Off the Kuff Rotating Header Image

Planned Parenthood

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.

“Fetal remains” rule goes into effect

Cue up that next lawsuit.

Texas’ proposed rules requiring the cremation or burial of fetal remains will take effect Dec. 19, according to state health officials.

Despite intense outcry from the medical community and reproductive rights advocates, the state will prohibit hospitals, abortion clinics and other health care facilities from disposing of fetal remains in sanitary landfills, instead allowing only cremation or interment of all remains — regardless of the period of gestation.

[…]

Proposed at the direction of Republican Gov. Greg Abbott, the health commission had argued the rules would result in “enhanced protection of the health and safety of the public.” Abbott said in a fundraising email that the rules were proposed because he doesn’t believe fetal remains should be “treated like medical waste and disposed of in landfills.”

But the new requirement prompted outrage from the reproductive rights community, which accused state leaders of pushing unnecessary regulations. Women who experienced miscarriages or lost children in utero questioned why the state would make their situations more difficult by enacting the requirements. And medical providers — including the Texas Medical Association and the Texas Hospital Association — had also raised concerns about who would bear the costs associated with cremation or burial — a figure that can reach several thousand dollars in each case.

In response to those concerns, health officials indicated that health care facilities — and not patients — will be responsible for the disposal of fetal remains and related costs. They also wrote that those costs would be “offset by the elimination of some current methods of disposition.”

See here, here, and here for the background. If you think it’s a coincidence that this was proposed within a few weeks of the SCOTUS ruling striking down HB2, I’ve got a carload of diplomas from Trump University to sell you. Let’s get that next lawsuit going so we can maybe have an injunction in place before this atrocity can take effect. (And if you want to help facilitate that, a donation to the Center for Reproductive Rights would be a fine way to do so.) The Austin Chronicle has more.

Why are so many pregnant women dying in Texas?

Better yet, what are we going to do about it?

The rate of Texas women dying of pregnancy-related causes nearly doubled from 2010 to 2014, with the state seeing more than 600 such deaths in the four-year span.

In a new study, set to be published in the September issue of Obstetrics and Gynecology, researchers found that Texas experienced a dramatic increase in pregnancy-related deaths from 2010 to 2012. While the rest of the country also experienced an increase, no other state saw the rate nearly double like it did in Texas.

Some health experts complain that the state has been slow to respond to the problem. A state task force on the issue is nearly three years into its work and has released no recommendations.

“We’re really seeing this is a serious problem with maternal mortality,” said Dr. Daniel Grossman, an OB-GYN who studies the effects of recent reproductive health legislation in Texas with the Texas Policy Evaluation Project at the University of Texas at Austin. “It really seems like that’s where the state officials should be focusing on trying to improve health and safety.”

From 2006 to 2010, the rate of Texas women who died while pregnant or within 42 days of being pregnant due to causes related to their pregnancies fluctuated between 18.1 and 18.6 deaths per 100,000 live births, according to the study. In 2011, the rate jumped to 33, and by 2014, it was 35.8.

In 2012, 148 women died from such causes, up from 72 deaths two years before.

The findings stumped the national researchers and have prompted them to begin a further study into maternal mortality in Texas. Vital statistics officials on both state and national levels “did not identify” any change in the data recording processes that could have resulted in the dramatic increase, according to the study.

The Texas Legislature created a task force in 2013 to study pregnancy-related deaths and severe complications in the state. It’s set to release its first report to lawmakers on Sept. 1.

[…]

The rise in pregnancy-related deaths in 2011 coincided with the beginning of major budget cuts in Texas. In September of that year, health care providers across the state began to feel the effects of a family planning budget reduced by two-thirds.

Sarah Wheat, a spokeswoman for Planned Parenthood of Greater Texas, said many of the family planning clinics that lost funding or closed were an “entry point into the health care system” for women.

“Chances are they’re going to have a harder time finding somewhere to go to get that first appointment,” Wheat said. “They may be delayed in getting that initial pregnancy test and then a prenatal referral.”

The study mentioned changes to women’s health services and clinic closures but didn’t go so far as to suggest there was a correlation between that and the uptick in pregnancy-related deaths.

“Still, in the absence of war, natural disaster, or severe economic upheaval, the doubling of a mortality rate within a two year period in a state with almost 400,000 annual births seems unlikely,” the study said.

I’m going to wait and see what that task force finally says on September 1. It took them three years to come up with something, so one hopes it will be worth the wait. In the meantime, I wonder why we haven’t heard more from the “pro-life” forces in this state, whom we know are legion and not at all the quiet types. One would certainly think that a sharp, unexplained rise in the rate of pregnant women dying would be the sort of thing that might attract their attention and at least some of their energy. Wouldn’t one? The Current has more.

Auditor asked to investigate Heidi Group health care grant

Good.

Right there with them

Right there with them

The left-leaning nonprofit Progress Texas is asking the state auditor’s office to investigate a $1.6 million state contract awarded to an anti-abortion group under the state’s new Healthy Texas Women program.

[…]

The Heidi Group does not currently provide medical services or employ medical staff, but founder Carol Everett has said that her group will coordinate with medical providers in rural areas to provide contraception, cancer screenings and other services.

According to Progress Texas advocacy director Lucy Stein, that raises some red flags about whether the Texas Health and Human Services Commission (HHSC) improperly awarded the funds to Everett’s group.

[…]

In its request for an investigation, Progress Texas notes that Everett serves on the Women’s Health Advisory Committee, which provides input to the state health department on the implementation of its retooled reproductive health care safety net. Texas has spent the last year or so reorganizing after anti-abortion lawmakers barred Planned Parenthood from receiving public funds, and the $18 million Healthy Texas Women program is the result.

Progress Texas questioned whether a group that until a few weeks ago operated with the stated mission of “helping girls and women with unplanned pregnancies make life-affirming choices” because abortion is “contrary to God’s will” could provide the medical services promised by the new program.

See here for the background. I can’t find the aforementioned statement anywhere, but Progress Texas does have this call to action on their webpage, along with a video introduction to Heidi Group founder Carol Everett. Any time a group with no experience in a particular field receives a grant to provide services in that field, there ought to be questions about how that happened. Add in the Heidi Group’s political advocacy and you can see the potential for shenanigans. I hope the auditor agrees to take a look at this.

Texas finds a new way to be hostile to women’s health

I feel like it must be someone’s job somewhere to come up with stuff like this.

Right there with them

Right there with them

A group led by an anti-abortion advocate appears to be one of the largest recipients of state funding from the “Healthy Texas Women” program, which lawmakers recently created to help women find health care services paid for by the state.

The Heidi Group, a Round Rock-based center that has promoted alternatives to abortion to low-income women, is set to receive $1.6 million from the women’s health program, according to the comptroller’s office. That makes it the second-highest grant recipient on the current list, behind the Harris County public health department, which will receive $1.7 million.

[…]

The Heidi Group “will now be providing women’s health and family planning services required by Healthy Texas Women, including birth control, STI screening and treatment, plus cancer screenings to women across Texas,” state agency spokesman Bryan Black said in an email.

Black said the group had already recruited doctors to begin establishing family planning clinics across the state. He also said the women’s health program’s contracts were not final and that there were “more to come.” The program offers $18 million each year.

Abortion-rights supporters lambasted the Heidi Group’s contract.

“It’s very inappropriate that the state would contract with an organization that has never performed the services required by the contract,” said Heather Busby, executive director of NARAL Pro-Choice Texas, in a statement. “The Heidi Group is an anti-abortion organization; it is not a healthcare provider.”

This is a political advocacy group that has been given a contract to provide health care. What could possibly go wrong with that? The Observer gives another reason to be concerned:

[Heidi Group founder Carol] Everett made headlines in early August following her testimony at a Texas Department of State Health Services meeting on new rules about fetal tissue disposal in Texas. There, she asserted that currently allowable means of fetal tissue disposal could result in HIV and other sexually transmitted infections being released into public water supplies, which she later repeated to an Austin Fox affiliate. Her concerns are not echoed by any major medical or public health groups.

So this is like hiring Jenny McCarthy to run your immunization program. This is what the state of Texas under Greg Abbott thinks about women’s healthcare. The Press, which has a more sympathetic portrait of Everett, and the Current, which is harsher, have more.

More on the “fetal remains” rule change

It’s stupid, harmful, unnecessary, expensive, and almost certainly in violation of the SCOTUS ruling in Whole Women’s Health v. Hellerstedt. But other than that, no biggie.

