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      US supreme court agrees to consider abortion pill access

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      The US supreme court on Wednesday agreed to hear oral arguments in a case that could determine the future of a pill used in most abortions in the US, in the first major abortion rights case to land at the country’s highest court since the justices overturned Roe v Wade and abolished the national right to the procedure in 2022.A decision in the case will probably arrive in summer 2024, just months before the presidential election. The outcome of the case could affect not just access to the pill, which has been repeatedly deemed safe and effective, but the Federal Drug Administration’s authority to regulate all manner of medications.The drug at the heart of the case is mifepristone, one of the two drugs typically used in medication abortions, which make up the majority of US abortions. Last year, an association of anti-abortion organizations and doctors, the Alliance for Hippocratic Medicine, filed a federal lawsuit arguing that the FDA had overstepped its authority when it approved mifepristone in 2000.In April, a Texas federal judge appointed by former president Donald Trump issued a preliminary ruling to suspend the FDA’s approval of mifepristone and pull the medication off the market. The US court of appeals for the fifth circuit – one of the most conservative federal appeals courts in the US – ruled in August that, while it was too late to suspend the FDA’s approval, the agency should significantly restrict access to mifepristone. The Biden administration and Danco Laboratories, which manufactures mifepristone, then asked the supreme court to weigh in on the case.The supreme court paused lower-court rulings while the case plays out, so mifepristone remains widely available in states that permit abortion. If the court allows the fifth circuit ruling to stand, it would roll back recent FDA efforts that refined the drug’s dosage and expanded access by allowing it to be prescribed later on in pregnancy and through telehealth.On Wednesday, the supreme court agreed to hear the consolidated petitions from the Biden administration and Danco Laboratories, which asked the justices to focus on the legal attempts to roll back those later FDA efforts. Those petitions also asked the justices to consider whether the challengers have the legal right, or standing, to bring the case in the first place.“You can’t just bring random lawsuits in court. You actually have to have been harmed by something,” said Greer Donley, an associate law professor at the University of Pittsburgh Law School. “That’s really what standing analysis is all about, to try to figure out if if the people who bring the lawsuit actually have a stake in the case.” Numerous legal experts have questioned whether the challengers in this case have properly demonstrated that they have been harmed by mifepristone’s continued legality.The supreme court also denied a petition from the Alliance for Hippocratic Medicine that asked the justices to explicitly consider the FDA’s 2000 approval of mifepristone. That move suggests that the supreme court is unlikely to pull mifepristone off the market entirely.In Donley’s view, the outcome of this case will probably signal whether the supreme court, which is controlled 6-3 by conservatives, wants to be involved in the post-Roe war over abortion rights. If the justices decide to focus on the standing issues in the case, they could sidestep having to rule on the substance of the case entirely.“I could see the more moderates on the supreme court thinking: ‘we don’t want to touch this,’” Donley said. “It might make the supreme court look like less of an activist court if it were to dismiss this case on the basis of really legitimate standing problems.”Any ruling by the court would affect all 50 states, including those that have protected abortion rights. (In recent months, officials in states such as Washington and California have announced that they have begun to stockpile mifepristone.)A ruling could also imperil the FDA’s regulatory power writ large and pose an existential threat to pharmaceutical companies. If courts can rewrite the FDA’s approval of abortion pills, any kind of drug – including, for example, drugs used to protect against HIV or to provide gender-affirming care – could end up in conservative jurists’ crosshairs.The ruling from the federal appeals court, Danco Laboratories warned in its briefs to the supreme court, “destabilizes the pharmaceutical and biotechnology industries by questioning when scientific studies – accepted by FDA – are sufficient”. More than 100 studies, conducted across 26 countries, have concluded that mifepristone is safe, a New York Times review found.If deprived of access to mifepristone, several abortion clinics have said that they would keep providing medication abortions using only misoprostol, the other drug typically used in medication abortions. Although misoprostol-only abortions are still overwhelmingly safe, they can have more side-effects and are slightly less effective than the two-drug protocol.Ultimately, regardless of how the supreme court rules, its decision will not curtail the thriving underground networks that routinely supply mifepristone to women looking to end their pregnancies, including in the 16 states with near-total abortion bans. In fact, a move to ban mifepristone is likely to cause a sharp rise in demand for the drug through those networks.In the wake of Roe’s fall, a vast web of abortion rights supporters and opportunistic merchants have sprung up to ship abortion pills to Americans. Inducing your own abortion is not illegal in most US states, even in states that have banned in-clinic abortions, and medical experts widely agree that it can be safe to use pills to “self-manage” an abortion early in pregnancy. More

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      ‘Couples Therapy,’ but for Politics

