The Mifepristone Case Isn’t the Endgame for Abortion Opponents
The Supreme Court on Tuesday appeared skeptical of arguments in favor of limiting access to mifepristone, a medication approved long ago by the Food and Drug Administration for abortions—at least on the grounds that the plaintiffs, a group of anti-abortion doctors who haven’t actually prescribed the drug, had standing to claim that its availability somehow injured them. Justice Neil Gorsuch mused that the case could be “a prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an FDA rule or any other federal government action.”
This is the first major abortion-related case the Supreme Court has heard since the conservative majority overturned Roe v. Wade in 2022. The FDA approved mifepristone in 2000, but attorneys for the plaintiffs—the Alliance for Hippocratic Medicine, which set up shop shortly after Roe was overturned—asked the court to block rules the agency implemented in 2016 and 2021 that made it easier to access the drug, including by mail. (Medication abortion represented 63 percent of all U.S. abortions in 2023, according to data from the Guttmacher Institute, and it’s believed that the rise in abortions since Roe was overturned is largely due to the availability of abortion pills by mail.)
The court will release a decision by early July at the latest, but even if mifepristone survives this ruling, abortion opponents will continue to bring legal challenges against the drug. States that have implemented abortion restrictions “will file copycat lawsuits to try to restrict access to medication abortion in every state in the country,” warned Julia Kaye, a senior staff attorney with the American Civil Liberties Union Reproductive Freedom Project.
During oral arguments on Tuesday, Justices Samuel Alito and Clarence Thomas indicated another potential legal avenue for restricting mifepristone: They frequently mentioned the Comstock Act, a nineteenth-century law that bans sending obscene material and drugs for abortions through the mail. The federal government effectively stopped enforcing the law nearly a century ago, and the courts have narrowed interpretation of the law to apply only to mailing explicitly illegal material. However, as my colleague Melissa Gira Grant wrote last year, abortion opponents have sought to revive the Comstock Act to block abortion medication.
“This case is just one inflection point in an ongoing assault by anti-abortion extremists against all of our freedoms, both from the state and local level to the federal level,” said Mini Timmaraju, the president and CEO of Reproductive Freedom for All, an advocacy group that supports abortion access.
A coalition of conservative groups, led by the Heritage Foundation, has prepared a nearly 1,000-page “playbook” for a potential Republican president in 2025, including plans to restrict abortion. This would include directing the FDA to rescind its approval of mifepristone and stopping “promoting or approving mail-order abortions in violation of long-standing federal laws that prohibit the mailing and interstate carriage of abortion drugs”—a reference to the Comstock Act.
Meanwhile, former President Donald Trump, the presumptive GOP nominee, has mulled supporting either a 16-week or 15-week ban on abortion, with some exceptions. Republicans in Congress have also proposed bills to limit abortion, such as legislation that would roll back the FDA regulations allowing telemedicine prescription and mail delivery of mifepristone and even ban medication abortion altogether. Although efforts to restrict mifepristone tanked an agriculture appropriations bill last year, abortion opponents hope that a Republican in the White House and GOP majorities in both chambers of Congress could strengthen their hand.
On top of the 14 states that have banned abortion outright, 12 other states have passed at least one restriction on telehealth medication abortion. Meanwhile, blue states have begun adopting “shield laws” to protect doctors from prosecution should they prescribe abortion medication for out-of-state patients. Progressive groups have also championed state ballot initiatives to protect the right to an abortion in red states.
“We are in the states fighting around these ballot initiatives and fighting for governors, and A.G.s, and state legislatures that will uphold reproductive freedom,” said Timmaraju.
Each week, I provide an update on the vibes surrounding a particular policy or political development. This week: The scene on the ground at the Supreme Court on Tuesday.
The scene outside the Supreme Court on Tuesday morning was a familiar one, as anti-abortion and pro-Roe demonstrators held competing rallies. There were signs calling abortion a “human right” and signs declaring, “Abortion pills are murder”; anti-abortion rallygoers lying on the ground in protest and abortion supporters in Planned Parenthood pink dancing as Beyoncé’s “Cuff It” thumped from massive loudspeakers.
