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Wednesday, September 25, 2024

AMERIKA
A college student lost her pregnancy. 
Then she was charged with homicide

Kelly Rissman
Wed 25 September 2024 at 1:46 pm GMT-6·5-min read


Demonstrators rally in support of abortion rights at the US Supreme Court (AFP via Getty Images)


A South Carolina State University junior suffered a pregnancy loss — then two months later, she was charged with homicide.

Amari Marsh, 23, is now speaking out about the harrowing ordeal, which her lawyers have argued was a devastating health emergency that had no business getting tied up in the court system. Her case serves as yet another example of how pregnancy is at risk of being criminalized in the wake of the Supreme Court’s reversal of Roe v. Wade — which protected the right to an abortion — in 2022.

“I couldn’t breathe,” Marsh told KFF Health News, recalling how in 2023, still in her second trimester, she suddenly gave birth in the middle of the night in her off-campus apartment. She said she screamed and cried as blood spilled across the bathroom floor, but she never could’ve imaged the loss would result in murder charges.


Just two months before the premature birth, Marsh had gone to Planned Parenthood in Columbia, South Carolina — where abortion has been banned after about 22 weeks — to “take the Plan-C pill which would possibly cause an abortion to occur,” according to an incident report obtained by the outlet. It doesn’t detail whether she actually took the pill. The report also notes that Marsh was advised to return to the clinic for a follow-up, which she never did.

But Marsh claimed to the outlet that she never went to Planned Parenthood and never took a pill to induce abortion.

“I’ve never been in trouble. I’ve never been pulled over. I’ve never been arrested,” she said. “I never even got written up in school.”

A month later, on February 28, the college junior went to the hospital after experiencing abdominal pains, and was informed she was pregnant and that a heartbeat had been detected. Marsh felt the “energy was off,” according to the report, and returned home. In the wee hours of the next morning, she gave birth in her toilet. “I screamed because I was scared, because I didn’t know what was going on,” she told the outlet.

Her then-boyfriend called 911, and the emergency dispatcher on the line “kept telling me to take the baby out” of the toilet, Marsh said. But she refused to do that: “I couldn’t because I couldn’t even keep myself together.”

Marsh’s ordeal is a “prime example of how pregnancy loss can become a criminal investigation very quickly,” said Dana Sussman, senior vice president of nonprofit Pregnancy Justice (Copyright 2024 The Associated Press. All rights reserved.)

As Marsh was transported to Regional Medical Center in Orangeburg, first responders retrieved the baby from the toilet and tried to perform life saving measures, which were ultimately unsuccessful.

While at the hospital, after Marsh was told that her baby hadn’t survived, a sheriff’s office deputy in her hospital room informed her that she was being investigated “due to the nature of the incident,” but that she was “currently not in any trouble,” the report states. Marsh insisted that she “did not feel as though she did anything wrong.”

Weeks later, in mid-May, an officer informed Marsh via text that he needed to meet with her in person “before I can close the case out. I am so sorry,” KFF Health News reported.

The meeting took place on May 2, 2023. It ended in her arrest, records show. She was charged with homicide by child abuse — which can result in a sentence of 20 years to life behind bars.

But a sentencing won’t happen. This August, more than a year after she was arrested, a grand jury declined to indict her.

The arrest warrant, obtained by KFF Health News, claims that refusing to move the baby from the toilet was “a proximate cause of her daughter’s death.”

Marsh’s attorneys believe her case belongs nowhere near the court system.

“This is not a criminal matter,” Zipporah Sumpter, one of Marsh’s lawyers, told the outlet. She accused authorities of treating the college student as a criminal rather than a grieving mother.

South Carolina Democratic state Rep Seth Rose, who is also one of Marsh’s attorneys, called it a “really tragic” case. He told the outlet: “It’s our position that she lost a child through natural causes.”

Marsh’s ordeal is a “prime example of how pregnancy loss can become a criminal investigation very quickly,” Dana Sussman, senior vice president of nonprofit Pregnancy Justice, told the outlet.

“The Dobbs decision unleashed and empowered prosecutors to look at pregnant people as a suspect class and at pregnancy loss as a suspicious event,” Sussman said.

In Ohio, Brittany Watts was criminally charged with abuse of a corpse after law enforcement found the remains of a fetus stuck in her toilet in September 2023; she had been repeatedly denied medical care to treat her miscarriage due to doctors’ uncertainty over whether she could legally abort the fetus. A grand jury ultimately declined to indict her.

Marsh told KFF Health News she is still processing the harrowing series of events, and keeps daughter’s ashes on a bookshelf in her bedroom. She’s taking classes at a local community college and hopes to soon re-enroll at South Carolina State University. She aspires to become a doctor.

