Federal Updates
Two-year compromise budget deal signed into law with some funding for social programs
On August 2, Trump signed a two-year, $2.7 trillion budget deal into law. The agreement suspends the U.S. debt ceiling until July 2021 – which means that the government will be able to borrow enough money to cover its debts — and allows for $1.3 trillion in defense and domestic spending over the next two years. The deal increases spending by $320 billion, including a 4% increase in domestic and 3% increase in defense funding. It also includes $77.4 in spending cuts, most of which are delayed nine years and will likely never take effect, a stark departure from the $150 billion that the Trump Administration wanted. The deal averted the potential disaster of sequestration (an across-the-board budget cut) but it is not perfect. It includes more money for social programs but also more money for the military.
U.S. Senate confirms 13 more conservative federal judges
The U.S. Senate confirmed 13 more Trump judicial nominees in August. In total, the Senate has confirmed 146 Trump-nominated federal judges, including two highly-contentious Supreme Court justices and 42 appeals court judges. The sheer number of confirmations has already radically re-shaped the federal judiciary. Nearly 1 in 4 of the federal appeals court judges were Trump-nominated, and there are still 1.5 years left in his term. Trump’s judges are mostly white (87%), mostly male (78%), and ultraconservative. Federal judges have a lifetime appointment, so this shift will impact civil rights, LGBT rights, reproductive rights, health care, the regulatory state, campaign finance, criminal legal reform, and more for decades.
Health Care Access
Trump Administration will not approve full federal funding for partial Medicaid expansion
The Center for Medicare and Medicaid Services (CMS) announced that it will not approve requests for partial Medicaid expansion. Under the Affordable Care Act (ACA), states that expand Medicaid coverage to all people who live at or below 138% of the federal poverty line receive more federal funds to help support the cost of covering more people. Some states proposed limiting coverage, for example to people at or below 100% of the federal poverty line or homeless people, while still asking the federal government to cover a bigger share of the costs. This is known as partial Medicaid expansion. It is a ploy by some Republican states to get more federal funds while covering fewer people and avoiding meeting ACA standards.
The Trump and Obama administrations agree that partial Medicaid expansion should be rejected, but for very different reasons. The Obama administration argued that partial expansion violated the central tenets of the ACA. The Trump administration, on the other hand, argues that partial Medicaid expansion should be rejected because the law that it relies on – the ACA – is unconstitutional.
The Food and Drug Administration (FDA) panel approves a new drug for PrEP, but excludes cisgender women
An FDA advisory panel voted 16-2 to approve Descovy to prevent HIV transmission for men and transgender women who have sex with men. Descovy is a combination of the drugs emtricitabine and tenofovir alafenamide (F/TAF) and is already approved as an HIV antiretroviral. This vote means that Descovy can also be used as pre-exposure prophylaxis, or PrEP, for men and transgender women – but not for cisgender women. The FDA advisory panel voted 10-8 against including cisgender women because the data that Gilead presented – from the DISCOVER trial — only included adult men and transgender women who have sex with men, due to a failure to adequately enroll cisgender women and transgender men in trials.
New Hampshire foiled in attempt to enact Medicaid work requirements
Another federal judge has blocked the Department of Health and Human Services (HHS) from allowing a state to enact Medicaid work requirements. New Hampshire’s work requirement was slated to go into effect in June, but Republican Governor Chris Sununu pushed back implementation because of widespread fears of massive coverage losses. Now, the court says, the state cannot move forward with that plan because HHS did not adequately consider the impact that the work requirement would have on Medicaid coverage rates. This is the fourth time a state work requirement has been blocked because HHS failed to take into account how many people would suffer under the change.
Illinois passes groundbreaking legislation to expand preventive health services for youth
Governor JB Pritzker signed the Youth PrEP bill, H.B. 2665, into law. The law will enable young people – 12 years or older – to access preventive health services, such a PrEP, without parent or guardian permission. The bill’s sponsor, Representative Lamont Robinson, noted that law will be especially important for homeless youth and those who cannot talk to their parents about sexual activity. It also aligns Illinois law with existing federal guidelines.
