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Planned Parenthood

Why endorse Sarah Davis?

It’s a good question.

Rep. Sarah Davis

Planned Parenthood’s Texas political arm on Thursday endorsed state Rep. Sarah Davis, rebuffing abortion rights activists who had lobbied the group to deny political support for the Houston Republican.

The efforts to deny Davis the endorsement had revolved around a petition circulated by Sherry Merfish, a deeply connected Democratic donor and former Planned Parenthood board member. The petition concedes that Davis “may have met the minimum standards of what it means to be ‘pro-choice,’” but argues that “the rest of her record stands completely at odds with the cause of reproductive justice and the purported mission of Planned Parenthood.”

It had gathered some 450 signatures by Wednesday afternoon, including numerous Planned Parenthood donors and two board members of the group’s Houston affiliate. One of the board members, Peggie Kohnert, had circulated her own petition.

The lobbying effort has revealed a fracture between key members of Houston’s abortion rights community and the leaders of Planned Parenthood Texas Votes, a political action committee that defines itself as nonpartisan but has struggled to find Republicans like Davis to endorse. As the debate plays out, Texas Democrats — desperate to capture a House majority before next year’s critical redistricting battle — are making an all-out push to unseat Davis, whom they view as one of the most vulnerable Republican legislators in the state.

Davis’ stances on abortion have angered members of her party but helped garner support from moderate voters. In the last two cycles, she won re-election while her party’s standard-bearers, Donald Trump and Ted Cruz, each failed to crack 40 percent in her district.

Houston lawyer Ann Johnson, Davis’ Democratic opponent, argues the incumbent has worked against women’s reproductive issues by opposing the Affordable Care Act and declining to vote for the law’s optional expansion of Medicaid. Davis disagrees, saying she has voted against “every anti-choice bill” during her time in office.

Some of Johnson’s supporters say groups such as Planned Parenthood Texas Votes have allowed Davis to carefully curate her moderate reputation while she aligns with her party on immigration and gun policies. Merfish said the group also would paint a misleading picture of Johnson by backing Davis.

“By endorsing Sarah, in people’s minds who may not be as familiar with Ann, it would cast doubt on whether Ann is aligned with them on these issues,” Merfish said. “Because, then why wouldn’t they endorse both of them, or why wouldn’t they stay out of it?”

Planned Parenthood Texas Votes announced the Davis endorsement Thursday as part of a slate of 18 new endorsements. Davis is the only Republican among the 27 candidates the group is backing this cycle.

In a news release, Planned Parenthood Texas Votes said it is “working to elect officials not to just defend access to sexual and reproductive health care, but to repair and expand the public health infrastructure damaged by Governor Abbott and other extremist politicians.”

There was a preview story about this on Wednesday, which covered much of the same ground. As the story notes, Davis also received the endorsement from the Human Rights Campaign, despite Ann Johnson being an out lesbian. The story goes into a lot of detail about Davis’ career and various votes and issues that are at the heart of the dispute, so I encourage you to read the rest.

On the one hand, I get why PPTV and the HRC want to endorse Republicans like Davis, who are an increasingly rare breed. It’s in their best interests, at least as they see it, to be non-partisan, which means they need to find Republicans they can support. From a national perspective, Democrats may be the majority in Congress now, but partisan control is likely to swap back and forth over time, and you need to have some connections to the Republican majority when it exists, no matter how otherwise hostile it is, because you can’t afford to be completely shut out. Long term, I’m sure groups like these very much want for their issues to not be seen as strictly partisan, but to have broad consensus across party lines, and the only way to do that is to have Republican faces you can point to and say “see, they support us, too”. They have done this for a long time, and it’s just how they operate.

On the other hand, the simple fact of the matter is that having Sarah Davis in the State House makes it that much more likely that the Republicans will maintain their majority in that chamber, and a House with a Republican majority and a Republican Speaker is absolutely, positively, one hundred percent going to pass at least one major anti-abortion bill in 2021, just as it has every session since 2003, when the Republicans first took the majority and thus gained trifecta control of Texas state politics. A State House with a Republican majority and Speaker will absolutely not pass a bill to expand Medicaid. I agree, such a bill would almost certainly be DOA in the Senate, but at least it would get there, and the voters in 2022 would have a tangible example of what they’ve been missing out on. And of course, a State House with a Republican majority and Speaker will absolutely make further cuts to women’s health (which is already happening without any legislative input) and add further restrictions to Planned Parenthood, again as they have been doing for years now. All of this would happen regardless of the virtuous votes that Sarah Davis would cast. I mean, it may be true that she has helped stop some things and reverse some cuts and spoken against some other things, but all this has happened regardless. She’s only one member, and they have always had the votes to do all that without her.

This debate has played out for several years at the national level, with the national Planned Parenthood PAC being criticized in the past for supporting the likes of Arlen Specter and Susan Collins and a handful of Congressional Republicans for their reasonably pro-choice voting records while overlooking the “which party is the majority” aspect. Indeed, for the first time ever, Planned Parenthood has endorsed Collins’ challenger, with her vote for Brett Kavanaugh being the proverbial last straw. Activists, including blogs like Daily Kos, have made the same argument about control of the chamber versus individual members with acceptable voting records. However you feel about what PPTV and HRC did here, it’s not at all a surprise to see this debate arrive here on this level.

Ann Johnson

Though individual endorsements rarely have the power to swing elections, Planned Parenthood Texas Votes holds more sway in House District 134 than the average political group, said Renée Cross, senior director of the Hobby School of Public Affairs at the University of Houston. The district, which covers Bellaire, West University Place, Southside Place, Rice University and the Texas Medical Center, is home to some of the most affluent, educated and politically engaged voters in the state and contains what Merfish described as a “trove of Planned Parenthood voters.”

The group’s endorsement is particularly significant for Davis, Cross said, because of President Trump’s struggles among suburban women.

“Just like the tea party helped bring her in back in 2010, the anti-Trump movement could help move her out, especially among women,” Cross said.

I agree that Davis is better positioned with these endorsements than without them. A bigger concern for Davis is just simply how Democratic HD134 was in 2018, when Beto took 60% of the vote, and Davis was fortunate to not have had a serious challenger. I see a parallel to Ellen Cohen, who won re-election in 2008 by a 14-point margin over a non-entity opponent, even as Republicans were carrying the district in nearly every other race. 2008 was a strong Democratic year overall in Harris County, but HD134 was actually a bit more Republican than it had been in 2006, when something like seven or eight downballot Dems also carried the district. Cohen still vastly outperformed other Dems in the Republican tidal wave of 2010, but that wave was too big for her to overcome. I get the same feeling about Davis this year. Maybe I’m wrong – no two elections are ever alike, and HD134 has been a Republican district far longer than it’s been a Democratic district – but there’s a reason why neutral observers view Davis as being endangered.

One last thing: When I say that groups like PPTV and HRC want to be supportive of Republicans like Sarah Davis, it’s because there’s literally no other Republicans like Sarah Davis, at least at the legislative level in Texas. The thing is, Republicans like her have been extremely endangered for some time now. Go ahead, name all of the Republican legislators you can think of from this century that you could classify as “pro-choice” with a straight face and without provoking a “no I’m not!” response from them. I got Joe Straus, Jeff Wentworth (primaried out by the wingnut Donna Campbell), and that’s about it. I’m old enough to remember when Gary Polland and Steven Hotze ousted Betsy Lake, the nice River Oaks Planned Parenthood-supporting lady who had been the Harris County GOP Chair in the 90s, thus completing a takeover of the party that has lurched ever further rightward since. If they can’t support Sarah Davis, I have no idea who else in the Republican Party they could support.

Abortion clinics say “ban’s over, we’re back”

I’m sure this will be left alone.

Right there with them

Texas clinics resumed offering abortions Wednesday after a strict bar on nonessential medical procedures was loosened at midnight.

The ban on nearly all abortions in Texas has been the subject of weeks of litigation — starting in late March when the governor postponed all surgeries not “immediately medically necessary” to preserve medical resources for coronavirus patients. Attorney General Ken Paxton said the ban extends to abortions, and the politically conservative 5th U.S. Circuit Court of Appeals has largely sided with state officials.

The legal fight is ongoing. Abortion providers have accused state officials of political opportunism, saying abortions rarely result in hospitalization and require little or no protective equipment.

A new order from Republican Gov. Greg Abbott that took effect Wednesday allows more procedures to resume in health care facilities that agree to reserve a certain number of beds for coronavirus patients and to refrain from seeking scarce protective equipment from public sources.

Abbott demurred when asked last week if abortions could proceed under his latest directive, saying it was a decision for the courts and “not part of this order.”

But abortion providers said Wednesday that they meet the criteria he laid out.

See here and here for the background. I assume this will wind up in court again, and the main question will be what ridiculous justifications the Fifth Circuit will come up with to agree with the state’s position. Until then, this is where we are today.

UPDATE: It appears that the state has agreed that the expiration of the order means that there is no further restriction on abortions. So that’s a relief.

Fifth Circuit flips off abortion rights again

I’m so sick of this shit.

Right there with them

A federal appeals court has again banned most abortions in Texas amid the coronavirus pandemic, though the ruling will only be in effect for two days.

The ruling on Monday by the Fifth Circuit Court of Appeals prohibits medication and surgical abortions for nearly all women except those nearing the state’s 22-week legal gestational limit to obtain one. The court had ruled last week that medication abortions could proceed.

But the court’s ruling will expire Tuesday night.

Republican Gov. Greg Abbott issued a new order loosening restrictions on nonessential surgical procedures — presumably including abortions — starting Wednesday, though neither he nor Attorney General Ken Paxton have clarified how abortions will be impacted.

Abbott’s original order restricted procedures to only those that require “immediate” response to protect a life or serious adverse medical outcome. The new order replaces “immediate” with “timely.” Physicians are left to determine whether the criteria is met.

Paxton has no plans to clarify how the new order applies to abortions, according to a spokeswoman. He has previously threatened criminal action against doctors who perform them during the ban.

In its ruling, the Fifth Circuit said medication abortions use masks and other critical protective gear needed for frontline doctors to respond to the coronavirus crisis. Abortion providers are required to meet with patients before and after providing them pills to terminate a pregnancy, the court wrote, and should be wearing protective gear during those visits.

“The question, then, is not whether medication abortions consume (personal protective equipment) in normal times, but whether they consume PPE during a public health emergency involving a spreading contagion that places severe strains on medical resources,” it wrote.

It was one week ago that the court allowed medical abortions to continue, so if you’re feeling some whiplash, you’re not alone. It boggles my mind that restrictions could be re-imposed by the court at a time when they are being eased up by the state, but that’s Fifth Circuit logic for you. What happens tomorrow when this order expires? Who the hell knows? It’s been bullshit from beginning to end. If we ever want to get off this demonic roller coaster, it’s going to require a new Governor and a new Attorney General, at the very least. The Trib has more.

Abbott and Paxton continue to play politics with abortion

This is exactly the problem with that Fifth Circuit ruling.

Right there with them

Though Gov. Greg Abbott loosened a ban on nonessential surgeries, he said Friday it would be up to courts to decide if his order restores access to abortions — the subject of a weekslong legal brawl — as the state continues to combat the coronavirus pandemic.

