Tag: abortion rights

Appeals court can rule at any time in dispute over suspending FDA approval of medication abortion drug | CNN Politics

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The Justice Department and a manufacturer of abortion pills have submitted the final round of court briefs in the emergency dispute over whether an appeals court should freeze a judge’s ruling that would suspend the Food and Drug Administration’s approval of medication abortion drugs.

Now that the filings have been submitted, the US 5th Circuit Court of Appeals Court could rule at any time on whether to put a hold on the order from US District Judge Matthew Kacsmaryk.

Kacsmaryk on Friday night said he was halting the FDA’s approval of the drug mifepristone but that he was delaying the order by seven days to give the pill’s defenders time to appeal the case. The Justice Department has asked the appeals court to act by 12 p.m. CT Thursday on its request that Kacsmaryk’s ruling be paused, to give the government time to seek a Supreme Court intervention if need be. The 5th Circuit is not obligated to meet that deadline.

The Justice Department wrote in its new filing that Kacsmaryk purported “to be acting in a restrained manner … but there is nothing modest about upending the decades-long status quo by blocking access nationwide to a safe and effective drug.”

“Effectively requiring Danco Laboratories and GenBioPro to cease distribution of mifepristone after more than two decades would upend the status quo, severely harming women, healthcare systems, and the public,” the Justice Department said, referring to the two US manufacturers of mifepristone.

The Justice Department filing pushed back on the assertions by the challengers, made in their filing overnight in the emergency dispute, that the 5th Circuit did not have the authority to hear the appeal of Kacsmaryk’s ruling. The Justice Department also called out Kacsmaryk and the challengers for relying on anonymous blog posts to claim mifepristone is unsafe.

Danco Labroratories, which intervened in the case to defend mifepristone’s approval, wrote in its new filing with the appeals court that if the ruling is not frozen, “women across the nation will face serious, unnecessary health risks from the elimination of access to a drug FDA has repeatedly deemed safe and effective and that is the standard of care.”

In an overnight filing, the anti-abortion doctors who sued to ban medication abortion drugs told a federal appeals court that it should leave in place the ruling that will halt the drug’s FDA approval.

The anti-abortion doctors defended Kacsmaryk’s ruling called it a “meticulously considered” ruling that “paints an alarming picture of decades-long agency lawlessness – all to the detriment of the women and girls FDA is charged to protect.”

Mifepristone has been approved by the FDA for terminating pregnancies for nearly 23 years. Leading medical associations have rebuked the claims by the approval’s legal challengers and by the judge that the drug is unsafe.

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April 12, 2021
Justice Department asks Supreme Court to intervene in abortion drug ruling | CNN Politics

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The Justice Department asked the Supreme Court Friday to intervene in an emergency dispute over a Texas judge’s medication abortion drug ruling, requesting that the court step in now rather than wait for an appeal to formally play out at the federal appellate level.

The case is the most important abortion-related dispute to reach the high court since the justices overturned Roe v. Wade last term. It centers on the scope of the US Food and Drug Administration’s authority to regulate a drug that is used in the majority of abortions today in states that still allow the procedure.

Solicitor General Elizabeth Prelogar said in the filing that it “concerns unprecedented lower court orders countermanding FDA’s scientific judgment and unleashing regulatory chaos by suspending the existing FDA-approved conditions of use for mifepristone.”

She said that if the ruling were allowed to stand it would “inflict grave harm on women, the medical system, the agency, and the public.”

Danco, a manufacturer of the drug, also asked the justices to step in on an emergency basis before Friday, with an attorney for the company saying in its filing that leaving the lower court opinion in play will “irreparably harm Danco, which will be unable to both conduct its business nationwide and comply with its legal obligations under the FDCA nationwide.”

“The lack of emergency relief from this Court will also harm women, the healthcare system, the pharmaceutical industry, States’ sovereignty interests, and the separation-of-powers,” the attonrey, Jessica L. Ellsworth, told the justices.

The clock is ticking. If the Supreme Court does not step in, the district court’s ruling, as amended by a subsequent appeals court opinion, will go into effect at midnight CT, and access to the drug, Mifepristone, will be restricted while the appeals process plays out.

Both the government and Danco are asking the court to freeze the lower court opinion, or alternatively, agree to take up the case themselves and hear arguments before the summer recess, a very expedited time frame.

The controversy began when US District Court Judge Matthew Kacsmaryk issued a broad ruling that blocks the FDA’s 2000 approval of the drug, as well as changes the FDA made in subsequent years to make the drug more accessible.

Late Wednesday, the 5th US Circuit Court of Appeals froze part of the ruling. The court said the drug, that was approved in 2000, could stay on the market, but agreed with Kacsmaryk that access could be limited.

The appeals court ordered a return to the stricter, pre-2016 FDA regime around the drug, which prevents mailing the pill to patients who obtained it through telehealth, or virtual visits with their providers rather than traveling to a clinic or hospital to obtain the drug in person.

The restrictions also affect the instructions on the label for the medication, shortening the window of obtaining the pill to seven weeks into pregnancy as opposed to 10. It’s possible however that even with the ruling in effect, some providers could go “off-label” and continue to prescribe mifepristone up until 10 weeks. Mifepristone is one of the drugs used for an abortion via medication as opposed to surgery.

Prelogar, the solicitor general, argued in her filing to the Supreme Court that the FDA’s expert judgment should not be challenged.

“FDA has maintained that scientific judgment across five presidential administrations, and it has modified the original conditions of mifepristone’s approval as decades of experience have conclusively demonstrated the drug’s safety,” she wrote, reminding the justices that currently, “more than half of women in this country who choose to terminate their pregnancies rely on mifrepristone to do so.”

She highlighted a key threshold issue in the case, arguing that the doctors opposed to abortion who are behind the suit do not have the legal right to be in court. That is because, she said, they neither “take nor prescribe” the drug, and the FDA’s approval “does not require them to do or refrain from doing anything.”

CNN Supreme Court analyst Steve Vladeck, who is a professor at the University of Texas School of Law, said the 5th Circuit’s ruling “froze the craziest, most harmful parts of Kacsmaryk’s ruling,” but that access to mifepristone is still significantly limited.

“The panel ruled that the challenge to the 2000 approval of mifepristone itself is likely time-barred, so it froze that part of the ruling,” he wrote on Twitter. “But it *didn’t* freeze Kacsmaryk’s block of the 2016 and 2021 revisions that (1) make mifepristone available up to 10 weeks; and (2) by mail.”

Medication abortion has emerged a particularly heated flashpoint in the abortion legal battle since the Supreme Court last year overturned the Roe v. Wade precedent that protected abortion rights nationally.