“Through all of this, I found my strength. I found my voice. I want to help other young women that are in my position now and will be in the future,” Marsh told the outlet. “I always had faith that God was going to be on my side, but I didn’t know how it was going to go with the justice system we have today.



Alaska Governor Signs Bill to Establish MMIP Commission


By Elyse Wild 
NATIVE NEWS ONLINE
 September 11, 2024

Alaska Governor Mike Dunleavy signed legislation last week to address the state's Missing and Murdered Indigenous Persons (MMIP) crisis.

Senate Bill 151 will establish a nine-member commission tasked with reviewing unsolved MMIP cases and making policy, practice, and service recommendations to the state legislature and the Department of Public Safety.

The commission will seat representatives from victim advocacy groups and Alaska Native Tribal organizations, police departments, village public safety departments, two members from the legislature, and a prosecutor with experience in homicide cases.

The commission meetings will be closed to the public.

The MMIP crisis is prevalent across the country, with Indigenous peoples being murdered at a rate up to ten times the national average. Homicide is one of the leading causes of death for Native women. While the Bureau of Indian Affairs estimates there are 4,200 unsolved MMIP cases, the actual number is likely higher, Native advocates say.

Advocates and lawmakers have identified multiple drivers of the MMIP crisis:Egregiously underfunded tribal law enforcement
Jurisdictional confusion between tribal, local, state police and the BIA
Exclusion of Indigenous people in data
Underwhelming media coverage

According to the National Missing Persons Database (NamUS), in 2021, Alaska topped the list of states with the most unsolved missing person cases among American Indian and Alaska Native cases at 292.

SB 151 was first introduced last May and received support from various Alaska Native groups.

In January 2024, a letter from the Alaska Native Women's Resources Center suggested the bill include language to: "create a review of the commission and reports before sunsetting these two programs to ensure that there has been an adequate amount of time to address all the needs, ideas and solutions. 2) include mandatory cultural training provided by an Indigenous organization, tribe or contractor for all law enforcement."

The bill also requires the Alaska Department of Public Safety (DPS) to file a missing persons report to the National Missing and Unidentified Persons System within 60 days of a report being filed at the local level. DPS will also employ at least two full-time MMIP investigators.

Along with the Alaska Native Women's Resources Center, the bill was supported by Planned Parenthood Alliance Advocates and the Fairbanks Native Association.

The law will take effect on January 1, 2025.

Friday, September 13, 2024

The global gag rule and women’s abortion rights


“Supporters of women’s equality understand that equal participation in the public sphere, and for women living our lives as full human beings, involves the right for women to choose if, and when, to become mothers.”

By Liz Lawrence

In the context of the forthcoming US Presidential election, in which Republican and Democratic parties take very different positions on abortion rights and in which the Democratic presidential contestant, Kamala Harris, is taking a clear pro-choice stance.

Why birth control is essential for women’s liberation

Decades of feminist campaigning in many countries have led to a widespread understanding among feminists, socialists and labour movement activists that access to birth control is essential for women’s liberation. Many trade unions now have pro-choice policies. Debates around access to birth control, both contraception and abortion, often contain debates about the position of women in society. For conservatives who seek to restrict reproductive rights women should primarily be wives and mothers, living in a traditional patriarchal family, with other activities, such as education, employment and participation in public life, secondary to the maternal role.

Supporters of women’s equality understand that equal participation in the public sphere, and for women living our lives as full human beings, involves the right for women to choose if, and when, to become mothers. A human being cannot participate equally in education, employment, politics or any other sphere, if life might be disrupted at any moment by unplanned pregnancy, and if their participation in the public sphere is always subject to the assumption that they might leave any position they occupy at any moment on account of pregnancy and motherhood. This stigma of potential maternity was used for generations to deny women equal opportunities in the workplace.

There are questions of bodily autonomy and access to health care involved. For the anti-abortionists the woman’s body is the property of anyone other than the woman, whether it be her parents, husband or the state. Birth control is healthcare. Without access to birth control many women suffer health damage and risk to life from repeated pregnancies and childbirth.

Why birth control is essential for women’s liberation

The global gag rule is a United States Government ban on foreign NGOs which provide abortion services (including abortion advice) from receiving any US Government funding. It is also known as the Mexico City policy, because this was the venue where it was announced by the US Government at the United Nations International Conference on Population and Development.