“Ultimately, obviously that will be a decision for courts to make,” Abbott said, adding, that an allowance for abortion is “not part of this order. The way that the order is written is in terms of what doctors write about the type of treatment that is provided.”

The Republican governor issued an order last month barring medical procedures that are not “immediately medically necessary” to preserve protective equipment and hospital beds for coronavirus patients. His directive extends through April 21 and Abbott said Friday the restrictions would be relaxed starting April 22.

But Attorney General Ken Paxton has declared Abbott’s first order applies to all abortions except those needed to protect the life or health of the woman. The near-total ban prompted a lawsuit from abortion providers, who accused state officials of political opportunism and argued the procedure does not usually require hospitalization nor extensive protective gear.

See here for the last entry. This is exactly what I meant when I said that if all it takes is a declaration of an emergency for the state to shutter abortion clinics, then there is no right to abortion in Texas and the law as it now exists is a sham. Abbott is on the one hand saying that we can start easing up on shutdown orders and we have plenty of hospital capacity (not that abortion has anything but a negligible effect on that), but hey, it’s not up to him to decide whether any of this means that reproductive health care can go back to its usual business even if other medical services that are deemed “non-essential” can resume. It’s cynical and chickenshit on his part, and it again shows that there has to be some kind of consistency. And it again shows why the Fifth Circuit sucks.

Fifth Circuit allows medical abortions to proceed

Well, this is a pleasant surprise.

Right there with them

A federal appeals court on Monday blocked Texas from enforcing a ban on medication-induced abortions as part of the state’s curbs on certain medical procedures during the coronavirus pandemic.

As a result of fast-moving litigation over Texas’s abortion restrictions, women seeking to terminate an unwanted pregnancy may do so through the use of medicine, but only women nearing their 22nd week of pregnancy may undergo a surgical abortion.

In its Monday ruling, the 5th Circuit Court of Appeals said it sided against Texas because it was unclear if the state’s public health order halting nonessential medical procedures applied to medication-induced abortions.

“[Abortion providers] argue that medication abortions are not covered by [the order] because neither dispensing medication nor ancillary diagnostic elements, such as a physical examination or ultrasound, qualify as ‘procedures,’” the three-judge panel wrote.

“Given the ambiguity in the record, we conclude on the briefing and record before us that [Texas officials] have not made the requisite strong showing [necessary for] relief,” the panel said.

The panel’s decision partially reinstates a lower court ruling that limited the Texas health order’s impact on abortions.

Following the 5th Circuit’s ruling, abortion providers on Tuesday withdrew an application submitted to the Supreme Court over the weekend that had asked the justices to intervene.

See here and here for the background. It’s still far less than great, in that it accepts the premise that abortions aren’t essential health care and can be routinely delayed for political reasons, but at least it recognizes that dispensing medication is in no way a threat to the supply of PPEs. From this godforsaken court, that counts as a ringing victory. SCOTUSBlog and the Trib have more.

And so we go to SCOTUS

Pardon me while I gird my loins for whatever happens next.

Right there with them

Texas abortion providers have taken a back-and-forth legal battle with the state of Texas over its temporary ban on the procedure to the U.S. Supreme Court.

The groups on Saturday requested an emergency stay from the high court, asking that it overturn a federal appeals court decision and allow medication-induced abortion services, and surgical abortions in limited circumstances, while the case proceeds.

The request comes amid the longest period that women in the state have ever been without access to abortion since the landmark 1973 Roe v. Wade case that legalized the procedure, as the more than two-weeklong legal saga continues.

The battle began when Gov. Greg Abbott on March 22 banned elective surgeries during the coronavirus state of disaster in a move intended to conserve personal protective equipment needed to fight the pandemic, and the groups quickly filed suit. The Texas Attorney General Ken Paxton, who is representing the state, did not immediately respond to a request for comment Saturday.

The state has argued that personal protective equipment would still be needed with medication abortions and that those could even require hospitalizations if complications followed. Paxton said in an interview with CBS on Wednesday that he figured that the case would rise to the nation’s highest court.

Legal battles are brewing in several other states where abortion rights groups have sued over similar bans, including Alabama, Ohio and Oklahoma, but Texas’ case is the first to reach the Supreme Court.

See here for the previous update. It’s possible that SCOTUS will react the way they did following the recent Louisiana case where that state passed an anti-abortion law nearly identical to the one SCOTUS had struck down from Texas in the Whole Women’s Health decision, with the message going to the Fifth Circuit that “you don’t get to overturn Roe v Wade, only we get to do that” (hat tip to Dahlia Lithwick for the concept). If that’s the case, they’ll allow the hold on the executive order to stay in place until they can rule on the issue, in which case they have whatever rein they want to restrict abortions. I mean, let’s be clear, if all it takes to shut down clinics across the state is for the governor to declare a state of emergency, then what’s stopping him from declaring a permanent state of emergency? Or at least saying that until there’s a broad-based coronavirus vaccine that meets whatever arbitrary standard of effectiveness that Texas would choose, all such restrictions must stay in place? A right is not a right if it can be revoked on a whim, and there has to be some clear and compelling reason for it to be restricted in the first place. We’ll see what SCOTUS makes of this, but we need to be prepared for some bad news.

Do I need to tell you that the Fifth Circuit did it again?

I’m going to tell you anyway, because it’s what happened.

Right there with them

In the latest turn of a whiplash-inducing federal court battle over Texas GOP officials’ near-total ban on abortion during the novel coronavirus outbreak, a federal appeals court on Friday once again lent support to state officials and prohibited the procedure under all but a few narrow circumstances.

For now, the higher court said, the only patients who may terminate their pregnancies in Texas are those who would pass the legal gestational limit for abortions while a gubernatorial emergency order barring elective medical procedures remains in place. The news comes just a day after a federal district judge in Austin ordered that those patients, as well as others planning to undergo “medication abortions,” which involve ingesting pills, should be permitted to terminate their pregnancies as planned.

Texans bans abortions starting 22 weeks after a patient’s last menstrual period, meaning some patients would have been unable to terminate their pregnancies at all.

Providers said the newest order from the federal appeals court makes abortion “largely inaccessible” and said they will weigh every legal option — including seeking emergency relief from the U.S. Supreme Court.

“The court is unjustifiably forcing women to wait until the 11th hour to get the time-sensitive, essential healthcare that they are constitutionally guaranteed,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “We will pursue all legal options to ensure no women are left behind.”

Already, hundreds of patients have seen their planned abortions disrupted, and providers have been thrust into uncertainty as the legal status of the procedures they perform has changed as many as three times during a single week.

The litigation is far from complete, with deadlines as soon this weekend for attorneys on both sides of the case to make more arguments before the court.

See here for the previous update. Someone whose galaxy brain is bigger than mine is going to have to explain to me the rationale for banning medication abortions, since as far as I can tell that imposes no burden on the healthcare system. I don’t know what else there is to say. The Chron has more.

Abortion ban partially lifted

Here we go again.

Right there with them

In a second rebuke to Texas GOP officials who have said a ban on nearly all abortions is essential as the state battles the novel coronavirus, a federal judge in Austin ruled Thursday that some abortions may proceed.

U.S. District Judge Lee Yeakel narrowed Texas’ prohibition to allow certain abortions to proceed while a gubernatorial emergency order barring medical procedures that are not “immediately medically necessary” still stands. The ruling will allow Texas abortion providers to proceed with medication abortions — which involve patients ingesting pills and do not consume scarce medical protective equipment — as well as procedural abortions for patients who risk meeting the state’s gestational age cutoff for abortions before Gov. Greg Abbott’s emergency order is lifted.

[…]

Abbott’s emergency order is set to expire later this month, but it may be extended as the state prepares for a peak in coronavirus cases that may not come for weeks. In Texas, abortions are prohibited starting 22 weeks after a patient’s last menstrual period — meaning even if Abbott’s order lifts in April, patients who wait might not have the opportunity to obtain a legal abortion in Texas at all.

U.S. 5th Circuit Judge Kyle Duncan had said the order was best understood not as an “absolute ban” but as a “temporary postponement” in line with delays for many medical procedures, like colonoscopies. But Yeakel argued that because abortions, unlike colonoscopies, are time-limited, “to women in these categories, the executive order is an absolute ban on abortion.”

See here for the last update. If you’re feeling a little whiplashed, I understand. I also caution you to hold on, because this revised restraining order is headed right back to the Fifth Circuit, where we will see if this is what they had in mind, or if they move the goalposts again. I’m not making any predictions. The Chron has more.

The Fifth Circuit sticks the shiv the rest of the way in

The worst court in the country does its thing again.

Right there with them

A New Orleans-based federal appeals court will, for now, allow Texas to enforce a ban on almost all abortions as the state battles the coronavirus pandemic.

Overturning the decision of a lower court, a three-judge panel on the politically conservative U.S. 5th Circuit Court of Appeals ruled Tuesday that the state may continue to prohibit all abortions except those for patients whose pregnancies threaten their lives or health — a restriction GOP state officials have insisted is necessary for preserving scarce hospital resources for COVID-19 patients.

Citing precedent from the U.S. Supreme Court, U.S. Circuit Judge Kyle Duncan, an appointee of President Donald Trump, wrote that “individual rights secured by the Constitution do not disappear during a public health crisis, but … Rights could be reasonably restricted during those times.”

“When faced with a society-threatening epidemic, a state may implement emergency measures that curtail constitutional rights so long as the measures have at least some ‘real or substantial relation’ to the public health crisis and are not ‘beyond all question, a plain, palpable invasion of rights secured by the fundamental law,’” he wrote.

U.S. Circuit Judge James Dennis, appointed to the court by Bill Clinton, dissented.

Abortion providers have characterized the state’s lawsuit as political opportunism. Most abortions do not take place in hospitals, and according to providers, they generally do not require extensive personal protective equipment, like the masks and gloves in short supply for doctors and nurses fighting COVID-19.

[…]

Duncan said Yeakel was wrong to characterize Abbott’s order as an outright ban on abortions.

“Properly understood,” he wrote, the executive order is a “temporary postponement” of many procedures, like colonoscopies.

But Texas bans abortions after 20 weeks, meaning prohibiting the procedure for any length of time leaves many patients unable to terminate their pregnancies at all. Abbott’s order is set to expire April 21 but can be extended.

The case now heads back to federal court in Austin, where a hearing is scheduled next week. The 5th Circuit had already paused Yeakel’s order blocking the ban, but Tuesday’s opinion threw it out entirely.

Further litigation is all but guaranteed. States including Ohio, Oklahoma and Alabama have imposed bans similar to Texas’, and similar lawsuits are playing out across the country.

See here for the background. I don’t know why there’s any pretense that the Fifth Circuit is an unbiased arbiter of the law. They rubber-stamp these appeals on the flimsiest of pretexts. I don’t know if they honestly believe there’s no difference between an abortion and a colonoscopy or if they just think we’re too stupid to understand the difference. The sheer arrogance of it is breathtaking. If Democrats manage to beat Trump and take the Senate in November, I’d be in favor of appointing about a hundred new judges to this court, to ensure as best as possible there’s never another Republican majority on any three-judge panel. This crap cannot continue.

The Fifth Circuit does what the Fifth Circuit always does

The fix, as ever, is in.