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      Growing political polarization is a problem that keeps me up at night. Not because I think it’s bad to have strong opinions, but because of what social scientists call affective polarization: polarization beyond political disagreement, when “ordinary Americans increasingly dislike and distrust those from the other party.” At its worst, affective polarization can lead to hate and dehumanization.When my colleague Thomas Edsall wrote about affective polarization earlier this year, he quoted Sean Westwood, an associate professor of government at Dartmouth, who said that part of what’s behind today’s intense partisan divide is that “Politicians, instead of focusing on the large list of issues where there is broad agreement in the American public, endlessly re-litigate social divides like gay rights and abortion to mobilize a base they fear will stay home if they focus on the mundane details of pragmatic governance.”I see this play out when I hear activists suggest that you can’t talk to them about climate change if you don’t agree with their stance on the Israel-Hamas war, or when I see politicians tying approval of military appointments to abortion access. The attitude seems to be: You have to agree with me about everything or you’re my enemy and we can’t work together on anything. It leads to a whole lot of nothing.Because I cover family policy, the lack of movement on areas of “pragmatic governance” where there is “broad agreement” drives me bonkers. A prime example is federal paid leave, which is popular among voters across the spectrum, yet remains in legislative purgatory, and has for decades. Though there’s a bipartisan working group in Congress on the issue, we’re still a long way from any change, leaving us out of step with most wealthy nations and creating a lot of stress and economic hardship for people just trying to make ends meet while also caring for children or sick family members.But there’s a group of people of all ideological backgrounds — social conservatives, progressive activists, budget wonks and lots of people in between — that’s been convening over the past year, and that gives me a bit of hope for family policy’s future. It also offers a road map for people who disagree vehemently on issues to have productive conversations and find points of connection. If nothing else, the group’s participants agree that too many American families are struggling, that families should be more of a political priority and that something needs to be done to help them.The convocation has the somewhat jargony name Convergence Collaborative on Supports for Working Families, and its members let me sit in on one of their guided discussions with the understanding that I would follow the Chatham House Rule — I can report on what was said during the session but not reveal “the identity nor the affiliation” of any speaker.The group consists of around 30 people and it has met monthly since April. It is directed by Abby McCloskey, who runs a research and consulting firm and was a policy adviser for Jeb Bush’s and Rick Perry’s 2016 presidential campaigns and Howard Schultz’s exploratory 2020 presidential run. The collaborative is funded by the David and Lucile Packard Foundation. With permission, after the meeting I reached out to some of the individuals involved to see if they’d be comfortable talking in general terms about their experiences in the group.During the initial meetings, the members came up with set of family policy principles they could mostly agree on. The discussion I observed involved them delivering feedback on a draft of a report outlining those principles. At first, I feared this was going to be an absolutely mind-numbing way to spend three hours of my life and that I would have to gently pinch myself to stay awake while listening to a discussion of the budgetary implications of the earned-income tax credit.Instead, the conversation was spicy while still being respectful, and full of fundamental disagreements that did not seem completely papered over simply for the sake of congeniality. McCloskey described it to me more than once as feeling like “couples therapy,” and it did.For example, a few people objected to wording in the report about center-based child care that they felt put a thumb on the scale against stay-at-home parents. Others disagreed with that objection, and there was an impassioned back-and-forth about it. Ultimately, the moderator stepped in, restated everyone’s point of view in a neutral way and advised that everyone needn’t agree on every detail to move forward.I give a lot of credit to that moderator, the aptly named David Fairman, who is a senior mediator at the Consensus Building Institute, for the structure and tone of the discussion. When we spoke on the phone afterward, he