This ban also affects NGOs which advocate for abortion law reform such as the decriminalisation of abortion. Even if any abortion-related activities are funded by the NGO from other sources, it still loses all US Government funding. The global gag rule originally ended $600 million in money for family planning services.  International Planned Parenthood lost 20% of its funding. Thus, healthcare organisations were faced with a choice of either losing funding or restricting the services they provided.

The global gag rule was first introduced in 1985 by President Ronald Reagan. Since then, each successive US administration has decided either to maintain or lift the gag. This has made funding for abortion-related healthcare services a party-political issue in the USA and a matter of increasingly sharp political division. In some countries such matters can be seen as healthcare issues where there is a bipartisan or multi-party consensus, which is based on respect for the right of women to choose and on medical and scientific evidence. In the USA a change of President can almost immediately mean either the lifting or the re-imposition of the global gag rule, with Democratic Presidents Clinton, Obama and Biden all lifting the gag.

In January 2017 President Trump expanded the global gag rule to cover more health areas. It had originally applied to NGOs in the family planning field, but it was extended to all international healthcare assistance and affected nearly $9 billion in healthcare funding. It thus affected areas like HIV education.

The global gag rule restricted the ability of healthcare workers to counsel clients properly and offer a full range of options or to campaign on healthcare issues. It had a chilling effect on health education and advocacy, similar to section 28 or other attempts by governments to limit sex education and advice by sexual health services. It can thus also be seen as a freedom of speech issue.

The health impact of the global gag

Maternal mortality worldwide is unacceptably high. About 287 000 women died during and following pregnancy and childbirth in 2020.  Almost 95% of maternal deaths occurred in low and lower middle-income countries in 2020, and most could have been prevented by access to better healthcare.

Women in low-income countries have a higher lifetime risk of maternal death. A woman’s lifetime risk of maternal death is the probability that a 15-year-old woman will eventually die from a maternal cause. In high income countries, this is 1 in 5300, versus 1 in 49 in low-income countries.

For many women in the world today pregnancy is a life-threatening condition, as it was centuries ago world-wide. This means women go through pregnancy knowing it could lead to their death or permanent injury to health. This takes a toll on both physical and mental health.

Cutting funding for family planning services leads to more unplanned pregnancies, and may increase the abortion rate. Bans on abortion do not stop abortion; they just increase the likelihood that the procedure occurs under unsafe conditions, with higher rates of mortality and morbidity. The World Health Organisation estimates that 45% of abortions are unsafe.

The global gag has also impacted health education and health advocacy, including HIV/AIDS education and support for marginal and vulnerable groups, including workers in the sex industry. When funding for healthcare is cut, it is often the poorest and most vulnerable who are most affected.

How the abortion issue has been politicised

“My name is Ann Richards. I am pro-choice and I vote.” This is what Ann Richards, Democratic Governor of Texas said at the Democratic National Convention in 1992. This is a good example of how women and pro-choice activists can be galvanised by this issue, as is happening now with the Kamala Harris campaign for the US Presidency.

The Republican Party has made alliances with the Christian evangelical right, treating abortion as a key political dividing issue. Ultra-conservatives often pick an issue or two, whether abortion, homosexuality, transgender rights or sex education in schools as a focus for campaigning and as a test of political acceptability.

Right-wing Christian evangelicals and other religious fundamentalists subscribe to a theology in which salvation is linked with conformity to narrowly-defined, traditional gender roles, in which sex is only for reproduction and in which foetal life is given equal or higher status than the life of the pregnant person. Hence the woman who declines motherhood or the person who lives in a same-sex relationship or seeks to change gender cannot be accepted. This is a quest for Gilead, the dystopian society portrayed by Margaret Atwood in “The Handmaid’s Tale”.

Some Republican politicians are Christian nationalists; that is to say, they want to remove the separation of religion and the state, which was one of the major achievements of the American Revolution and to establish some version of a theocratic state. It can be hard for reasonable and liberal-minded people to appreciate just how reactionary all of this is.

Donald Trump and JD Vance use misogyny to mobilise a section of the electorate and to attack their opponents. It may fire up their base, but it will also turn off many American voters. Vance is mentioned often for his notorious remark that the US was governed by ‘childless cat ladies’ and the implication that only parents have a right to an opinion or a vote. Such views are off the wall and have sparked many amusing ripostes. Nonetheless they should not be ignored because they express both a serious level of misogyny and contempt for single people.

What happens in the US presidential election has significant implications for women’s lives and for reproductive rights and healthcare provision world-wide.


  • Liz Lawrence is a former President of University and College Union (UCU).
  • This article was originally published by Anti*Capitalist Resistance on 24th August 2024.
  • The Labour Outlook Editorial Team may not always agree with all of the content we reproduce but are committed to giving left voices a platform to develop, debate, discuss and occasionally disagree.