In November, anti-abortion doctors and plaintiffs brought the lawsuit challenging the FDA’s 2000 approval of the drug and targeting how the agency has since changed the rules around its use in ways that have made the pill easier to obtain.

A split 5th Circuit panel said in its order that it was reinstating the approval of the drug because of certain procedural obstacles the plaintiffs face in challenging it. But the appeals court said that the abortion pill’s defenders had not shown that they were likely to succeed in defeating the plaintiffs’ claims against the FDA’s more recent regulatory actions toward mifepristone.

The appellate order was handed down by Circuit Judges Catharina Haynes, a George W. Bush nominee, and Kurt Engelhardt and Andrew Oldham, both Donald Trump nominees. Haynes, however, did not sign on to some aspects of the order.

The FDA approved mifepristone after a four-year review process. It has shown to be a safe and effective way to terminate a pregnancy in the two-plus decades it’s been on the market. But anti-abortion doctors and medical associations allege that the agency ran afoul of the law by not adequately taking into account the drug’s supposed risks.

This story has been updated with additional developments.

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April 12, 2021
Nebraska governor signs bill that bans most abortions at 12 weeks, gender-affirming care for those under 19 | CNN Politics

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Nebraska Gov. Jim Pillen, a Republican, signed a bill into law on Monday that bans most abortions after 12 weeks with exceptions for sexual assault, incest and medical emergencies.

The bill does not define “medical emergency” and the legislation includes a clause that will put the rules into immediate effect the day after it is signed.

LB 574, which passed the state’s Republican-controlled unicameral legislature in a 33-15 vote last week, also bans gender-affirming care for people under 19 years old. The abortion amendment was tacked onto the legislation after previous efforts to restrict abortions failed to overcome a filibuster.

The bill only allows medical procedures for transitioning after a “waiting period” and “therapeutic hours” to determine if a person’s gender dysphoria is “long-lasting and intense.” The details of those provisions will be determined by the chief medical officer of Nebraska’s Division of Public Health.

In a statement released after the bill’s passage, Pillen said, “All children deserve a chance to grow and live happy, fruitful lives. This includes pre-born boys and girls, and it includes children struggling with their gender identity. These kids deserve the opportunity to grow and explore who they are and want to be, and they can do so without making irreversible decisions that should be made when they are fully grown.”

The new law reflects ongoing legislative efforts around the US to restrict access to abortion and gender-affirming care. More than a dozen states have moved to restrict gender-affirming care in 2023 and more than 130 bills that target LGBTQ rights, especially health care for transgender patients, have been introduced nationwide this legislative session, according to data compiled by the American Civil Liberties Union.

“From North Carolina to Nebraska, extremists so-called leaders continue to restrict access to abortion across the nation,” Vice President Kamala Harris tweeted Monday. “Enough is enough. We need a federal law to restore the protections of Roe v. Wade for women in all 50 states.”

Major medical associations say that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, the psychological distress that may result when a person’s gender identity and sex assigned at birth do not align, according to the American Psychiatric Association. But some Republicans have expressed concern over long-term outcomes of the treatments.

Some Nebraskans have expressed displeasure with the bill and many protested and filled the halls of the state Capitol last week as lawmakers spoke, resulting in the arrest of several people on Friday on charges ranging from disturbing the peace to obstructing a government operation.

ACLU of Nebraska executive director Mindy Rush Chipman said in a statement last week that the consequences of the law will be “devastating.”

“To be clear, we refuse to accept this as our new normal. This vote will not be the final word. We are actively exploring our options to address the harm of this extreme legislation, and that work will have our team’s full focus. This is not over, not by a long shot,” Chipman said.

This story has been updated with additional information Monday.

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April 12, 2021
Why there won’t be a backlash against the Supreme Court this time | CNN Politics

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The Supreme Court handed down several key rulings this past week that dismayed liberals. Chief among them was the court’s decision to disallow colleges and universities from using race or ethnicity as a specific factor in admissions. The court also found that President Joe Biden’s student debt forgiveness plan was unconstitutional and that a Colorado web designer could refuse to create websites that celebrate same-sex weddings over religious objections.

Unlike last year, when the Supreme Court greatly upset liberals by overturning Roe v. Wade, this year’s big rulings by the justices are unlikely to spark a major backlash from the public at large.

This is well reflected in the public polling. Roe v. Wade, the 1973 decision that legalized abortion nationwide, had become massively popular.

Right before the decision to overturn Roe leaked in May 2022, a Fox News poll found that 63% of registered voters were opposed to such a move while 27% supported it. An ABC News/Washington Post poll put the split at 54% wanting the court to uphold Roe and 28% wanting the decision overturned.

This majority of Americans who wanted abortion to be legal nationally have maintained their stance since the Supreme Court officially struck down Roe in June 2022. Since that time, abortion supporters have won every related measure placed on the ballot across the country – from deep-blue states like California to ruby-red ones like Kentucky.

California is an important state to note because voters there faced a 2020 ballot measure to consider the use of race, sex or ethnicity in government institutions (such as education). A clear majority, 57%, voted against allowing state and local entities to consider such factors in public education, employment and contracting decisions.

When a state that voted for Biden by nearly 30 points is against affirmative action, it shouldn’t be surprising that the nation as a whole is.

A Pew Research Center poll released last month found that 50% of Americans disapproved of certain colleges and universities taking race and ethnicity into account in admissions decisions to increase diversity. Only 33% approved of the practice.

This Pew poll is no outlier. An ABC News/Ipsos poll conducted after the court decided its case showed that 52% of Americans approved of the decision, while 32% were opposed.

Some polling before the ruling had shown even more opposition: 70% of Americans in a recent CBS News/YouGov survey indicated that the Supreme Court should not allow colleges to consider race and ethnicity in admissions.

But perhaps what’s most interesting isn’t how many people are for or against considering race in college admissions. Rather, it’s how many people simply didn’t care enough to pay close attention to the affirmative action case before the Supreme Court.

When explicitly given the option, a majority (55%) said in a May Marquette University Law School poll that they hadn’t heard enough to form an opinion about the case. (Those who had heard enough were against allowing colleges to use race in admissions.)

This is quite different from March 2022, when just 30% of Americans hadn’t heard enough to form an opinion about the court potentially overturning Roe v. Wade, when asked the same question by Marquette but about the abortion case. (A plurality of those who had heard enough didn’t want the court to overturn Roe.)

It’s hard for an issue to galvanize voters when they aren’t paying attention to it.