explained that C.B.I. is one of “roughly a dozen” similar organizations that help conduct mediation on public issues. His job is to help find common ground among people with different backgrounds and belief systems.There are three main things Fairman does to facilitate these discussions. The first is to build relationships among participants, so that “they discover that there’s more to them than the battle of tweets that they’ve had or the countering publications or testimony and the identities that they carry with their businesses, with their advocacy groups or whoever.” That kind of humanizing is done partly through guided conversations in breakout groups, and some of it is done more organically through events like in-person cocktail hours.The second is by getting people to “listen openly” during discussions, which means calming down their “rebuttal minds, the hamster wheel that is almost always turning as we listen to someone with whom we disagree, coming up with the counterarguments,” Fairman explained. Instead, he urges people to ask “clarifying questions, not rhetorical questions, not debating questions.” And he gave this example: “What do you mean by saying that ‘you really feel strongly that the child tax credit should remain universal’? Is it that the most important thing about it is that it’s for everyone? Or is it that you are worried that the political support for it will not be there if it is not universal, or is it something else? I just want to know.”The third, and I would argue the most difficult component, is trying to get beyond people’s stated positions to their underlying interests, values and principles, to create space “to explore new ways of thinking about the options,” Fairman said. He referred to a disagreement over how generous a child care tax credit or other allowance could be. The group was at an impasse. While they couldn’t agree on the appropriate size of the credit, a new idea emerged: that more flexibility for parents to choose how to spend the credit “over the life cycle of their child would be a win, even if it doesn’t address the question of the absolute amount of funding.”I also interviewed several members of the group about their experiences. My takeaway was that overall, people were happy to be in conversation with one another, to meet basically agreeable people with totally different ways of framing the problems at hand and to think hard about their own biases. “I think the level of candor was surprising,” said Patrick Brown, a fellow at the right-leaning Ethics and Public Policy Center. “I think everybody committed to coming in with a willingness to critique their own side where necessary and to say frankly where their red lines were.”But the process was certainly not a cure-all. Many said that they wished they had even more time to work through the document they were creating. Some felt that some fundamental concerns — particularly with regard to race and immigration — weren’t aired thoroughly enough before moving on to the particulars of policymaking. More than one person expressed frustration that systemic racism was not more explicitly addressed and that barriers to accessing currently available benefits weren’t fully interrogated.While all the participants thought they would have a document at the end of the process that they would be willing to put their names to, some wondered if it would wind up being so watered down that it wouldn’t have “truly moved the needle,” as Lina Guzman, the chief strategy officer at Child Trends, put it, to get more people fired up about these issues.Even if they come up with something that isn’t earth-shattering, every person I spoke to felt that the process was worthwhile because of the relationships they built. “I think that having created the space to do this is valuable in and of itself, even if what we come out with falls short of what some people might have hoped,” said Katharine Stevens, the founder and chief executive of the Center on Child and Family Policy.We don’t know what unexpected alliances and priorities might arise in national politics in the coming years. But because these professionals have spent a lot of hours together talking about their deepest values, giving and getting clarity about their beliefs, they may find unexpected sources of support for specific ideas that aren’t yet mainstream.I came out of observing the discussion mostly wishing that we could all have mediators like Fairman at our holiday tables. We can’t simply wish away the profound disagreements many of us have. But I’ll certainly be trying to ask more clarifying questions of people I don’t agree with. Quieting my rebuttal mind, as a professional opinion haver, will be a rough one, but I’m going to do my best, and I’m going to try to maintain as much good faith as I can muster. We’ll need it in 2024. More