In the aftermath of a car accident in 2014, Denee Booker was told by her doctor that the child she was carrying had died in utero.

To avoid complications, she agreed with her doctor’s suggestion to remove the fetus instead of waiting for it to “naturally pass,” Booker told state health officials during a Thursday hearing on a proposed state rule that would require the cremation or burial of fetal remains.

“That I would have had to take or make either of those decisions is mind-boggling and terrifying,” Booker said of the proposed requirements. “I can’t imagine how much worse that would’ve made my situation.”

Booker was among dozens who testified on a pending rule change that prohibits hospitals, abortion clinics and other health care facilities from disposing of fetal remains in sanitary landfills, instead allowing only cremation or interment of all remains — regardless of the period of gestation — even in instances of miscarriages.

[…]

Medical professionals and others have also questioned whether the new rules would trigger a requirement for death certificates so that fetal remains could be cremated or buried.

Under current rules, the state requires funeral directors or a “person acting as such” who take custody of a dead body or fetus to obtain an electronic report of death before transporting the body, according to the associations’ letter.

The Funeral Consumers Alliance of Texas came out against the measure. Sarah Reeves, a representative for the group, testified that the state’s fiscal analysis of the rule change was incomplete because it found there would be no significant cost to individuals or businesses that must comply.

In a letter submitted to health officials, the group’s director wrote that the average “basic fee” for funeral services is $2,000.

The proposed rule does not indicate who would pay those costs. Hospitals and abortion providers currently contract with third-party medical waste disposal services.

During the hearing, Joe Pojman, executive director of Texas Alliance for Life, suggested that abortion providers should absorb any “nominal increase” in costs associated with the cremation or burial rule as some funeral homes and cemeteries do in cases of miscarriages.

In questioning the health-related justifications for the proposed rules, Planned Parenthood and NARAL Pro-Choice Texas testified that state health officials have not provided any evidence that current methods used by abortion providers to dispose of fetal tissue — which have been approved by the state for 20 years — are less safe or not optimal for public health and safety.

State officials have defended the rule change, saying it was proposed in “the best interests of the public health of Texas.” They also say the proposed rule change reflects the state’s efforts to affirm the “highest standards of human dignity.”

Planned Parenthood has pointed out that the proposed rules treat fetal tissue differently than other medical tissue.

The rule change would not apply to other human tissue that might be removed during surgery, for instance, and the existing disposal methods were not modified for the placenta, gestational sac and other tissue that results from miscarriages and abortions, the organization wrote to health officials.

“While we support reasonable updates to rules that are within the department’s statutory authority and protect and enhance public health and safety, the proposed rules go beyond the limits of this authority, do not further these aims and appear motivated solely by political forces,” said Yvonne Gutierrez, executive director of Planned Parenthood’s political arm in Texas.

The possibility of a legal challenge to the rule change hung over the hearing, with many repeating a warning by reproductive rights lawyers that the proposal “will almost certainly trigger costly litigation.”

See here for some background. The “possibility” of legal action is roughly 100%, I’d say. Lamar Hankins goes into great detail about why this proposed rule change is ridiculous, and it’s clear that this is another example of the state insisting it knows health and medicine better than any dumb ol’ doctors. The rules for this have been the same for 20 years, so the only motive I can think of for changing them now is backlash to Hellerstedt. Maybe the Department of State Health Services will reconsider before they make it official, but if not, we’ll see you in court again. The Observer, the Current, the Austin Chronicle, and Rewire have more.

Harris County DA drops charges against video fraudsters

Disappointing, to say the least.

Right there with them

Right there with them

Criminal charges against the anti-abortion activists behind undercover recordings of a Houston Planned Parenthood facility were dismissed Tuesday.

David Daleiden and Sandra Merritt, the videographers who infiltrated Planned Parenthood Gulf Coast, had been charged with tampering with a governmental record, a second-degree felony charge that carries up to 20 years in prison. A court clerk confirmed that the Harris County district attorney’s office filed the motion to dismiss the case against Daleiden and Merritt.

Harris County DA Devon Anderson said in a statement that Texas limits what can be investigated after a grand jury term gets extended, which happened in this case.

“In light of this and after careful research and review, this office dismissed the indictments,” Anderson said.

The misdemeanor charge against Daleiden was dismissed by the judge in June. The defense had filed a motion back in April to dismiss the felony charges on the grounds that the grand jury had not been properly empaneled, and the fraudsters rejected a plea deal later in April. If you’re wondering why now, when there hadn’t yet been a hearing on the defense motions, the DA’s office decided to throw in the towel, you’re not alone.

The decision came as a surprise because the district attorney’s office had argued at length in a 30-page motion filed in May that the issue about the grand jury’s term was “meritless.”

Planned Parenthood Gulf Coast’s attorney Josh Schaffer said Tuesday’s decision was based on a political calculation by a Republican incumbent who has drawn criticism for pursuing the case. It also came just days after sharp criticism of the DA’s office in an unrelated case over the jailing of a mentally ill rape victim to ensure she would testify.

“I think it smacks of a politically expedient decision made from the highest levels of the office,” Schaffer said. “It was an easy out for a district attorney who had already received a lot of heat from her party over this case and had received a lot of heat this week for the handling of another case, one involving a rape victim.”

If prosecutors were concerned about a technical error over the grand jury extension, he said, they could have remedied it months ago by taking it to another grand jury. The district attorney’s office could still file charges, he noted.

“I do not think what happened in this case was based on law or the facts,” he said. “It was based on politics.”

[…]

The lawyers had scheduled a hearing before state District Judge Brock Thomas in which they were expected to argue the grand jurors were improperly empaneled longer than their standard three-month term, rendering any indictments null and void.

Instead of arguing the point, prosecutors agreed in a surprise move that the defense raised a “colorable claim” and dismissed all of the charges.

[…]

Political and legal observers said the dismissal is understandable given the amount of resources it would have taken to prosecute versus the likely outcome.

“If I were writing the prosecutorial memo, it seems like this case would be a whole lot of work that would, at best, end up with a slap on the wrist,” said Geoffrey Corn, a professor at the newly named Houston College of Law. “There are bigger fish to fry in Houston.”

Corn said Anderson should not be criticized for using her discretion to dismiss a case that would expend county resources for a minor conviction.

“These were a couple of zealots who were overreaching and gaming the system,” he said. “DA’s have to make hard decisions about where to allocate resources. This seems to make sense to me.”

I Am Not A Lawyer, so I cannot evaluate the merits of the defense’s arguments or the reasons why the prosecution decided to buy into them. What Professor Corn says makes some sense, but one might ask why they didn’t make that calculation before taking this to a grand jury in the first place. It’s not like they couldn’t have seen this cost/benefit calculation coming from that vantage point. I can’t say what motivated Devon Anderson to change course now, but the timing of it sure is funny.

One more thing:

“The decision to drop the prosecution on a technicality does not negate the fact that the only people who engaged in wrongdoing are the extremists behind this fraud,” said Melaney Linton, president and CEO of Planned Parenthood Gulf Coast.

Yep. This is the very definition of “getting off on a technicality”. Let us not lose sight of that. The Press and the Current have more.

What do you get when you cut off funds for HIV testing?

You get no HIV testing, of course.

Right there with them

Right there with them

When Texas abruptly ended its $600,000 HIV prevention contract with Planned Parenthood’s Houston affiliate in late December, state health officials promisedthat there would be no interruption in services. The Department of State Health Services parceled the money out to three county health departments in the Houston area and insisted at the time that the counties would have the capacity to pick up where Planned Parenthood left off.

But the Observer has learned that as of early June, Harris County’s health department has yet to perform a single HIV test with the money.

So far, the department has received about $250,000 in state funding but is still in the planning stages for its program. The Fort Bend and Galveston County health departments also received smaller portions of the money — Galveston began providing testing in March; Fort Bend hired its staff and began testing in May.

In the five months since losing its contract, Planned Parenthood Gulf Coast (PPGC) estimates that it would have provided 2,900 HIV tests and distributed around 165,000 condoms. Rochelle Tafolla, PPGC’s spokesperson, said most of its testing was conducted in Harris County, the most populous in Texas and home to nearly 23,000 Texans living with HIV. According to state data, Harris County is home to one in four new Texas HIV cases every year and its diagnosis rate is nearly double the state average. Among the state’s five largest urban counties, only Dallas County has a higher new diagnosis rate.