Right there with them

A federal appeals court on Tuesday temporarily reinstated Texas’s ban on abortions amid the coronavirus outbreak, saying it needs time to review arguments about its impact.

The ruling is the latest in a ricocheting legal battle that began last week after the governor postponed non-essential surgeries, and the attorney general declared abortions to be included.

The Republican-led state is one of several that have moved to block abortions, arguing that providers are draining critical medical supplies that could be used to respond to the coronavirus pandemic.

Two of the conservative justices on the Fifth Circuit Court of Appeals issued the ruling, and gave both sides until Friday to respond, meaning the ban will remain in effect at least through this week.

In a dissent, Circuit Judge James Dennis noted that a federal judge in Austin had declared a day earlier that “irreparable harm would flow from allowing the (governor’s) order to prohibit abortions during this critical time.”

See here for the background. I wish these predictions weren’t so easy to make, but this is literally what the Fifth Circuit does. I’m going to go walk my dog and hurl curses in their direction. You go read Mark Joseph Stern and Mother Jones for more details about this.

Latest abortion ban halted for now

We follow the script.

Right there with them

A federal judge on Monday temporarily blocked Texas’ ban on abortions, a prohibition state officials said was necessary to preserve medical resources during the coronavirus pandemic.

The ruling came less than a week after Texas abortion providers announced a lawsuit against top state officials, challenging Attorney General Ken Paxton’s assertion that Gov. Greg Abbott’s executive order banning all procedures deemed to be not medically necessary should be interpreted to include abortions.

The court granted the abortion providers’ motion to temporarily block the state from enforcing the order, which was set to expire April 21, as it relates to abortions. The temporary restraining order will expire April 13.

“Regarding a woman’s right to a pre-fetal-viability abortion, the Supreme Court has spoken clearly,” wrote U.S. District Judge Lee Yeakel. “There can be no outright ban on such a procedure.”

Yeakel also wrote that people seeking abortions would “suffer serious and irreparable harm” if the ban were allowed and that temporarily blocking the executive order “will not disserve the public interest.”

“The attorney general’s interpretation of the Executive Order prevents Texas women from exercising what the Supreme Court has declared is their fundamental constitutional right to terminate a pregnancy before a fetus is viable,” Yeakel wrote.

See here for the background. The next page of this script is the state appealing to the Fifth Circuit, and the Fifth Circuit inventing some reason to give the state what it asked for. After that it gets a little murky, but by then it almost doesn’t matter because the state gets to do what it wants in the interim. In theory, once the emergency order is lifted then the justification for this ban goes away, but if you don’t think there’s some way that Abbott and Paxton might try to work around that, you’re not thinking hard enough. The Current and Slate have more.

Abortion providers file suit over Abbott executive order

You can’t let crass opportunism go unchallenged.

Right there with them

Texas abortion providers announced a lawsuit against top state officials, challenging an executive order earlier this week that included abortion in a ban of all procedures that are deemed to not be medically necessary.

In a press conference Wednesday, national and state abortion rights groups said they are seeking a temporary restraining order, with hopes of a more permanent injunction to follow. They are representing various abortion providers in the state, including Austin Women’s Health Center and Southwestern Women’s Surgery Center.

The ban, which Attorney General Ken Paxton later clarified applies to abortion clinics as well, was enacted to ensure the state maintains health care capacity as it prepares for an influx of COVID-19 patients. But abortion clinics and activists in the state pushed back almost immediately, with Planned Parenthood President Alexis McGill Johnson calling it an “exploitation” of the current crisis.

Sealy Massingill, the chief medical officer of Planned Parenthood of Greater Texas, took politicians to task for “playing politics” at a critical time. Planned Parenthood of Greater Texas still plans to keep clinics open, though he said the organization is bracing for further developments.

“I find it extremely distressing … that we are trying to respond to a purely political fight that [Gov. Greg Abbott] started. Patients who need abortions are on a time-sensitive deadline,” Massingill said.

Providers have already had to turn away patients, Massingill added, and delays of even a few weeks could render some abortions impossible if the patients’ pregnancies extend past legal deadlines.

Here’s the Trib story about the executive order. I didn’t get around to blogging about it because there’s just too much these days. It should be obvious that a “medically necessary” procedure is one that simply cannot be put off, at least not for a significant length of time, and that by that definition, abortion clearly fits. To claim otherwise, as the state of Ohio has also done, is sophistry at best and a straight up lie otherwise. In a rational world, this would get stopped in a hot second by any court. In a world that includes the Fifth Circuit Court of Appeals, your guess is as good as mine. Given that Abbott has declined to issue a statewide stay-at-home order, preferring to leave that to the locals, who have not seen fit to order clinics to stop providing abortions, the case for this is even flimsier. I feel confident that a district court judge will issue a temporary restraining order, but after that who knows. The Chron has more.

ACLU sues the “abortion sanctuary cities”

This was expected.

The ACLU filed a lawsuit against seven Texas cities on Tuesday for passing ordinances that aim to ban abortion by outlawing providers and advocates from doing business in their towns.

The suit, brought by the ACLU of Texas and ACLU National, contends the cities are violating the free speech of the eight banned groups, which include abortion providers and organizations that help people who need abortions. The ordinances label the groups “criminal organizations” and make it unlawful for them to operate within city limits.

“These ordinances are unconstitutional,” said Anjali Salvador, staff attorney for the ACLU of Texas. “Abortion is legal in every city and state in the country. Cities cannot punish pro-abortion organizations for carrying out their important work.”

The ordinances subject groups that would aid women seeking an abortion to illegal punishment without a fair trial, according to the lawsuit. The Lilith Fund and Texas Equal Access Fund, two of the eight groups banned from operating in the cities, are among the plaintiffs. Other banned organizations include Planned Parenthood, NARAL Pro-Choice Texas, Whole Woman’s Health and Whole Woman’s Health Alliance.

The ordinances make it unlawful for the organizations to offer services of any kind in the city, rent office space, purchase property or establish a physical presence. On the other hand, the ordinances acknowledge that cities cannot ban abortion under current law unless the U.S. Supreme Court were to overturn abortion protections guaranteed in Roe v Wade.

[…]

Waskom, a small town on the Texas-Louisiana border, became the first city in the state to ban abortion this way, although it had no abortion clinics. City officials voted unanimously in favor of the ordinance, fearful a Louisiana law banning abortions once a fetal heartbeat is detected could push clinics to relocate in Texas. Six other small cities in East Texas have passed similar ordinances: Naples, Joaquin, Tenaha, Rusk, Gary and Wells.

The ordinances make it illegal to provide transportation, instructions or money to someone intent on having an abortion. They also offer families of an aborted fetus the ability to sue abortion providers.

See here for some background, and here for a copy of the lawsuit, which was filed in federal court. I haven’t blogged about most of these ordinances because there’s not much new to say for each, and so far all of the “cities” involved have been tiny towns that have no clinics in them. You’d think that just the provision making it “illegal to provide transportation, instructions or money to someone intent on having an abortion” would be unconstitutional – would a city also be allowed to make it illegal to “provide transportation, instructions or money to someone intent on” gambling in Louisiana, or smoking weed in Colorado, or visiting the Bunny Ranch in Nevada, all things that are presumably also frowned upon by the people of Waskom? In theory, the Uber driver who takes you to the Greyhound station for a trip to Planned Parenthood in Houston would be guilty under this law, as would the driver of the Greyhound bus. You can’t stop someone from engaging in a perfectly legal pursuit.

As is always the case with this sort of thing, I agree completely with the intent of the lawsuit, and I’d love to see these towns get socked with large legal bills for their exercise in unconstitutional frivolity, that they may serve as grim examples for the next burg that might find itself tempted by the zealous anti-abortion grifters that sold them on it. But I admit to having some concerns as well. Do we really want to 1) provide another opportunity for Ken Paxton to grandstand (which, even though the state is not a party to the lawsuit, you know he will), 2) provide the Fifth Circuit with an opportunity to invent a reason why this is all hunky dory, and 3) provide SCOTUS with another opportunity to kneecap Roe v. Wade without explicitly overruling it? I shouldn’t have to feel this way – these ordinances are so obviously wrong there should be no cause for concern – but this is the world we live in. I just don’t love the risk/reward profile on this, and I hate myself for saying that. The Trib has more.

The extraordinary danger of being pregnant and uninsured in Texas

So utterly appalling.

Right there with them

From 2012 through 2015, at least 382 pregnant women and new mothers died in Texas from causes related to pregnancy and childbirth, according to the most recent data available from the Department of State Health Services; since then, hundreds more have likely perished. While their cases reflect the problems that contribute to maternal mortality across the United States — gross medical errors, deeply entrenched racism, structural deficiencies in how care is delivered — another Texas-size factor often plays a significant role: the state’s vast, and growing, problem with health insurance access.

About one in six Texans — just over 5 million people — had no health insurance last year. That’s almost a sixth of all uninsured Americans, more than the entire population of neighboring Louisiana. After trending lower for several years, the Texas rate has been rising again — to 17.7% in 2018, or about twice the national average.

The numbers for women are even worse. Texas has the highest rate of uninsured women of reproductive age in the country; a third were without health coverage in 2018, according to a DSHS survey. In some counties, mainly along the Mexico border, that estimate approaches 40%.

Public health experts have long warned that such gaps can have profound consequences for women’s health across their lifespans and are a critical factor in why the U.S. has the highest rate of maternal deaths in the developed world. Texas’ maternal mortality numbers have been notably troubling, even as errors in key data have complicated efforts to understand what’s going on and led skeptics, including the governorto question whether there’s really a crisis.

Hardly anyone outside the policy world has taken a deep look at how these insurance gaps play out for women in the second-largest state in the U.S. — at how, in the worst-case scenarios, lack of access to medical care endangers the lives of pregnant women, new mothers and babies.

ProPublica and Vox have spent the last eight months doing just that — combing through government data and reports, medical records and research studies, and talking with scores of women, health care providers, policymakers and families of lost mothers around the state. We learned about Rosa Diaz and dozens of others, mostly women of color, by scouring medical examiner’s databases for sudden, “natural” deaths, then inspecting investigator and autopsy reports for clues about what went wrong.

The picture that emerges is of a system of staggering complexity, riddled with obstacles and cracks, that prioritizes babies over mothers, thwarts women at every turn, frustrates doctors and midwives, and incentivizes substandard care. It’s “the extreme example of a fragmented system that cares about women much more in the context of delivering a healthy baby than the mother’s health in and of itself,” said Eugene Declercq, professor of community health sciences at Boston University School of Public Health.

Most of the mothers whose cases we examined were covered by Medicaid for low-income pregnant women, a state-federal health insurance program that pays for 53% of the births in Texas, more than 200,000 a year, and 43% of all births nationwide. In Texas, the program covers OB-GYN visits, medications, testing and nonobstetric care, from endocrinologists to eye exams.

But the application process is so cumbersome that women in the state have the latest entry to prenatal care in the country, ProPublica and Vox found. It can take months to be seen by regular providers and even longer to access specialists. This poses the greatest danger for high-risk mothers-to-be — as many women on Medicaid are, having had no medical care for significant parts of their lives. Then, roughly two months after delivery, pregnancy Medicaid comes to an end, and the safety net gives way to a cliff. For many new mothers, the result is a medical, emotional and financial disaster.