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      What Is the Real Meaning of ‘Pro-Life’?

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      More from our inbox:The Texas Abortion RulingThe Campus Clash of Free Speech and AntisemitismThe Undemocratic Electoral CollegeTrump and NATO Illustration by Alicia Tatone; Photographs by Yiming Chen, SDI Productions, Joshua Roberts/Getty ImagesTo the Editor:Re “Republicans Are Finding Out That ‘Pro-Life’ Has Too Many Meanings,” by Liz Mair (Opinion guest essay, Dec. 6):Ms. Mair, a G.O.P. campaign strategist, writes about all the desperate ways Republican politicians are trying to explain their stance on abortion now that their decades-long fight to make it illegal has taken a step forward.It seems her clients are scrambling, surprised to find that “rank-and-file G.O.P. voters are not as pro-life as we might have thought.”The medical community is not surprised. You see, there are no party affiliation requirements for unplanned or medically doomed pregnancies. Doctors have seen staunch Republicans obtain safe and legal abortions for decades. I’m sure that every single white male Republican legislator who signs “heartbeat” laws, piously claims he is pro-life and rails against Planned Parenthood knows a woman who has had an abortion. And he may have caused one himself.Instead of spinning the message on their terrible policies, her advice to her G.O.P. clients should be to stop blocking funding for reliable contraception, stop interfering with medical decisions between women and their doctors and start writing laws that support women who can’t afford another pregnancy because of poverty, a lack of postpartum job security or abusive partners.You know, “pro-life” stuff.Cheryl BaileySt. Paul, Minn.The writer is a retired gynecologic oncologist.To the Editor:In recommending that Republicans finesse the abortion issue, Liz Mair doesn’t mention one point. Pro-choice advocates are not anti-life, but we disagree with those who call themselves pro-life in two fundamental ways. We do not believe that humans can claim to know what God — who certainly allows miscarriages — wants, and we do not believe that humans claiming to have this knowledge have a right to impose their religious beliefs on others.Republicans may continue to succeed politically by demagoguing the abortion issue, but most Americans, religious or not, do not believe that the law should forbid women from obtaining a safe abortion.Jamie BaldwinRedding, Conn.To the Editor:Liz Mair is absolutely correct that “pro-life” has many meanings, but she mistakenly focuses only on abortion.Being “pro-life” also means things like good pre- and post-natal care for all mothers; good health care for everyone, including babies born to the poorest among us; accessible and affordable child care and preschool for all; gun safety laws to ensure that bullets are no longer the biggest cause of accidental death among U.S. children, and, not least, more commitment to combating climate change.Republicans need to consider these matters when they (or if they) decide to come up with a better, more marketable definition of “pro-life.”Nadine GodwinNew YorkThe Texas Abortion Ruling Kate Cox, via Associated PressTo the Editor:Re “Texas Supreme Court Rules Against Woman Who Sought Abortion” (news article, Dec. 12):I hope the women of Texas go on strike and march to the state capital. Women, especially mothers, all over the country will stand with them.Eve Rumpf-SternbergSeattleTo the Editor:Is there no end to these people’s cruelty?Linda GrunbaumNew YorkThe Campus Clash of Free Speech and Antisemitism Adam Glanzman for The New York TimesTo the Editor:Re “Censorship Can’t Help University Presidents,” by David French (column, Dec. 11):Mr. French argues that what American campuses need is more viewpoint diversity and true freedom of speech — not the current hypocrisy of some speech being favored and other speech censored.But what Mr. French does not mention at all is the need for morality and truth to be part of the curriculum. President John F. Kennedy, a Harvard alumnus, said “the goal of education is the advancement of knowledge and the dissemination of truth.”The university presidents’ failure before Congress to unambiguously repudiate calls for “the genocide of Jews” reflected how far these schools have strayed from that purpose. Allowing more speech on campus without a moral compass will yield only more noise and little else.Nathan J. DiamentWashingtonThe writer is the executive director for public policy of the Union of Orthodox Jewish Congregations of America.The Undemocratic Electoral College Christopher Lee for The New York TimesTo the Editor:Re “‘The Exploding Cigar of American Politics,’” by Gail Collins (column, Nov. 30):Ms. Collins’s excellent column about the Electoral College should have commented more on the U.S. Senate, which is even more unrepresentative and undemocratic.Two out of three of our elected national arms of government are unrepresentative. (The third “arm,” the House, is roughly representative, but tainted by gerrymandering, “dark” money and increasing voter suppression.)The Electoral College has overturned the national popular vote five times in America’s nearly 250-year history, but twice already in this still young century. It’s likely to happen again, probably soon (’24?).One reason the founding fathers decided not to have direct elections to the presidency was a fear of a mostly uneducated and ill-informed electorate voting in either a fraudster or a populist demagogue as president. Some would say we got two for the price of one in 2016.We should abolish the Electoral College and directly vote for the president (as we do for the Senate and the House). Failing that, embrace the National Popular Vote Interstate Compact, by which states agree to award their electoral votes to the winner of the national popular vote.I dread the day when many more Americans despair of the ballot box and instead choose far more dangerous ways of expressing their will — i.e., more Capitol insurrections, but successful ones.The founding fathers must be spinning in their graves at our inability to modernize our now dangerously outdated Constitution.Michael NorthmoreStaten IslandTrump and NATOFormer President Donald J. Trump has made it clear that he primarily sees NATO as a drain on American resources.Doug Mills/The New York TimesTo the Editor:Re “Trump’s Stance Toward NATO Alarms Europe” (front page, Dec. 10):I’m 73 years old and frightened. So many things I have taken for granted my entire life are threatened. My dad fought overseas in World War II. He, and I, always assumed that the things he fought for would remain protected.I never contemplated that the coalitions we established with our allies after the war would be threatened. I came to believe that the isolationism thriving before the war had been essentially put to rest.But now Donald Trump and his disciples have awakened the blind nationalism that raises the specter of totalitarianism. That menace should strike terror in all who treasure our democracy.And we can’t allow a feeling of helplessness or a belief that such things could never happen here prevent us from protecting what we can no longer take for granted.Stephen F. GladstoneShaker Heights, Ohio More

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      Kate Cox begged Texas to let her end a dangerous pregnancy. She won’t be the last | Moira Donegan