Shanay Watson-Whittaker, the director for Michigan campaigns at Reproductive Freedom for All, had traveled from her home state. Bedecked in the organization’s signature deep purple, Watson-Whittaker spoke of her six children in their mid-twenties. “This is about their future. It’s up to them what they want to do with their bodies, and I want to make sure that the government does not interfere with that,” she said. “I’m here to make my voice heard for them and their future.”
Inside the courthouse, most justices appeared skeptical about whether the anti-abortion doctors could prove concrete harm from mifepristone. Kaye argued that the case “should have been laughed out of court from the start,” adding, “We are certainly hoping that the justices will recognize that anti-abortion groups’ arguments in this case defied bedrock legal principles and are not based on a shred of credible evidence.”
But Kristen Day, the executive director of Democrats for Life, argued that “this is about providing medication to women without a doctor.”
“As Democrats, we support regulation. We support regulation in every avenue. And for some reason we’ve carved out abortion as, ‘Let’s give this to women without regulations and health and safety standards,’” Day said outside the court, as she waited to speak before the crowd of abortion opponents. (As the American College of Obstetricians and Gynecologists noted in an amicus brief in this case, “Serious side effects occur in less than 1% of patients, and major adverse events—significant infection, blood loss, or hospitalization—occur in less than 0.3% of patients.”)
While mifepristone can be prescribed by a doctor or obtained through a clinic, including via telehealth, a patient’s ability to access it may depend on how strictly their state has restricted abortion; the legality of using mifepristone in a state where abortion is banned is murky.
In April, the Supreme Court is expected to hear oral arguments in a case relating to a federal law allowing emergency access to abortion procedures. One thing is all but certain: When the court next convenes to consider a case relating to abortion rights, there will be protesters jostling outside, shouting to have their voices heard.
Can this forgotten anti-poverty program be saved? by Grace Segers in The New Republic
Can a tribe’s religious freedom claims halt a major copper mine? by Taylar Dawn Stagner in Mother Jones
‘The whole bridge just fell down.’ The final minutes before the Key Bridge collapsed, by Lee O. Sanderlin and Adam Willis in The Baltimore Banner
In a secret game of prisoner swaps, Putin has held most of the cards, by Aruna Viswanatha, Bojan Pancevski, Drew Hinshaw, and Joe Parkinson in The Wall Street Journal
Living abroad, Jim McDermott finds his liberal utopia, by Ariel Cohen in Roll Call
Why some LGBTQ groups oppose the current Kids Online Safety Act, by Jasmine Mithani in The 19th
How Kate Cox became a reluctant face of the abortion rights movement, by Charlotte Alter in Time
Want to have your pet included at the bottom of the next newsletter? Email me: gsegers@tnr.com.
This week’s featured pet was submitted by Tom Grafton. Hank is pictured after a long day at the dog park.
Every once in a while, a bipartisan group of lawmakers comes together to support a popular policy that fulfills the interests of industry leaders and everyday Americans alike. These instances are supposed to be the slam dunks of legislating, a time for lawmakers to prove they are interested in governing to the advantage of their constituents.
It’s all easier said than done.
So it goes with the Affordable Connectivity Program Extension Act, bipartisan and bicameral legislation to fund a program that aims to provide 23 million households with affordable internet access. Unless the Affordable Connectivity Program, or ACP, receives an additional $7 billion in funding from Congress, April will be the final full month that households will receive the benefit. In early February, the program stopped accepting new enrollment.
“It’s a good thing that the program has broad bipartisan support. It’s a terrible thing that no one has been able to figure out how to turn that support into actual dollars for the program,” said Greg Guice, chief policy officer at the Vernonberg Group and spokesperson for the Affordable Broadband Campaign.
As a supplemental funding request, the ACP Extension Act was designed to be attached to a larger legislative vehicle. This week, Congress is considering the second tranche of bills to fund the government for the current fiscal year. It’s unlikely that the bill will be tacked onto this spending minibus, and it’s unclear when another opportunity to approve the additional funding for the ACP might arise. So the Federal Communications Commission, telecommunications companies, and low-income Americans alike are bracing for the end of the program.
Senator Peter Welch, the Democrat who introduced the bill in the Senate, said that while the funding bill was not the “last opportunity” to approve the ACP Extension Act, it nevertheless represented “the best opportunity” to get the measure over the goal line. “The ACP has a lot of support, but finding a vehicle to include it, on a practical level, is the challenge,” Welch told me.
