Federal Updates
Immigrant Justice
Trump Administration Ends Temporary Protected Status for Nicaraguan and Haitian Refugees
In early November, the Trump administration announced it would not renew temporary protected status (TPS) for thousands of Nicaraguan and Haitian refugees that have been residing in the U.S. for years. TPS shields refugees from deportation when it is unsafe for them to return to their countries. Both countries came under TPS after being devastated by earthquakes, Nicaragua in 1998 and Haiti in 2010. Now with the end of their TPS, 2,500 Nicaraguan refugees have been given 14 months and leave 59,000 Haitian refugees have been given 18 months to leave the country. The Department of Homeland Security is also currently considering the TPS of 57,000 Honduran refugees.
Advocates Fight to Save DACA by Urging Congress to Pass a Clean DREAM Act
22,000 young immigrants who were unable to renew their DACA status after Trump ended the Deferred Action for Childhood Arrivals (DACA) program in September, are facing imminent deportation. Congress has yet to pass new legislation to protect these young people, who in the absence of a resolution, will be forced to leave the U.S. by March 5, 2018. Immigrant rights advocates are hoping to get Congressional support for a bipartisan Development, Relief, and Education for Alien Minors (DREAM) Act before the end of 2017., Until legislation is passed, 850 young immigrants will lose their residency protections each week. Without DACA protections in place, they will lose their driver’s licenses, work authorizations, and access to in-state college tuition rates. Starting March 6, 2018, the remaining 800,000 DREAMers will also be at risk of deportation as their DACA renewals expire.
Federal Judge Strikes Down Trump Administration’s Attack on Sanctuary Cities
On November 21, U.S. District Judge, William Orrick, rejected Trump’s executive order threatening to cut funding to so-called sanctuary cities that refused to cooperate with or devote local law enforcement resources to federal immigration enforcement. The lawsuit was brought on behalf of San Francisco and Santa Clara counties in California. In his ruling, Judge Orrick pointed to the administration’s own comments in finding that the executive order was too broad and clearly intended to be a weapon against cities that would not comply.
Sexual and Reproductive Rights
Republicans Include Anti-Abortion Language in Tax Bill
Congressional Republicans buried a provision that allows families to open educational savings accounts for “unborn children” in their “tax reform” bills. The inclusion of “fetal personhood”, the legal theory that a fetus has the same legal rights as a person, was unprecedented for a tax bill and serves no economic purpose. Though the language was ultimately stricken from the final language of the bill after the Senate parliamentarian deemed that it violated the Byrd Rule, a provision that omits unrelated policy riders from the budget reconciliation process, including this type of irrelevant anti-choice language in the tax bill reflects the administration’s commitment to expanding religious freedom curtailing sexual and reproductive rights.
House Holds Hearing on Heartbeat Protection Act to Ban Abortions After 6 Weeks
At the beginning of November, the House held a hearing on HR 490, the Heartbeat Protection Act sponsored by Rep. Steve King (R-IA). The Act would make it illegal for doctors to perform abortions after a fetal “heartbeat” is detectable (usually at 6 weeks), despite the fact that there is no medical reason for this timeline. Many people do not know they are pregnant at 6 weeks and pregnancy is not even detectable by ultrasound by that time. If passed, the “Heartbeat Protection Act” would essentially create a complete federal ban on abortion.
Conscience Protection Act 2017
Anti-Abortion legislators in both houses of Congress are hoping to include a provision in their spending bills that would protect healthcare providers who have religious objections to abortions. The so-called “Conscience Protection Act” would expand existing law to allow hospitals and healthcare staff to sue if they face and negative consequences for refusing to participate in providing abortion-related care. The bill’s language was included in the FY 2018 House appropriations package passed earlier this year, but was not included in stopgap spending bills passed by both houses last week to fund the government through December 22.
Health Care Watch
New ACA Regulations Threaten Comprehensive Coverage Requirements
On November 2, the Trump administration issued new regulations to remove the ACA’s essential health benefit (EHB) requirements. EHB standards were created to ensure that insurance plans provided comprehensive coverage to consumers and established minimum coverage requirements, like certain prescription drugs and health services, that insurers must include to sell coverage on the insurance market. The new regulations would give states much greater flexibility with EHBs, specifically when it comes to loosening the requirements for standard coverage. This is a major concern for people with pre-existing conditions including people living with HIV that rely on comprehensive coverage plans required by the ACA.
CMS Approves Work Requirements for Medicaid Waiver Program
On November 7, Seema Verma, Centers for Medicare and Medicaid Services (CMS) Administrator, announced that Medicaid Section 1115 waivers could be used to create work or work-related requirements for individuals to maintain Medicaid coverage. The announcement reflects a departure from decades of Medicaid policy that allowed states to use these waivers to achieve the goals of increasing and strengthening coverage, to now allowing flexibility to “promote upward mobility”. Research has shown that stripping people of access to healthcare will not help them find or maintain a job. In fact, most low-income adults enrolled in Medicaid already work and having Medicaid helps them to keep working. Allowing states to impose work requirements is expected to have widespread negative impacts, particularly on unemployed people with chronic health conditions.