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      In most cases, we would never have learned her name. Kate Cox, a Texas woman, is in a sadly common set of circumstances: a 31-year-old mother of two, Cox was pregnant with her third child when doctors informed her that something was wrong. Pregnancy complications are common, but in a state like Texas, they have become newly dangerous, threatening women with potentially disfiguring health complications, along with unimaginable heartbreak, as the state’s multiple bans have mandated grotesque and inhumane treatment of doomed pregnancies.Cox’s fetus had trisomy 18, a chromosomal disorder. Trisomy 18 is a devastating diagnosis. Most pregnancies end in stillbirths; those infants born alive with the disorder live anguished, short and painful lives. Cox was informed that her fetus, in the sterile medical parlance, “could not sustain life”. The fetus had malformations of the spine, heart, brain and limbs. The pregnancy also posed dire threats to Cox’s health; most significantly, she was at risk of losing her future fertility if she remained pregnant.If Cox made it to delivery – a big if – the child would live for perhaps an hour, perhaps a week. It would have to be treated with pain medications for the entirety of its brief life. None of these were cognizable concerns under Texas’s abortion ban. The law said that she would have to remain pregnant – would have to get sicker, have to endure greater and greater pain and grief, and then would have to labor and give birth to a daughter, who she would watch suffer and die.There are hundreds of women like Cox living in Republican-controlled states, women carrying pregnancies in which there is no hope that a living baby will result at the end of nine months. These are pregnancies that – because of abortion bans that provide no actionable exemptions for medically futile pregnancies or maternal health – women are forced to keep carrying anyway.Most people in this situation suffer in private; they endure the cooing at their bellies from oblivious strangers while they remain pregnant, and they purchase tiny urns in the brutal days after. Cox is different only because she made the decision to share her situation publicly. As her health deteriorated and she made multiple visits to the emergency room, she published an op-ed in the Dallas Morning News, and petitioned Texas courts for an abortion. It is the first recorded instance of an adult woman having to ask for government permission to end her pregnancy since Roe. On Friday night, the Texas supreme court refused. On Monday, Cox left the state, seeking an abortion elsewhere.There is a tendency, in coverage of abortion law, for writers to try and discipline their language. The issue is fraught and passionate enough, the thinking goes, surrounded as it is by stigma, ignorance and misinformation. There is one line of journalistic thought that holds that the best way to serve one’s readers, and to maintain their trust, is to write with as strict neutrality as the facts will allow. If I were to follow that line, I would tell you that the case raises vexed and unresolved legal questions about the extent of medical exemptions to abortion bans, and that the actions of Ken Paxton, the Texas attorney general, whose office intervened to prevent Cox from receiving an abortion, is signaling a maximalist view. I might not mention, in the interest of neutrality, that among the Texas supreme court justices who denied Cox her abortion was John Devine, an extremist Christian conservative with a long history of anti-choice activism, including, according to his boast at a campaign event, being arrested 37 times in harassment actions outside abortion clinics.But there is another line of thought that holds that euphemism is dishonesty, and that the effort to maintain journalistic neutrality in situations of grave injustice winds up obscuring more than it reveals. If I were to follow this latter method, I would tell you plainly that, by refusing to let her end this pregnancy, Paxton and the state of Texas in effect allowed Kate Cox to be tortured, and that she was forced to flee to escape that torture.Cox will not be the last woman in this position. She will not be the last woman to make a public plea to be permitted an abortion for a dangerous and non-viable pregnancy; she will not be the last one who is denied. She is part of a growing cast of abortion rights plaintiffs, a product of Dobbs’s cruelties and of the shifting strategic posture of the reproductive rights movement. These new claimants are not the traditional pro-choice litigators – clinics or doctors – but prospective patients themselves. In particular, the new plaintiffs are women who are seeking medical exemptions to terminate wanted but dangerous pregnancies. (In her op-ed, Cox referenced Zurwaski v Texas, a lawsuit in which 20 such women are suing to clarify and expand medical exemptions to Texas’s abortion ban.)Think of it as a crusade of the medically endangered: women who are faced with tragic, dangerous and heartbreaking circumstances in their pregnancies are emerging as a new face of the pro-choice legal movement. Like the anti-choice movement spent decades chipping away at the abortion rights and expanding restrictions, these women’s lawsuits seek to expand access in the most sympathetic of cases – those of medical emergencies – to carve out slightly larger loopholes for more women to access abortion through.It’s an incrementalistic strategy, one that assumes that legal abortion bans like those in Texas are here to stay for the foreseeable future. And it is also a strategy that makes some concessions to the bigotries and biases of the Texas court, to say nothing of American public opinion. Like many of the medically endangered plaintiffs, Cox is white and married. She is already a mother, and wants to be pregnant – she speaks extensively, and movingly, of desiring more children, and of wishing that she could have this one. Unlike many in her shoes, when faced with a horrible consequence of a sadistic law, she was able to seek both publicity and legal help. Unlike many in her shoes, when she was denied an abortion, she was able to flee.None of these things about Cox – neither her privilege not her palatability – make her a bad person, or make her suffering any less horrific. But they do make her an appealing face for a movement that is seeking to reason with a rabid and revanchist cadre of judges. There is nothing the right can object to in her, the thinking goes, and there is nothing they can get from making her suffer: her child will die. And yet her plea was rejected by the Texas courts, which suggests that the anti-choice movement does feel that they can get something out of Kate Cox. They get the ability to make her beg. Then, they get the satisfaction of saying no.The way we talk about abortion has warped in the wake of Dobbs. We use bloodless language of gestational limits; we may even be tempted to describe once-unheard of 15 week bans as comparatively “moderate”. We look on the bright side, like to the fact that Cox, denied the care that will keep her healthy and alive in Texas, was able to go elsewhere. Amid these adjusted expectations it is easy to lose track of how far we’ve fallen in our standards for women’s dignity and freedom. Two years ago, a woman in Cox’s shoes was able to control her own body and life on her own terms; now, she has to go before a court, all her virtues on display, and beg not to be maimed. “I am a Texan,” Cox said in her op-ed. “Why should I or any other woman have to drive or fly hundreds of miles to do what we feel is best for ourselves and our families, to determine our own futures?” It was an appeal to her dignity as a citizen. But Texas only saw her as a woman.
      Moira Donegan is a Guardian US columnist More