More than half of all maternal deaths in the U.S. now occur following delivery, according to the Centers for Disease Control and Prevention, with as many as 24% happening six or more weeks after a woman gives birth. In Texas, the proportion of late-postpartum deaths is closer to 40%, with black women bearing the greatest risk. “To lose health care coverage really has a tremendous potential to worsen outcomes,” said Dr. Lisa Hollier, chief medical officer for obstetrics and gynecology for Texas Children’s Health Plan and chair of the state’s maternal mortality review committee.

This is a long excerpt, but there’s a lot more to the story, so please read the whole thing. There are numerous policy decisions at fault here – not expanding Medicaid, low Medicaid reimbursements, cutting off Planned Parenthood and substituting in wholly inadequate alternatives, and more – and all of them can be laid at the feet of the state’s Republican leadership. Whoever runs against Greg Abbott and Dan Patrick and Ken Paxton in 2022 should loudly and repeatedly assert that every maternal death in Texas is their fault. I keep saying this, and it keeps being true: Nothing will change until we have different, and better, government in this state. There’s no other way to do it.

Let this finally be the end of the Heidi Group’s grift

And you should all be thoroughly appalled at the waste, fraud, and abuse committed in the name of screwing Planned Parenthood.

Right there with them

An anti-abortion group that came under fire for failing to provide services to thousands of Texas women must repay $1.5 million in overpayments and prohibited costs, state investigators said Thursday.

The findings, announced by the office of the health inspector general, are a new blow to the Heidi Group. The organization had hoped to replace Planned Parenthood as a top family planning provider, but was cut off from millions in funding last year after failing to serve tens of thousands of low-income women.

The office said on Thursday it had uncovered “serious contractual violations” and is expanding its inquiry to the entire span of the Heidi Group’s contracts, going back to 2016. That could mean additional repayments.

Forensic accountants found the group had paid medical providers hundreds of thousands in excess fees, had overspent on payroll and fringe benefits, and had expensed thousands in unallowable costs like food, gift cards, clothing and retail membership fees, according to a copy of the internal investigation obtained by the Houston Chronicle.

The inquiry covered a seven month period, from September 2017 to March 2018.

“It’s a travesty when you look at all the women who should have been receiving services and were not because of this,” said Rep. Donna Howard, D-Austin. “We’re talking about women who don’t have means to afford health care like many of us do.”

See here for a deeper dive on the Heidi Group’s utter failure, and here for all previous blog posts. As the Observer notes, the state finally canceled their contracts last month, after three years of shoveling good money after bad. In the meantime, thousands of women were denied the health care the needed and deserved. This is what happens when you put rabid ideology over reality. Until we get better government in this state, there’s always a chance it will happen again.

How anti-choicers have won even as they’ve lost

The number of clinics that provide abortion care in Texas will never be what it was before HB2 was passed, despite the SCOTUS ruling that struck it down.

Right there with them

It’s been three years since the U.S. Supreme Court struck down parts of Texas’ controversial abortion law – and yet, most of the clinics forced to close after it first passed haven’t reopened.

The law, known as House Bill 2, was seen as one of the most restrictive crackdowns on abortion clinics in the country. It required clinics to operate like surgical centers and that doctors performing abortions have admitting privileges at a nearby hospital.

Like many other clinics across the state, the Planned Parenthood in San Angelo found the new requirements almost impossible to comply with. Shortly after the law passed, the clinic closed its doors.

“I really do miss it,” said Susanne Fernandez, who managed the clinic for more than two decades. “[We] were helping women be seen for their needs.”

The former clinic looks a lot like it used to, Fernandez said on a visit to the building earlier this month. The only difference is it’s been painted gray.

“Even the blocks in front of the building that have inscriptions on them, they are all still there,” she said. “They are just covered up.”

The clinic was the last abortion provider in that part of West Texas, a mostly rural, expansive part of the state, hundreds of miles away from any major city.

Fernandez said she knew many of the women the clinic served – who were largely low-income – would be greatly affected by its closure.

“The last day was sad; it was somber,” she said. “We did a lot of cleaning up. We all knew that was it.”

Fernandez said she still runs into women who used to come to the clinic.

“There is that thing in the back of your mind – where did these women go?” she said. “Where do they go now? I don’t believe a lot of them found any other health care afterward.”

I guarantee you, the legislators who voted for HB2 have never given that a single thought, and neither have the “pro-life” zealots who enable them. The unsung villain in all this is, as is so often the case, the Fifth Circuit, which not only overruled the district court that had sided with the plaintiffs, they also removed the temporary restraining order, thus allowing HB2 to be enforced while the case was being litigated. The upshot of that was that Texas got to put a lot of clinics out of business with what in the end was an unconstitutional law. See what I mean about winning even as they lose? There will never be a just remedy for this wrong.

A starter agenda for when we have a Democratic state government

I’ve been pondering the recent legislative session, which as we have discussed wasn’t great but also wasn’t nearly as bad as some other recent sessions have been. The qualification for all this is that the key defining factor for our legislative sessions is defense. How well did we do preventing bad bills from becoming law? Oh, there are occasional good bills, on things like criminal justice reform and medical marijuana and the injection of money into public education this session, which should be good until the lack of a funding mechanism becomes an issue. But actually moving the ball forward, on a whole host of items, is a non-starter.

That’s not a surprise, with Republicans in control of all aspects of state government. But Dems picked up 12 seats in the House and two in the Senate, and came close in several statewide races in 2018. There’s a decent chance that Dems can win the House in 2020, and I have to believe we’ll have a stronger candidate for Governor in 2022. The Senate remains a challenge, but after the 2021 redistricting happens, who knows what the landscape may look like. Dems need to aim for the House in 2020, and have a goal of winning statewide in 2022. It won’t be easy, and the national landscape is a huge variable, but we know we’re moving in the right direction, and if not now then when?

And if these are our goals, and we believe we have a reasonable chance at achieving them, then we need to talk about what we want to accomplish with them. It’s a cliche that our legislature is designed to kill bills and not to pass them, but having a unified, overarching agenda – which, let’s not forget, can get a boost by being declared “emergency items” by the Governor – can help overcome that.

So towards that end, I hereby propose a starting point for such an agenda. Moving the ball forward is the ultimate aim, but I believe we have to first move the ball back to where it was before Republicans assumed full control of the government in 2003 in order to really do that. That’s the idea behind this list, which I want to stress is a starting point and very much open to discussion. There are a lot of things a Democratic government will need to do, from health care to voting rights to equality to the environment to climate change and so much more, but we can’t overlook fixing the bad things first.

My list, therefore, covers bills passed since 2003 when Republicans took over. I am skipping over constitutional amendments like the 2003 tort “reform” item, because they will require a supermajority to pass, which we surely will not have. I’m aiming for simplicity, in that these are easy to understand and rally around, and for impact. So without further ado, here are my ideas:

1. Repeal voter ID.
2. Repeal “sanctuary cities”.
3. Repeal anti-Planned Parenthood legislation, from prohibitions on PP receiving Medicaid to this session’s ban on cities partnering with PP on anything, and restore the previously used Women’s Health Program.

Like I said, simple and straightforward, with a lot of impact. The first two are obvious and should have unanimous Democratic support. The third is more of a challenge because even with a Democratic majority in the Senate, we won’t necessarily have a pro-choice majority. Eddie Lucio, and to a somewhat lesser degree Judith Zaffirini, are both opponents of reproductive rights, though Zaffirini is more nuanced than Lucio and ought to be gettable on this kind of bill via an appeal to health care access.

As I said, this is a starting point. There are things I have deliberately left off this list, though I am not by any means discounting or overlooking them. The “Save Chick-fil-A” bill from this session, whose real life effect is not yet known, needs to go but might be better handled as part of a statewide non-discrimination law. (Also, too, there’s the Eddie Lucio problem in the Senate.) Campus carry and open carry are terrible laws, but might be better handled via comprehensive gun control legislation. Tuition deregulation, a big cause of skyrocketing college costs at public universities, which was passed in 2003 as one of many cut-the-budget effort over the years, will be a more complex issue that may require time to study before a consensus solution can be brought forward. All these things and more need to be on the agenda, but some things are more involved than others.

Again, this is a starting point. I make no claim that this is a be-all or end-all. Hell, I make no claim that I’m not forgetting anything equally simple and substantive. I welcome all constructive feedback. Ultimately, what I want out of this is for Dems to recognize the need to decide what our priorities are before we get handed the power to affect them, and to make it part of the case we will be making to the voters to give us that power. I believe having some uniformity to our message will help us. Now it’s up to us to figure out what that message needs to be.

Another dive into the Heidi Group grift

The Observer is on it this time, and as before if you’re not mad by the time you’ve finished reading you’re doing it wrong.

Right there with them

The state of Texas has poured hundreds of thousands of taxpayer dollars into [Carol] Everett’s clinic, which opened in a strip mall in Round Rock last spring, and millions through her anti-abortion organization, the Heidi Group. Everett’s group was tapped as a test case in the effort to defund Planned Parenthood and lift up faith-based, anti-abortion clinics in state and national family planning programs. It didn’t go well. In September, the state announced it would end Everett’s funding, two weeks after the Observer reported that the group had served just 5 percent of the patients promised in its first year.

Now, internal documents, communications and financial statements obtained by the Observer, along with state records and interviews with half a dozen former Heidi Group employees and with Everett, paint a picture of mismanagement, contract violations, lack of oversight and misuse of taxpayer funds — problems that state officials knew about even as they continued to extend the Heidi Group’s contract for more than two years.

[…]

State lawmakers have funnelled millions into the kind of clinics that Everett has championed. The budget for Texas’ Alternatives to Abortion program, which funds faith-based pregnancy centers, has grown 16-fold since its inception in 2006, following this legislative session, with a total investment of about $170 million through 2021. In 2011, Republican lawmakers slashed the state’s family planning budget by two-thirds, shuttering 82 clinics. Two years later, they kicked Planned Parenthood and other abortion provider affiliates out of the state’s low-income women’s health program, forgoing millions in federal dollars to begin a state-funded program instead. At the time, less than a quarter of the estimated 1.8 million poor Texas women in need of publicly funded contraceptive services were getting them. The cuts resulted in tens of thousands more women losing access to reproductive health services like gynecological exams, birth control, cancer screenings and STD testing.

Then, in 2016, the state’s goals and Everett’s aligned in what she called “the greatest possibility for expansion of pro-life care for the poor ever.” Texas’ health agency had scrambled for years to rebuild the reproductive health care safety net without established family planning providers like Planned Parenthood. Now, the Health and Human Services Commission (HHSC) was launching a replacement program called Healthy Texas Women, which would provide reproductive health care and preventive screenings to low-income women. Officials needed someone to fill the gap left by Planned Parenthood, which had previously served 40 percent of patients in Texas’ women’s health program.

Everett had no experience with state family planning programs. But officials awarded her multimillion-dollar contracts to find and oversee providers in Healthy Texas Women and in the Family Planning Program, the state’s other reproductive health program that also covers men and undocumented patients. Everett pledged to serve an astounding 69,000 patients in the two programs during her first year — more than Planned Parenthood.

