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February’s Hot Topic:
Reproductive Health Rights and Justice – Lawsuit threatens access to Medication Abortion
Every month PWN puts out the Monthly Policy Update (MPU), tracking and analyzing the major policy changes that PWN members care about. For this special new year edition, here are the five biggest policy changes we tracked in 2022 that impacted the lives of women, trans and gender non-binary people living with HIV.
Any day now, a Trump-appointed judge in Texas could issue a decision to ban a medication abortion drug, mifepristone, in every state in the nation—even in states where abortion is legal and protected. This case challenges the Federal Drug Administration’s (FDA) approval of mifepristone—one of two medications in a regimen for medication abortion.
Mifepristone is a safe, effective, and commonly-used medication for medication abortion. The FDA rigorously tested mifepristone prior to its approval over twenty years ago and decades of data have continued to confirm it is safe and effective. A bad ruling in this case could take mifepristone off the shelves nation-wide and bar health care professionals from prescribing it in every state in the nation. If this happens, people will still be able to use the misoprostol-only method for medication abortion (misoprostol is the second medication in the regimen as of now).
Nevertheless, a nationwide ban on mifepristone would create massive disruptions to abortion access in the U.S. The loss of FDA approval would not change mifepristone’s safety or efficacy. People have always self-managed abortions, regardless of politics or legal barriers, and will continue to do so with the love, support, care, and knowledge of our communities. The risk this decision poses is legal. It would open the door to increased surveillance and criminalization of communities who are most likely to self-manage abortion, especially Black, Indigenous, people of color (BIPOC) communities, queer, trans, and non-binary folx, rural communities, and people struggling to make ends meet. This case could also have far-reaching consequences for patients’ access to other FDA-approved medications by threatening the FDA’s authority over the medication approval process.
The organization that filed this case has been labeled as a hate group and helped write the Mississippi law that the Supreme Court used to dismantle Roe v. Wade. They hand-picked a Texas district court judge, Judge Matthew Kacsmaryk, to hear the case. Kascmaryk is a Trump appointee who worked for an organization that aimed to discriminate against LGBTQ+ people.
Everyone should be able to make decisions about their own reproductive lives and futures, including choosing the method of abortion that works best for them. This case is rooted in politics, racism, and sexism, not medicine. The decision has not come out yet, and medication abortion through mifepristone is still accessible. We will continue to monitor and stand in resistance and support of abortion care access through upcoming community actions and beyond.
More on Reproductive Health Rights and Justice
- The Biden-Harris Administration took steps to expand access to birth control coverage without cost-sharing through employer-sponsored and university student health insurance plans.
- In a promising step forward, the U.S. Health and Human Services (HHS) department updated its clinical guidelines for infant feeding, including recommendations for better support and shared decision-making between providers and parents living with HIV who choose to breast/chestfeed.
- The Kentucky Supreme Court declined to block two abortion bans, which means that providers will not be able to provide abortions while legal challenges to allow abortion in the state continue through the courts.
- By law, states must provide pregnancy-related Medicaid coverage through 60 days postpartum. Since the start of the COVID-19 pandemic, postpartum coverage has been continuous but that will end when the public health emergency ends in May. To see how this might affect your state, check out this Medicaid postpartum coverage extension tracker.
Access to Healthcare:
The state of Tennessee recently rejected HIV prevention funds from the federal government. Advocates point out that the decision is rooted in anti-trans and anti-abortion hate and marks a dangerous shift away from the federal strategy to prioritize BIPOC gay, queer and trans people, Black women, people who are unhoused and people who use injection drugs. So far, no other state has followed Tennessee’s lead in rejecting HIV funds, but HIV advocates, especially in the U.S. South, are staying vigilant.
The COVID-19 national emergency and public health emergency declaration are expected to end in May. There will be serious implications for the Medicaid, Medicare, SNAP and CHIP programs. Check out 10 things to know about how Medicaid enrollment will change, potentially impacting millions of Medicaid enrollees.A recent study shows that severe gender and racial inequities persist in HIV mortality rates, even as overall HIV mortality declines. Women living with HIV had a higher risk of death compared with men and Black women living with HIV in particular had the highest premature mortality rate. The federal government can and must take steps to improve the health, lives, and wellbeing of Black women living with HIV.
California is set to become the first state in the country to expand Medicaid services for young people and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release.
A proposed bill in Georgia would, if passed, expand Medicaid to Georgians living with HIV.
The U.S. Health and Human Services (HHS) department is considering a proposal to create an unnecessary and overly-broad surveillance tool through the creation of a PrEP database for the Ready Set PrEP program. Join CHLP, PrEP4All, EPIC and PWN-USA to oppose the creation of the database which involves overly burdensome eligibility requirements and the threat of unnecessary surveillance without any public health benefit.
LGBTQ+ Health, Safety & Justice
- States continue to attack the humanity and dignity of people of trans experience. The governors of Utah and South Dakota signed bills into law banning gender-affirming medical care for trans youth. Meanwhile, Tennessee is proposing restrictions to ban the only evidence-based care for gender dysphoria for trans youth.
- As of writing this update, 382 anti-LGBTQ+ bills have been introduced in the U.S. In Mississippi alone, we have seen at least 31 anti-LGBTQ+ bills introduced.
- The Federal Drug Administration (FDA) announced plans to lift the requirement that gay, bisexual and other men who have sex with men defer from donating blood. This updated guidance is a step in the right direction, but still falls short of ensuring that no one is unfairly turned away from donating blood. You can read more and make a public comment on the FDA proposal through the Human Rights Campaign portal.
Ending Criminalization
- People living with HIV are still being criminalized through HIV-specific laws in 25 states. Learn more about the National HIV Criminalization Study which shares the views and experiences of people living with HIV on laws that criminalize HIV transmission, exposure, and nondisclosure of HIV status.
A Georgia court rejected an attempt to stop the construction of Atlanta’s “Cop City,” a proposed militarized police training megadevelopment. Ecologically and socially, Cop City is dangerous and bolsters the prison industrial complex. Learn more and get involved.
Economic Justice
A new federal law, the PUMP for Nursing Mothers Act, provides critical protections, including break time to nurse and a private place to pump, for people who choose to breastfeed in the workplace.
Ending Violence
California politicians are disguising sweeps of people who are unhoused as “care” through a recently passed law that forces unhoused people into court-ordered treatment programs and unstable temporary housing.
A commentary article shows that pregnant people are shackled and abused in a Harris County Jail. This example is illustrative of a wider human rights concern in the U.S., where pregnancy “care” is grossly harmful, negligent, or altogether nonexistent in prison, jail, and immigrant detention systems.
In a deeply disturbing display of white supremacy and targeted anti-Black racism, a supermajority of white politicians voted to advance a bill that would create a separate, unelected court system and an expanded police force within Jackson, Mississippi, a city home to a higher percentage of Black residents than any major American city. This is part of a pattern wherein majority-white state leaders attempt to remove decision-making power from Jackson residents, 83% of whom are Black, and instead put control in their own hands.