The same holds true for Biden’s student loan forgiveness plan that the court blocked. A USA Today/Ipsos poll from April indicated that 52% of Americans were familiar with the case and a mere 16% were very familiar with it. (Those who had student loans were more familiar at 71%, though that’s a fairly low percentage for something that could affect them directly.)

Possibly because of that low familiarity, the percentage of Americans who favor or oppose canceling certain student debt differs greatly depending on how the question is worded. When Marquette didn’t mention Biden or the government specifically in its May poll, a majority (63%) said they favored forgiveness of up to $20,000. It was a much lower 47% in the Ipsos poll.

Surveys that did identify the proposal as Biden’s plan tend to be in the same ballpark, with a split public and a sizable percentage unsure.

The ABC News/Ipsos poll showed that 45% approved of the court striking down Biden’s student debt plan, with 40% disapproving. About a sixth (16%) of the public was undecided.

This jibes with polling before the court’s decision was announced. An NBC News poll from last year showed that 43% said Biden’s plan was a good idea compared with 44%, who said it was a bad idea. Just over 10% had no opinion.

The USA Today/Ipsos survey found that 43% of Americans wanted the Supreme Court to allow the government’s student loan forgiveness plan to move forward, while 40% did not. Another 17% had no opinion.

(I should point out that those with student debt were more likely to want government forgiveness in all these surveys, though about 80% of Americans don’t have student loan debt.)

The public was similarly split about the court ruling in favor of the Colorado web designer who refuses to make wedding websites for same-sex couples over religious objections. According to the ABC News/Ipsos poll, 43% of Americans agreed with the court’s decision, 42% disagreed and 14% were undecided.

There was limited polling on this case before the ruling, though none of it indicated massive opposition. A majority (60%) in a Pew poll that specifically mentioned “wedding websites” and “same-sex marriages” indicated they believed business owners should be allowed to refuse services if it violated their religious or personal beliefs.

The polling on Roe v. Wade didn’t look anything like this last year. There were no close splits in opinion. People were consistently against overturning Roe, and they cared a lot about it. This led to a historically strong performance for the party in the White House during the 2022 midterm elections and a major backlash against the Supreme Court.

The current polling on affirmative action in college admissions, Biden’s student loan forgiveness plan and allowing people to opt out of certain services to married LGBTQ couples if they believe it goes against their religion suggests that court’s opinions on those issues aren’t likely to have a similar impact.

This story has been updated with additional information.

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April 12, 2021
Why the US ‘does not get to assume that it lasts forever’ | CNN Politics

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As the United States marks its 247th birthday Tuesday, questions about how many more the nation will celebrate in its current form have become ominously relevant.

Possibly not since the two decades before the Civil War has America faced as much pressure on its fundamental cohesion. The greatest risk probably isn’t a repeat of the outright secession that triggered the Civil War, though even that no longer seems entirely impossible in the most extreme scenarios. More plausible is the prospect that the nation will continue its drift into two irreconcilable blocs of red and blue states uneasily trying to occupy the same geographic space.

“I can’t recall a time when we’ve had such fundamental friction between the states on such important issues,” says Donald Kettl, former dean and professor emeritus of the University of Maryland’s School of Public Policy and author of the 2020 book, “The Divided States of America.”

The strains on America’s basic unity are broad and diverse. They include a widening divergence in the basic rules of life between red and blue states on everything from the availability of abortion and guns to what teachers can say in the classroom; sharpening conflicts not only between the states, but among the urban and rural regions within them; a growing tendency of voters in each political coalition to view the other party not only as a political rival but as an “enemy” that threatens their core conception of America; the increasing inability of almost any institution – from the media to federal law enforcement to even consumer products – to retain comparable credibility on both sides of the red-blue divide; more common threats of political violence, predominantly from the right, against local and national officials; and the endurance of Donald Trump as the first leader of a truly mass-scale American political movement who has demonstrated a willingness to subvert small-d democracy to achieve his goals.

Behind almost all of these individual challenges is the same larger force: the mounting tension between those who welcome the propulsive demographic and cultural changes reshaping 21st century America and those who fear or resent those changes. It’s the collision between what I’ve called the Democrats’ “coalition of transformation” and the Republican “coalition of restoration.” As the US evolves toward a future, sometime after 2040, when people of color will constitute a majority of the population, political scientists point out that the country is trying to build something without exact modern precedent: a true multi-racial democracy that provides a voice to all its citizens.

The urgent demands for greater opportunity and inclusion from traditionally marginalized groups (from Black to LGBTQ people) and the ferocious backlash against those demands that Trump has mobilized in his “Make America Great Again” movement demonstrate how fraught that passage has become.

“To expect we are going to be as unified as we [have been] trying to negotiate these fundamental transformations of American demography is wholly unrealistic,” says Daniel Cox, a senior fellow in polling and public opinion at the conservative American Enterprise Institute. “There is going to be real differences and divisions on these things and, unfortunately, some people are weaponizing them in a way that is unhelpful.”

The ideal of national unity celebrated on July Fourth has almost always been overstated: the country from its founding has been riven by sectional, racial, class and gender conflicts. Large groups of people living within our borders have always felt excluded from any proclaimed national consensus: American Indians who were brutally displaced for decades, Black people who faced generations of legal slavery and then decades of state-sponsored segregation, women denied the vote until the 20th century.

But today’s proliferating and intersecting pressures have reached a height that is forcing experts to contemplate questions few Americans have seriously considered since the Civil War era: can the United States continue to function as a single unified entity, and if so, in what form?

In the late 1990s, Alan Wolfe, a Boston University political scientist, wrote a book called “One Nation, After All” based on in-depth interviews with hundreds of Americans around the country. His book was one of several published in the era that concluded the broad American public was not nearly as divided as its leaders and that average Americans, however much their views differed on issues, recognized the importance of finding common ground with others of opposing views.

Now, Wolfe told me in an interview, he considers the current situation much more worrying. “I was so optimistic with the title of ‘One Nation, After All,’ but I couldn’t say that now,” Wolfe, a professor emeritus, said. “I think the book was right for its time. I think the sociology of it was right. That’s what I found. But I’m sure I wouldn’t find it now.”

To Wolfe, the US is now trapped in a “vicious cycle” of rising partisan and ideological hostility in which political leaders, particularly on the right, see a “benefit in fueling the rage even more.” While President Joe Biden, Wolfe says, has struck traditional presidential notes of emphasizing the value of national unity, Trump – currently the front-runner for the 2024 GOP presidential nomination – has built his political strategy on widening the nation’s divides in ways that may be difficult to reverse any time soon. “I don’t know if [Trump’s] a political genius or just instinctively knows something, but he sure has exacerbated the shocks, and I don’t know how we are going to recover from him,” Wolfe says.