The experiment failed dramatically. For fiscal year 2017, the Heidi Group was awarded $1.6 million to serve 51,000 patients in Healthy Texas Women; it spent $1.3 million and served 2,300, according to HHSC data. In the Family Planning Program, the group got $5.1 million to serve nearly 18,000 people. After realizing the Heidi Group was falling short of those targets, the state clawed back and reallocated funds mid-year. It ended up spending $605,000 to serve just over 1,000 patients. HHSC released data for fiscal year 2018 in May, but did not specify the number of patients served by contractors. According to an Observer analysis, which added the patients served by Heidi Group subcontractors and the Heidi Clinic in each program in 2018, roughly 4,000 patients were served through Healthy Texas Women and about 2,700 through the Family Planning Program. The state ended Everett’s contracts in December, and launched an investigation into more than $1 million in questionable spending. Her own clinic, which has served just a few hundred women, faces an uncertain future.

Read the rest. The Chron wrote a similar story a couple of months ago, and it’s just as infuriating. Ultimately, I think Carol Everett was a true believer who got way in over her head by being in the right place at the right time with the right things to say. She’s not evil, she’s just Forrest Gump’s incompetent anti-abortion zealot cousin. It’s everyone who enabled the system to throw millions of dollars at her, all the while consigning thousands of poor women to crappy-at-best health care, who deserve all the scorn. That’s Greg Abbott, his appointed flunkies at HHSC like Stuart Bowen, Dan Patrick, Ken Paxton, and every Republican legislator who voted to kick out Planned Parenthood. They made this mess, and some day it will be up to the rest of us to clean it up.

There’s always time for an attack on Planned Parenthood

This one comes with an attack on local control, so it’s a twofer.

Right there with them

Texas and its local governments would no longer be able to partner with abortion providers or their affiliates — even for services like sexual health education and pregnancy prevention initiatives — under a bill the Texas House passed in a preliminary vote late Friday after hours of emotional debate.

Senate Bill 22, which critics call the biggest threat to Planned Parenthood this legislative session, would forbid a government entity from transferring money to an abortion provider, even for services not related to the procedure. It would also bar a transfer of goods or services and any transactions that offers the provider “something of value derived from state or local tax revenue.” Abortion rights advocates fear that the bill could even prohibit privately funded programs held on government property, like pop-up sexual health education booths at community colleges.

The controversial bill dominated the lower chamber’s agenda Friday for more than seven hours and tentatively passed in an 81 to 65 vote.

“This is a taxpayer protection bill,” said Rep. Candy Noble, R-Allen. “Taxpayers who oppose abortion should not have to see their tax dollars subsidizing the abortion industry.”

The bill needs one more vote in the lower chamber before it heads back to the Republican-controlled Senate. State Rep. Jonathan Stickland, R-Bedford, added an amendment that clarifies the bill would not restrict a city or county from banning abortions. If the upper chamber agrees with that change, the bill will then head to Republican Gov. Greg Abbott’s desk.

The bill would also apply to an affiliate of an abortion provider, so no Planned Parenthood clinic could partner with a local government — even clinics that don’t provide abortions. That would include programs like one in Dallas County where Planned Parenthood staffers have provided sexual health education, including information on how to prevent sexually transmitted diseases, at juvenile detention centers.

[…]

Planned Parenthood partners with Texas cities and counties to provide services like HIV testing, teen pregnancy prevention initiatives, and breast and cervical cancer screenings — along with assistance in public health crises. During the 2016 Zika outbreak, the Harris County Health Department provided mosquito repellent and prevention brochures to Planned Parenthood patients. After Hurricane Harvey, Houston city government offices distributed vouchers for no-cost care at local Planned Parenthood clinics.

Opponents of the bill say providers like Planned Parenthood are an integral part of the healthcare safety net for low-income residents in a state that has the highest rate of uninsured adults in the country. Furthermore, they say low-cost and free reproductive health services are especially critical given Texas’ high rate of teen pregnancy, maternal mortality, and sexually transmitted diseases. Cutting off birth control services, they argue, could even drive up abortion rates. And many bill opponents called the measure “an attack on local control.”

As the Texas legislature has rolled back funding for abortion providers, lawmakers have boosted funding for state-run programs like Healthy Texas Women, which provides free or low-cost family planning services. Bill supporters hope to divert women away from abortions clinics and their affiliates and instead direct them toward these state-run alternatives.

But abortion rights advocates argue that such programs are ineffective because they don’t reach enough people. Almost half of the approximately 5,400 Healthy Texas Women providers saw no patients in the 2017 budget year, according to the Texas Observer. If less women can access reproductive health care, some lawmakers unsuccessfully argued, abortion rates would ultimately rise.

So just to recap, this will have no effect on abortion, but it will make it harder to stop Zika outbreaks. How much more pro-life can you get?

The one possible piece of good news here is that according to Scott Braddock, the Stickland amendment may make SB22 vulnerable to a point of order. If that’s true, it’ll happen this morning when the bill comes up for third reading. Hope for the best. And remember, the only way to prevent shit like this from happening is to elect a Democratic majority in the Lege. Nothing will change until that happens. The Observer has more.

UPDATE: On the plus side, vote suppression bill SB9 is not on the House calendar today or tomorrow, so it will not get a House floor vote before the deadline. It could still get in via the back door of being tacked onto another bill, but it’s on life support now.

The Heidi Group grift

You’re not mad enough right now. Read this, that’s fix it.

Right there with them

On a Monday evening in May 2016, Carol Everett sent an email to fellow anti-abortion activists detailing “an extraordinary pro-life opportunity.” Her nonprofit, the Heidi Group, she said, had spent the past year pushing for nearly $40 million in funding to help Christian pregnancy centers “bless many poor women” across Texas.

“It is no exaggeration to say this is the greatest possibility for expansion of pro-life care for the poor ever,” she wrote.

The enthusiasm might have sounded familiar to those who knew Everett, whose decades of work in the anti-abortion movement had earned her accolades from the state’s leading conservatives. But this wasn’t an advocacy project she was describing, and these weren’t private dollars. It was an application she had just submitted to become one of the state’s leading family planning providers.

Everett had never contracted with the state and had no clinical background. Many of the pregnancy centers she cited don’t provide contraception, a core service. Yet state health officials gave her much of the money anyway, ignoring warning signs and overruling staff who recommended millions less in funding, according to a review of the contracting by the Houston Chronicle. When Everett’s clinics began failing, the state delayed for months in shifting money to higher performing clinics, instead devoting vast amounts of time to support Everett and her small, understaffed team.

Though it’s impossible to say how many more women could have been served had the resources been shifted sooner, several competing clinics burned through their funding early in the grant cycle, surpassing their targets for both spending and patients treated. Had they been sent some of the $6.75 million sitting in wait for the Heidi Group, the door could have opened for thousands more women to receive access to contraception, STD screenings and breast exams.

It goes from there, and you should read the rest. I’ve blogged about the Heidi Group before. They’ve wasted millions of your tax dollars not providing health care to women who desperately need it, all in the service of ideology. If this doesn’t make you mad, I don’t know what it’s going to take.

Fifth Circuit does it again

Another terrible ruling by a terrible judge on a terrible court.

Right there with them

A federal appeals court has lifted a lower court order that blocked Texas from booting Planned Parenthood out of Medicaid, potentially imperiling the health care provider’s participation in the federal-state health insurance program.

A three-judge panel on the U.S. 5th Circuit Court of Appeals ruled Thursday that Sam Sparks, the federal district judge who preserved Planned Parenthood’s status in the program in February 2017, had used the wrong standard in his ruling. The appeals court sent the case back to him for further consideration.

The case stems from a long-running flap over a misleading video released in late 2015 by the anti-abortion group Center for Medical Progress, which suggested that abortion providers at Planned Parenthood sold fetal tissue for profit. The sting video included edited clips of Planned Parenthood officials discussing the use of fetal tissue for research. A string of investigations that followed the video’s release were unable to confirm its claims, but it energized a crusade against the health care provider and sparked outrage from the state’s Republican leadership.

[…]

In February 2017, a federal judge in Austin ruled that Texas clinics affiliated with Planned Parenthood could continue to care for patients under the state’s Medicaid program. The state’s arguments, Sparks wrote in a 42-page ruling, were “the building blocks of a best-selling novel rather than a case concerning the interplay of federal and state authority through the Medicaid program.”

But a panel on the conservative-leaning appeals court said Thursday that Sparks had used the wrong standard in his ruling, taking the arguments as a novel, or “de novo,” review and by “giving no deference” to the findings of the state agency that opted to expel Planned Parenthood in the first place. The Office of Inspector General, an arm of the state’s health and human services agency charged with rooting out fraud and abuse, claimed the videos “showed “that Planned Parenthood violated state and federal law.”

“OIG is the agency that the state of Texas has empowered to investigate and penalize Medicaid program violations. The agency is in the business of saying when providers are qualified and when they are not,” Judge Edith Jones wrote. “It is [odd] to claim that federal judges, who have no experience in the regulations and ethics applicable to Medicaid or medical practice, much less in regard to harvesting fetal organs for research, should claim superior expertise.”

See here for the background. Of course Edith Jones would insist that we have to take seriously the lying video of lying liars when it suits her agenda. She’s as predictable as the sunrise. Now we go back to district court and try again to knock down the bullshit. What an utter disgrace.

Planning to fail

Big surprise.

Right there with them

Anti-abortion activist Carol Everett had no experience running a family planning program when the state of Texas awarded her millions in taxpayer funds to help rebuild a network of low-income women’s health providers. The state knew that. So it should have been no surprise when Everett’s organization, the Heidi Group, failed to provide services to thousands of women after the Legislature slashed family planning funds and kicked out Planned Parenthood.

Last year, officials with the Texas Health and Human Services Commission (HHSC) acknowledged that the Heidi Group hadn’t met its contractual obligations, and the agency clawed back some of the money. But, until now, HHSC has refused to reveal how many patients Everett served, or just how much was spent on their care. Data obtained by the Observer shows that in fiscal year 2017, the Heidi Group served just over 3,300 clients, less than 5 percent of the nearly 70,000 Everett had pledged to cover. Nonetheless, the state renewed the group’s multimillion-dollar contracts for a third year.

“It’s outrageous. In what other area of state government would this kind of incompetence be rewarded over and over and over again?” said Dan Quinn, communications director at Texas Freedom Network, which called for an investigation into the Heidi Group contracts. “It’s a betrayal of taxpayers and especially of women who need these services and aren’t getting them.”

[…]

One of Heidi Group’s contracts is for the Healthy Texas Women program, which provides family planning services and preventive screenings for poor Texans. For fiscal year 2017, Heidi was initially awarded about $1.6 million to build a network of providers — a mix of clinics, individual doctors and crisis pregnancy centers — to serve nearly 51,000 patients enrolled in Healthy Texas Women. Despite spending more than $1.3 million, Heidi Group only managed to serve 2,300 clients, according to the new data.

Through a second contract, HHSC awarded the Heidi Group $5.1 million to serve nearly 18,000 clients through the Family Planning Program, the state’s other reproductive health program. Last year, the health agency conceded that the Heidi Group was falling short and cut back its contract by just over $4 million, reducing Heidi’s proposed client totals to about 3,500 and reallocating the remaining funds to other contractors. The Heidi Group missed that mark too, spending about $605,000 to serve just over 1,000 clients.