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      Tommy Tuberville says he will end blockade of 400 military promotions

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      Senator Tommy Tuberville said on Tuesday he was ending his blockade of hundreds of military promotions, clearing the way for numerous generals and admirals to take new roles after a nearly 10-month protest over the military’s abortion policy.The Alabama Republican said he was “not going to hold the promotions of these people any longer”.More than 400 military nominations have been in limbo due to Tuberville’s blanket hold on confirmations and promotions for senior military officers. It is a stance that has left key national security positions unfilled and military families with an uncertain path forward.He finally relented after heavy pressure from fellow Republican senators who had grown increasingly alarmed about the damage his holds were having on US military readiness. More than half of the US military’s 850 senior general and admiral roles had been affected by Tuberville’s holds, and that number was expected to grow to three-quarters of all senior military officials by the end of the year.Tuberville, a former college football coach and neophyte lawmaker, was blocking the nominations in opposition to new Pentagon rules that allow reimbursement for travel when a service member has to go out of state to get an abortion or other reproductive care.Joe Biden’s administration instituted the new rules after the supreme court overturned the nationwide right to an abortion, and some states have limited or banned the procedure.Critics said that Tuberville’s ire was misplaced and that he was blocking the promotions of people who had nothing to do with the policy he opposed.“Why are we punishing American heroes who have nothing to do with the dispute?” said his fellow Republican senator Dan Sullivan of Alaska. “Remember we are against the Biden abortion travel policy, but why are we punishing people who have nothing to do with the dispute and if they get confirmed can’t fix it? No one has had an answer for that question because there is no answer.”Tuberville had little choice but to back down. Senate Democrats had introduced a proposal that would let the Senate make a one-time exception to its rules to confirm the military appointees, and it had garnered enough Republican support that it was going to pass if Tuberville did not shift his position.He will now allow the Senate to vote to confirm almost all of the top-ranked military positions, but will keep his hold on four-star generals, blocking 10 or so of the most senior military promotions.The Associated Press contributed to this report More

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      Dozens of independent abortion clinics closed in 2023 post-Roe, study finds

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      Dozens of independently owned reproductive health clinics shuttered in 2023, the year after the US supreme court overturned Roe v Wade, according to a new report from the Abortion Care Network.The group found that 23 independently owned clinics closed this year, on top of the 42 that shuttered in 2022, leaving over a dozen states, mainly in the American south and midwest, without a single brick-and-mortar clinic that provides abortion.“Even before Roe fell, we were the only abortion clinic in a very rural, very underserved state with limited access to health care, and now that’s all been exacerbated,” said Katie Quinonez-Alonzo, executive director of Women’s Health Center of West Virginia.Like most independent clinics in the United States, the Women’s Health Center of West Virginia struggled to keep its doors open after the supreme court decision paved the way for the state to ban abortion last year. The clinic still provides other reproductive and sexual health services, like gender-affirming care for transgender patients.“We want to stay here in our community and help the patients that are still counting on us, but it’s been one uphill battle after another,” Quinonez-Alonzo told the Guardian.The Women’s Health Center of West Virginia is an especially crucial lifeline for low-income, uninsured people in the state, who rely on the clinic for routine gynecological check-ups. Those services became harder to offer after West Virginia banned abortion, slashing the clinic’s revenue by roughly half a million dollars.This year, Quinonez-Alonzo anticipates a roughly $350,000 budget deficit.Independently owned clinics – in contrast with bigger players like Planned Parenthood – provide the majority of abortions in the United States. According to the ACN report, “indie” clinics make up the majority of clinics operating in states that are most hostile to abortion, and offer the broadest range of options for patients seeking the procedure. ACN researchers found that 73% of indie brick-and-mortar clinics offer both medical and surgical abortions, compared with just 42% of Planned Parenthood affiliates – so as they dwindle in number, so do options for women seeking care.Before the supreme court overturned Roe, the West Alabama Women’s Center provided over half of the abortions in the state.“In the deep south, it was always indie providers that were the ones providing abortions. Very few Planned Parenthoods existed in our region,” said Robin Marty, executive director of West Alabama Women’s Center.“Alabama used to have three Planned Parenthoods, we have just one now, the others have closed,” Marty said. “We’re still here, though.”After Alabama enacted a sweeping ban on abortion, the Tuscaloosa clinic refocused on protecting newly pregnant people’s access to affordable prenatal healthcare.But Alabama is one of 10 states that has not expanded Medicaid, leaving roughly one in seven women of childbearing age without any form of health insurance. The state allows newly pregnant women to apply for Medicaid, but that requires a doctor’s letter confirming the pregnancy.“But of course, as these people do not have insurance, they can’t get into a doctor in order to get this letter for Medicaid,” Marty said. “This is why we’re seeing so many people in Alabama who don’t have prenatal care in the first trimester.”Even after a patient receives a doctor’s letter confirming their pregnancy, it can take four to six weeks for the state to approve coverage. To help care for uninsured and pregnant people in Alabama, Marty said her clinic provides free prenatal care until a patient’s Medicaid coverage is approved. If financial trouble forces the clinic to close, a bad maternal health landscape will get worse.“The people in our community need prenatal care and birth control and STI testing just as much as they need abortion,” Marty said. “For these patients, there isn’t another healthcare provider here for them.” More