Sexual and Reproductive Health, Rights and Justice
Federal court temporarily stopped three anti-abortion laws from taking effect in Arkansas
A federal court blocked three Arkansas laws that would have devastated access to abortion in the state. Together the laws would have done three things: 1) banned the abortion procedure at 18 weeks of pregnancy, 2) banned abortion based on the person’s reason for seeking care, and 3) prohibited certain qualified physicians from providing abortion.
Planned Parenthood forced to withdraw from Title X
As of August 19, Planned Parenthood will no longer receive federal funding under Title X. Planned Parenthood declined Title X funding due to the Trump Administration’s new “domestic gag rule” prohibiting grantees from providing or referring patients for abortion except in the case of rape, incest or medical emergency. Organization officials say it serves about 40% of the nation’s 4 million Title X recipients, who receive services such as contraception and HIV testing.
Even though the rule is a devastating set back to reproductive rights, in particular for low-income people, people of color, people living with HIV, and LGBTQ people, the fight to defeat the rule is not over. Planned Parenthood is challenging the Administration’s gag rule, with oral arguments before the U.S. Court of Appeals for the Ninth Circuit set for the week of September 23.
Immigrant Health, Safety, and Rights
Trump Administration finalizes new public charge regulations aimed at coercing immigrant families out of essential services
On August 12, the Department of Homeland Security released the final “public charge” rule to the public. The regulation only applies to people applying for admission to the U.S. or attempting to change their status to become a lawful permanent resident (“green card” status). It uses fear and intimidation to coerce immigrant families to disenroll from public health, nutrition, and housing programs, ultimately forcing millions of families – primarily those from majority Black, Latin American, and Asian countries – to choose between the things they need and the people they love.
“Public charge” is an immigration legal term used to designate people likely to depend on cash assistance, such as Supplemental Security Income (SSI) and Temporary Assistance to Needy Families (TANF), or government-funded long-term institutional care. The new rule grossly extends the impact of “public charge” to apply to people who have received even modest benefits from a much broader range of public programs, including non-emergency Medicaid, Supplemental Nutrition Assistance Program (SNAP, or food stamps) and several federal housing programs. The rule also gives DHS officials the discretion to deny green cards to people living with chronic health conditions like HIV and people with low incomes.
The rule is slated to go into effect October 15 if it is not stopped in the courts beforehand; however data shows that immigrant families have already disenrolled from programs in record numbers due to fear of being targeted. Several groups have filed suit to challenge the rule. You can read PWN-USA’s statement here.
Trump Administration ends Medical Deportation Deferral Program with no announcement or process
For years, the U.S. has had a program in place known as “medical deportation deferral,” which allows immigrants with critical medical care needs to apply for protection to stay in the U.S. for up to two years to receive health care that is not available in their own countries. This program has been used primarily for children with serious health challenges, such as cancer, HIV, and cystic fibrosis.
In mid-August, U.S. Citizenship and Immigration Services (USCIS) began mailing letters to families enrolled in this program to advise them that they had 33 days to leave the U.S. or they would be forcibly removed. Families who received the letters contacted attorneys who subsequently put in inquiries to USCIS to obtain more information. In response to media inquiries, USCIS confirmed that the agency will no longer handle requests for medical deportation deferrals and that all pending requests, including renewals and pending applications, will be affected by this policy change, which went into effect on August 7, without any public announcement by the administration. Further, USCIS has stated that ICE will now be making medical deportation deferral decisions. This is a developing story.
Family separation continues at U.S.-Mexico border despite court order to stop
According to the ACLU, the Trump Administration has taken nearly 1,000 children from their parents at the U.S.-Mexico border after a federal court ordered the government to stop the practice and reunite family over one year ago.