Experts may be the least concerned about the most often discussed scenario for a future American unraveling. That’s the prospect the nation will fully split apart into separate entities, as it did when the South seceded to create the Confederate States of America after the election of Abraham Lincoln in 1860. Rep. Marjorie Taylor Greene, the far-right Republican from Georgia who has become a close ally of House Speaker Kevin McCarthy, has called for “a national divorce” in which Republican- and Democratic-leaning states would go their separate ways, presumably peacefully. “We need to separate by red states and blue states and shrink the federal government,” Greene said in a tweet on President’s Day this year.

Susan Stokes, a political scientist and director of the Chicago Center on Democracy at the University of Chicago, said that prospect could receive growing discussion in coming years, particularly on the right, “if we continue to go in this direction and we continue to view each other as threats and as anathema, immoral, and a threat to each other’s existence.”

But the practical barriers to any formal national divorce, she says, are likely to limit such discussion to the fringes. Unlike the Civil War, which had a clear geographical boundary, the nation’s current political divide has created a checkerboard – with Democrats strongest in coastal and upper Midwest states, as well as parts of the Southwest, while Republicans hold the edge in most Heartland states, particularly those in the South and Great Plains. Plus, Stokes notes, the red-blue line runs not only between but within the states, with the urban areas of every state leaning relatively more toward Democrats than their rural neighbors. In some future national divorce, “What do you do with upstate New York? What do you do with Memphis or Austin?” she asked.

For those reasons, none of the experts I spoke to worry much about full-scale national separation through any intermediate time frame, though most no longer consider it inconceivable either. (Polls don’t show extensive interest among the public, with one national CBS/YouGov survey last year finding a quarter of Americans favoring the idea.) One wild card is what might happen if Trump wins in 2024 and moves to implement some of the policies he’s proposed that amount to mobilizing federal power against blue institutions and individuals – including a massive deportation program of undocumented immigrants and the deployment of the National Guard into high-crime cities. Blue state governors, legislatures and mayors might respond to such an offensive in forceful ways difficult to predict today.

The nation’s greater challenge may be the continuing incremental separation between the red and blue blocs – the political equivalent of continental drift. Polls show that voters in each coalition hold darkening views of the other. In that 2022 CBS/YouGov survey, about half of the voters for both Trump and Biden said they considered the other party not just “political opposition” but “enemies, that is, if they win, your life or your entire way of life may be threatened.”

More tangibly, red and blue states are hurtling apart. The most aggressive moves have come from red states shifting social policy sharply to the right on a broad array of issues, from retrenching abortion and LGBTQ rights, to censoring classroom discussion of race, gender and sexual orientation, expanding access to guns while limiting access to books that provoke conservative objections, and restricting access to voting. With red states exploring various ways to discourage their residents from traveling to blue states for banned activities (such as abortions or gender-affirming care for transgender minors), and blue states passing laws to inhibit such red state enforcement, the nation is facing open conflict over the cross-border application of state law reminiscent of the bitter disputes between free and slave states over the Fugitive Slave Act.

No single issue separates the red and blue states today as profoundly as the gulf between those with and without legal segregation during the Jim Crow era, or that between states with and without slavery before the Civil War. But, as experts point out, the current divergence involves more issues in more states than those earlier conflicts, with nearly half the country joining the red state drive to create what I’ve called “a nation within a nation” operating by its own rules and values.

“I really feel like we are becoming two different countries, if not that it has already happened,” says Wolfe. “I don’t like it, but I don’t see what we have in common anymore. I really don’t.”

To some students of government, allowing states to set their own course on these divisive issues may relieve pressure and help hold the nation together. “In some ways, you can say how this is terrible, how can we remain a unified country and address global concerns” when states are separating this fundamentally, says Cox. “But by the same token, there’s something that is positive about these ‘laboratories of democracy’ where one party is given free rein to put forward their ideas and legislate and the public can see how they do and react to that.”

Yet allowing states to diverge this comprehensively may do more to heighten than relieve national tensions. Cox acknowledges one reason: severe gerrymandering in many states’ legislative districts means most politicians are unlikely to suffer consequences even if the public doesn’t like the agenda they have advanced.

A second problem is this experimentation is unlikely to proceed on an even track. The Republican-appointed majority on the US Supreme Court has encouraged the red state social offensive with decisions that stripped away national rights – most prominently on abortion and voting. Many legal experts believe that conservative majority is unlikely to block many of the new red state social laws that critics (including, in many cases, the Biden administration) are challenging in federal courts. On the other hand, the six GOP-appointed justices have shown no hesitation about overturning blue state initiatives, such as gun control measures that conflict with their reading of the 2nd Amendment, or LGBTQ protections they argue infringe on religious liberty or free speech. “Given the make-up of the courts, it’s difficult for blue states to be hopeful about this,” says Kettl.

The biggest challenge created by the widening distance among the states is where to draw the line between local leeway and preserving a baseline floor of nationally guaranteed rights in every state. Racial segregation, after all, was justified for 70 years on the ground of respecting “local traditions.”

From both Congress and the Supreme Court, the general trend in American life from the 1950s through the 2010s was to nationalize more rights and to restrict the ability of states to curtail those rights. Now, though, the red states are engaged in the most concerted effort over that long arc to roll back the “rights revolution” and restore a system in which people’s basic civil rights vary much more depending on where they live.

“It is certainly good to have a chance to have a contest over basic values, and that’s one of the great strengths of the American republic,” says Kettl, co-author of the new book “Bridgebuilders: How Government Can Transcend Boundaries to Solve Big Problems.” He continued: “But there is also a basic question of the fundamental rights of individuals and whether the balance of power in deciding them ought to lie” with states or the nation as a whole.

The chasm between the civil rights and liberties available in blue and red states has widened to the point where it will be highly explosive for either side to attempt to impose its social regime on the other. If Democrats win unified control of the White House and Congress in 2024 and pass legislation to restore a national floor of abortion or voting rights, red state leaders would likely sue to block them (even though abortion rights are popular in several of them). This Supreme Court majority could prove receptive to such challenges. Conversely, the fear that Republicans will seek to pass national legislation imposing the red state rules on blue and purple states, particularly on abortion and guns, may be the best Democratic asset in the 2024 presidential race in the key swing states of Michigan, Pennsylvania, Wisconsin and Arizona.