Martha Marquez, spokesperson for the Harris County Public Health and Environmental Services Department, told the Observer that the department plans to hire three staff members and begin testing “in the coming weeks.”

[…]

Testing individuals at risk for HIV as quickly as possible is “key” for reducing new infection rates, said Daniel Williams, policy and regional field coordinator atEquality Texas.

“It’s unfortunate that an organization that had a proven track record in doing exactly what this contract was intended to do was removed from it,” he said. “It’s doubly unfortunate that the contract was then sent to an agency that doesn’t have the resources to pick it right up without the delay.”

Williams pointed to other organizations in the Houston area that provide HIV testing and might have been better prepared than the county health department to pick up where PPGC left off, such as Legacy Community Health or The Montrose Center.

“Harris County has lagged behind the rest of the state in reducing its HIV infection rate, and this six-month gap in performing testing and getting people into treatment is making the situation worse,” he said.

See here for the background. You know who doesn’t care about any of this? Greg Abbott and Dan Patrick, that’s who. I guarantee, we’ll never hear them talk about this in any way that suggests they recognize there was a problem. They really do care about the sanctity of life, don’t they? Slate has more.

Misdemeanor charge dropped against video fraudster Daleiden

Just the misdemeanor charge, not the felony.

Right there with them

Right there with them

A Harris County judge has dropped one of the criminal charges against an anti-abortion activist who was indicted after making undercover recordings of a Houston Planned Parenthood facility.

David Daleiden, one of the videographers who infiltrated Planned Parenthood Gulf Coast, had been charged with the very crime he tried to secretly catch Planned Parenthood committing — a misdemeanor charge for offering to sell or buy fetal tissue. But that charge was dismissed on Monday, according to the Harris County District Clerk website.

[…]

Daleiden’s team in April asked the judge to dismiss his indictments, alleging they were a result of improper proceedings by prosecutors and that the grand jury — originally asked to investigate Planned Parenthood, not the videographers — exceeded its authority.

In a statement Tuesday, Harris County District Attorney Devon Anderson said the judge’s ruling was not based on Daleiden’s motion to quash the indictments.

“The basis for the judge’s ruling was not raised by the defense at any time,” Anderson said. “We do not intend to appeal the judge’s decision. Our office remains focused on the felony charge pending in the 338th District Court.”

See here and here for some background. The Press explains why the misdemeanor indictment for offering to sell or buy fetal tissue was tossed:

Judge Bull reasoned that the indictment was defective because prosecutors did not list an “exception” to the criminal charge—essentially, prosecutors didn’t list a few scenarios in which the defendants’ actions would in fact be legal. One of those exceptions that prosecutors failed to list? It just so happens to be the very defense that Planned Parenthood mounted against the radical right’s attacks: “reimbursement of expenses…incurred by the donor of a human organ in connection with the donation of the organ.”

Yes, because prosecutors didn’t write down that exception in the formal indictment, Judge Bull says the case is void.

I’m not particularly concerned about this. It’s the felony charges that matter, and those are still in place for both Daleiden and Merritt, who apparently has not yet made a decision about whether or not to accept the offer of probation from the DA. As long as Daleiden in particular goes down in a blaze of self-righteous baloney at the end of all this, I’m good. The Chron, the Observer, and Trail Blazers have more.

Use of abortion pill rises

Until the Lege reconvenes, anyway.

Misoprostol

There’s been a sharp increase in the number of Texas women who are using the abortion pill to end their pregnancies now that federal officials have eased restrictions on the drug, according to officials at Planned Parenthood of Greater Texas.

Until recently, the number of women seeking medically induced abortions at Texas’ Planned Parenthood facilities had dipped to about 1 percent because of stringent guidelines put in place by state lawmakers, officials say.

That changed in late March, when the U.S. Food and Drug Administration relaxed guidelinesfor women taking mifepristone, a pill geared to induce abortion early in a pregnancy.

“We have seen a fourfold increase in the number of our patients choosing medication abortion since the FDA updated its protocol,” said Sarah J. Wheat, chief external affairs officer at Planned Parenthood. “From our perspective, it’s restoring options for women.

“It’s putting decisions back in the hands of women instead of politicians at the Capitol.”

No firm numbers are available yet, but Texas researchers and abortion providers say they see the increase and hope to have better estimates in the coming months.

[…]

Planned Parenthood continues to run clinics statewide, including the Southwest Fort Worth Health Center, a privately funded $6.5 million licensed ambulatory surgical center that opened in 2013.

A medical abortion has remained an option for patients at these facilities, but fewer women have used it because Texas law required them to visit the clinic four times for it, said Daniel Grossman, an investigator with the Texas Policy Evaluation Project and a professor at the University of California, San Francisco.

“In the six months after HB 2 went into effect, there was a 70 percent decline in medication abortions performed statewide,” said Grossman, who is working with researchers at the University of Texas at Austin to determine the impact of legislation on abortions. “Interviews with women … [showed they were] incredibly frustrated when they had a preference for medication abortion” and couldn’t get it.

Wheat said some women have had to travel 100 miles or more to reach a Planned Parenthood clinic, which put a hardship on them for multiple visits.

“That requirement alone created huge barriers for our patients,” she said.

Now that the FDA change has loosened restrictions in Texas — requiring a lower dose, 200 milligrams instead of 600 milligrams; fewer doctor visits; and allowing the medication up to 10 weeks in a pregnancy instead of seven weeks — more women are choosing the medical abortion option, Wheat and Grossman say.

Exact numbers won’t be available for weeks or months, but “many of the independent abortion providers who have already started using the new FDA regimen are saying their numbers are back up,” Grossman said. “Many women have a preference and prefer this.”

[…]

Now the question is whether Texas lawmakers will weigh in on the issue when they return to work in January.

Planned Parenthood officials say they hope not.

“The restrictions the Legislature put in place were not based in science,” Wheat said. “The FDA is the national expert in how medications are provided, and they approved these updates.

See here for the background. I’d laugh at the futility of hoping that science and rationality would prevail if it weren’t so painful. The best hope as I see it is for HB2 to be sufficiently gutted by the Supreme Court. That will surely only slow down the zealots, but it’s probably the best we can expect until we start electing different leaders.

Video fraudsters to go to trial

All righty then.

Right there with them

Right there with them

David Robert Daleiden, 27, and his colleague, Sandra Susan Merritt, 63, both of California, have rejected a plea deal that would have effectively put an end to the criminal charges against them, their lawyers confirmed Friday.

“I don’t advise my clients to accept responsibility for cases that they haven’t done anything wrong in,” said Dan Cogdell, Merritt’s attorney.

The pair were charged in January with tampering with a governmental record, a second-degree felony with a possible sentence of up to 20 years in prison. Daleiden also faces a misdemeanor charge of attempting to buy human organs.

After a brief status hearing Friday, attorneys said they will not accept offers of pretrial diversion, a low-level probation that would have allowed the charges against them to be dismissed if they did not break the law for a year. It’s commonly offered by the Harris County District Attorney’s Office to first-time offenders with minor charges such as shoplifting.

Earlier this month, attorneys for Daleiden filed motions to quash the indictments against him, arguing that the Harris County grand jury that handed down the indictments was not properly empaneled.

See here and here for the background. The defense has alleged that DA Devon Anderson is in cahoots with Planned Parenthood, the defendants are utterly convinced of their righteousness and are prepared to martyr themselves for their cause. This will be…interesting. There’s no mention of a court date, so we’ll just have to be patient.

Two Medicaid stories

From the Trib:

It's constitutional - deal with it

It’s constitutional – deal with it

State health officials confirmed Tuesday they have asked the Obama administration to keep a 15-month lifeline of federal Medicaid money flowing into Texas to help hospitals treat uninsured patients.

That money would offer temporary relief to health care providers who face losing the funds — some $3.1 billion annually — over state leaders’ refusal to provide government-subsidized health coverage to low-income adults under the Affordable Care Act, President Obama’s signature health law.

Federal officials previously signaled they would stop footing the bill for at least some of Texas’ costs for “uncompensated care” — the burden on hospitals when patients can’t pay for their visits. Under the Affordable Care Act, Texas was encouraged to expand its Medicaid program to cover nearly 1 million additional adults living in poverty — a move that would have given more poor patients a means to pay for care. The state’s Republican leadership has vehemently opposed that option, criticizing Medicaid as an inefficient government program.