The Heidi Group was the only contractor in either program to have funds revoked in 2017.

See here and here for the background. We need to be clear that the Heidi Group’s incompetence, in conjunction with its anti-choice pedigree, is a feature and not a bug. As such, from the perspective of our state leadership, they’re doing a heck of a job. The Trib has more.

Texas’ maternal mortality rate not as bad as previously reported

Good news, if a bit puzzling.

Several of the state’s top health experts released a report in the medical journal Obstetrics & Gynecology on Monday showing that by using the new method, the number of women who died dropped from 147 to 56.

The study uses an enhanced method of counting maternal deaths that involves cross-referencing birth certificates, death certificates, hospital discharge data and medical records to confirm that a woman who died was pregnant before she died. The state’s current method of calculating maternal deaths includes using specific medical codes and requiring officials to check a box on death certificates indicating whether a woman was pregnant before she died.

The study said the state’s 2012 maternal death numbers inflated the number of women 35 and older who were classified as a maternal death and included reporting errors in which women who had not been pregnant were reported as maternal deaths. The researchers said they also found 2012 deaths that were not included in the state’s original maternal death numbers.

The authors noted that other states have used the same methodology to calculate maternal deaths. They said they chose 2012 for the new analysis because it was the year when maternal deaths peaked in Texas.

The study’s authors said they plan to use the new method to confirm maternal deaths and calculate maternal mortality rates for additional years.

See here for the background. The story notes that even with the revision, which the authors of the new study attribute to “data error” in the initial report, the mortality rate for black women was still double what it was for white women. There are still other serious concerns as well, as expressed by Lisa Falkenberg:

“I would hate to see us lose the momentum that we’ve gained,” said Dr. Lisa Hollier, an obstetrician and gynecologist at Texas Children’s Hospital.

“We still have women dying of preventable causes,” she said. “We still have a two-fold, a doubling, in the risk of death for African-American women. Those things need to change. I don’t think we should accept where we are.”

Hollier, who co-authored this week’s report and also chairs the Texas Maternal Mortality and Morbidity Task Force, points out that deaths aren’t the only measure of the problem. For every maternal death, Hollier says there are 50 women who experience severe complications that can lead to hysterectomies, breathing problems requiring ventilator support and kidney failure, to name a few.

“If there are 50 women who die in a particular year, there are 2,500 women who had severe complications,” Hollier said. “There are so many more women who are affected than just that tiny tip of the iceberg which is mortality.”

All this happens in a state where as Falkenberg reminds us our Republican leadership has refused to expand Medicaid – something like half of all births in Texas are paid for by Medicaid – and have cut back on access to healthcare for women by gutting Planned Parenthood. The definition of “pro-life” in this state is so narrow you could slide it under a lobbyists’ door. So go ahead and be happy that things aren’t as bad as we feared, but don’t be satisfied with it.

UPDATE: Sophie Novack in the Observer makes a lot of really good points about this revised study. Go read what she says.

Another national publication looks at CD07

Mother Jones, come on down.

Rep. John Culberson

In addition to [Laura] Moser, the top competitors for the March primary are first-time candidates with stories that fit the political moment in different ways. Lizzie Fletcher, a well-connected lawyer at a large downtown firm, got her start in politics as a teenager during the 1992 Republican National Convention, when she volunteered to stand outside abortion clinics blocking Operation Rescue types from chaining themselves to the entrance. Alex Triantaphyllis, who at 33 is the youngest of the bunch, co-founded a mentoring nonprofit for refugees in Houston after spending time at Goldman Sachs and Harvard Law School. Jason Westin, an oncologist and researcher at Houston’s MD Anderson Cancer Center, told me he first thought about running a week after the election, after watching his daughter’s soccer game. She had taken a hard fall and Westin told her to “get back up and get back in the game”—but sitting on the couch later that day, scrolling through Facebook, he decided he was a hypocrite. He decided to enter the race with encouragement from 314 Action, a new political outfit that encourages candidates with scientific backgrounds to run for office. The primary is not until March, but in a sign of the enthusiasm in the district, Culberson’s would-be Democratic challengers have already held two candidate forums.

The 7th District starts just west of downtown Houston, in the upscale enclave of West University Place near Rice University, and stretches west and north through parts of the city and into the suburbs, in the shape of a wrench that has snapped at the handle. It had not given any indication of turning blue before last year. But a large number of voters cast ballots for both Hillary Clinton and Culberson. Moser and Fletcher see that as a sign that Republican women, in particular, are ready to jump ship for the right candidate. In the Texas Legislature, West University Place is represented by Republican Sarah Davis, whose district Clinton carried by 15 points, making it the bluest red seat in the state. Davis is an outlier in another way: She’s the lone pro-choice Republican in the state Legislature and was endorsed by Planned Parenthood Texas Votes in 2016. “To the outside world it looks like a huge swing,” Fletcher says of the November results, “but I think that a more moderate kind of centrist hue is in keeping with the district, so I’m not surprised that people voted for Hillary.”

But whether they’re Sarah Davis Democrats or Hillary Clinton Republicans at heart, those crossover voters still make up just a small percentage of the overall population. Houston is the most diverse metro area in the United States, and a majority of the district is non-white—a fact that’s not reflected in the Democratic candidate field. To win, Democrats will need to lock in their 2016 gains while also broadening their electorate substantially from what it usually is in a midterm election. That means making real inroads with black, Hispanic, and Asian American voters in the district, many of whom may be new to the area since the last round of redistricting. “[The] big thing in the district is getting Hispanic voters out, and nobody knows how to do that,” Moser acknowledges, summing up the problems of Texas Democrats. “If we knew how, we wouldn’t have Ted Cruz.”

[…]

At a recent candidate forum sponsored by a local Indivisible chapter, Westin, the oncologist, warned voters against repeating the mistakes of Georgia. “One of the take-home messages was that a giant pot of money is not alone enough to win,” he said. Westin’s message for Democrats was to go big or go home. While he believes the seven candidates are broadly on the same page in their economic vision and in their opposition to Trump, he urged the party to rally around something bold that it could offer the public if it took back power—in his case, single-payer health care. “We’re behind Luxembourg, we’re behind Malta, we’re behind Cypress and Brunei and Slovenia in terms of our quality of health care,” Westin says. “That is astounding.” Who better to make the case for Medicare-for-all, he believes, than someone in the trenches at one of the world’s most prestigious clinics?

Moser, who likewise backs single-payer, may be even more outspoken about the need to change course. She argues that the Obama years should be a teachable moment for progressives. They let centrists and moderates like former Sens. Joe Lieberman and Max Baucus call the shots for a once-in-a-generation congressional majority, she says, and all they got was a lousy tea party landslide. “I don’t know if we would still have been swept in 2010—probably, because that’s the way it goes—but at least we could have accomplished some stuff in the meantime that we could claim now more forcefully and more proudly,” she says. A missed opportunity from those years she’d like to revisit is a second stimulus bill to rebuild infrastructure in places like Houston, where floods get worse and worse because of a climate Culberson denies is changing.

In Moser’s view, Democrats lose swing districts not because they’re too liberal but because they’re afraid to show it. When DCCC Chairman Ben Ray Luján, a congressman from New Mexico, told The Hill in August that the party would support pro-life Democratic candidates next November on a case-by-case basis (continuing a long-standing policy backed by Nancy Pelosi), Moser penned another article for Vogue condemning the position. “As a first-time Congressional candidate, I’ve been warned not to criticize Ben Ray Luján,” she wrote, but she couldn’t help it. Red states like Texas were not a justification for moderation; they were evidence of its failure. “I have one idea of how to get more Democratic women to polling stations: Stand up for them.”

Fletcher and Triantaphyllis have been more cautious in constructing their platforms. They’d like to keep Obamacare and fix what ails it, but they have, for now, stopped short of the single-player proposal endorsed by most of the House Democratic caucus. “I don’t think anyone has a silver bullet at this point,” Triantaphyllis says. Both emphasize “market-based” or “market-centered” economic policies and the need to win Republican voters with proposals on issues that cut across partisan lines, such as transportation. Houston commutes are notorious, and Culberson, Fletcher notes, has repeatedly blocked funding for new transit options.

Still, the field reflects a general leftward shift in the party over the last decade. All the major candidates oppose the Muslim ban, proposals to defund Planned Parenthood, and Trump’s immigration crackdown. Even in America’s fossil-fuel mecca, every candidate has argued in favor of a renewed commitment to fighting climate change. It is notable that Democratic candidates believe victory lies in loudly opposing the Republican president while defending Barack Obama in a historically Republican part of Texas. But Moser still worries her rivals will fall for the same old trap.

“I just think in this district people say, ‘Oh, but it’s kind of a conservative district,’ [and try] to really be safe and moderate, and I find that the opposite is true,” Moser says. “We just don’t have people showing up to vote. We don’t even know how many Democrats we have in this district because they don’t vote.”

Pretty good article overall. I often get frustrated by stories like this written by reporters with no clue about local or Texas politics, but this one was well done. This one only mentions the four top fundraisers – it came out before Debra Kerner suspended her campaign, so it states there are seven total contenders – with Moser getting the bulk of the attention. It’s one of the first articles I’ve read to give some insight into what these four are saying on the trail. They’re similar enough on the issues that I suspect a lot of the decisions the primary voters make will come down to personality and other intangibles. Don’t ask me who I think is most likely to make it to the runoff, I have no idea.

As for the claims about what will get people out to vote next November, this is an off-year and it’s all about turnout. CD07 is a high turnout district relative to Harris County and the state as a whole, but it fluctuates just like everywhere else. Here’s what the turnout levels look like over the past cycles:


Year    CD07   Harris   Texas
=============================
2002  37.37%   35.01%  36.24%
2004  66.87%   58.03%  56.57%
2006  40.65%   31.59%  33.64%
2008  70.61%   62.81%  59.50%
2010  49.42%   41.67%  37.53%
2012  67.72%   61.99%  58.58%
2014  39.05%   33.65%  33.70%
2016  67.04%   61.33%  59.39%

These figures are from the County Clerk website and not the redistricting one, so the pre-2012 figures are for the old version of CD07. High in relative terms for the off years, but still plenty of room to attract Presidential-year voters. Note by the way that there are about 40,000 more registered voters in CD07 in 2016 compared to 2012; there were 20,000 more votes cast in 2016, but the larger number of voters meant that turnout as a percentage of RVs was down a touch. Job #1 here and everywhere else is to find the Presidential year Democrats and convince them to come out in 2018; job #2 is to keep registering new voters. The candidate who can best do those things is the one I hope makes it on the ballot.

Yet another lawsuit filed over yet another unconstitutional anti-abortion law

Stop me if you’ve heard this one before.

Texas is heading to court over a state law going into effect in September banning the most common second-trimester abortion procedure.

The Center for Reproductive Rights and Planned Parenthood announced on Thursday they’re suing over a provision in Texas’ Senate Bill 8 bill that outlaws dilation and evacuation abortions. In that procedure, a doctor uses surgical instruments to grasp and remove pieces of fetal tissue. SB 8 only allows the procedure to be done if the fetus is deceased.