The ACP provides up to $30 monthly discounts on internet bills for low-income families and up to $75 monthly discounts for eligible households on tribal lands. It is used by low-income Americans in urban, suburban, and rural areas; it benefits families in red and blue states alike. Indeed, eight of the states that rank highest for enrollment—Louisiana, Kentucky, North Carolina, Ohio, South Carolina, Mississippi, and Oklahoma—are largely controlled by Republicans. In November, 26 governors of both parties sent a letter to congressional leaders requesting Congress work with the Biden administration to extend the program.
According to a recent national survey by the Benenson Strategy Group, 49 percent of ACP participants are military families and 19 percent are households with seniors. That same report found that 95 percent of participants said they would struggle with costs if the program is not reauthorized, 75 percent said they fear losing online health care services, 65 percent fear job loss, and 81 percent of parent participants would worry about their child falling behind in school.
Research by the Benton Institute for Broadband and Society has shown that the ACP has helped connect more Americans to the internet. In a recent ethnographic survey, the AARP further found that internet access helps older Americans maintain connections and adapt to a changing world, with participants calling the loss of the ACP “unthinkable.” Some reports also demonstrate a clear economic benefit: Recent analysis by Benton found that every dollar spent on ACP subsidies “returns nearly two dollars in impacts to those using the program.”
ACP supporters outside of Congress comprise a broad coalition, from telecommunications companies like AT&T and Verizon to advocacy groups like the NAACP, the AARP, and the American Civil Liberties Union. It’s also popular with voters: A recent poll by the Digital Progress Institute found that majorities of Republican, independent, and Democratic voters support extending the ACP.
Nevertheless, the program has its detractors. Some Republican lawmakers have questioned whether ending the ACP would truly result in millions of Americans losing their internet access, with several writing in a December letter to FCC Chairwoman Jessica Rosenworcel that “it appears the vast majority of tax dollars have gone to households that already had broadband prior to the subsidy.” Senator Ted Cruz has also argued that the ACP is redundant, given a preexisting program called Lifeline intended to lower the cost of broadband. (The discount offered by Lifeline is far lower than that of the ACP, and it also has more stringent eligibility requirements.)
However, a recent survey by the FCC found that 68 percent of ACP recipients had inconsistent or no internet service prior to enrolling in the program, with the majority of those respondents citing affordability as the biggest roadblock to obtaining service. The survey also found that 29 percent of participants would drop their internet service provider if they no longer received the $30 discount monthly. The ACP—which was established by the 2021 bipartisan infrastructure law—replaced the pandemic-era Emergency Broadband Benefit Program, which had around nine million participants. Many who received subsidies through that program then transferred to its successor.
With congressional action uncertain, the FCC is preparing for the wind-down of the ACP. Participants may receive a partial ACP benefit in May, with the amount determined by individual service providers. Qualifying ACP participants earning under a certain threshold could apply for Lifeline, although several providers that participate in ACP do not also participate in Lifeline. Some cities and states have their own internet subsidy programs, and several internet service providers have discounts for low-income and elderly users.
Even if Congress did approve legislation to extend the ACP, it would only keep the program solvent for the next year. A longer-term solution, Guice said, would be for the FCC to expand its revenue base for the universal service fund, which collects money from telecommunications companies with the goal of providing universal internet access. Unlike the ACP, the universal service fund is not subject to the congressional appropriations process.
“What we have now proven, I believe, is that if you leave it to Congress to figure out how to help low-income families get broadband, they’re clearly going to get it wrong,” said Guice. “That failure demonstrates why we cannot let low-income broadband services be provided for through the appropriations process.”
This article first appeared in Inside Washington, a weekly TNR newsletter authored by staff writer Grace Segers. Sign up here.
The funding minibus that will theoretically be approved by Congress in the coming days includes a provision to add 12,000 special immigrant visas, or SIVs, for Afghans who helped the United States during its war in Afghanistan. The current cap is 38,500 SIVs, a congressionally authorized limit that was expected to be reached around the August anniversary of the withdrawal of U.S. forces from Afghanistan.
This number falls short of the 20,000 additional visas sought by the Biden administration. Still, advocates are celebrating the increase as a qualified victory—an improvement on the current situation, if still insufficient to address the overarching need.