[…]

First created as a $29 billion pot of money paid to Texas health care providers over five years, about 40 percent of that money came from local funds — mostly property tax dollars — and 60 percent from the federal government. The Obama administration approved the program in 2011, and it was set to expire in September.

By asking for the program to be renewed for a significantly shorter timeframe, state health officials indicated that they expect the federal government will be reluctant to continue handing out cash to reimburse hospitals for patients who can’t pay for their visits. Federal health officials have repeatedly told state leaders they have no desire to use waiver funds to pay for costs that would otherwise be covered by a Medicaid expansion.

In Florida, the Obama administration recently agreed to extend a similar source of hospital funding in that state, but only for two years and at a significantly reduced rate. That arrangement diminished the state’s low-income pool by about 50 percent for the first year and 70 percent for the second.

See here and here for some background, and here for a copy of the letter. This is the 1115 waiver, and I’ve been rooting for the feds to tell Texas to go pound sand unless they expand Medicaid. This is at least a step in that direction.

And from Think Progress:

The Obama Administration just sent a strong signal to states trying to defund Planned Parenthood, warning all 50 states that attempts to strip Medicaid funding from the women’s health care provider is most likely illegal.

The letter, sent to each state’s Medicaid director, cautions lawmakers that “providing the full range of women’s health services… shall not be grounds for a state’s action against a provider in the Medicaid program.” In other words, the fact Planned Parenthood provides abortion services in addition to other women’s health services is not legal grounds to cut it off from Medicaid funding. It stipulates that the only justifiable reason to remove a provider’s Medicaid funding is if that provider isn’t able to bill for or perform covered medical services.

“Once again, the Centers for Medicare and Medicaid Services has made it clear that it’s illegal for politicians to tell women where they can and cannot go for care,” said Cecile Richards, President of Planned Parenthood, in a statement.

[…]

The Obama Administration has warned specific states before that cutting off Medicaid funding for Planned Parenthood may violate federal law, but this is the first time that they have sent a letter to every state in the country.

As we know, Planned Parenthood has filed a lawsuit against Texas after it announced it was cutting PP out of any program it hadn’t already cut them out of as punishment for those faked videos by the fraudsters Daleiden and Merritt. I don’t know what effect, if any, this federal action will have on that, but I do know we could easily solve all these problems (and more) if Texas would expand Medicaid and obey the law. It’s all so simple, really.

It’s a conspiracy!

Oh, noes! Planned Parenthood is in cahoots with the Harris County DA! Run for your lives!

The anti-abortion activist accused of falsifying records to secretly videotape Planned Parenthood officials in Houston is accusing the Harris County district attorney’s office of illegally colluding with the nonprofit.

The allegations were raised in court documents filed Thursday seeking to dismiss the charge against David Robert Daleiden, of Davis, Calif.

[…]

On Thursday, his attorneys filed motions to quash the indictments, saying the Harris County grand jury that handed down the indictments was not properly empaneled.

“The DA’s office has chosen to wage a war on the pro-life movement,” said attorney Jared Woodfill. “We believe there is clear evidence of Planned Parenthood actually colluding with and pushing the District Attorney’s office to move forward with these indictments.”

At a press conference on the courthouse steps that Daleiden did not attend, Woodfill and attorney Terry Yates said the indictments are “fatally flawed.”

The motions filed to quash the felony charge is here, and for the misdemeanor charge is here. I’ve read through the first one, and with the usual reminder that I Am Not A Lawyer, it looks to me like the bulk of the issue being taken is with the grand jury being held over:

The investigation of Planned Parenthood was brought before the 232nd grand jury [in] September [of 2015].

However, at the close of the 2015 term, no action had been taken in the investigation of Planned Parenthood. A grand jury “hold over” order was drafted by the Harris County District Attorney’s office and presented to the 232rd Court for entry on December 16, 2015. (Exhibit “B”). However, in that order, the prosecutor failed to specifically state or articulate any specific individual or case that the grand jury was holding over to investigate. The order recites boilerplate language set forth in Section 19.07 of the Texas Code of Criminal Procedure; however, due to the lack of specificity required the order is deficient.

From there, they complain that evidence from the grand jury hearings was provided to lawyers for Planned Parenthood and the National Abortion Federation, including video evidence that was supposed to be covered by a temporary restraining order, and that Daleiden’s lawyers were never notified that he had become a target of the investigation. They cite various mainstream media accounts published after Daleiden and Merritt were indicted as evidence of this.

I’ll leave it to the attorneys in attendance to comment on the claims made by Woodfill and Yates. My layman’s impression is that hold over grand juries are fairly routine – whether they need specific instructions about who or what is being investigated is not something I know – and as for the alleged collusion, I kind of have a hard time believing the lawyers involved, including the assistant DAs, would be that stupid if this was indeed something shady. I would also note that Tamara Tabo, who unlike me is a lawyer and who also unlike me opposes abortion, believes it is clear that Daleiden did indeed break the law. Which doesn’t mean that the indictments weren’t compromised and won’t be tossed, but it is worth keeping in mind. Woodfill and Yates aren’t arguing Daleiden isn’t guilty of anything, they’re arguing the process went bad. I can’t wait to see what the judge makes of this. The Trib, which supplied the defendant’s motions, and the Press have more.

More troubles for the Planned Parenthood video fraudsters

Couldn’t happen to a nicer guy.

Right there with them

Right there with them

Investigators with the California Department of Justice on Tuesday raided the home of David Daleiden, the anti-abortion activist behind a series of undercover videos targeting Planned Parenthood, the activist said.

Authorities seized a laptop and multiple hard drives from his Orange County apartment, Daleiden said in an email. The equipment contained all of the video Daleiden had filmed as part of his 30-month project, “including some very damning footage that has yet to be released to the public,” he said.

A spokeswoman for California Attorney General Kamala Harris (D) said she could not comment on an ongoing investigation. But the raid confirms that California is among the states looking into possible criminal activity on the part of Daleiden and his organization, the Center for Medical Progress, which have been the center of controversy since releasing videos purporting to show that Planned Parenthood illegally sells fetal tissue for a profit.

[…]

The National Abortion Federation, a professional organization for abortion providers that was also targeted in Daleiden’s videos, lauded news of the raid.

“We fully support a thorough investigation into the activities perpetrated by David Daleiden and the Center for Medical Progress,” president Vicki Saporta said in a statement. “As the evidence has shown in our case, he engaged in a long-running criminal conspiracy. His actions are not without consequences.”

Saporta said the videos have led to a spike in threats and violence against abortion clinics.

See here, here, and here for the background. Given all that’s been said and done so far, it’s hard not to see that surge in violence directed at the clinics as anything but a planned outcome. I’ll say again, I’m happy for Daleiden to martyr himself for this cause, as long as he really really gets to suffer for it. He’s earned every bit of retribution coming his way. It’s my further hope that the evidence that California authorities uncover can be used to help facilitate those consequences. Daily Kos, Politico, the Chron, and Kevin Drum have.

Local Planned Parenthood joins lawsuit against the video fraudsters

Good.

Right there with them

Right there with them

A Texas-based Planned Parenthood affiliate on Thursday moved to join a federal lawsuit filed in California against the anti-abortion group behind undercover videos of the organization’s clinics.

The lawsuit, filed in a San Francisco-based federal court in January, alleges the Center for Medical Progress engaged in conspiracy, fraud and other activities that violate organized crime law and other federal regulations in its pursuit of secretly recorded videos of Planned Parenthood. Citing recordings of staff at a Houston clinic, Planned Parenthood Gulf Coast filed to join the lawsuit as a plaintiff.

The recordings, released by the group last summer, depicted Planned Parenthood staff discussing the procurement of fetal tissue. The group alleged that Planned Parenthood was illegally profiting from the sale of tissue of aborted fetuses — an accusation the organization has vehemently denied.

The lawsuit against the group was first filed by Planned Parenthood Federation of America and seven California affiliates against the Center for Medical Progress, Biomax Procurement Services and several anti-abortion activists, including videographers David Daleiden and Sandra Susan Merritt.

See here for the background on the existing lawsuit, and here for a copy of the complaint. There’s another federal lawsuit against these clowns as well, plus a lawsuit by PP against the state over revocation of Medicaid funds. If these CMP idiots want to be martyrs for their cause, I hope the justice system helps them get there, one judgment (and conviction) at a time. The Chron and the Observer have more.