Senate Tax Bill Aims to Kill ACA Individual Mandate
On November 14, Senate Majority Leader Mitch McConnell announced that the senate tax bill would include a provision repealing the ACA’s individual mandate. The mandate requires that people have health insurance coverage or face a penalty. Without it, millions of people are expected to drop their coverage, which will destabilize the insurance market and drive up the price of premiums for everyone else, including people with pre-existing conditions. An estimated 13 million people would lose coverage by 2027 if the mandate is repealed. This is an addition to the House bill’s proposed $25 billion in cuts from Medicare in 2018 and an additional $5.8 trillion in cuts over the next ten years to Medicare, Medicaid, and Social Security. More resources on the tax bill available here.
HIV Prevention Justice
Republicans FY 18 Budget Proposes Millions in Cuts to SAMHSA’s Minority AIDS Initiative Programs, Eliminates Secretary’s Minority AIDS Initiative Fund
Trump’s proposed budget would cut $12.4 million to SAMHSA’s Center for Substance Abuse Prevention (CSAP) and $5 million to the Center for Mental Health Services (CMHS), a critical funding source to grantees providing HIV prevention, treatment and mental health services for people of color who are living with and vulnerable to HIV. Despite the fact that racial and ethnic minorities are disproportionately impacted by HIV, both Trump’s and the House passed spending bill also eliminate the (HHS) Secretary’s Minority AIDS Initiative Fund, which supports a wide range of activities to improve HIV prevention efforts, access to care, treatment and health outcomes for communities of color. More info on the impact of the proposed cuts here.
Internal Condoms to be Down-Classified to Same Level as Standard Condoms
FDA representatives have said they will issue a federal order in early 2018 to down-classify female (also known as internal) condoms. When the proposed order is issued, there will be an opportunity for public comments that support this reclassification. Since the mid-1990s, the FDA has grouped female condoms along with breast implants and pacemakers as Class III devices while standard (male) condoms have always had Class II status. Class III devices face stricter regulations which prevented innovation and created barriers to research as well as manufacture of internal condoms. Changing the classification to Class II status will make it easier for manufacturers to produce a wide variety of internal condoms for consumers to choose from.
National Institute of Allergy and Infectious Diseases Moves to Cut Microbicides Research
Microbicide development may soon no longer be a priority in government-funded HIV prevention research. For years, women have called for an HIV prevention tool that is woman-initiated, easy to use, undetectable during sex and, ideally, came in both contraceptive and non-contraceptive forms. The answer was microbicides, products that could be applied vaginally or rectally to prevent pregnancy and sexually transmitted illnesses. The first microbicide clinically proven to prevent HIV transmission could be on the market by 2020. However, it would be the first and last since the National Institute of Allergy and Infectious Diseases (NIAID) has said it aims to move away from microbicide research and toward implants, injectables, and vaccines instead.
State Updates
Washington, Oregon, Alaska, and Idaho
States Join Forces to Establish Northwest Abortion Access Fund
In early Nov., The Network for Reproductive Options in Oregon and The CAIR Project in Washington combined to form the new Northwest Abortion Access Fund. The fund will have a budget of nearly $315,000 available to help women in Oregon, Washington State, Idaho and Alaska pay for abortions and related expenses, such as travel. The organization is expected to serve at about 1,000 people a year, with an average grant of $180.
New York
Medicaid Special Needs Plans Expand Access to Transgender Individuals
As of November 1, New York State Medicaid Special Needs Health Plans (SNPs) will be open to all transgender individuals who qualify, regardless of their HIV status. Until now, New York SNPs have only enrolled eligible individuals who are living with HIV or people who are experiencing homelessness regardless of HIV status.
Paid Leave Expanded to Include Survivors of Domestic Violence, Assault and Trafficking
On November 6, New York City Mayor de Blasio signed a bill that expands paid leave to domestic violence, sexual assault, stalking and trafficking survivors. The mayor stated that no one should be forced to stay in an unsafe situation because they fear losing their job or income.
Maine
Maine Voters Overcome Governor’s Vetoes to Expand Medicaid via Referendum
On November 7, 60% of Maine voters approved Medicaid expansion in the state through a referendum ballot initiative. The vote comes after the state’s Republican Governor Paul LePage repeatedly vetoed Medicaid expansion passed through the state legislature.
Wisconsin
State Assembly Bans Abortion Coverage for State Employees
Wisconsin’s state Assembly has approved a bill that would prohibit state workers’ health insurance plans from covering abortions, except in specific circumstances. The bill would bar the Group Insurance Board, which offers health insurance for state employees, from providing insurance that covers abortion procedures, except abortions that result from rape, incest, or are deemed medically necessary to save the life of the mother.
California
Supreme Court to Hear Arguments Against California’s Reproductive FACT Act
On November 13, the Supreme Court agreed to hear arguments against California’s Reproductive FACT Act which requires crisis pregnancy centers to post notice that state funds are available to cover contraception and abortions. Crisis pregnancy centers are religiously-affiliated medical and counseling centers that strongly push anti-abortion views on the pregnant women who go to them for care. The centers argue that the law is violating their free speech rights.
Massachusetts
Governor Signs Law Protecting Access to Birth Control
Massachusetts’ Republican Governor Baker has signed legislation that protects the ACA requirement for free birth control coverage by making it state law. The law passed with large majorities in both houses of the state legislature. The law is effective immediately and requires state insurance providers to cover birth control without co-pays and allows people to obtain a year’s supply of pills at once.