Michael Podhorzer, the former long-time political director for the AFL-CIO, has argued that the wave of restrictive red state social laws has simply made more apparent something that has long been true: that the red and blue parts of the country are so divergent in their values, priorities and even economic structures that they are more accurately described as separate nations than separate regions. In his mind, what’s changed isn’t that these different regions – or different nations – have divergent approaches on both social and economic issues, but that the Trump-aligned MAGA movement ascendant in the red states is now pursuing such an extreme and even anti-democratic (small d) agenda.

Eric Liu, co-founder of Citizen University, a non-partisan organization that trains people to work together on local problems across ideological, racial and other boundaries, agrees that Trump and much of his movement represent a unique threat to the future of American democracy. The nation, Liu says, now faces the challenge of doing two things at once: countering and isolating that threat to democracy, while building a bigger coalition for cooperation and consensus-building among what he calls (borrowing from Richard Nixon’s phrase) the “silent majority” of Americans who want to coexist.

Liu counsels that lowering the temperature does not require an artificial level of agreement between people of differing views: “It’s OK to argue it out. It’s necessary to argue it out because America is an argument.” But it does, he believes, require both sides to commit to respecting the democratic process and staying engaged with the other when that process produces decisions they don’t support. “That means to recognize that politics is not a one-and-done, winner-take-all, wipe-the-other-side-off-the-face-of-the-earth, scorched earth endeavor,” he says.

Even more important, strengthening the nation’s bonds, he believes, requires people on both sides of the political divide to see the other “as three-dimensional, complicated, sometimes contradictory human beings.” The best way to achieve that, he says, is to work together to solve local problems. Liu’s group tries to facilitate that through programs like Civic Saturdays that promotes collaborative local actions, or initiatives that bring together rural and urban residents around shared concerns.

Such interactions, Liu believes, can nudge the US toward the national unity it celebrates on July Fourth. But he acknowledges there’s no assurance this patient nurturing of civic connection can overcome all the forces in politics, the media and communications technology blowing toward separation. Even the most carefully cultivated garden, after all, may not survive a gale-force wind.

“It is totally not a given that we get through this,” Liu told me. “The United States does not get to assume that it lasts forever.”

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April 12, 2021
Ohio’s showdown over abortion rights intensifies as group files signatures for ballot measure | CNN Politics

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Ohio is poised to become the next major abortion battleground after groups seeking to enshrine abortion rights in the state’s constitution on Wednesday submitted hundreds of thousands of petition signatures to the secretary of state’s office.

If certified, those 710,000 signatures – nearly 300,000 more than state law requires – would place the proposed amendment on ballots in November alongside municipal and school board elections across the state.

The statewide vote would come the year after two of Ohio’s neighboring states – deep-red Kentucky and the political battleground of Michigan – supported abortion rights in their own ballot measures.

It would position Ohio, traditionally a presidential swing state that has shifted in the GOP’s favor in recent years, as the latest test of voters’ attitudes ahead of a 2024 presidential election in which the debate over abortion rights could play a central role in both the Republican primary and the general election.

“We know that Ohioans, just like our neighbors in Michigan and Kentucky – when they have the opportunity to vote for abortion access, they will,” said Lauren Blauvelt, vice president of Planned Parenthood Advocates of Ohio.

Abortion rights advocates on Wednesday said they were pulled into politics in the wake of the US Supreme Court’s decision last June to overturn Roe v. Wade’s long-standing federal abortion protections and return the issue to the states.

“I was never very political before all this started last year,” said Dr. Aziza Wahby, a Cleveland dermatologist who has become active over the last year with Ohio Physicians for Reproductive Rights, a group that was part of the effort to gather signatures. “This has made me pay more attention and I think it will do the same for others.”

The proposed amendment in Ohio would ensure “every individual has a right to make and carry out one’s reproductive decisions.” It could make Ohio the only state with a ballot measure on abortion rights this year.

Local officials have until July 20 to verify the signatures, with Ohio Secretary of State Frank LaRose having final approval to place the issue on this fall’s ballots by July 25.

Before the November election, though, is another key vote: an August 8 special election set by Ohio’s Republican-dominated legislature, in which voters will decide whether to raise the threshold for amending the state constitution from the current simple majority to 60%.

The debate over the constitutional amendment and the change to the amendment process has galvanized both sides of the abortion fight.

After filing U-Haul truckloads of petition signatures Wednesday, abortion rights advocates complained that the special election was slated for a moment when families will be wrapping up summer vacations and preparing for the start of school – a period when the state’s voters are not used to casting ballots.

“And they’re doing that on purpose because they know that their agenda is not the agenda of Ohioans,” said Kellie Copeland, the executive director of Pro-Choice Ohio.

Amy Fogel, who said she became awakened to politics during the Trump era and joined the grassroots group Red Wine and Blue, has spent months helping collect signatures for the citizen-led initiative for the November ballot. She said she was “absolutely heartbroken” when the August special election was approved by the Republican supermajority in the statehouse.

“It was just a blatant power grab to take away the majority vote of Ohioans,” Fogel said.

She said she and other volunteers would not be deterred by the new hurdle.

“We started out telling people to vote in November and now we have to tell them to make sure you plan an absentee ballot, vote early, or show up at the polls on August 8,” Fogel said. “You have to vote ‘No,’ to protect the Ohio constitution and majority vote in August and then ‘Yes,’ in November.”

It is confusing, she said, by design.

Amy Natoce, the press secretary for Protect Women Ohio, the coalition working to defeat the abortion rights ballot measure in November, dismissed suggestions that a special election in August was in any way undemocratic because of concerns over historically low voter turnout in the summer.

“There is no time like the present to protect Ohio’s constitution,” Natoce said in an interview. “Ohioans should be reminded of the fact that this is allowing them to determine how their constitution is amended. We’ve seen the other side saying one person, one vote, this takes away the people’s vote. Not at all.”

For the next month, both campaigns will be unfolding across Ohio – on “Issue 1,” to raise the threshold of support needed to change the constitution, and on the November ballot measure on abortion. From door-to-door canvassing to a multi-million dollar television ad campaign, both sides are intensifying their efforts ahead of the August and November elections.

“We’re going to continue in all 88 counties across Ohio,” Natoce said. “But we have to move ahead as if it will be on the ballot in November.”

Two former Republican governors, Bob Taft and John Kasich, have come out against the August 8 special election, saying such a consequential change to state law shouldn’t happen during a low-turnout summer election.

“I just think it’s a major mistake to approve or disapprove such a change at the lowest-turnout election that we have,” Taft said at a forum in Dayton last week. “This is a kind of change that really needs to be considered by all the people who go out and vote in a presidential election.”