Trump issued an executive order in June 2018 to officially end the “zero tolerance” family separation policy, instead permitting separation if the parent would “pose a risk to the child’s welfare.” Advocates were horrified to learn the government was abusing its discretion by expansively interpreting the “risk” carve-out to include parents with minor offenses, such as traffic violations or misdemeanors, or non-threatening communicable diseases. Late last month, for example, Chief Brian Hastings of the U.S. Custom and Border Patrol (CBP) suggested during a congressional hearing that CBP routinely separates families based on HIV status. HIV was removed from the list of communicable diseases barring entry to the United States in 2010 because it is not transmitted through casual contact. Yet Hastings’ comments suggest CBP officers could be ignoring this policy change and the underlying science in order to justify tearing families apart at the U.S.-Mexico border.
Federal appeals court blocks Trump Administration’s asylum restrictions, but only in certain states
The Ninth Circuit stopped a rule that would flout long-standing immigration practices and international law. The rule would require any migrant traveling through another country to: 1) apply for and 2) be denied asylum protections in a transit country. If neither of these steps happen, the U.S. would deny their asylum claim with some limited exceptions. It is a barely-veiled attempt to end asylum protections for Central American migrants coming to the U.S. southern border.
Last month, a lower federal court blocked the rule from going into effect nationwide. This ruling by the Ninth Circuit partially reverses that decision, blocking the rule within the Ninth Circuit – which includes California and Arizona – only. It means that the Trump Administration can impose the rule in other border states.
Largest U.S. Immigration and Customs Enforcement (ICE) raid in U.S. history in small Mississippi community
ICE agents conducted raids at a number of Mississippi food processing plants, arresting 680 mostly Latinx workers. It was the largest workplace raid in U.S. history and occurred just four days after a white nationalist terrorist killed 22 mostly Latinx people after posting Trump-inspired, anti-immigrant language online. Labor activists say that the Trump administration appears to be specifically targeting companies – like the one involved in this raid — where immigrant workers have organized to fight against discrimination or unsafe conditions.
Raids like this inflict violence against and trauma on immigrant communities. They tear families apart and instill fear in immigrant workers, making it less likely that they will report exploitation or unsafe, unsanitary, discriminatory, or hostile work environments for fear of retaliation.
LGBTQ Rights
Trump Administration issues rule to allow government contractors to discriminate against LGBT workers
The Department of Labor issued a proposed rule that would open the door to increased discrimination against LGBTQ people in the workplace. More 42,000 US businesses who hold federal contracts are required to abide by a set of rules that protect workers from discrimination. Under the Obama administration, sexual orientation and gender identity were added to the list of protected characteristics.
This proposed policy would weaken current discrimination protections by expanding a “religious exemption” so that employers could fire or refuse to hire certain employees citing faith or religion as the reason, and also expanding the group of employers to whom the exemption applies. The new rule is expected to disproportionately impact LGBTQ communities by giving contractors tacit permission to discriminate based on LGBTQ animus. Federal contractors could use the guise of religious freedom to disadvantage LGBT workers in their employment decisions. This proposed rule was published at a crucial time: the U.S. Supreme Court will hear arguments in October challenging whether federal employment anti-discrimination laws protect LGBT employees, and just this month the Trump Administration filed a brief arguing that the answer is no for trans workers. The rule could also be interpreted to allow discrimination against people of different faiths in an employment context.
Idaho must provide gender affirming surgery for incarcerated transgender person
The U.S. Court of Appeals for the Ninth Circuit held that the Idaho state government’s refusal to provide gender affirming surgery for a transgender person who have been incarcerated violated the Eighth Amendment’s protection against cruel and unusual punishment. Adree Edmo, the individual in question, requested gender affirming surgery for years, demonstrating it was medically necessary for her safety, health, and well-being. However, Idaho prison officials failed to meet Edmo’s needs going as far as to be “deliberately indifferent to her mental and physical safety.” The Ninth Circuit’s decision recognizes that all transgender people, including transgender persons who are incarcerated, are entitled to adequate and comprehensive health care.