Nancy Northrup, president and CEO of the Center for Reproductive Rights, said in a news release that Texas legislators “have once again compromised the health and safety of the women they were elected to represent” to appease abortion opponents.

“The law we challenged today in Texas is part of a nationwide scheme to undermine these constitutional rights and ban abortion one restriction at a time,” Northrup said. “We are prepared to fight back using the power of the law wherever politicians compromise a woman’s ability to receive the care she needs.”

Medical professionals deem the method the safest way to perform an abortion on a pregnant woman, and reproductive rights groups have said this change would subject women to an unnecessary medical procedure. Abortion opponents call the procedure “dismemberment” abortions and argue it’s inhumane.

Provisions similar to SB 8 have been halted in Louisiana, Kansas, Oklahoma and Alabama, according to the center’s news release.

See here for the background, and here for the news release. This will be stopped by the courts, and when all is said and done we the taxpayers will get to pick up the tab for the legal fees incurred as the state defends this indefensible monstrosity. Personally, I think it would be more efficient to just make a donation to the CRR directly, but to each their own. Oh, and do keep in mind that the madness never ends, so get ready for even more of this fun in the not too distant future. The Observer and the Current have more.

State seeks Medicaid money it gave up over Planned Parenthood ban

Ugh.

Right there with them

Four years after Texas gave up millions of dollars in federal Medicaid funds so it could ban Planned Parenthood from participating in a family planning program for low-income women, the state is asking the Trump administration for the money back.

The request presents an important early test for the administration of President Trump, who recently appointed an anti-abortion official to oversee federal family planning programs. Under President Obama, federal health officials would not allow Medicaid funds to flow to the Texas program after it excluded Planned Parenthood, because federal law requires states to give Medicaid beneficiaries their choice of “any willing provider.”

If the administration agrees to restore the funding for Texas, it could effectively give states the greenlight to ban Planned Parenthood from Medicaid family planning programs with no financial consequences.

“They’re asking the federal government to do a 180 on its Medicaid program rules,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute, a research center that supports abortion rights. “And depending how this shakes out, you could see a number of other states follow suit.”

[…]

In its draft waiver application, the state said it hoped that by turning Healthy Texas Women back into a Medicaid waiver program, it would improve access and participation. The application noted that Texas had the nation’s highest birthrate, with more than 400,000 births in 2015, more than half of which were paid for by Medicaid. It also noted than more than one-third of pregnancies in the state were reported as unintended, and that Texas had one of the highest teen birthrates in the country.

On Monday, at a public hearing on the plan in Austin, several women and representatives of health advocacy groups expressed concern about the request.

“A strong Healthy Texas Women program should include Planned Parenthood,” said Blanca Murillo, 25, who said she relied on Planned Parenthood for contraception that helped treat her polycystic ovary syndrome when she was a student at the University of Texas. “I’m asking the state to choose the health of Texas women — which it has a duty to protect — over scoring political points.”

Stacey Pogue, senior policy analyst at the Center for Public Policy Priorities, a liberal research group, pointed to the so-called freedom of choice provision in Medicaid and said she was concerned that “submitting the waiver as is would invite litigation.”

A spokeswoman for the Centers for Medicare and Medicaid Services, or C.M.S., which oversees Medicaid waiver programs, declined to comment.

Carrie Williams, a spokeswoman for the Texas Health and Human Services Commission, said, “We’re been encouraged to present new and innovative ideas to C.M.S. for discussion for possible funding. This is a new administration, and we’re looking at what funding opportunities may exist for us.”

Texas is also seeking to cut off all Medicaid funding to Planned Parenthood; a federal judge blocked the effort earlier this year, but the state is appealing the decision.

It’s for stuff like this that Republicans have remained loyal to Trump regardless of the disaster he creates everywhere. They want their shiny ideological objects, and it doesn’t get much shinier than shivving Planned Parenthood. Who cares if some of the money winds up going to frauds? It’s not like they actually cared about women’s health in the first place. So yes, I expect this request to be granted in short order, and then replicated in other states. The only way to undo that is going to be to undo who is in charge of the government. The Associated Press, the Trib, and the Current have more.

Winning the battles but losing the war

That’s the story of reproductive rights, and access to reproductive health care in general, in Texas.

Right there with them

“We have made tremendous gains,” said Joe Pojman, executive director of the Texas Alliance for Life. He hopes that someday, perhaps under Trump, the Supreme Court will overturn the Roe v. Wade ruling upholding abortion rights. In the meantime, when he surveys abortion trends in Texas, he sees “huge progress.”

Abortion rights advocates ruefully agree they have lost ground.

“What makes Texas unique is that the clinic system was undercut so quickly,” said Elizabeth Nash, senior state issues manager at the Guttmacher Institute, a reproductive rights research group. “Texas has taken what might have happened in a decade or more in another state and collapsed it into a year.”

Texas has “eroded the fabric of care once in place to serve women and make the current landscape extremely difficult to navigate,” Whole Women’s Health CEO Amy Hagstrom Miller wrote in an email. “As a result of these laws, there are fewer abortion providers in the state and many women have to travel hundreds of miles to receive care.”

Whole Woman’s Health had five clinics in the state a few years ago. After Texas imposed new restrictions, the group shuttered two and decided to challenge the law in court. One clinic is finally set to reopen in Austin in the next couple of weeks. The other, in Beaumont on the Gulf Coast, will remain closed

[…]

More than half the clinics and abortion facilities in the state had already shut down. Just 17 abortion facilities remained in six counties — down from 41 centers in 17 counties in 2012, according to the Texas Policy Evaluation Project, a university group that tracks legislation’s impact on reproductive rights.

About half of the Planned Parenthood clinics in the state are among those that have closed. The clinics that are still open face new restrictions and onerous administrative requirements for them and their patients. Women seeking abortion services face travel distances that have increased by four times over the past few years, according to the Texas Policy Evaluation Project.

A few abortion providers are making plans to re-open: Northpark Medical Group in Dallas started performing abortions again in February after a three-year hiatus. Planned Parenthood will reopen its clinic in Waco by the summer. And Whole Woman’s Health, the Supreme Court plaintiff, will reopen soon in Austin.

But access is unlikely to get back to where it was. Planned Parenthood has no plans to re-open its six shuttered clinics, though it has also resumed services at its San Antonio clinic in 2015. That’s the closest clinic for a woman in the Lower Rio Grande Valley — 250 miles away.

Read the whole depressing thing. I’ve said it before and I’ll say it again, nothing will change until we change who gets elected. There’s a bottomless appetite for bills to restrict abortion in any number of crazy ways, and while they can sometimes be defeated in court, they do a lot of damage in the meantime and cost a bunch of money to litigate away. The only way to stop this is going to be to have a Legislature that doesn’t pass these bills and/or a Governor who will veto them. Nothing will change until that happens.

Video fraudsters in trouble again

In California this time.

Right there with them

California prosecutors on Tuesday charged two anti-abortion activists who made undercover videos of themselves trying to buy fetal tissue from Planned Parenthood with 15 felonies, saying they invaded the privacy of medical providers by filming without consent.

The charges against David Daleiden and Sandra Merritt of the Center for Medical Progress come eight months after similar charges were dropped in Texas.

State Attorney General Xavier Becerra, a longtime Congressional Democrat who took over the investigation in January, said in a statement that the state “will not tolerate the criminal recording of conversations.”

Prosecutors say Daleiden, of Davis, California, and Merritt, of San Jose, filmed 14 people without permission between October 2013 and July 2015 in Los Angeles, San Francisco and El Dorado counties. One felony count was filed for each person. The 15th was for criminal conspiracy to invade privacy.

[…]

Daleiden and Merritt had previously been indicted in Texas on similar charges in January of 2016, but all of the charges were eventually dropped by July as prosecutors said a grand jury had overstepped its authority. The grand jury had originally been convened to investigate Planned Parenthood, but after finding no wrongdoing turned around and indicted Daleiden and Merritt instead.

The California charges stem from recording people without their knowledge, which is a crime in some states but not in others. The charges here were the result of creating phony drivers licenses to back up the aliases they used. The circumstances under which the Harris County indictments were dropped remain somewhat fishy, but I suppose it was just a matter of time before these two clowns got into trouble again. It’s what happens when everything you do is based on a lie. Think Progress, the Current, and Slate’s Mark Joseph Stern, who has a thorough and nuanced look at the California law in question, have more.

This is why you leave women’s health to the professionals

Because amateurs and zealots do a lousy job.

Right there with them

In pushing a replacement for the Affordable Care Act that cuts off funds for Planned Parenthood, Republicans are out to reassure women who rely on the major health care organization that other clinics will step up to provide their low-cost breast exams, contraception and cancer screenings.

Texas is already trying to prove it. But one big bet is quietly sputtering, and in danger of teaching the opposite lesson conservatives are after.

Last summer, Texas gave $1.6 million to an anti-abortion organization called the Heidi Group to help strengthen small clinics that specialize in women’s health like Planned Parenthood but don’t offer abortions. The goal was to help the clinics boost their patient rolls and show there would be no gap in services if the nation’s largest abortion provider had to scale back.

The effort offered a model other conservative states could follow if Republicans make their long-sought dream of defunding Planned Parenthood a reality under President Donald Trump. Several states are already moving to curtail the organization’s funds.

But eight months later, the Heidi Group has little to show for its work. An Associated Press review found the nonprofit has done little of the outreach it promised, such as helping clinics promote their services on Facebook, or airing public service announcements. It hasn’t made good on plans to establish a 1-800 number to help women find providers or ensure that all clinics have updated websites.

Neither the group nor state officials would say how many patients have been served so far by the private clinics.

The Heidi Group is led by Carol Everett, a prominent anti-abortion activist and influential conservative force in the Texas Legislature.

In a brief interview, Everett said some of the community clinics aren’t cooperating despite her best efforts to attract more clients.

“We worked on one Facebook site for three months and they didn’t want to do it. And we worked on websites and they didn’t want to do it,” Everett said of the clinics. “We can’t force them. We’re not forcing them.”

Everett said that advertising she planned was stalled by delays in a separate $5.1 million family planning contract.

Everett proposed helping two dozen selected clinics serve 50,000 women overall in a year, more than such small facilities would normally handle. Clinic officials contacted by the AP either did not return phone calls or would not speak on the record.

The Texas Health and Human Services Commission, which awarded the funding to the Heidi Group, acknowledged the problems. Spokeswoman Carrie Williams said in an email that the agency had to provide “quite a bit” of technical support for the effort and make many site visits. She disputed that the contract funding has been as slow as Everett alleged.

“The bottom line is that we are holding our contractors accountable, and will do everything we can to help them make themselves successful,” she said.

See here and here for some background on the Heidi Group. I’m thinking that maybe the reason these clinics didn’t want Carol Everett’s help is because she’s incompetent. Nothing in her history suggests she has any of the relevant skills, and clearly promoting women’s health isn’t her main focus. Anti-abortion activists tend to be pretty hostile to things like contraception, and often are quite ignorant of basic biology, so who can blame the clinics for keeping her at arm’s length. But let’s let Carol Everett herself sum this up:

Asked whether the Heidi Group would meet the patient targets in her contract, Everett said her own goal was to serve 70,000 women.