How much more “undue” does it need to be?

HB2 is doing exactly what it was intended to do.

A new report released Thursday shows Texas abortion patients traveled farther for services and experienced higher out-of-pocket costs following the closure of more than half of the state’s legal abortion providers in 2014. The closures came after the implementation of parts of Texas’ omnibus anti-abortion law, HB 2, which is currently being challenged at the U.S. Supreme Court.

Thursday’s is the latest report from the Texas Policy Evaluation Project (TxPEP), a University of Texas research group that studies the long-term effects of Texas’ omnibus anti-abortion law and other changes to reproductive health funding and policies. TxPEP surveyed 398 women who sought abortions between May and August of 2014, when all but 19 abortion clinics in Texas were closed. Researchers then compared the experiences of two groups: women whose nearest clinic closed after HB 2’s admitting privileges requirement first took effect, and those whose nearest clinic didn’t close.

Women whose nearest clinic closed (38 percent of the 398 surveyed) ended up traveling an average of 85 miles for their abortion, while those whose nearest clinic stayed open (62 percent) traveled 22 miles. According to the Guttmacher Institute, the national average distance traveled to an abortion clinic is 30 miles.

[…]

Researchers found that 32 percent of women whose nearest clinic closed reported spending more than $100 in out-of-pocket expenses to access abortion because of extra necessities, such as transportation, overnight accommodations, child care, and also lost wages from taking time off work. Those expenses were added to the cost of the procedure itself.

Either the “undue burden” standard – which Anthony Kennedy authored – means something, or it doesn’t. If this law doesn’t violate that standard, then we may as well admit that it means nothing. I continue to hope that the good Anthony Kennedy will be there for this one. Newsdesk and Think Progress have more.

Oral arguments before SCOTUS on HB2

From Texas Monthly:

Right there with them

Right there with them

It’s been a circuitous journey for HB2, the omnibus abortion bill the Texas Legislature passed 2013. Suits have been filed, the law has been overturned, appeals have been made. A collection of Texas abortion clinics, led by Whole Woman’s Health, filed the most debated lawsuit, which is aimed the broader provisions of the bill: Specifically, Whole Woman’s Health v. Hellerstedt challenges the constitutionality of HB2’s requirement that doctors performing abortions in Texas have admitting privileges at hospitals and also the requirement that each clinic meet the standards of an ambulatory surgical center.

Although the case had a similar courtroom path to previous suits against the law—including being overturned at the district level—Whole Woman’s Health vs. Hellerstedt went even further. The Supreme Court stepped in almost immediately to issue an injunction against HB2 going into effect until the high court had the chance to hear it on appeal.

That happened Wednesday.

New York-based attorney Stephanie Toti, representing Whole Woman’s Health (and joined by U.S. Solicitor General Donald Verrilli), made her arguments against HB2 before the eight-members of the court; representing Texas and Hellerstedt, our state’s Solicitor General Scott Keller defended the law.

There are a few key issues to be determined by the court. The first is if Whole Woman’s Health vs. Hellerstedt is the appropriate case to be raising these arguments, or if another case, Planned Parenthood vs. Abbott, should have addressed them. Also related to that facet of the case is if the window for examining the law has since closed because that suit didn’t appeal to the Supreme Court. The second issue—and the one that received the majority of the focus Wednesday—is on the question of the “undue burden” on Texans seeking abortions. In the last major abortion case the court heard, 1992’s Planned Parenthood vs. Casey, the court found that states could impose restrictions on abortion if the restrictions didn’t pose an undue burden on the rights of the person who seeks an abortion. But that ruling didn’t specify a definition for “undue burden,” so attorneys on both sides attempted to make claims that the phrase does—or doesn’t—refer to HB2.

[…]

The pressure stayed on Keller throughout the duration of his argument, with Sotomayor and Kagan looking past “undue burden” to get to the ultimate question surrounding the bill since it was being debated in Austin: Namely, is this about increasing standards of care, as some proponents of the bill have argued, or is it about restricting access, as the law’s opponents have claimed? (It’s worth noting that some of the bill’s supporters in the legislature—from former Lt. Governor Dewhurst to Sen. Eddie Lucio—have expressed more openly that they passed the bill out of an interest in opposing abortion.)

This came to a head near the close of oral arguments. Kagan hit on several points about the state’s interest in raising standards of care: She’d asked, for example, about whether the state had the right to require all health care providers to meet the standard of the best hospital in the country (citing Massachusetts General), to which Keller responded that the state did have that right, so long as it didn’t create an undue burden on people seeking treatment. Breyer and Sotomayor noted that the rate of complications in colonoscopies are higher than in abortions, but facilities that offer colonoscopies don’t face the same regulations that abortion clinics do under HB2. (The word “colonoscopy” was said a surprisingly high number of times for a Supreme Court hearing about abortion.)

But near the end of Keller’s argument, Kagan cut to the chase. She noted that she understood that Keller’s argument was that the law allows Texas to impose regulations on abortion clinics that it doesn’t apply to other procedures—but she wanted to know why it picked abortion.

“You said that as the law is now, under your interpretation of it, Texas is allowed to set much, much higher medical standards, whether it has to do with the personnel or procedures or the facilities themselves, higher medical standards, including much higher medical standards for abortion facilities than for facilities that do any other kind of medical work, even much more risky medical work. And you said that that was your understanding of the law; am I right?” Kagan asked Keller, “And I guess I just want to know: why would Texas do that?”

In all, it was an aggressive series of questions from the court’s liberal justices—but the fact that the four liberal justices would find a lot to dislike in HB2 isn’t exactly news. In the wake of Antonin Scalia’s death, the question became much more about what could be expected of the four remaining judges on the bench.

From Think Progress:

Prior to Wednesday’s oral argument and Scalia’s death, however, it was an open question whether this law would actually “withstand judicial obstacles.” The question on most Court-watchers’ mind was which Justice Kennedy would show up to hear this case. On the one hand, Kennedy finds abortion icky — just read some of the gruesome descriptions of a particular abortion procedure in Kennedy’s opinion in Gonzales v. Carhart to get a sense of just how icky he regards it. On the other hand, Kennedy is unwilling to kill Roe outright. In Planned Parenthood v. Casey, Kennedy coauthored an opinion that limited abortion rights, but which also purported to retain “the essential holding ofRoe v. Wade.” So the question on many Court-watchers minds before oral argument was whether Icky Kennedy or Casey Kennedy would show up to work today.

Icky Kennedy stayed at home. Though Kennedy did ask some tough questions about a procedural issue in this case, he largely remained silent as the liberal justices tore into Texas Solicitor General Scott Keller. And he asked a few questions on the merits that were critical of Keller’s arguments.

The liberal justices treated Texas’ arguments in much the same way that Holly Holm treated Ronda Rousey’s head. Justice Ruth Bader Ginsburg pointed out that it makes no sense to require clinics to comply with expensive requirements applied to surgical facilities if those clinics perform no surgeries. Justices Stephen Breyer and Sonia Sotomayor noted that Texas imposed these heavy burdens on abortion clinics, but did not impose them on facilities that perform riskier procedures. Colonoscopies, according to Breyer, are 28 times more likely to result in a complication than an abortion, but they do not need to be performed in an ambulatory surgical center.

[…]

Kennedy was almost completely silent during these one-sided exchanges, although he did chime in with a few questions while Keller was at the podium. At one point, he suggested that Keller’s arguments lead to the conclusion that Texas’s law creates an “undue burden” on the right to obtain an abortion, a conclusion that, under Casey, would require the Court to strike the law down. At another point, Kennedy expressed concern that the law caused many women who would otherwise have medication abortions to instead receive surgical abortions, a shift that “may not be medically wise.”

So that’s the good news for Team Choice. If this case is decided on the merits, it appears very likely that Kennedy will vote to strike down the Texas law.

The bad news is that it is far from clear that the Court will reach the merits. For complicated reasons related to the fact that the admitting privileges and ambulatory surgical centers requirements were implemented on different schedules, the lower courts in this case ruled on a facial challenge to the first provision before fully considering the second one. Whole Woman’s Health came to the Supreme Court as an appeal from the second decision, and Texas argues that the plaintiffs are effectively precluded from pressing their facial challenge to the admitting privileges requirement at this stage of the litigation. Without diving into the very arcane nuances of this argument, it’s worth noting that this is a serious enough procedural complication that Justice Ginsburg raised it shortly after the lawyer for the plaintiffs’ took the podium.