“It’s not a silver bullet, but it is rare in this work that we’re able to celebrate our victories,” said Shawn VanDiver, the founder and president of #AfghanEvac, a coalition that helped to evacuate Afghans during the withdrawal. The authorization of additional SIVs provides “breathing room” for the program, as it grants additional time before the cap is reached and helps thousands of Afghans eligible for SIVs in the U.S. who arrived before completing their application process.
Adam Bates, the supervisory policy counsel at the International Refugee Assistance Project, or IRAP, said in a statement that the “authorization of additional visas extends a vital lifeline for Afghans who risked their lives on behalf of the U.S. mission in their country, but it’s not nearly enough to fulfill the promises the U.S. government made to Afghan allies.” IRAP has undertaken a class-action lawsuit challenging federal delays in SIV application processing.
“With an application backlog of more than 100,000 applicants, many of whom have waited for years, Congress must continue authorizing additional visas until every eligible applicant has one,” Bates said.
Representative Jason Crow, a veteran who served in Afghanistan, said that Congress would need to approve more SIVs next year. “We think [it] gives us time over the next year to process those who are in the immediate pipeline and have passed the chief admission approval or prepared for interviews, but certainly next year we’ll have to go back for more,” Crow said. The State Department has said that the agency is issuing 1,000 visas per month, meaning that the additional 12,000 will likely not last as long as some advocates would hope.
Remember the previous segment of this newsletter, when I talked about bipartisan and bicameral bills that, for whatever reason, are unable to pass? One such measure is the Afghan Adjustment Act, legislation that would expand eligibility for SIVs, streamline the SIV application and approval process, authorize additional SIVs, and provide Afghan evacuees paroled into the U.S. who are not eligible for SIVs with a pathway to permanent residency. A group of senators unsuccessfully attempted to tack on an amendment based on the Afghan Adjustment Act to a national security supplemental bill approved last month. (Another, slightly narrower bipartisan bill, the Afghan Allies Protection Act, has also been unable to garner sufficient support to be approved.)
Senator Richard Blumenthal, a co-sponsor of the Afghan Adjustment Act in the Senate, echoed the sentiment that increased SIV numbers were preferable to inaction. “Any number is better than none, but I still hope the Afghan Adjustment Act will be approved,” Blumenthal said.
Another co-sponsor of the bill, Republican Senator Jerry Moran, also praised the addition of SIVs to the minibus even as he called for the passage of the Afghan Adjustment Act. “I don’t think it diminishes the political support or the need for the Afghan Adjustment Act, but it will help many Afghans who helped the United States have a future,” Moran told me.
However, with thousands of Afghans paroled into the U.S. having already applied for asylum, VanDiver worried that passing the Afghan Adjustment Act might eventually become a moot point. “I’d like to see adjustment, but the challenge is that Congress doesn’t seem willing to do it,” said VanDiver. “We’ll have most of the asylum [claims] adjudicated for these Afghans by the time Congress passes anything.”
Helal Massomi, the Afghan policy adviser at Global Refuge, a refugee advocacy and resettlement organization, argued that passing the Afghan Adjustment Act when it was first introduced would have solved some of the issues relating to SIV availability and backlog. “If there is a problem with SIVs right now, it’s because Congress doesn’t act on time, or act at all,” said Massomi, who herself had to evacuate from Afghanistan. “If they don’t pass the Afghan Adjustment Act, we will keep facing these kinds of problems.”
Moran said that “the urgency seems to be missing” from those in Congress who do not support the bill. “Even when there’s a sense of urgency around here, things happen without a lot of urgency,” Moran noted wryly.
Massomi also noted the time crunch regarding the impending presidential election. Former President Donald Trump, the Republican nominee, issued a ban on people from Muslim-majority countries entering the U.S. as one of his first acts in office, and may be less inclined to support efforts to expand SIV access.
“It’s time for the leadership in the House, the leadership in the Senate, to do something. If the administration changes, if we have another president, it will be extremely hard for Afghans to be resettled here,” Massomi said.
