Health Care Access

Federal court halts Trump admin plan to bar immigrants unable to prove they can cover health care costs

On October 4, Trump issued a proclamation to prohibit immigrants from entering the U.S. unless they can prove that they will have health insurance within 30 days or have the financial means to cover medical bills. Under the terms of the proclamation, some common forms of coverage – like Medicaid and subsidized health plans on the ACA marketplace – would not count as “approved health insurance.” But a federal court temporarily stopped the new policy before it took effect, saying that it could cause irreparable harm to immigrants and their families. The policy would have applied to all immigrants applying for a visa with the intent of living in the U.S. permanently, with limited exceptions.

This policy would have represented another brick in Trump’s “invisible wall,” a quiet and effective campaign to end legal immigration for anyone not rich or white. It is not about encouraging health care coverage; it’s about gutting legal immigration. Researchers estimate that up to two-thirds of future immigrants, admissible under current law, could be blocked by the proclamation.

House Representatives reintroduce the Health Equity and Access Under the Law (HEAL) Act

Representatives Jayapal (D-Wash) and Haaland (D-N.M.) re-introduced the HEAL Act this month. The HEAL Act is a bold piece of legislation that would ensure access to affordable health care coverage for immigrant families. It removes the dangerous mandatory five-year waiting period for lawful permanent residents to access federal health care; removes the exclusion of undocumented immigrants from the Affordable Care Act (ACA) health insurance exchanges; and ensures Deferred Action for Childhood Arrival (DACA) recipients have access to public health care.

The bill has been endorsed by the National Asian Pacific American Women’s Forum (NAPAWF) and 120 other organizations (including PWN). Given the Trump administration’s relentless attacks on the health, dignity, and human rights of immigrant families, it is more important now than ever to demand access to affordable health care for all, regardless of immigration status.

Multiple federal courts block the Trump Administration’s public charge rule

As of November 6, six federal courts have temporarily blocked the Department of Homeland Security from implementing its final “public charge” rule. The rule, which was scheduled to go into effect October 15, is a racially-motivated “wealth test” that seeks to intimidate and punish immigrants from using basic health, nutrition, and housing programs. The rule could have also been used to prevent people living with HIV, other chronic health conditions, and people with low incomes from getting a green card. Now that the rule is blocked in the courts, immigrants can continue to participate in the public programs that help them and their families thrive. Unfortunately, the specter of public charge has already led to wide reports of immigrant families dropping out of services and health care. You can read more about the rule here.


California will become first state in the U.S. to offer pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) without prescription

On October 2, Governor Gavin Newsom signed a law that will allow pharmacists to furnish at least a 30-day supply of two HIV prevention drugs – PrEP and PEP – without a prescription. With this new law, California is leading the way in expanding access to the HIV prevention medications and significantly advancing its efforts to end the HIV epidemic in the state.

Sexual and Reproductive Health, Rights, and Justice

The U.S. Supreme Court will weigh in on the constitutional right to abortion

In early October, the U.S. Supreme Court announced that it would hear oral arguments in June Medical Services LLC v. Gee, a case involving a Louisiana law that would require abortion providers to have admitting privileges at local hospitals. This law would cause every abortion clinic except one to close in the State.

The Supreme Court struck down a substantively identical Texas law in 2016 because it violated the constitutional right to access legal abortion. That should make this case a no-brainer: same law; same constitutional violation. However, today’s Supreme Court is radically different from three years ago. Trump nominated and the Senate confirmed two deeply conservative, anti-abortion justices, shifting the ideological balance of the court decisively to the right.

The outcome of this case will be monumental. The Supreme Court could severely gut – or worse, overturn – the protections in Roe v. Wade, the case that established a fundamental constitutional right to abortion. This would give states the leeway to place insurmountable barriers in between patients and the safe, legal abortion care they need.

On the other hand, the Court could affirm that we have a right to access abortion care no matter what politicians think of that healthcare decisions. This would protect future abortion access in Louisiana and beyond. It would also sharply repudiate the highly restrictive abortion laws that have passed in conservative states in recent two years.

Low income people, people of color, and those who live in the South will bear the brunt of this decision. Gee is another example of why elections matter: when politicians nominate anti-abortion judges, our rights are put at risk.

Abortion in the States: An Update

In positive news for abortion access, federal courts in Georgia and Alabama have temporarily stopped anti-abortion laws from going into effect in both states. Georgia and Alabama passed two of the most restrictive abortion bans in the country, criminalizing the procedure at all, or nearly all, stages of pregnancy. A slew of states passed similar extreme abortion bans in early 2019 and courts have been temporarily blocking them one by one since. Such court orders – known as preliminary injunctions – stop the abortion restrictions from going into effect until the courts can determine the laws’ constitutionality.