Monday, September 09, 2024

EXPOSE
Inside conservative activist Leonard Leo’s long campaign to gut Planned Parenthood

Rachana Pradham, KFF Health News
September 8, 2024 

Federalist Society

LONG READ

A federal lawsuit in Texas against Planned Parenthood has a web of ties to conservative activist Leonard Leo, whose decades-long effort to steer the U.S. court system to the right overturned Roe vs. Wade, yielding the biggest rollback of reproductive health access in half a century.

Brought by an anonymous whistleblower and later joined by Texas Attorney General Ken Paxton, the suit alleges the Planned Parenthood Federation of America and three Planned Parenthood affiliates defrauded the Texas and Louisiana Medicaid programs by collecting $17 million for services provided while it fought state efforts to remove it as an approved provider.

The suit claims violations of the False Claims Act, an obscure but powerful law protecting the government from fraud, and seeks $1.8 billion in penalties from Planned Parenthood, according to a motion that lawyers for the whistleblower filed in federal court in 2023.

The lawsuit builds on efforts over years by the religious right and politicians who oppose abortion to deliver blows to Planned Parenthood — which provides sexual and reproductive health care at nearly 600 sites nationwide — now bolstered by Leo’s work reshaping the American judiciary.

Anti-abortion groups and their allies secured a generational victory in 2022 when the Supreme Court overturned Roe vs. Wade, which ended the constitutional right to abortion and paved the way for bans or severe restrictions in 20 states. The court challenge in Texas demonstrates how the forces behind the end of Roe threaten access to other health and family planning services.

The Planned Parenthood clinics being sued do not provide abortions. They are in Texas and Louisiana, which banned nearly all abortions, respectively, in 2021 and 2022.

Leo, an anti-abortion Catholic, is connected to the key players in the Texas lawsuit — the whistleblower plaintiff, an attorney general, and the judge — according to a KFF Health News review of tax records, court documents from multiple lawsuits, statements to lawmakers, and website archives.

Leo provided legal counsel to the anti-abortion group at its center, and he has financial and other connections to Paxton.

They filed the case in federal court in Amarillo, Texas, where Matthew Kacsmaryk is the only judge. He is a longtime member of the Federalist Society, the conservative legal juggernaut for which Leo has worked for over 25 years in various capacities and currently serves as co-chair.

Kacsmaryk’s rulings have curtailed access to reproductive health since the Senate confirmed him in 2019. He suspended the FDA’s approval of mifepristone, a drug used in medication abortion, propelling the issue to the Supreme Court, which ultimately threw out the case. In another case, Kacsmaryk ruled to limit young people’s access to birth control through a federal family planning program.

Leo did not respond to questions for this article and a spokesperson declined to comment. Through a court spokesperson, Kacsmaryk declined to comment for this article.

The anonymous whistleblower in 2021 accused the Planned Parenthood Federation of America and Planned Parenthood affiliates of defrauding the Medicaid programs of Texas and Louisiana. Paxton, who has repeatedly acted to thwart abortion rights and joined the case in 2022, alleges in the lawsuit that clinics received payments they weren’t entitled to from Texas Medicaid from early 2017 to early 2021 as the state was pushing to end Planned Parenthood’s status as a Medicaid provider. Louisiana and the Department of Justice have not joined the complaint.

The lawsuit’s origins go back a decade. The anonymous whistleblower, between 2013 and 2015, “conducted an undercover investigation to determine whether Planned Parenthood’s fetal tissue procurement practices were continuing, and if they were legal and/or ethical,” according to the whistleblower’s complaint filed in 2021.

The explanation mimics how the Center for Medical Progress, a California-based anti-abortion group founded by activist David Daleiden in 2013, has publicly described its work. “The Human Capital project is a 30-month-long investigative journalism study by The Center for Medical Progress, documenting how Planned Parenthood sells the body parts of aborted babies,” the group states on its website.

In a November 2022 court order, Kacsmaryk said the private party initiating the lawsuit is “the president of CMP,” the title Daleiden held at that time, according to a Center for Medical Progress tax filing.

The Center for Medical Progress and Daleiden did not respond to requests for comment.

By law, federal funds can’t pay for abortions unless the pregnancy threatens the life of a woman or is the result of rape or incest, but the program reimburses for other care such as contraception, screenings for sexually transmitted infections, and cancer screenings. Medicaid, which provides health coverage for people with low incomes, is jointly financed by states and the federal government.