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April 12, 2021
Iowa House passes 6-week abortion ban in special session called by GOP governor | CNN Politics

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Iowa’s state House passed a bill Tuesday night that would ban most abortions in the state as early as six weeks into pregnancy, acting quickly in the special session ordered by GOP Gov. Kim Reynolds with the sole purpose of restricting the procedure in the state.

The bill now heads to the Senate, where it must earn approval before it can move to Reynold’s desk for her signature.

Senate File 579 prohibits physicians from providing most abortions after early cardiac activity can be detected in a fetus or embryo, commonly as early as six weeks into pregnancy, before many women know they are pregnant.

The bill includes exceptions for miscarriages, when the life of the pregnant woman is threatened and fetal abnormalities that would result in the infant’s death. It also includes exceptions for pregnancies resulting from rapes reported within 45 days and incest reported within 140 days.

The state House voted 56-34 largely along party lines to advance the measure following a roughly 12-hour day that saw the measure move through rounds of consideration and debate. Debate in the state Senate continued late into Tuesday night.

The bill would immediately take effect with Reynolds’ expected signature.

However, while the bill language makes clear it is “not to be construed to impose civil or criminal liability on a woman upon whom an abortion is performed in violation of the division,” guidelines on how physicians would be punished for violating the law are left up to Iowa’s board of medicine to decide – leaving the potential for some vagueness in how the law ought to be enforced in the interim.

“There may or may not ever be rules promulgated,” said Iowa Senate President Amy Sinclair, a Republican, amid several questions from Democrats on the floor. There were no legal penalties for physicians added in the bill, she said.

“As far as clarity, this is about as clear as mud,” Democratic state Sen. Molly Donahue said on the floor.

Reynolds last week called for Iowa’s legislature to convene for the special session “with the sole purpose of enacting legislation that addresses abortion and protects unborn lives,” weeks after Iowa’s Supreme Court declined to lift a block on the state’s 2018 six-week abortion ban, deadlocking in a 3-3 vote whether to overturn a lower court decision that deemed the law unconstitutional.

The new bill and its 2018 predecessor are nearly identical, though the latter was not enacted immediately, granting the board of medicine time to flesh out how it planned to administer the law.

Democratic backlash to the bill and Reynolds’ special session grew throughout the day, with state House Minority Leader Jennifer Konfrst saying in a statement, “Women are not free when they cannot make their own healthcare decisions. And after today, women won’t be free.”

Iowa’s Senate Democratic Leader Pam Jochum said in a statement that her Republican colleagues were “ignoring Iowans in their rush to pass an extreme ban” and that “their actions today threaten the health and futures of all Iowa women.”

“This extreme Republican power grab infringes on the personal freedom of every Iowa woman and girl. There are women alive today who will not be alive in six months because of this law,” Jochum added.

Iowa’s position as the first-in-the-nation caucus state for the coming GOP presidential primary has thrust its state politics onto the national stage, with Republican candidates jockeying for the favor of its voters.

Former Vice President Mike Pence posted his support of the bill on Twitter Tuesday night, writing, “Grateful to see Iowa Republicans and Governor @KimReynoldsIA Standing For Life! Pro-Life Americans are Cheering You On!”

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April 12, 2021
Pence says he supports banning abortions for nonviable pregnancies | CNN Politics

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Former Vice President Mike Pence said abortion should be banned when a pregnancy is not viable, according to the Associated Press.

“I’m pro-life. I don’t apologize for it,” Pence told the AP in a recent interview. “I just have heard so many stories over the years of courageous women and families who were told that their unborn child would not go to term or would not survive. And then they had a healthy pregnancy and a healthy delivery.”

CNN has reached out to the Pence campaign for comment.

Pence strongly opposes abortion and has been perhaps the most outspoken Republican candidate about the issue as many of his GOP rivals have avoided staking out a clear position on abortion.

During a CNN town hall in Iowa last month, Pence said he supports a federal abortion ban including exceptions for rape, incest, and life of the mother. He also backs federal legislation limiting the procedure and has called on other 2024 GOP candidates to support a 15-week national abortion ban.

Pence told CNN’s Wolf Blitzer back in March that he would support legislation restricting abortion to six weeks of pregnancy. Florida Gov. Ron DeSantis signed a bill into law in his state that banned abortion at six weeks while President Donald Trump has suggested the legislation was “too harsh.”

Clinicians use ultrasound results and measure pregnancy hormone levels in order to determine “whether a pregnancy is viable beyond the first trimester,” according to the American College of Obstetricians and Gynecologists.

Pregnancies that are deemed unviable regardless of gestational age include tubal ectopic pregnancies and early pregnancy loss, according to the ACOG, which can be deadly for the pregnant person. There are cases, such as “genetic or isolated structural abnormalities in which essential structures do not develop properly,” in which survivability is poor and patients may choose to end their pregnancies or give birth with palliative care options, the ACOG notes.

Since Roe v. Wade was overturned last year, several women have shared their harrowing stories of trying to obtain medically necessary abortions in states that have greatly restricted the procedure. One Texas woman told CNN’s Elizabeth Cohen that she nearly died after her water broke four months into her pregnancy, putting her at high risk for a life-threatening infection. Doctors in Texas had to wait until the woman was sick enough so they felt legally safe to terminate her pregnancy and then bring her to the ICU after she started developing symptoms of sepsis.

A Christian conservative, Pence views the “cause of life” as “the calling of our time.”

“As your President, I will always stand for the sanctity of life and I will not rest and I will not relent until we restore the sanctity of life to the center of American law in every state in the land,” he said in his presidential campaign announcement last month.

Pence has called for more support and resources for women in crisis pregnancies and advocated for adoption as alternatives to abortion.

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April 12, 2021
The crisis pregnancy center next door: How taxpayer money intended for poor families is funding a growing anti-abortion movement | CNN

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A few blocks from the Ohio State University campus in Columbus, America’s battle over abortion is playing out under one roof.

On one side of a squat single-story office building, a Planned Parenthood clinic offers reproductive health care and refers patients for abortions. Next door is a branch of Pregnancy Decision Health Center, a crisis pregnancy center that offers counseling and support for pregnant women – but also works to dissuade them from terminating their pregnancies and has been accused of promoting misinformation about abortion.

Of the two neighboring organizations, only Planned Parenthood provides medical services such as Pap smears, birth control and STD treatments.

But the crisis pregnancy center is the one receiving money from the state government. Ohio has funneled nearly $14 million in taxpayer funds to the center and others like it over the last decade, according to government records – even as state leaders have cut funding that previously went to Planned Parenthood for programs such as breast and cervical cancer screenings. 

Ohio isn’t alone. More than a dozen states devote some of their budget to funding crisis pregnancy centers, a CNN review found. About half of those states distribute federal money intended to help needy families to the centers.