During the Court’s discussion of this procedural issue, Kennedy raised the possibility of sending this case back down to the trial court so that it can engage in additional fact-finding that will help the justices sort through this issue. Should the Supreme Court ultimately go this route, it could delay final resolution of the case for as long as a couple of years. That’s not death to the abortion clinics in Texas, so long as the Texas law is stayed pending resolution of the case, but the possibility of more litigation undoubtedly hit abortion advocates with a thud as they contemplated two more years of fighting and uncertainty.

From SCOTUSBlog:

But when the argument turned from the reason for closures to a question of the capacity of any remaining clinics to handle the tens of thousands of abortions that women in the state seek every year, the case shifted abruptly. It was Kennedy who raised the possibility that the case be sent back to lower courts to allow lawyers to put in evidence about that capacity question.

Several things immediately seemed important about that suggestion.

First, it would allow the Court to avoid a decision about the validity of either part of the Texas law, if it should turn out that, at Friday’s planned discussion of the case in a private Conference, the initial vote came out split four to four (the late Justice Antonin Scalia was a fervent foe of abortions). Returning the case for gathering of new evidence would avoid that outcome — indeed, any immediate outcome — and thus would avoid the even division that settles nothing and always disappoints the Court. It might even put off the case until the current vacancy on the bench is filled with a new Justice.

Second, of equal or perhaps even greater importance, there may have been a logical basis for that suggestion and it could have been in Kennedy’s mind. If he had any inclination to uphold either or both of the provisions, Kennedy would understand that this would probably lead to a four-to-four tie. But taking that position would mean he had done so without knowing whether the capacity of the remaining clinics — nine or ten at most — would be enough to handle all abortions that would be sought in the state (recently, between 60,000 and 75,000 a year)? Thus Kennedy might hesitate even more to push the Court into a tie vote.

Third, Kennedy’s hesitation on taking a stand on the merits of the law seemed even more likely because of a question he asked later in the argument. He pressed the lawyer for Texas, state Solicitor General Scott A. Keller, on whether the enforcement of the two provisions would actually lead more women to have more abortions through surgery, by forcing them to wait, with more risk than having an earlier abortion through the use of drugs that induce termination of pregnancy (“medical abortion”).

Kennedy cited data that the number of drug-induced abortions had increased nationally, but the number in Texas was down, and he commented that “this may not be medically wise.” The abortion clinics and doctors who are challenging the Texas laws have made that prospect a part of their argument that the two provisions impose an unconstitutional burden on Texas women’s constitutional right to seek an abortion, and Kennedy appeared to have taken that seriously.

Returning the case to lower courts to get more evidence on the incidence of later abortions might be one way to deal with that prospect, but so would striking down the law — by a five-to-three vote — because of the negative consequences of inducing more mid-term abortions. Since Roe v. Wade, the Court (including Kennedy since he joined the bench) has always been more comfortable with earlier abortions, partly because they are safer but also because of a concern for protecting the developing life of the fetus. Kennedy was a key part of the Court’s compromise ruling in 1992 (Planned Parenthood of Southeastern Pennsylvania v. Casey) when the Court expressed new support for state power to protect potential life, an interest that was said to increase the longer a pregnancy continues.

The Justices will cast at least a preliminary vote on the case when they assemble on Friday morning for a private Conference. If the case is going to be sent back to lower courts, or if the Court essentially gives up and casts a four-to-four vote, those outcomes might be announced quite soon, perhaps as early as next Monday. There is, of course, the possibility that more discussion would be necessary to sort out where the Court wants to go.

So basically, there’s a case for optimism, with the possibility of the law being struck down, and the possibility of it being sent back to the lower court for more hearings, while the injunction presumably stays in place. If the latter happens, then the issue could be revisited after a new justice is appointed, hopefully by President Clinton or Sanders. We may know quickly if that is going to happen, or we may not. Keep your fingers crossed. The WaPo, SCOTUSBlog, the Trib, and the Observer have more.

UPDATE: Still more, from Dahlia Lithwick, Alexa Garcia-Ditta, Genevieve Cato, and Jessica Mason Pieklo.

SCOTUS to hear HB2 oral arguments

It’s the big one.

Right there with them

Right there with them

Before Wendy Davis took to the floor of the Texas Senate for an 11-hour filibuster that ultimately failed to stop sweeping new restrictions on abortion, there was Casey.

Shorthand for Planned Parenthood v. Casey, the 1992 U.S. Supreme Court case reaffirmed a woman’s right to an abortion but gave states more power to restrict the procedure to “further the health or safety of a woman.” The 5-4 ruling, however, also said states can’t enact “unnecessary” regulations that have the “purpose or effect” of imposing an undue burden on those seeking the procedure.

On Wednesday, the court is expected to revisit the standards set by Casey — and potentially redefine the next era of abortion restrictions in the United States — when it takes up a legal challenge to Texas’ 2013 abortion restrictions, collectively known as House Bill 2. The Texas case, formally known as Whole Woman’s Health v. Hellerstedt, will allow the court to address disagreements among lower courts over what constitutes an undue burden and clarify how far states can go in restricting abortion.

It’s the next step of a legal journey that began in Texas when lawmakers passed HB 2 almost three years ago. The law requires abortion clinics begin to meet the same standards as hospital-like ambulatory surgical centers, which range from minimum sizes for rooms and doorways to the number of nurses required to be on staff. A separate provision requires doctors who perform abortions to have admitting privileges at a hospital within 30 miles of an abortion clinic.

Only 19 Texas clinics remain of the more than 40 that were open before HB 2 passed, and the restrictions are blamed. If the Supreme Court upholds the abortion law in its entirety that number could fall to less than 10, all in major metropolitan areas.

“There will be a right in name as long as Roe is still on the books, but if there are no clinics, then what does that really mean in terms of the right to abortion if you can’t exercise the right?” asked Cary C. Franklin, a constitutional law professor at the University of Texas at Austin. “This case really puts that question front and center.”

Indeed it does, though the makeup of the Court right now clouds things a bit. If we get the good Anthony Kennedy, in which case HB2 would have been struck down even with Antonin Scalia still on the bench, then perhaps there will finally be a limit put on the radical state legislators who have been busy enacting a tidal wave of dishonest laws whose sole focus is denying that right to women who wish to exercise it. If not – and some people think Scalia’s death makes Kennedy more likely to uphold Texas’ law – then that right is largely going to vanish in Texas and almost certainly Louisiana as well, though the rest of the country will still be in flux. The one thing that could change this is a Democratic President with a Democratic Senate that will allow SCOTUS to be restored to nine Justices. I mean, there’s no reason to believe Mitch McConnell will change his mind about voting on a replacement Justice if he’s still Majority Leader under President Clinton or Sanders, right? Maybe Kennedy will be dissuaded by the specter of chaos, or maybe he’ll just have had enough. For now, that’s the best hope. A summary and overview of the case from RH Reality Check is beneath the fold, and the Chron has more.

(more…)

Federal judge smacks video fraudsters

That’s gonna leave a mark.

Right there with them

Right there with them

In a sharp rebuke, a federal judge on Friday issued a preliminary injunction ordering abortion opponents not to release videos they had secretly made at meetings of abortion providers, and he added that the opponents’ claims that such organizations were illegally selling fetal tissue were baseless.

In the ruling, Judge William H. Orrick of United States District Court in San Francisco also brushed aside claims by the abortion opponents that their use of fraudulent documents and violations of confidentiality agreements to infiltrate meetings of abortion providers were protected because they were journalists involved in what they described as an undercover investigation.

The ruling marked the second major setback in recent weeks for the anti-abortion group, the Center for Medical Progress.

[…]

In his ruling, Judge Orrick said that his review of hundreds of hours of video secretly shot by the center at meetings of abortion providers found no evidence that any of them had violated the law. No one “admitted to engaging in, agreed to engage in, or expressed interest in engaging in potentially illegal sale of fetal tissue for profit,” he wrote.

Lawyers for the Center for Medical Progress argued in the case that the First Amendment protected the group because its members were informing the public about abortion providers — a defense that Mr. Daleiden has also raised against the recent criminal charges.

But Judge Orrick said that the desire of the National Abortion Federation to have its members protected from unwarranted harassment was paramount. And he questioned whether Mr. Daleiden and his colleagues were involved in journalism.