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      Talk About Abortion, Don’t Talk About Trump: Governors Give Biden Advice

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      At an annual gathering in Arizona, Democratic governors offered a series of explanations for the president’s political struggles and suggested ideas for selling voters on his re-election.America’s Democratic governors brag about booming local economies, preside over ribbon-cuttings of projects paid for with new federal legislation and have successfully framed themselves as defenders of abortion rights and democracy.Almost all of them are far more popular in their home states than the Democratic president they hope to re-elect next year.While President Biden is mired in the political doldrums of low approval ratings and a national economy that voters are sour on, Democratic governors are riding high, having won re-election in red-state Kentucky last month and holding office in five of the seven most important presidential battleground states.The governors, like nearly all prominent Democrats, are publicly projecting confidence: In interviews and conversations with eight governors at their annual winter gathering at the Arizona Biltmore in Phoenix over the weekend, they expressed on-the-record optimism that Mr. Biden would win re-election.But also like many Democrats, some privately acknowledged fears that former President Donald J. Trump could win a rematch with Mr. Biden. They also said that Mr. Biden, at 81 years old, might not compare well with a younger Republican like Nikki Haley, the former United Nations ambassador, Gov. Ron DeSantis of Florida or even former Gov. Chris Christie of New Jersey.The governors offered a series of explanations for Mr. Biden’s political struggles and supplied free advice. Here are six ways they believe he can raise his standing ahead of next year’s election.Talk more about abortion.Mr. Biden barely says the word abortion in his public statements, a fact that frustrates fellow governors hoping he can, as many of them have, use anger over the Supreme Court’s 2022 decision overturning Roe v. Wade to improve his political fortunes.“We should talk about all the threats to women’s health care, including abortion, and use that word specifically,” said Gov. Gretchen Whitmer of Michigan. “We should be talking about it like that because Americans are awake. They are angry that this right could be stripped away and we are the only ones fighting for it.”On abortion politics, Gov. Phil Murphy of New Jersey acknowledged that “it’s widely known that this is probably an uncomfortable reality for him,” given that Mr. Biden, a practicing Catholic, once voted in the Senate to let states overturn Roe v. Wade and his stance on abortion rights has evolved over the years.Mr. Murphy said Mr. Biden must be forthright about discussing the likelihood that Republicans would aim to enact new abortion restrictions if they win control of the federal government in 2024 and emphasizing the Democratic position that decisions about abortion should be left to women and their doctors.“That has to be laid out in a much more crystal-clear, explicit, affirmative way,” he said.Stop talking about Trump.The governors broadly agreed that Mr. Trump would be the Republican nominee. They don’t love Mr. Biden’s recent turn to focus more attention on his predecessor.“You’ve got to run for something and not against someone,” said Gov. Andy Beshear of Kentucky. That is easy for Mr. Beshear to say — he is among the nation’s most popular governors and just won re-election in a deep-red state.Gov. Laura Kelly of Kansas urged the president to stop talking about Mr. Trump altogether. Be positive, she said, and let others carry the fight to Mr. Trump.“If I were in Biden’s shoes, I would not talk about Trump,” she said. “I would let other people talk about Trump.”Appeal to moderate Republicans and independents.Gov. Tim Walz of Minnesota also said Mr. Biden needed to adopt some of Mr. Trump’s penchant for bragging.“He’s been modest for so long, to watch him do it now feels a little uncomfortable,” Mr. Walz said.Gov. Roy Cooper of North Carolina said his constituents were hoping Republicans would nominate someone other than Mr. Trump.Mr. Murphy said hopefully that Republicans supporting someone else in their primary might stay home or wind up voting for Mr. Biden next year.“What if Trump is the nominee? What’s the behavior pattern among the Haley, DeSantis and Chris Christie supporters? Where do they go?” Mr. Murphy said. “I find it hard to believe that a majority of them are going to Trump.”Tell people what Biden’s done.Gov. Gavin Newsom of California, fresh off a prime-time Fox News debate against Mr. DeSantis that seemed meant in part to elevate the ambitious Mr. Newsom to the role of Mr. Biden’s leading defender, lamented “the gap between performance and perception.”He was one of several governors who said their constituents felt good about their lives but were pessimistic about the state of the country.