Washington View, June 2024

Partisan Politics Plague Congress and Courts

Congress completes 2024 funding bills: new speaker faces old challenge

On the last weekend in March, with the threat of a government shutdown looming, Congress finally — a full six months late — passed the last package of Fiscal Year 2024 spending bills.

Included in the package were the State Department and Foreign Operations bill, which includes global reproductive health and family planning programs, and the Labor, Health and Human Services, and Education bill, which provides for the domestic family planning program.

Like nearly all appropriations legislation, House Republicans loaded these two bills with extreme provisions targeting family planning programs and LGBTQ+ rights. These provisions were never going to be approved by the Senate nor signed by President Biden, but the MAGA wing of the Republican caucus in the House held government funding hostage for half a year. In the end, they failed.

Funding for international family planning programs held steady at $607.5 million, still woefully short of what’s needed to meet the existing demand, but a rejection of the House effort to slash the funding by 25%. The final bill also rejected House efforts to reimpose the Global Gag Rule and prohibit aid to UNFPA. This outcome is especially noteworthy because overall funding for foreign assistance and global health programs was reduced.

On the domestic side, the Title X (ten) family planning program is funded at $286.5 million, remaining stagnant for more than a decade. And while, as with the international program, this is far below what’s needed, it is a flat rejection of House leaders’ efforts to eliminate the program altogether.

As the House was finishing work on the spending package, Rep. Marjorie Taylor Greene (R-GA) announced that she was filing a motion to vacate the chair to force a vote on removing the Speaker of the House. House rules allow for just one member of the majority party to bring such a vote forward. It is what led to the removal of Kevin McCarthy just a few short months ago and the installation of Mike Johnson as Speaker after several other candidates failed to win a majority.

As of May 6, Rep. Greene had not brought her motion to the floor of the House for a vote. But stay tuned.

Biden administration announces rule to protect reproductive health care privacy

On April 22, the Biden administration announced a new rule to protect individuals’ reproductive health care privacy under HIPPA. The new rule will help protect against people having their private health care data used against them when they seek reproductive health care outside of their own state.

Secretary of Health and Human Services Xavier Becerra said:

Many Americans are scared their private medical information will be being shared, misused, and disclosed without permission. This has a chilling effect on women visiting a doctor, picking up a prescription from a pharmacy, or taking other necessary actions to support their health. The Biden-Harris administration is providing stronger protections to people seeking lawful reproductive health care regardless of whether the care is in their home state or if they must cross state lines to get it. With reproductive health under attack by some lawmakers, these protections are more important than ever.

Supreme Court further threatens reproductive freedom

The United States Supreme Court heard two cases that could further restrict access to safe, legal abortion across the country, including in states where abortion remains legal.

On March 26, the Court heard arguments in FDA v. The Alliance for Hippocratic Medicine (AHM) in which a group of anti-abortion individuals is seeking to invalidate the FDA’s approval of the abortion medication mifepristone nearly a quarter-century ago. Medication abortion now accounts for nearly two-thirds of abortions in the U.S.

The FDA originally approved the medicine in 2000, and updated the requirements for its use in 2016 and again in 2021. The first update allows for the use of the medication through 70 days gestation, permits advanced practice providers to prescribe it, allows patients to take their second dose at home instead of coming back to the clinic, and dropped the requirement that the follow-up visit be in person. The Covid era 2021 update eliminated the in-person requirement altogether, allowing prescription through telehealth and delivery through the mail.

The Supreme Court did not hear arguments on AHM’s challenge to the original approval, but is considering the case against the two subsequent changes. If AHM is successful, it will mean that the requirements will be rolled back to those created by the 2000 FDA approval. Patients would only be able to use mifepristone through 49 days gestation and would have to make a minimum of three in-person visits to a doctor.

The second case, heard on April 24, is Idaho v. United States. This case centers on Idaho’s complete ban on abortion even in cases when it’s necessary to save a pregnant person’s life.

After the Dobbs decision eliminated the nationwide right to abortion, Idaho’s ban went into effect. But this ban is in direct conflict with the Emergency Medical Treatment and Labor Act (EMTALA), a federal law that says that if a pregnant person shows up at an emergency care facility that receives federal funds and requires an abortion, it must be provided.

In August 2022, a federal judge blocked Idaho’s ban as it related to emergency care because of EMTALA. Idaho’s Attorney General and lawyers representing the State Legislature appealed the decision. In January of this year, the Supreme Court agreed to hear the appeal, and stayed, or blocked, the lower court injunction against enforcing the ban in emergency situations.

Idaho’s ban is having dramatic effects on care as a number of OB/GYNs have left the state and hospitals have stopped providing labor and delivery services.

Decisions in both cases are likely to come out later in the summer.