According to its 2022-23 annual report, Planned Parenthood affiliate clinics provided 9.13 million health care services to 2.05 million patients nationally in 2022. Testing and treatment for sexually transmitted infections accounted for about half of those services, contraception amounted to a quarter, and abortions constituted 4%.


Planned Parenthood Gulf Coast, which operates clinics in Texas and Louisiana, is among the branches Paxton and the whistleblower are suing. From July 2022 to June 2023, its clinics provided patients more than 86,000 tests for sexually transmitted infections, 44,000 visits for birth control, and nearly 7,000 cancer screening and prevention services, CEO Melaney Linton told KFF Health News.

“All of these services and more are at risk in this politically motivated lawsuit,” Linton said. The lawsuit’s allegations “are false. Planned Parenthood did not commit Medicaid fraud.”

Linton has said the lawsuit’s purpose is clear: “trying to shut Planned Parenthood down.”

Texas terminated Planned Parenthood’s Medicaid participation in March 2021. Until then, affiliates “were entitled to receive reimbursement” for services to Medicaid patients because their provider agreements with Texas’ Medicaid program were valid, attorneys for the Planned Parenthood clinics wrote in a February 2023 court filing in support of their motion for summary judgment.

Louisiana has not removed Planned Parenthood from its Medicaid program.

Leo served as legal counsel to the Center for Medical Progress, according to documents produced as part of a separate lawsuit Planned Parenthood filed in federal court in California against the anti-abortion group. Among those, a July 2018 document lists 25 emails Leo and Daleiden traded in June and July 2015, including in the days before the anti-abortion group released its first video.


Paxton’s ties to Leo can be traced back at least a decade to when the former state senator and rising conservative star was about to begin his first term as attorney general.

In 2014, Leo, then executive vice president of the Federalist Society, was a rare non-Texan named to Paxton’s attorney general transition advisory team. Tax filings show that the Concord Fund, one of several Leo-linked groups that spend money to influence elections and aren’t required to disclose their donors, gave $20.3 million from July 2014 through June 2023 to the Republican Attorneys General Association, the political nonprofit that works to elect Republicans as states’ top law enforcement officers. Known as RAGA, the group funneled more than $1.2 million to Paxton’s campaign over three election cycles from 2014 to 2022, Texas campaign finance records show.

Texas government officials knew the state was reimbursing Planned Parenthood clinics for medical services from 2017 to 2021, which renders the state’s argument that clinics violated the False Claims Act “without merit,” said Jacob Elberg, a professor at Seton Hall Law School and an expert in health care fraud.


The law is intended for situations “where essentially someone submits a claim for payment or keeps money that they’re not entitled to where they have information that the government doesn’t have,” Elberg said. “And they essentially know that if the government knew the truth, the government wouldn’t pay them or would be demanding money back.”

But with Planned Parenthood, “everything involved here happened out in the open,” Elberg said. “They were submitting bills and the government knew what was going on and was paying those bills.”

The plaintiffs’ arguments are a “tortured use” of the False Claims Act, said Sarah Saldaña, a former U.S. attorney for the Northern District of Texas.


“Things like this, which have these obvious political overtones, tend to undermine further the view of the public of the judicial courts system,” Saldaña said.

The office of the attorney general did not respond to requests for comment.

Anti-abortion groups support the Paxton lawsuit even though abortion is essentially outlawed in the Lone Star State. Planned Parenthood “is still a pro-abortion organization,” said John Seago, president of Texas Right to Life. Even though Planned Parenthood provides other care, “all of those services are tainted by their pro-abortion mindset,” he said.

“Planned Parenthood is a danger to Texans. We wish that Planned Parenthood didn’t have a single location within our state,” Seago said. “Whenever the state pays Planned Parenthood to do something, even if it’s a good service, we are building up their brand and giving them more reach into our Texas communities.”

Roughly three dozen Planned Parenthood clinics in Texas continue to provide non-abortion services like birth control and STI screenings. The $1.8 billion the whistleblower is seeking is equivalent to nearly 90% of Planned Parenthood’s annual revenue, according to its most recent annual report.
The Campaign Against Planned Parenthood



The Center for Medical Progress was little known in 2015 when it began releasing videos containing explosive allegations that Planned Parenthood was illegally selling tissue from aborted fetuses, which Planned Parenthood denies.

The group and Daleiden had ties to powerful anti-abortion organizations. They include Live Action, where Daleiden worked before creating the Center for Medical Progress, and Operation Rescue, the Kansas-based group that staged demonstrations against George Tiller’s abortion clinic in that state before a gunman killed the physician in 2009.