“People feel pretty good about their states, feel pretty good about their communities, even their own lived lives,” Mr. Newsom said. “You ask, ‘How are you doing?’ They say, ‘We’re doing great, but this country’s going to hell.’”Mr. Newsom said Mr. Biden’s biggest problem was that he had not been able to communicate to voters that he is responsible for improvements in their lives.“People just don’t know the record,” he said. “They don’t hear it. They never see it.”In North Carolina, which last week became the 40th state to expand Medicaid under the Affordable Care Act, Mr. Cooper said people who are newly eligible for health care were not likely to credit Mr. Biden or White House policies.“The people who are getting it don’t really associate it with anybody other than finally being able to get health care for themselves,” he said.Focus more attention on legislative achievements.The governors all seemed to agree that they would like to see Mr. Biden spend more time cutting ribbons and attending groundbreakings for new projects paid for by infrastructure, climate and semiconductor funding he signed into law.“I would be doing those morning, noon and night,” Mr. Murphy said.Ms. Kelly of Kansas, who won her red state twice, said Mr. Biden should announce the opening of new projects and factories because she said it would focus attention away from his age.“I would spend a lot of time doing those just because they’re relatively easy and they are energizing,” she said.And Mr. Walz, whom his fellow governors voted the new chairman of the Democratic Governors Association, said Mr. Biden’s challenge would be explaining to people the future benefits of investments being made now.“The problem is going to be, it’s going to take us 20 years to build all this infrastructure out,” Mr. Walz said. “Whether they see it within the next 11 months or not, that’s what we need to tell the story.”Find some Democrats with enthusiasm.No governor at the Phoenix gathering expressed more desire to give Mr. Biden another term in the White House than Mr. Newsom, who used a 40-minute chat with reporters to take a victory lap from his debate with Mr. DeSantis, a ratings bonanza for the Fox News host Sean Hannity that doubled as the largest audience of the California governor’s political career.Mr. Newsom, who since the middle of last year has evolved from a friendly critic of Mr. Biden’s political messaging to one of his most enthusiastic supporters, said his fellow governors needed to perform like old-school politicians who could deliver a constituency for an ally through force of will by activating supporters to follow political commands.“We, the Democratic Party, need to get out there on behalf of the leader of the Democratic Party, Joe Biden, and make the case and do it with pride,” Mr. Newsom said. “We’ve got to wind this thing up.”The task may be difficult. Mr. Cooper described “a general malaise and frustration” that has Americans blaming Mr. Biden for forces often beyond his control.But Mr. Newsom said that if others were wary of carrying the torch for Mr. Biden in the next year, he was not afraid to do so all by himself.“If no one’s showing up doing stuff, I’m going to show up,” he said. “I can’t take it. I can’t take the alternative. I can’t even conceive it.” More

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      Republicans Are Finding Out That ‘Pro-Life’ Means a Lot of Things to a Lot of People

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      Electoral results since the Dobbs v. Jackson Women’s Health Organization decision should tell a lot of people in the Republican Party something they absolutely do not want to hear: Even rank-and-file G.O.P. voters are not as pro-life as we might have thought when Roe v. Wade was the law of the land.That trend was confirmed last month in Ohio — the latest sign that the Republican Party needs to figure out a new way of addressing abortion.Many conservatives may call themselves pro-life, but in practice, that may be a more aspirational statement than an accurate reflection of hard policy views. Perhaps by figuring out what it now means to be pro-life — and recognizing that pro-life policy is easiest to sell only when it amounts to a ban on abortions later in pregnancy — Republicans can come up with a new approach to the politics of the issue.Before Roe was overturned, the term “pro-life” covered a lot of ground — which was useful over decades in galvanizing a broad coalition willing to use abortion as a political cudgel. As Republicans are finding out today, “pro-life” means many things to many people.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber?  More