Irish Wish is a crypto-fascist, AI-generated harbinger of doom, by Rachel Handler in Vulture
D.C.’s crime problem is a democracy problem, by Harry Jaffe in The Atlantic
Beyoncé has a country hit. How will country radio handle that? by Emily Yahr in The Washington Post
‘It feels like a mountain you never get done climbing’: Covid isn’t over for disabled and older adults, by Sarah Luterman in The 19th
Young people don’t want to farm anymore. Can Pennsylvania change their minds? by Marcia Brown in Politico
This week, embattled Haitian Prime Minister Ariel Henry agreed to resign. He had spent the last week stranded in Puerto Rico, unable to return, as armed gangs took control of the airport in Haiti’s capital, Port-au-Prince. Henry’s announcement came after negotiations involving Haitian stakeholders, Caribbean leaders, and U.S. and Canadian officials resulted in the proposed creation of a presidential transition council. Henry, who was appointed—not elected—with international backing, had served as leader of Haiti since the 2021 assassination of President Jovenel Moïse. Haiti has been wracked by violence in recent years, with gangs controlling 80 percent of Port-au-Prince.
Kenyan officials had previously vowed to lead a multinational security support mission in the form of a deployment of 1,000 police officers to help combat the gangs. On Monday, Secretary of State Antony Blinken pledged an additional $100 million to finance the deployment; this brings the total promised contribution to $300 million, along with $200 million promised by the Department of Defense.
The Biden administration has also called on congressional Republicans to release a hold on an additional $40 million in pledged funds, arguing that it is necessary for a multinational force led by Kenya to deploy.
“The security force was needed months ago, but now it’s really needed,” said Senator Tim Kaine, the chair of the Senate Foreign Relations Subcommittee that oversees Western-hemisphere policy. “It would be a disaster if they were to say, ‘Well, we can’t do it, because the U.S. isn’t meeting its commitment.’”
Lawmakers have released $10 million of the pledged funds, although a congressional Republican aide said that money had not yet been spent by the administration. On Wednesday, House Minority Leader Hakeem Jeffries said in a letter to Speaker Mike Johnson that “it is imperative that the United States ensures they have the resources to complete the mission.”
“The situation on the ground in Haiti has rapidly deteriorated while House Republicans have refused to deliver the resources necessary to carry out this mission,” Jeffries wrote. “It is not in America’s national security interests to hold up the transfer of funds that support security stabilization in Haiti, particularly given the present crisis on the ground.”
The State Department says that it has briefed Republicans in Congress on the planned deployment multiple times, but GOP lawmakers and staff say that they have not received key logistical information on how long the deployment would last and what the long-term goals are, not to mention how to transport the Kenyan force when the airport is currently closed. While the GOP congressional aide said that the White House has offered an organizational structure, this does not include specific price tags or timelines.
“We need to feel some level of confidence that this is an effective plan moving in an effective direction. And we’ve given money to support moving in that direction, but then they’ve not reciprocated with anything to kind of instill confidence,” the aide said.
Moreover, after Henry’s announcement this week, Kenyan officials said that the deployment is on hold until a new government is formed, raising further questions about how the United States can and should respond to the ongoing crisis.
“We remain confident that the mission will go forward,” a senior State Department official told reporters in a press call on Tuesday. “In all the conversations we’ve had, Kenyan officials have said that they intend to go forward and they intend to lead this mission.”
But Haiti has a complex history of international interventions, from its founding more than 200 years ago in a revolution by enslaved people overthrowing the French colonialist power. In 2010, thousands of Haitians died in a cholera outbreak that was sourced to a U.N. peacekeeping camp established after a devastating earthquake.
“You just have this cyclical pattern in Haiti of intervention, and things get worse after the intervention. And I think there is a knee-jerk reaction where people say, ‘Well, it’s entirely because of the intervention, so we shouldn’t have any interventions ever again,” said Sophie Rutenbar, a visiting fellow at the Brookings Institute who previously served as mission planning officer for the United Nations Integrated Office in Haiti.
The U.S. in particular must strike a delicate balance in offering assistance to Haiti, given how the Haitian people might interpret the superpower next door barging into their affairs.
“The role that the U.S. should play is following the people of Haiti, what they want to do, listening to them, and listening and letting CARICOM lead,” said Representative Gregory Meeks, the Democratic ranking member of the House Foreign Affairs Committee, referring to the coalition of Caribbean countries. “It should not be us imposing anything on anyone in Haiti. The voices of the Haitian people need to be heard.”
Representative Ayanna Pressley, a co-chair of the House Haiti Caucus who has a large Haitian population in her Massachusetts district, also highlighted her support for a transitional government. “The United States and international community must help........
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