“The evidence I am gathering deeply implicates Planned Parenthood affiliates across the country in multiple felonies and can trigger severe legal and financial consequences for PP and their associates, while providing new justifications for state defunding efforts and turning public opinion against Planned Parenthood and abortion,” Daleiden wrote in a May 2013 email produced as part of the litigation Planned Parenthood brought in California. The subject line: “Meeting to Take Down PP.”

Texas tried to remove Planned Parenthood clinics from its Medicaid program following the center’s release of the undercover videos, a move that was part of a larger political firestorm. Roughly a dozen states launched investigations into the reproductive health provider, and Republicans in Congress renewed calls to strip Planned Parenthood of government funding.

Paxton made his feelings clear about abortion as he pursued an investigation of Planned Parenthood in Texas. During a July 29, 2015, legislative hearing, he said “the true abomination in all of this is the institution of abortion.”

“We are rightfully horrified by what we’ve seen on these videos,” Paxton said. “However these videos also serve as a larger reminder that, as a society, we’ve turned a blind eye to the gruesome horrors that occur in abortion clinics across America every single day. They remind us that this industry as a whole has lost the perspective of humanity.”

Planned Parenthood denied selling fetal tissue and other claims in the videos, some of which contained graphic footage. It said the videos were “deceptive” and heavily edited to be misleading. A grand jury in Texas cleared Planned Parenthood of wrongdoing.

Daleiden worked on the center’s “Human Capital Project” for years, receiving advice from Leo and his associates, according to the Center for Medical Progress’ website, and Daleiden’s email correspondence and other documents produced as part of the separate lawsuit in federal court in California.

The July 2018 document filed as part of the litigation in California describes emails between Leo and Daleiden as “providing legal communication with counsel regarding legal planning” and “for counsel to provide legal advice regarding investigative journalism methods and the legality of fetal tissue procurement practices,” among other descriptions. Daleiden sent one email to Leo “regarding legal planning” on July 13, 2015, the day before the Center for Medical Progress released its first video.

A November 2018 letter from the Center for Medical Progress’ lawyers stated “CMP was receiving legal advice” from Leo, as well as other conservative lawyers and organizations. Lawyers representing the center and Daleiden in a December 2018 legal filing said Leo “provided legal advice on how to ensure successful prosecutions of the criminal actors which CMP identified.”

In its defense, Planned Parenthood has said it billed the Texas Medicaid program for reimbursement for “ lawfully provided” services from February 2017 to March 2021 as a participating Medicaid provider in the state.

In 2015 and 2017, federal courts in Louisiana and Texas blocked those states from terminating Planned Parenthood’s Medicaid provider agreements. Judge John deGravelles of the U.S. District Court for the Middle District of Louisiana said the state was prohibited “from suspending Medicaid payments to (Planned Parenthood Gulf Coast) for services rendered to Medicaid beneficiaries.”

The 5th Circuit Court of Appeals in November 2020 vacated the Texas and Louisiana injunctions, but the court never weighed in on clawing back Medicaid funds that had been paid to clinics. Texas terminated Planned Parenthood in March 2021, following a state court ruling.

Texas and the whistleblower argue that, once the court injunctions were lifted, Planned Parenthood’s termination from each state’s Medicaid program became effective years earlier — 2015 in Louisiana and 2017 in Texas — due to the dates that state officials gave clinics final notice.

Planned Parenthood has argued that it is under no obligation to return payments received while injunctions were in place. Kacsmaryk disagrees. In a recently unsealed summary judgment order in the case, the judge wrote that Planned Parenthood clinics “had an obligation to repay the government payments they received as a matter of law.”

The order was unsealed after attorneys for the Reporters Committee for Freedom of the Press intervened. The committee argued the public has a presumptive and constitutional right to access judicial records, and that Kacsmaryk’s stated concerns — which included the tainting of a potential jury pool or jeopardizing the safety of those involved in the lawsuit — didn’t justify keeping the document secret.

Kacsmaryk’s brief justification for sealing the document, contained in the order itself, “was very thin,” said Katie Townsend, legal director for the Reporters Committee for Freedom of the Press.

She said his decision to seal such an important document was “highly unusual” and “very troubling.”

“Those orders are almost always completely public,” she said.
What Paxton Gains



Paxton has publicly toyed with the idea of pursuing federal office, and former President Donald Trump has said he’d consider him for U.S. attorney general should Trump return to the White House.

For Republicans in Texas, there are political benefits to going after Planned Parenthood, said Mark Jones, a political scientist at Rice University in Houston. “Doing anything punitive against Planned Parenthood and anything that would reduce the ability of Planned Parenthood to be active and effective in Texas is going to be greeted with near-universal consensus within the Republican primary electorate,” Jones said. “There’s no downside to it.”

