. Bill Nelson (D), who is being challenged by Scott for his Senate seat, according to analysis released in May by Data for Progress. The datacould not produce a single legislator at any level of government in Florida who is personally more popular than Medicaid expansion.” 

Though Florida Democrats’ Medicaid expansion tour is new—starting Tuesday in Gainesville—the push to join 31 other states in expanding Medicaid started in 2017. Florida Democratic legislators in December filed resolutions that would amend the state constitution to expand the health-care program. State Sen. Annette Taddeo (D-Miami-Dade) pushed for Medicaid expansion and won a special election last year that flipped a GOP seat. 

Thirty-nine percent of respondents to a St. Leo Polling Institute survey strongly agreed with expanding Medicaid, which would make the program available to those making 138 percent of the poverty line. Twenty-nine percent somewhat supported expansion, while 11 percent somewhat opposed it and 17 percent strongly opposed the policy.

The Data for Progress analysis shows that support for expanding Medicaid reaches more than 70 percent in traditionally Democratic districts. Support for expansion ranges from the mid-50s and low-60s in Republican districts.

“States that have expanded Medicaid have seen their health care outcomes rise to the top,” state senate candidate Kayser Enneking said Tuesday at the Democrats’ Medicaid expansion tour stop, Florida Politics reported. “The argument that we can’t afford to expand Medicaid is a false argument.”

In 2018, the federal government will pay for 94 percent of the cost of expansion, while the state pays the remainder. That federal “matching rate” will ratchet down to 90 percent by 2020, but never go below that. State-level GOP legislators across the United States are turning down at least $32 billion from the federal government by not expanding Medicaid under Obamacare.

Virginia Democrats, with the help of a few GOP lawmakers, pushed through Medicaid expansion this month after making outsized gains in the November 2017 election. Many of those freshman Virginia Democratic lawmakers campaigned on Medicaid expansion and other measures that would make health care more accessible. Around 400,000 people in Virginia will benefit from expansion.

“Democrats in search of a policy agenda that works for all Americans need look no further than making our most popular and successful anti-poverty measures available to all,” John Ray, senior adviser at Data for Progress, said in a statement.

Florida lawmakers in 2015 came close to expanding Medicaid access. Statehouse GOP leaders halted the legislative session that year after the state senate had approved funds that would have made expansion possible. Scott then filed a lawsuit against the Obama administration, alleging it tried to coerce the state into expanding Medicaid access.

Scott, a former hospital executive whose company paid more than $840 million in fines for defrauding Medicaid and Medicare, has deemed Floridians losing access to health care a “federal problem.” He’s has gone back and forth on whether he backs Medicaid expansion. 

Texas GOP’s Raft of Anti-Choice Laws Gets Sweeping Legal Challenge

A coalition of reproductive rights advocates on Thursday announced a lawsuit challenging Texas laws that restrict access to abortion care by interfering with the doctor-patient relationship, targeting abortion providers, and stigmatizing those seeking abortion care.

The Republican-controlled state legislature over the past decade has passed anti-choice laws that have forced more than half of the state’s abortion clinics to close. The lawsuit was filed in federal court on behalf of Whole Woman’s Health Alliance, the Afiya Center, Fund Texas Choice, Lilith Fund, North Texas Equal Access Fund, West Fund, and Dr. Bhavik Kumar.

Amy Hagstrom Miller, president of Whole Woman’s Health Alliance, said in a statement that the lawsuit is part of a strategy to build upon the success of the U.S. Supreme Court’s decision in Whole Woman’s Health v. Hellerstedt, which found major parts of Texas’ omnibus abortion law, HB 2, unconstitutional.

“We went all the way to the Supreme Court in 2016 to defeat harmful abortion restrictions and we are not done fighting so that every Texan can get the health care they need and deserve,” Hagstrom Miller said. “All Texans, no matter who they are, where they live, or how much they earn, should be able to make the health care decisions that are best for them and get the care they need with dignity.”

The lawsuit identified five categories of laws being challenged, including targeted regulation of abortion provider (TRAP) laws, restrictions on medication abortion and telemedicine abortion; requirements that patients receive state-mandated forced counseling; parental involvement requirements that restrict minors’ access to abortion services; and laws that criminalize abortion providers.

Nan Little Kirkpatrick, executive director of the Texas Equal Access Fund, said in a statement that these laws create a burdensome regulatory regime for providers and uncertainty for people seeking abortion care.

“The group of laws being challenged may seem on the surface to be a hodgepodge of random requirements, but together they weave a huge barrier to abortion access for thousands of people in Texas, especially low-income people, people of color, and people in our vast rural areas,” Kirkpatrick said.

Marginalized communities in Texas have been disproportionately impacted by laws restricting access to abortion, and the effects have been the most pronounced in rural communities, low-income communities, and communities of color.

“Black women’s reproductive choices have historically been under attack and we stand here today on our historical experiences for the right to choose,” Marsha Jones, executive director of the Afiya Center, said in a statement. “We have always resisted, and we will continue to resist these antiquated laws that the state of Texas is attempting to move forward to control our reproductive destinies.”