However, “it’s not as easy as it looks because we are not Planned Parenthood. We are working with private physicians and providers,” Everett said after leaving a committee hearing this week at the Texas Capitol. She said the clinics she is working with are busy seeing 40 to 50 women a day. “They don’t have time to go out and do some of the things that we would really like to help them do. But we’re there if they want to. And we’re there when the need it. And we’re in their offices and we’re helping them.”

Emphasis mine. No, you’re not. And you never will be. Link via the Current.

Texas cannot bar Planned Parenthood from Medicaid

Good.

Right there with them

U.S. District Judge Sam Sparks ruled Tuesday afternoon that Texas clinics affiliated with Planned Parenthood can continue to care for patients under the state’s Medicaid program, a phew-worthy victory for reproductive rights advocates and a loss for the state’s GOP leaders.

In a 42-page ruling, Sparks wrote that the state’s arguments in the case were “the building blocks of a best-selling novel rather than a case concerning the interplay of federal and state authority through the Medicaid program.”

“After reviewing the evidence currently in the record, the Court finds the Inspector General, and thus [the Texas Health and Human Services Commission], likely acted to disenroll qualified health care providers from Medicaid without cause,” the ruling read. “Such action would deprive Medicaid patients of their statutory right to obtain health care from their chosen qualified provider.”

[…]

In court, Planned Parenthood attorneys argued that not allowing the reproductive health provider to stay in the Medicaid program, which is largely funded by the federal government, would severely curb access to care for poor Texas men and women seeking preventive and sexual health services. The attorneys also argued that the state did not have the capacity to deliver these services in the same way Planned Parenthood does and reiterated that state and federal law already prohibit taxpayer dollars from being spent on abortion services.

State attorneys, meanwhile, leaned heavily on the web video throughout court proceedings, pointing out various clips as part of their evidence. While the video appeared to back up their claims, Planned Parenthood attorneys forced several of the state’s witnesses to concede that no employees were seen committing illegal acts in the undercover video.

Throughout the ruling, the phrase “no evidence” appears multiple times. Sparks said Texas Health and Human Services Commission Inspector General Stuart W. Bowen Jr. “did not have prima facie of evidence, or even a scintilla of evidence” for the termination. He cited that the Center for Medical Progress video, the evidence against Planned Parenthood Gulf Coast and dragging in other Planned Parenthood affiliates were “three overarching bases for termination.”

Sparks said that “for those not blessed with eight free hours to watch” the video, it mostly contained a Planned Parenthood Gulf Coast employee and Center for Medical Progress representatives talking in “unclear and ambiguous dialogue” that was open to interpretation. He said the Texas Health and Human Services Commission did not provide evidence that they had authenticated the video before going forward with termination efforts.

While state attorneys tried to show that the reproductive health organization had “a willingness” to profit from procuring fetal tissue, Sparks said he did not find evidence of that.

“The Court is unconvinced mere willingness, without any evidence of attempt, is enough to deprive a Medicaid beneficiary of the right to her otherwise qualified provider,” the ruling read.

See here for the previous update. Shockingly, the fraudulent anti-PP videos made by the lying liars at the Center for Medical Progress turned out to have no evidentiary value for the state. Who’d a thunk it, am I right? I presume the state will appeal from here, and if the Trump scandal machine ever lets up enough to allow legislation to be passed by Congress, a federal bill could be passed to change the law that PP relied on here to get this action overturned. It’s a little premature to celebrate, is what I’m saying. Still, this is a big deal, and it’s always nice to see Ken Paxton lose in court. The Chron, the AusChron, and Trail Blazers have more.

Planned Parenthood still in Medicaid

For now, pending judgment.

Right there with them

U.S. District Court Judge Sam Sparks on Thursday delayed Planned Parenthood’s ouster from the state’s Medicaid program until Feb. 21.

[…]

During closing arguments Thursday hearing, attorneys from both sides cited clips from the video. Sparks said he wanted all involved to review the video footage and present their findings to him Jan. 30.

“I don’t know if I’ll be able to give an opinion [without further review of the video],” Sparks said.

During the final day of testimony, the state continued to make its case that Medicaid patients would still have access to health services without Planned Parenthood’s help.

Jami Snyder, associate commissioner for Medicaid and CHIP, said on the stand that there were 141,000 providers available in the program, including 29,000 primary care physicians and 3,300 OBGYNs. She said the program has “a very robust network” thanks to strict network adequacy requirements for the managed care organizations that help with Medicaid and patients have a variety of tools to help them find a new doctor. She said the available providers dwarf Planned Parenthood’s presence.

“What we know to be true is that a variety of providers in our network offer family planning services,” Snyder said.

But Planned Parenthood lawyers pressed Snyder on provider availability, forcing her to admit she was unsure if all of the Medicaid providers offer weekend hours or walk-in appointments like the reproductive health organization does. Snyder also admitted Medicaid providers do not necessarily offer the exact same services as Planned Parenthood.

Snyder also elicited gasps in the courtroom when she admitted she did not know about surging maternal mortality rates in Texas.

See here and here for the background. The video in question is of course the bullshit Center for Medical Progress video. Way to be on top of breaking women’s health news there, Jami Snyder! With skills like that I don’t know how you weren’t picked to head up HHS in Washington. Trail Blazers, the Current, Newsdesk, and the Chron have more.

Here we go again with Planned Parenthood and Medicaid

Rooting for another injunction.

Right there with them

Texas officials are back in federal court this week over abortion-related policy, this time to defend efforts to oust Planned Parenthood from Medicaid.

Planned Parenthood has asked U.S. District Judge Sam Sparks to block the ouster as illegal, unjustified and unfair — an improperly political move that could deprive about 11,000 low-income Texans of access to contraceptives, cancer screening, breast exams and testing for sexually transmitted infections.

Lawyers for Texas argue that a 2015 video, shot by abortion opponents using a hidden camera, showed a pattern of “gross violations of medical and ethical standards” — as well as human decency — in the fetal tissue donation practices of a Planned Parenthood clinic in Houston.

“The state should not have to wait until it is too late before it can act to protect Medicaid recipients and taxpayers,” lawyers for Attorney General Ken Paxton told Sparks in a legal brief.

Sparks will hear three days of testimony beginning at 9 a.m. Tuesday in his Austin courtroom in a case with a tight deadline. Planned Parenthood is scheduled to be dropped from the Texas Medicaid program Saturday.

One option for the judge is a temporary order blocking the ouster — keeping the status quo until he can research and write an opinion.

That’s what Sparks did when abortion providers sued to block a state rule requiring clinics and hospitals to bury or cremate fetal remains from abortions or miscarriages. After hearing two days of testimony earlier this month, Sparks promised a ruling by the end of next week.

No matter how Sparks rules — in either case — the losing side is expected to appeal, meaning it could be months before the fate of Planned Parenthood or the fetal burial rule is determined.

See here for the background. Yes, the state is actually using those utterly fraudulent Center for Medical Progress videos as evidence for tossing Planned Parenthood from Medicaid. This is basically the equivalent of arguing that because you found a dollar under your pillow this morning, the Tooth Fairy must really exist. I don’t think there’s anything one can add to that. The Trib has a first day of testimony report, and Trail Blazers and the Texas Standard have more.

Back to court for Planned Parenthood

Here we go again.

Right there with them

Planned Parenthood late Friday asked a federal judge in Austin to block plans by Texas officials to kick the organization out of Medicaid.

Calling state plans “nothing more than a politically motivated witch hunt,” Planned Parenthood asked U.S. District Judge Sam Sparks to issue an injunction or temporary restraining order allowing an estimated 11,000 Texans to continue receiving contraceptives, well-woman exams and screenings for cancer and HIV from the organization.

Planned Parenthood received $4.2 million in Medicaid funding in fiscal year 2015, the latest information available, to provide the services to low-income Texans.

A hearing in the case had previously been set for 9 a.m. Jan. 17 in Sparks’ Austin courtroom.

Citing undercover videos shot by abortion opponents and made public last year, Texas officials announced Dec. 20 that Planned Parenthood would no longer be an approved Medicaid provider as early as Jan. 21.

[…]

Planned Parenthood also argued that Medicaid, a joint federal-state program, operates under U.S. rules that allow patients to receive care from the qualified provider of their choice.

Similar efforts to oust Planned Parenthood from Medicaid programs in Louisiana, Alabama, Arkansas, Kansas and Mississippi have all been blocked by courts for violating the federal provider-choice rule, the organization’s lawyers said.

See here for the background. The video is bullshit, produced by known liars, but it’s sufficient as a pretext for the state to do what it has wanted to do for over a year. The only question is whether they’ll get away with it or not. The DMN has more.

Texas follows through on threat to pull Medicaid funds from Planned Parenthood

More than a year after the initial threat was made. Clearly, you can’t rush these things.

Right there with them

After more than a year of delays, Texas is officially kicking Planned Parenthood out of the state’s Medicaid program.

In a move that could affect thousands of low-income women, state health officials on Tuesday delivered a final legal notice to defund the organization from the Medicaid program through which it provides family planning and women’s health services to the poor. Planned Parenthood had previously received $3.1 million in Medicaid funding, but those dollars will be nixed in 30 days, according to the notice which was obtained by The Texas Tribune.

That cut-off day will only be delayed if the organization appeals the state’s decision in the next 15 days by requesting an administrative hearing with the Texas Health and Human Services Commission. But Planned Parenthood officials say they will instead turn to the courts to block the cuts.

“Planned Parenthood continues to serve Medicaid patients and will seek a preliminary injunction in an ongoing lawsuit filed in November 2015, following the state’s original threats to take action against Planned Parenthood’s patients,” said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes, the organization’s political arm.

[…]

In the final notice, Texas Health and Human Services Inspector General Stuart Bowen said the undercover videos — which depicted Planned Parenthood officials discussing the use of fetal tissue for research — showed “that Planned Parenthood violated state and federal law.”

Bowen claimed in the letter that the videos revealed Planned Parenthood has a history of “deviating from accepted standards” to procure tissue samples for researchers and a “willingness to charge more than the costs incurred for procuring fetal tissue,” among other violations.

“Your misconduct is directly related to whether you are qualified to provide medical services in a professionally competent, safe, legal and ethical manner,” Bowen wrote in the letter. “Your actions violate generally accepted medical standards, as reflected in state and federal law, and are Medicaid program violations that justify termination.”

Planned Parenthood has vehemently denied those claims, and it has criticized the videos the state is pointing to as evidence as being heavily edited to imply malfeasance. Its health centers in Texas have also said they do not currently donate fetal tissue for research. Their Houston affiliate did participate in a 2010 research study with the University of Texas Medical Branch.

State health officials initially alleged they also had “reliable information indicating a pattern of illegal billing practices” by the organization. But Tuesday’s letter made no mention of billing fraud.

The “videos” in question are the ones made by the fraudsters in Houston, who wound up being indicted themselves before those charges were dropped in an oddly-timed fashion. The fact that the state is still citing these fraudulent videos and still making the same wild claims they have never even tried to back up tells you everything you need to know about the strength of their case. There’s already been a lawsuit filed over this, and now that the state has sent a final letter it will move forward, which among other things means the state will have to produce whatever evidence it has. Good luck with that. I should note also that multiple other states have tried this in the recent past, and all of them have lost in court. Some lessons have to be learned the hard way. The Austin Chronicle has more.