The Republican Attorneys General Association, which can accept unlimited political donations that it distributes to candidates, is a Paxton supporter. Campaign finance records show it gave more than $730,000 to Paxton’s attorney general campaigns in 2014 and 2018.

Tax filings show that the Marble Freedom Trust, a political nonprofit where Leo serves as trustee and chair, gave the Concord Fund $100.9 million from May 2020 through April 2023. During the 2022 election cycle, the Concord Fund gave $6.5 million to RAGA, which then contributed $500,000 to Paxton’s campaign. It was tied as the highest contribution to the Texas attorney general, matched by a $500,000 contribution from a political action committee backed by conservative Texas billionaires, according to Transparency USA, a nonprofit that tracks spending in state politics.

RAGA has praised Leo’s role, calling him its “greatest champion.”

“Leonard Leo has helped shape the trajectory of RAGA and the conservative legal movement more than anyone else. As RAGA’s greatest champion, Leonard Leo reimagined the role of the state attorney general and promoted men and women dedicated to the persistence of the rule of law and the original meaning of the Constitution,” reads a RAGA website post from 2019 that has since been deleted.

“You want access to Leo because Leo gives you access to money,” said Chris Toth, former executive director of the National Association of Attorneys General.

In many conservative states like Texas, Toth said, “the issue is worrying about getting primaried. And that is where playing nice with Leonard Leo and the Concord Fund come in because if you’re on their side, basically, you’re going to have no problem gettingreelected.”

The Concord Fund gave $4 million to RAGA between July 1, 2022, and June 30, 2023, four times what it gave the prior fiscal year.

Abortion rights supporters have warned that they anticipate ongoing reproductive health battles in Texas and beyond, with access to contraception, fertility services, and other types of care under threat.

As an example, some point to the Griswold vs. Connecticut decision from 1965, in which the Supreme Court legalized the use of contraception among married couples. The high court ruled that a state law violated a constitutional right to privacy, a rationale that was central to Roe vs. Wad e eight years later.

In a 2017 speech at the Acton Institute, a conservative think tank, Leo criticized Griswold as a decision amounting to “the creation of rights found nowhere in the text or structure of the Constitution.”

The Planned Parenthood lawsuit in Texas is expected to go to trial, potentially this year. The central question is whether Planned Parenthood knowingly withheld money owed to the government.

All the while the public is expressing greater uncertainty about rights once considered constitutionally guaranteed. In a KFF poll conducted in February, 1 in 5 adults said the right to use contraception is threatened and likely to be overturned.

Fewer than half of adults considered it to be secure.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.


Tuesday, August 27, 2024

The global gag rule and women’s abortion rights



Tuesday 27 August 2024, by Liz Lawrence

Liz Lawrence looks at the importance of birth control for women’s liberation, the history of the global gag rule on healthcare funding for NGOs (non-governmental organizations) which provide abortion services, and the health impact of the global gag rule.

In the context of the forthcoming US Presidential election, in which Republican and Democratic parties take very different positions on abortion rights and in which the Democratic presidential contestant, Kamala Harris, is taking a clear pro-choice stance.

Why birth control is essential for women’s liberation

Decades of feminist campaigning in many countries have led to a widespread understanding among feminists, socialists and labour movement activists that access to birth control is essential for women’s liberation. Many trade unions now have pro-choice policies. Debates around access to birth control, both contraception and abortion, often contain debates about the position of women in society. For conservatives who seek to restrict reproductive rights women should primarily be wives and mothers, living in a traditional patriarchal family, with other activities, such as education, employment and participation in public life, secondary to the maternal role.

Supporters of women’s equality understand that equal participation in the public sphere, and for women living our lives as full human beings, involves the right for women to choose if, and when, to become mothers. A human being cannot participate equally in education, employment, politics or any other sphere, if life might be disrupted at any moment by unplanned pregnancy, and if their participation in the public sphere is always subject to the assumption that they might leave any position they occupy at any moment on account of pregnancy and motherhood. This stigma of potential maternity was used for generations to deny women equal opportunities in the workplace.

There are questions of bodily autonomy and access to health care involved. For the anti-abortionists the woman’s body is the property of anyone other than the woman, whether it be her parents, husband or the state. Birth control is healthcare. Without access to birth control many women suffer health damage and risk to life from repeated pregnancies and childbirth.

What is the global gag rule?

The global gag rule is a United States Government ban on foreign NGOs which provide abortion services (including abortion advice) from receiving any US Government funding. It is also known as the Mexico City policy, because this was the venue where it was announced by the US Government at the United Nations International Conference on Population and Development.