Because other anti-abortion laws have closed clinics and created financial and logistical barriers to care in states like Louisiana, Mississippi, and Alabama, Florida has become a regional access point for the Southeastern U.S. The state has seen an influx of people coming from nearby states where abortion care is not accessible. But in a troubling development, Florida lawmakers pre-filed two anti-abortion bills in October. One, H.B. 271, could make abortion care illegal as early as six weeks into pregnancy with no exception for cases of rape, incest, or life endangerment. The second, H.B. 267, would require written consent from a parent or guardian before a young person could have an abortion. The bills could devastate abortion access in the region, potentially rendering the entire Southeastern U.S. “an abortion desert.”

Economic Justice

Department of Labor rule expands drug testing for unemployment compensation

The Department of Labor (DOL) published a final rule that could make it harder for unemployed workers to get the benefits they need to survive. The rule gives broad discretion to states to require drug testing for unemployment insurance (UI) and, if a jobless worker fails a drug test, the state can deny them the benefits to which they are entitled.

The Obama administration issued regulations to place strict limitations on drug testing for UI: only employees fired for drug use or in a few high-risk occupations (such as law enforcement, airplane pilots, or child care) could be required to test. In 2017, the Republican-controlled Congress invalidated those regulations and now the Trump administration is opening the floodgates for states to implement blanket drug testing for UI in a wide net of occupations. The rule raises serious constitutional and human rights concern. It also stigmatizes being out of work by suggesting that applying for UI alone is grounds to suspect drug use. It is not. The rule became effective November 4.

Ending Criminalization

Federal Court rules Pennsylvania safer consumption site is legal

In a historic victory for harm reduction advocates, a federal court ruled that a Philadelphia planned safer consumption site – where people can use drugs in a safe, medically supervised space – does not violate federal law. Safer consumption sites are an important tool used globally to protect drug user health, prevent overdoes, and prevent new cases of HIV and viral hepatitis. The court rejected the Trump administration’s argument that the plan violates federal law, affirming that the “ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it.”

This is the first federal court decision on the legality of safer consumption sites and paves the way for Philadelphia to become the first U.S. city to open one.

LGBTQ Rights, Safety and Justice

U.S. Supreme Court heard oral argument in important cases about non-discrimination protections for LGBTQ employees

The U.S. Supreme Court heard oral arguments in three cases that could radically impact civil rights protections in the workplace for LGBTQ employees. Title VII of the Civil Rights Act of 1964 prohibits employment discrimination on the basis of sex, including discriminating against someone because they do not fit traditional gender stereotypes (i.e. not acting the way your employer thinks people of a particular gender should act). The question now in front of the Court is whether Title VII’s broad umbrella of sex-based discrimination also protects against discrimination on the basis of sexual orientation or gender identity.

This is the Supreme Court’s first big LGBTQ rights case since the retirement of Anthony Kennedy – a justice with a long but complicated legacy of upholding gay rights – and since the appointment of two far-right justices, Gorsuch, and Kavanaugh.

Currently, 22 states bar employment discrimination based on sexual orientation, and 21 do so based on gender identity. If the Court rules against LGBTQ inclusion, employers in the states that do not have such employment protections could discriminate against employees for being gay or transgender.

There is even more at stake in these cases. The government is arguing that sexual orientation and gender identity are not protected because lawmakers didn’t intend to protect LGBTQ people in 1964 (when Title VII was enacted). If the Court agrees with the government, other employment protections that currently exist but arguably weren’t intended by the 1964 Congress – like protections for people who have experienced gender stereotyping or even sexual harassment – could be at risk as well.

Federal Court rules to legalize discrimination on the basis of gender identity and intention to terminate pregnancy

Section 1557 of the Affordable Care Act bars health care entities that receive federal funds from discriminating “on the basis of sex” (along with other protected categories). The Obama administration was clear – and a number of courts have affirmed — that protections against sex discrimination also include protections against discrimination based on gender identity and pregnancy termination.

This month, a federal court in Texas came to the opposite conclusion: that the Obama administration’s inclusive interpretation of “sex” violates federal law. The ruling came from Judge Reed O’Connor, the same judge who deemed the ACA unconstitutional. This means that, in theory, a health care entity could rely on O’Connor’s ruling to deny coverage for abortion, refuse to perform gender affirming surgery, or roll back non-discrimination protections for people of trans experience and people seeking abortion care. However, the conflicting opinions from other courts and the pending Supreme Court case (above) mean that the question is still unresolved. The ACLU and others will likely appeal O’Connor’s decision to the Fifth Circuit.

Ending Violence Against Women and People of Trans Experience

D.C. Council held public hearing on a bill that would fully decriminalize the sex trade

The Washington D.C. City Council held a 14-hour hearing on the Community Safety and Health Amendment Act of 2019, a bill that would eliminate all criminal penalties for commercial sex between consenting adults in D.C. A similar measure failed to pass in 2017, and this hearing marks the furthest a sex work decriminalization bill has gone through the D.C. legislative process. The bill was introduced by councilmember David Grosso in consultation with DecrimNOW, a coalition of current and former sex workers, organizers, and activists fighting for harm reduction, gender justice, racial justice, LGBTQ rights, and more. The bill must next be voted out of the Council’s Judiciary and Public Safety Committee; however, Councilmember Charles Allen indicated that a vote is unlikely.