He wrote that the group’s projects “thus far have not been pieces of journalistic integrity, but misleadingly edited videos and unfounded assertions.”

This lawsuit was filed last July; there was already a temporary restraining order barring the CMP from releasing videos, transcripts or other material from the meetings pending the judge’s review. There is a separate lawsuit filed last month by Planned Parenthood against the CMP as well. None of this has anything to do with the criminal case against the fraudsters, but the judge’s ruling does directly address their stated defense that they’re just journalists doing normal journalistic things. I feel confident that ruling will be given a careful reading by the Harris County DA’s office. It’s also a reminder that these guys are lying liars who have lied about pretty much everything so far, and while a strategy of lying can score some political points, it generally won’t get you very far in court. In a more decent society, people who had previously sided with these guys would be backing away from them now, not wanting to have their own credibility tainted by association with them. You can draw your own conclusions as to why Texas Republicans like Greg Abbott, Dan Patrick, and Ken Paxton have not done so.

The easily predicted results of de-funding Planned Parenthood have resulted as predicted

Who’d a thunk it?

Right there with them

Right there with them

A new study released Wednesday reports that after anti-abortion Texas lawmakers blocked Planned Parenthood from participating in the Texas Women’s Health Program (TWHP) in 2013, fewer low-income women received the most effective kinds of contraception. The study, published in the New England Journal of Medicine, is also the first to analyze the subsequent significant rise in some Medicaid-covered deliveries after the provider’s ouster.

Comparing quarterly medical and pharmaceutical claims from 2011 to 2014, researchers with the Texas Policy Evaluation Project (TxPEP) found that 35 percent fewer patients received highly effective intrauterine devices (IUDs) and implants — known as long-acting, reversible contraception (LARC) — over the four-year period. Claims for the injectable Depo shot, which requires follow up every three months, decreased by 31 percent. Researchers found that the rate of Medicaid-covered deliveries among women in the Depo group then increased by 27 percent.

The reduction in claims, said lead author Amanda Stevenson, highlights the fact that despite recent state efforts to recruit more providers, and claims of successwithout Planned Parenthood, patients have lost services.

“The reproductive health safety net cannot just absorb all of the demand for highly effective contraception when you remove Planned Parenthood from the network,” Stevenson told the Observer. TxPEP’s findings, she said, “directly contradict” claims “that Planned Parenthood can be removed from federally-funded healthcare programs and other providers will just step up to pick up the slack.”

[…]

For this study, TxPEP focused on patient claims that reflect the eligibility criteria for enrollees in the TWHP: legal Texas residents between the ages of 18 and 44 and who live at or below 185 percent of the federal poverty line (an annual income of approximately $44,000 for a family of four). They also compared services in counties with and without a Planned Parenthood health center.

The study found that contraceptive claims decreased most dramatically in counties with Planned Parenthood clinics, while counties without a Planned Parenthood clinic were largely unaffected.

The percentage of women who returned for their birth control shot every three months illustrates the long-term impact of losing Planned Parenthood as a program provider. Before the exclusion, 56.9 percent of patients living in counties with a Planned Parenthood clinic received their follow-up injections. After the exclusion, just 37.7 percent of patients got their subsequent shots.

In addition to cutting family planning funding by more than $70 million, the 2011 Legislature also funneled what remained of the state’s available family planning dollars away from specialty reproductive health providers, including Planned Parenthood. That, compounded by the cuts, led to the closure of 82 family planning clinics statewide; about one third of those were Planned Parenthood health centers.

I don’t even know what else to say, so I’m just going to let this speak for itself. Just repeat after me: Nothing will change until our electoral results change.

Video fraudsters offered probation

First the one, on Wednesday.

Right there with them

Right there with them

A California woman charged last week for her role in the production of undercover videos at a Houston Planned Parenthood clinic will be offered probation, a Harris County prosecutor said in court.

Sandra Susan Merritt, of San Jose, Calif., appeared in court Wednesday morning on charges of tampering with a governmental record, a second-degree felony which carried a possible sentence of up to 20 years in prison.

[…]

On Wednesday, Merritt made her bail, was processed by the Harris County Sheriff’s Office and turned herself in to state District Judge Brock Thomas. Dressed in her regular clothes, she appeared with a team of defense attorneys. She was also accompanied to and from the court by a handful of sheriff’s deputies because of the intense media scrutiny the case has generated, according to one official.

Merritt, who sat in the gallery with supporters, did not appear before the judge or speak in court. During a scheduling conference at the bench, Assistant District Attorney Sunni Mitchell said she is not considered a flight risk. The prosecutor said Merritt will be offered pre-trial diversion, a form of probation that typically does not require a guilty plea or stringent conditions. Typically reserved for low-level non-violent first offenders, like shoplifters, a suspect is diverted out of the court system. If they stay out of trouble, the charges are eventually dismissed. Merritt’s case was rescheduled until next month to work out the parameters of her probation.

Officials with the Harris County District Attorney’s Office would not discuss whether Daleiden would be offered a similar deal when he appears in court Thursday.

They did offer him a similar deal, and he rejected it.

Anti-abortion activist David Daleiden, one of the videographers indicted after infiltrating a Houston Planned Parenthood facility, on Thursday rejected prosecutors’ offer of a probation deal, according to his attorney.

[…]

County prosecutors this week offered both activists pre-trial diversion, a form of probation. But Daleiden rejected the offer and plans to fight the charges, said attorney Jared Woodfill. It’s unclear whether Merritt has accepted or rejected the deal.

[…]

Pre-trial diversion, a sort of probation, is offered to many first-time nonviolent offenders. If offenders keep a clean record for a predetermined length of time, their charges can be dismissed. Prosecutors have not drawn up a specific contract and conditions for Daleiden and Merritt.

Don’t bother. He ain’t taking it, whatever it is.

“The only thing we’re going to accept is an apology,” said Daleiden’s defense attorney Terry Yates. “We believe the indictments are factually and legally insufficient.”

Harris County District Attorney Devon Anderson responded that she has offered the videographer and his associate, Sandra Susan Merritt, 62, of San Jose, Calif., an “exit from their legal predicament.”

She also accused the activists of using their criminal charges to grandstand in a case that has drawn national attention due to heated opinions on both sides of the abortion debate.

“Currently, no evidence has been presented to me that gives me legal grounds to dismiss the indictments against Mr. Daleiden and Ms. Merritt,” she said by email. “Among those familiar with criminal prosecution, my offer would be immediately accepted as ‘an offer you can’t refuse;’ unless of course, your goal is not to avoid prosecution, but rather to keep the circus going and going.”

[…]

“It’s unusual because a pre-trial diversion is a pretty sweet outcome for an alleged felony,” said Geoffrey Corn, a professor at South Texas College of Law. He said Daleiden could have several reasons for refusing the offer, including believing that the law is not justified, that a jury would never convict him or that being convicted would add significance to his anti-abortion crusade.

“This guy thinks that what he did is morally justified,” Corn said. “Every now and then you encounter a defendant who, for whatever reason, says ‘I don’t believe in the law.'”

It’s more than fine by me that Daleiden rejected this offer, because I want them to be convicted of something, and I think their “we’re journalists and we did what journalists do” defense is deeply flawed. They don’t need to have jail time – honestly, this is not the sort of crime that really calls for jail time – but there needs to be an example set, to at least make any future copycats think twice. The reason why a conviction really matters is because the real potential for punishment will come from the civil courts, and nothing will help the various lawsuits against these clowns like a guilty plea or verdict. I’m not surprised that Daleiden rejected the plea – these people are believers, and I suspect more than willing to play the martyr – and I won’t be surprised if Merritt does as well. And if/when that happens, I want to see them nailed at trial.

How the tables got turned on the video fraudsters

A must read.

Right there with them

Right there with them

Planned Parenthood’s legal strategy was in some ways similar to how corporations facing major white-collar criminal investigations often cooperate closely with prosecutors to try to influence the outcome.

From the start, Planned Parenthood and its Houston lawyer Josh Schaffer settled on a strategy of cooperating with investigators, said Rochelle Tafolla, a spokeswoman for the affiliate. It included volunteering documents and encouraging prosecutors to interview employees, as well as giving prosecutors tours of the Houston facility, according to Schaffer.

“We certainly began the process as suspects of a crime, and the tables got turned and we ended up victims of a crime,” Schaffer told Reuters in an interview.