This ban also affects NGOs which advocate for abortion law reform such as the decriminalisation of abortion. Even if any abortion-related activities are funded by the NGO from other sources, it still loses all US Government funding. The global gag rule originally ended $600 million in money for family planning services. International Planned Parenthood lost 20% of its funding. Thus, healthcare organisations were faced with a choice of either losing funding or restricting the services they provided.

The global gag rule was first introduced in 1985 by President Ronald Reagan. Since then, each successive US administration has decided either to maintain or lift the gag. This has made funding for abortion-related healthcare services a party-political issue in the USA and a matter of increasingly sharp political division. In some countries such matters can be seen as healthcare issues where there is a bipartisan or multi-party consensus, which is based on respect for the right of women to choose and on medical and scientific evidence. In the USA a change of President can almost immediately mean either the lifting or the re-imposition of the global gag rule, with Democratic Presidents Clinton, Obama and Biden all lifting the gag.

In January 2017 President Trump expanded the global gag rule to cover more health areas. It had originally applied to NGOs in the family planning field, but it was extended to all international healthcare assistance and affected nearly $9 billion in healthcare funding. It thus affected areas like HIV education.

The global gag rule restricted the ability of healthcare workers to counsel clients properly and offer a full range of options or to campaign on healthcare issues. It had a chilling effect on health education and advocacy, similar to section 28 or other attempts by governments to limit sex education and advice by sexual health services. It can thus also be seen as a freedom of speech issue.

The health impact of the global gag

Maternal mortality worldwide is unacceptably high. About 287 000 women died during and following pregnancy and childbirth in 2020. Almost 95% of maternal deaths occurred in low and lower middle-income countries in 2020, and most could have been prevented by access to better healthcare.

Women in low-income countries have a higher lifetime risk of maternal death. A woman’s lifetime risk of maternal death is the probability that a 15-year-old woman will eventually die from a maternal cause. In high income countries, this is 1 in 5300, versus 1 in 49 in low-income countries.

For many women in the world today pregnancy is a life-threatening condition, as it was centuries ago world-wide. This means women go through pregnancy knowing it could lead to their death or permanent injury to health. This takes a toll on both physical and mental health.

Cutting funding for family planning services leads to more unplanned pregnancies, and may increase the abortion rate. Bans on abortion do not stop abortion; they just increase the likelihood that the procedure occurs under unsafe conditions, with higher rates of mortality and morbidity. The World Health Organisation estimates that 45% of abortions are unsafe.

The global gag has also impacted health education and health advocacy, including HIV/AIDS education and support for marginal and vulnerable groups, including workers in the sex industry. When funding for healthcare is cut, it is often the poorest and most vulnerable who are most affected.

How the abortion issue has been politicised

“My name is Ann Richards. I am pro-choice and I vote.” This is what Ann Richards, Democratic Governor of Texas said at the Democratic National Convention in 1992. This is a good example of how women and pro-choice activists can be galvanised by this issue, as is happening now with the Kamala Harris campaign for the US Presidency.

The Republican Party has made alliances with the Christian evangelical right, treating abortion as a key political dividing issue. Ultra-conservatives often pick an issue or two, whether abortion, homosexuality, transgender rights or sex education in schools as a focus for campaigning and as a test of political acceptability.

Right-wing Christian evangelicals and other religious fundamentalists subscribe to a theology in which salvation is linked with conformity to narrowly-defined, traditional gender roles, in which sex is only for reproduction and in which foetal life is given equal or higher status than the life of the pregnant person. Hence the woman who declines motherhood or the person who lives in a same-sex relationship or seeks to change gender cannot be accepted. This is a quest for Gilead, the dystopian society portrayed by Margaret Atwood in “The Handmaid’s Tale”.

Some Republican politicians are Christian nationalists; that is to say, they want to remove the separation of religion and the state, which was one of the major achievements of the American Revolution and to establish some version of a theocratic state. It can be hard for reasonable and liberal-minded people to appreciate just how reactionary all of this is.

Donald Trump and JD Vance use misogyny to mobilise a section of the electorate and to attack their opponents. It may fire up their base, but it will also turn off many American voters. Vance is mentioned often for his notorious remark that the US was governed by ‘childless cat ladies’ and the implication that only parents have a right to an opinion or a vote. Such views are off the wall and have sparked many amusing ripostes. Nonetheless they should not be ignored because they express both a serious level of misogyny and contempt for single people.

What happens in the US presidential election has significant implications for women’s lives and for reproductive rights and healthcare provision world-wide.

P.S.

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