Some of the organizations that receive money have been accused of spreading abortion misinformation or using the funds to advocate anti-abortion causes instead of helping women. 

“Public dollars should go to promoting public health,” said Ashley Underwood, the director of Equity Forward, an abortion rights advocacy group. Crisis pregnancy centers, she said, “solely exist to deter people from getting abortion services.”

Since the US Supreme Court overturned Roe v. Wade this summer, a wave of abortion restrictions has swept the country, leaving millions of women with easier access to crisis pregnancy centers than abortion care. Crisis pregnancy centers far outnumbered abortion clinics across the US even before the court’s ruling, and anti-abortion groups are now planning to expand. 

Pregnancy center leaders and their state government allies say the organizations deserve taxpayer funds because they provide pregnant women with resources like free diapers and ultrasounds. But some of the centers also lie to women about the safety and potential risks of abortion, according to multiple studies, abortion rights activists, and women who have been to the centers. 

That kind of deception isn’t typical in any other area of health care, said Dr. Amy Addante, an Illinois OB-GYN who performs abortions and has been a vocal critic of crisis pregnancy centers.

“The purpose of these centers is to try to stop someone from having an abortion,” said Addante. “I cannot think of any other medical decision or any other aspect of health care where there is a group of individuals whose only intent is to stop you from receiving that health care.”

Big open windows invite patients and passersby into the waiting room at the Pregnancy Decision Health Center (PDHC). With velvety green chairs, leafy plants, and a coffee station that greets visitors as they come in the door, the crisis pregnancy center could pass for an upscale dental office or spa.

Outside, PDHC’s sign towers over the neighboring Planned Parenthood, literally casting a shadow over the clinic’s entrance. Inside, the contrast is even starker: Planned Parenthood’s waiting room looks run-down – old chairs crowd the small space, faded informational posters cover the walls, and daylight is blocked by signage on the windows and mirrored doors meant to protect patients’ privacy.

Multiple times a week, patients looking for Planned Parenthood mistakenly walk through PDHC’s doors, according to a Planned Parenthood clinician, Jennifer, who asked CNN not to use her last name out of security concerns. Some patients have told Planned Parenthood that PDHC employees told them abortion wasn’t safe or said PDHC tried to delay them and make them late for their Planned Parenthood appointments.

“They’ve provided an array of misinformation, whether it’s about abortion care or even about contraceptive services,” said Lillian Williams, the vice president of health services of Planned Parenthood of Greater Ohio.

Ayla Krueger, a 23-year-old Columbus resident, visited PDHC earlier this month with a friend who was seeking an STD test. She said that during their hour-and-a-half visit, an employee claimed that condoms were only 50% effective, the spread of STDs could only be prevented if people followed “God’s plan” of avoiding sex before marriage, and that if a woman who has an STD gets an abortion, “your STDs travel up your cervix into your organs and could kill you.”

“I was dumbfounded,” Krueger said of the encounter. “My heart was breaking, thinking about girls who don’t understand what they’re walking into there… and possibly getting coerced.”

Experts said that the center’s rhetoric was not medically accurate. “We do worry about ascending infections in abortions and pregnancy, but the risk is really, really low,” said Dr. Jonas Swartz, an OB-GYN and professor at Duke University Medical Center. “Crisis pregnancy centers regularly overstate the risk of abortions and this is just one example of that.”

The center also offers “abortion pill reversal,” according to its website, annual reports and pamphlets at the office. Abortion reversal is a medically dubious, unproven treatment that purports to undo a medication abortion but has been denounced by medical groups and found to be dangerous by researchers. A clinical trial that attempted to study abortion reversal was halted prematurely in 2019 when several participants suffered hemorrhaging.

Kathy Scanlon, PDHC’s president, declined an interview request and didn’t respond to CNN’s questions about Krueger’s allegations or abortion pill reversal.

“Every woman deserves care and compassion when facing an unexpected pregnancy,” Scanlon wrote in an email, adding that the center provides “practical pregnancy care and support ranging from free pregnancy tests and ultrasounds to parenting education classes and much-needed baby items” such as diapers and car seats.

Research has found that crisis pregnancy centers commonly disseminate misinformation. A study released last year by The Alliance, an abortion rights advocacy group, found that almost two-thirds of crisis pregnancy centers in nine states promoted false or biased information about abortion on their websites. That included false claims that abortions increased the risk of cancer or infertility.  More than a third of clinics also advertised that they offered abortion pill reversal – and state-funded clinics were more likely than privately-funded ones to offer the unproven procedure and less likely to offer prenatal care, according to the study. 

Similarly, a 2012 academic study of crisis pregnancy centers in North Carolina found that 86% of centers promoted false or misleading medical information on their websites. 

Crisis pregnancy center leaders say they are working to help women. Peggy Hartshorn, who founded the Columbus center and is now the chair of Heartbeat International, one of the largest global networks of crisis pregnancy centers, said the allegations that the groups spread misinformation are “a false narrative.”

She said that the information her centers provide to clients is “very well-researched, medically referenced – we document everything with multiple sources.”

“Deep down in their hearts, women do not want to have abortion,” Hartshorn said. “Pregnancy centers are good for America, they really are.”

In Ohio, a new six-week abortion ban that went into effect after the Supreme Court decision, is currently on hold amid court battles. The Planned Parenthood clinic near Ohio State University doesn’t perform abortions – it refers patients to a Planned Parenthood surgical center on the other side of town that does.

That facility, too, has a state-funded crisis pregnancy center operating across the street. On a recent afternoon, a handful of protesters lined the clinic’s fence with signs depicting bloody fetuses and shouted “you are already a mother” and “abortion is murder” whenever a patient came within earshot. One protester – wearing a reflective vest and holding a clipboard, similar to Planned Parenthood volunteers – tried to direct patients away from the abortion clinic and to the crisis pregnancy center across the street. The center told CNN the protesters weren’t affiliated with their organization.

It’s not rare for pregnancy centers to operate near abortion clinics. More than 100 pregnancy centers around the country are located within 200 meters of an abortion clinic or Planned Parenthood location, according to a CNN analysis. Some – in states like Delaware, Indiana and Michigan – are next door to clinics. 

Abortion rights advocates say the intention is to mislead women and block them from accessing abortion.  

“The purpose of co-locating near a legitimate provider is to intercept someone seeking legitimate health care and divert them into walking through their doors instead,” said Tara Murtha, the co-author of a report about pregnancy centers and a spokesperson for the Women’s Law Project. “It’s basically an obstacle course and a systemic barrier to abortion care.”