Schaffer was retained by Planned Parenthood last summer when Texas officials demanded it face a criminal investigation after the anti-abortion activists posted videos online purporting to show the organization’s employees discussing the sale of aborted fetal tissue, which is illegal in the United States if done for a profit.

[…]

Although what happened during the grand jury’s secret deliberations may never be known, Schaffer said it did not vote on whether to indict Planned Parenthood.

That is because the grand jury’s focus shifted to a case against the anti-abortion campaigners, Schaffer said on a conference call with reporters, citing information he said he received from a prosecutor.

Planned Parenthood said that Daleiden and Merritt used fake driver’s licenses in April 2015 when they posed as executives from a fictitious company to secretly film conversations at the Houston facility. That led to the charges they used fake government documents with the intent to defraud.

One critical juncture in the case may have occurred when Planned Parenthood gave law enforcement an important tip: Merritt’s true name, according to Schaffer.

Her identity remained unknown from the time she visited Planned Parenthood with a fake California driver’s license until about December when Daleiden revealed it during a deposition as part of a separate civil lawsuit in state court in Los Angeles, Schaffer said.

As part of his strategy, Schaffer said he explicitly pushed prosecutors to charge Daleiden and Merritt.

“I made the argument regarding the charges that the grand jury returned,” Schaffer said in the interview, “but I did not have to make them very forcefully because it was self-evident to the prosecutors that they engaged in this conduct.”

Fascinating, and I expect it will just enrage the people who are already losing their minds over this, but as I said before a lie can only be sustained for so long. Sooner or later, you have to put your cards on the table. It’s not like we couldn’t have guessed that these guys were liars – there’s a long evidence trail of people like them saying and doing similar things. It’s not even the first time that DA Devon Anderson has been called upon to investigate some wild claims about an abortion provider that turned out to be complete fabrications and lurid fantasies. It’s one thing to believe these stories even though the objective evidence suggests they’re too outrageous to be true (as Daniel Davies has said, there’s no fancy Latin phrase for giving a known liar the benefit of the doubt), but it’s another thing entirely (as Fred Clark often reminds us) to want to believe them, to fervently hope that they really are true, and to keep on believing them even when any reasonable person knows they are not true.

Which brings us to the fraudsters’ defense attorneys, who have their own impossible things to believe.

“We believe this is a runaway grand jury that has acted contrary to the law,” former Harris County Republican Party Chairman Jared Woodfill told reporters Wednesday. “They’ve gone after the whistle-blowers.”

Woodfill and prominent criminal defense attorney Terry Yates announced they will represent the two activists and said their defense will turn on First Amendment protections afforded to undercover journalists and focus on the activists’ “intent” when they created fake identifications and offered to buy fetal tissue from a Planned Parenthood Gulf Coast office last year.

On Wednesday, Woodfill and Yates conceded that Daleiden, 27, and Merritt, 62, used fake California driver’s licenses to conceal their identities to gain entry to Planned Parenthood offices and corresponded with officials.

“These are techniques that investigative journalists have used for years,” Woodfill said. “If they were to criminalize this conduct, most investigative journalists would be prosecuted for doing the exact same or similar things.”

Fred Brown, an ethics expert for the Society of Professional Journalists, said reporters rarely falsify their identities and said it is “frowned upon.”

“It should be considered a last resort and it’s not really ethical,” Brown said.

Most major newspapers have rules against reporters concealing their identities or using fake names.

Law professor Eugene Volokh would take issue with what Woodfill says, too. It’s interesting to read the story and see how many times they retracted or walked back something they initially asserted. The amount of mental gymnastics they are doing must be quite tiresome.

One more thing:

Daleiden also is charged with trying to purchase human organs, namely fetal tissue, a Class A misdemeanor.

Woodfill scoffed at the charge, saying, “It’s going to be very difficult for prosecutors to say that they intended to actually purchase human body parts.”

Um, wasn’t the whole point of their exercise to prove that body parts were being sold? How could they do that if they didn’t also believe they could buy them? I know, that’s not quite the same as “intent” in a legal sense, but I think their story will be a little harder for a jury to believe if the claim is they were just trying to get Planned Parenthood to give them their price list. Murray Newman, the Wall Street Journal, the Press, Campos, and David Ortez have more.

Every investigation on Planned Parenthood has cleared them

From Think Progress:

After a months-long investigation, a Texas grand jury decided not to indict Planned Parenthood on Monday — providing more confirmation that there’s no solid evidence to support the accusations against the national women’s health organization.

This trend goes far beyond Texas. Across the country, GOP-led investigations into Planned Parenthood’s activities haven’t turned up any proof that the organization is breaking the law.

Planned Parenthood has been under fire thanks to a series of undercover videos secretly filmed byanti-abortion activists affiliated with a sting group called the Center for Medical Progress. After those videos were released, right-wing lawmakers rushed to accuse Planned Parenthood of illegally trafficking in aborted baby parts, and GOP officials launched investigations into the group at both the state and federal levels. This fall, Planned Parenthood president Cecile Richards was required to testify before Congress to defend her organization’s activities.

Despite the increased scrutiny on Planned Parenthood’s fetal tissue donation program, however, Republican officials are coming up empty.

In addition to the grand jury in Texas, officials in 11 other states — Kansas, Florida, Ohio, Washington, Pennsylvania, Georgia, Indiana, Massachusetts, Michigan, Missouri, and South Dakota — have also concluded their investigations into Planned Parenthood by clearing the organizationof any wrongdoing. Many of these investigations have been quite extensive and time consuming. In Missouri, for example, the state attorney general confirmed there’s no evidence of misconduct at the state’s only Planned Parenthood clinic in St. Louis after reviewing more than 3,500 pages of documents and conducting multiple interviews with the clinic’s employees.

Eight additional states, meanwhile, have determined they don’t have enough evidence against Planned Parenthood to justify conducting an investigation in the first place. Although politicians there pushed for a probe, officials ultimately concluded that it would be a waste of time.

See here for the background. The Harris County District Clerk has released scans of the indictments – the “tampering with a government document” indictments are here, and the “knowingly offer to buy human body parts” indictment is here; this Trib story adds some details. Basically, the two CMP clowns presented fake California drivers’ licenses to the Planned Parenthood people they interacted with, and they did this for the purpose of proving to them that they were not on PP’s internal list of known bad guys. That’s “intent to defraud and harm another”, which is what made this more serious than your average underage kid showing fake ID to get into a bar. I’m sure their defense attorneys will vigorously contest the indictments – this Trib story suggests they will claim a First Amendment justification for creating the fake IDs – and it’s certainly possible they’ll succeed, but that’s what the charges are about.

Again, the larger point is that the practices that these liars accused Planned Parenthood of engaging in – selling fetal tissue for profit – has been investigated coast to coast by nearly two dozen different state entities, and every single one of them has concluded that those claims are false. A normal person, one with a modicum of honesty and integrity, might reasonably conclude that the weight of the evidence so far more than exonerates Planned Parenthood. A dishonest person who lacks any integrity will keep trying to prove that the lies are true.

The Harris County investigation was one of several that began in the state after the center released footage of a Houston clinic executive casually discussing the methods and costs of preserving fetal tissue, which Republican state officials said was proof the organization was making a profit.

Lt. Gov. Dan Patrick, a tea party firebrand from Houston, was the first to call for the Harris County District Attorney’s Office to investigate. He also directed a state Senate committee to conduct its own probe.

On Monday, Patrick issued a statement saying the Senate probe would continue because “the horrific nature of these videos demand scrutiny and investigation.”

Gov. Greg Abbott and Attorney General Ken Paxton, who also ordered their own investigations, released statements saying they would continue.

“The fact remains that the videos exposed the horrific nature of abortion and the shameful disregard for human life of the abortion industry,” Paxton said.

You guys are going to have to clap harder than that. Tinker Bell will never get better unless you really, really mean it. What I believe is that while one can win transient battles based on lies, sooner or later it falls apart and the truth comes out. When that happens, there is a price to be paid. I look forward to seeing the tab for this one. BOR, the Trib, Vox, RH Reality Check, Dan Solomon, TPM, Lisa Falkenberg, and Andrea Grimes, who has a decidedly more pessimistic take than I do, have more.

UPDATE: Another Chron story, noting that 1) a lot of damage has already been done to Planned Parenthood, and 2) the fanatical opponents aren’t going anywhere. Meanwhile, DA Devon Anderson is probably happy all this happened after the filing deadline for the primaries, and Dahlia Lithwick weighs in.