Despite the groups’ apparent spreading of misinformation, at least 18 states have funded crisis pregnancy centers with taxpayer money, according to a CNN review of government records and statements from state agencies. The largest is Texas, which has sent more than $200 million to the groups over the last decade. 

More than a half-dozen states bankroll crisis pregnancy centers at least partly with funds from Temporary Assistance to Needy Families (TANF), a federal welfare program. Those federal funds are sent to states as a block grant, which gives state officials wide latitude in how to spend it, including on programs like “alternatives to abortion” grants for crisis pregnancy centers. 

Research has shown that a smaller percentage of poor families are now receiving cash assistance from the TANF program than in previous decades.

While about 68% of families with children in poverty received cash assistance through TANF in 1996, when the program was created, that percentage declined to just 21% by 2020, according to a study by the Center on Budget and Policy Priorities, a nonpartisan think tank. The percentage was even lower in some of the GOP-dominated states that use TANF funding to support crisis pregnancy centers, such as Texas and Louisiana.

“When you look at successes in reducing poverty by strengthening the safety net, cash assistance is the most effective way to help families,” said Aditi Shrivastava, who co-authored the study. “We are seeing states spend less of their money directly on cash assistance, and we don’t think that is what the program should be doing.”

In the wake of the Supreme Court overturning Roe v. Wade, some states are piloting new efforts to fund crisis pregnancy centers. Lawmakers in Arkansas and Iowa approved state funding for such groups for the first time this year.

The states have argued that crisis pregnancy centers deserve taxpayer funding because they provide services to pregnant women in need. 

“If we are going to be the most pro-life state in the union, we have to be prepared when those mothers come to a facility and they need help,” Arkansas state Rep. Robin Lundstrum said at a legislative hearing about the state’s new program earlier this year.

In Columbus, Pregnancy Decision Health Center is receiving more than $528,000 from the state government in the current fiscal year, according to government records. All of that comes from federal TANF funds. The funding amounts for about a fourth of the center’s total revenue, while the rest comes from private donations, according to the group’s most recent tax records available.

Despite the large amounts of money, there’s little oversight of how the taxpayer dollars are being used. 

Many of the appropriations are written into spending bills passed by GOP-dominated state legislatures. Pennsylvania, for example, has sent more than $70 million over the last decade to crisis pregnancy centers through Real Alternatives, an anti-abortion group that distributes state funding to crisis pregnancy centers. 

A 2017 report by the state auditor general found that Real Alternatives used hundreds of thousands of dollars of the money it received from Pennsylvania “to fund its activities in other states,” in what the auditor said was an example of the group “siphoning funds intended to benefit Pennsylvania women.” Real Alternatives denied the allegations in a statement, saying that they had “no basis in fact or law.”

Michigan, which had contracted with Real Alternatives to distribute funding for crisis pregnancy centers, canceled its contract after Gov. Gretchen Whitmer vetoed the funding for it in 2019. In a letter about the veto, Whitmer thanked a watchdog group that had issued a report accusing the organization of only helping a fraction of the pregnant women it had agreed to support.

Real Alternatives, which also receives TANF money from Indiana, said the Michigan report was “riddled with inaccuracies, distortions, half-truths and defamatory statements.”

A bill in the Ohio legislature that would have required crisis pregnancy centers receiving state funding to provide their clients with only medically accurate information died in committee in multiple recent legislative sessions. The state’s GOP legislative leaders did not respond to requests for comment.

Meanwhile, some of the same red states that have bankrolled crisis pregnancy centers have stripped funding from Planned Parenthood. In Ohio, for example, the group never received state funding for abortions, but for years it received money for other services like cancer screenings, STD prevention and treatment, and sex education for teens.

In 2016, however, Ohio lawmakers banned the state from funding any organization that performs abortions, and the law went into effect after it was upheld by a federal appeals court in 2019. That meant that Planned Parenthood affiliates in Ohio lost about $600,000 a year in state funding, and led to the cancellation of some of their non-abortion health programs.

While Planned Parenthood does receive some additional reimbursements through Ohio’s Medicaid program for providing non-abortion health care to people on Medicaid plans, it no longer receives state grants.

Planned Parenthood also lost additional federal funding under Title X, a program that funds birth control and reproductive health services, under a Trump administration rule. But the organization started receiving that money again this year after the Biden administration reversed the rule.

Maria Gallo, a sexual and reproductive health epidemiologist at Ohio State University, said that state funding for crisis pregnancy centers shows how conservative lawmakers prioritize anti-abortion rhetoric over medical care for women.

“It’s dangerous in part because they are legitimizing (crisis pregnancy centers),” Gallo said. “They are legitimizing that as a source of medical care when they’re not licensed medical facilities.”

Crisis pregnancy centers drastically outnumber abortion clinics in the United States. There were 790 abortion clinics operating in 2021, compared with about 2,600 crisis pregnancy centers, according to a database compiled by Reproaction, an abortion-rights group.

That disparity is only likely to grow in the wake of the Supreme Court decision. Hartshorn, the chair of Heartbeat International, said the organization has created an online training program to help people open new pregnancy centers, especially in places without existing ones.

“We need more people, we need more places, and we need more paths to pregnancy health,” Hartshorn said.

A study by the National Center for Responsive Philanthropy found that the groups have taken in more and more money in recent years: They received over $1 billion in revenue in 2019, the most recent year data was available, compared to about $771 million in 2015. 

Several women who went to state-funded crisis pregnancy centers told CNN they felt misled and manipulated by the groups, and disturbed that they were getting taxpayer money.

Last year, a woman who asked to be identified by her middle name, Eve, had just lost her job when she suspected she might be pregnant. She and her boyfriend went to Women’s Care Center in Columbus after finding the group on Google. Money was tight, and she chose the center – which is receiving more than $700,000 from the state of Ohio in the current fiscal year – because it promised free pregnancy testing. 

Eve’s test was positive, and she asked the staff about an abortion. She said they handed her a pamphlet that warned her the procedure could cause infertility – though abortion doesn’t typically affect a person’s ability to become pregnant in the future. For three hours, Eve said the staff pressured her to carry the pregnancy to term.

“It became very clear that they were against abortion really quickly,” said Eve, who left the center feeling upset and later got an abortion. The center didn’t respond to questions about Eve’s visit but said in an email they are “absolutely committed to accuracy, excellence and transparency in all we do.”

One day, Eve said she hopes to have kids. But at the time, she didn’t feel financially or emotionally stable enough to have a baby.

“Nobody wants to make a decision to have an abortion,” Eve said. “And they made me feel really guilty and bad about it.”

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December 31, 1969