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Trump is dismantling a key worker safety group. It’s another betrayal of the working class | Devan Hawkins
by Evelyn Reynolds 6 May 2025, 12:00
As Donald Trump announced his tariffs in the White House Rose Garden last month, he proclaimed: “We’re standing up for the American worker.” While it remains to be seen what impact these tariffs will have on American workers, his words were belied by the fact that just a day before this announcement, hundreds of workers at the National Institute for Occupational Safety and Health (Niosh) – an organization that has stood up for US workers since 1970 – discovered that they had been laid off.Niosh was founded as part of the Occupational Health and Safety Act with the purpose of “developing and establishing recommended occupational safety and health standards”. The organization has been on the frontline of protecting worker health and safety ever since. Its work has focused on understanding the risks faced by millions of workers throughout the country who put their safety on the line every day to perform their jobs. For example, Niosh’s Fire Fighter Fatality Investigation and Prevention Program investigates fatalities to understand their circumstances and make recommendations, ensuring that more of these workers, who risk their lives for others daily, can be safer in the line of duty.Far from being a caricature of a federal body firmly entrenched in the Beltway, Niosh’s work is spread across the country. One of Niosh’s most notable sites is its Morgantown, West Virginia, facility. Located in the heart of coal country for decades, it has focused on studying the health impacts of coalmining – particularly black lung disease – which has seen notable increases in recent years. Nearly 200 workers were fired from the Morgantown location, which will severely hamper this work. (Some were temporarily rehired.)Niosh also supports surveillance programs run out of 23 states. These state-based programs focus on the unique needs of the workforce in those areas. For several years, I was fortunate to have been an epidemiologist with such a program in Massachusetts, where my colleagues and I focused on understanding and preventing health challenges ranging from bloodborne pathogen exposure among healthcare workers, to asthma risk among cleaners, to fatalities in the construction industry.Since its founding, Niosh has been a nimble organization, adapting to and studying new and emerging threats. The World Trade Center Health Program, which is administered by Niosh, was created to study the health impacts of responding to those terrorist attacks – ranging from traumatic injuries and respiratory disease to cancer and mental health – while providing support for those responders.In a similar way to its response to the September 11 attacks, in the grip of the epidemic of opioids and suicides that have cost tens of thousands of lives over the past two decades, Niosh has sought to understand the workplace component of these challenges. These efforts have helped to shed light on the pathway linking occupational injuries to a high risk of drug overdoses among workers in certain occupations, particularly in the construction industry, and contribute to efforts to prevent these deaths.During the Covid-19 pandemic, Niosh studied the risks faced by frontline workers. The pandemic also highlighted one of Niosh’s most essential functions: air filtration ratings. Niosh tests, approves and certifies respirators to ensure that workers are protected from airborne risks ranging from silica dust to lead.Niosh also supports the future of occupational safety and health workers. Niosh traineeship programs across the country provide support to students studying occupational health and safety. I was fortunate to be supported by such a program when I was in graduate school. Throughout the country, hospital employee safety departments, union workplace safety committees, and community occupational health and safety advocacy organizations are staffed by others like myself who received this support.Now is the worst possible time for Niosh to be dismantled. Traditional workplace hazards still remain. In 2023, the last year with available data, there were 5,283 fatal occupational injuries – one every 99 minutes. Violent injuries at work are a growing concern, particularly among healthcare workers. Increasing temperatures caused by climate change place many vulnerable workers at high risk for illness, injury and death, while extreme weather events, such as the wildfires that devastated southern California earlier this year, threaten the health and safety of emergency workers. Emerging technologies such as artificial intelligence are changing the nature of work, presenting new dynamics and hazards.We need Niosh to study these emerging threats and safeguard workers.It remains to be seen what will happen to the remainder of the organization and the programs supported by Niosh throughout the country. Regardless of what occurs, we should support the current and former workers of the organization and carry forward its mission, just as Niosh workers have advocated for the health and safety of workers across this country since the organization’s inception.
Devan Hawkins is a writer and researcher from Massachusetts. He is the author of the book Worthy and Unworthy: How the Media Reports on Friends and Foes More
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My rare disease was getting closer to a cure. RFK Jr could undermine that | Jameson Rich
by Evelyn Reynolds 6 May 2025, 10:00
Since Robert F Kennedy Jr assumed control of the US health department in February, with a mandate to “[lower] chronic disease rates and [end] childhood chronic disease”, he has moved quickly to remake the US’s federal health infrastructure. But the Trump administration’s actions on medical research are already threatening that goal – and could end medical progress in this country for good.Kennedy’s office oversees the National Institutes of Health, the control center of disease research in the United States. Kennedy’s agency has killed almost 800 active projects, according to Nature, affecting medical research into HIV/Aids, diabetes, women’s health, heart disease, cancer, Alzheimer’s and more. The administration wants to cut the NIH’s budget up to 40% while consolidating its 27 agencies – separated by disease area – into just eight. Elon Musk’s Doge has been reviewing previously awarded grant funding, reportedly requiring researchers to explain how they are using their grants to advance the Trump administration’s political goals. (Audio obtained by the Washington Post suggests this “Defend the Spend” initiative may be a smokescreen, with one NIH official admitting: “All funding is on hold.”) Separately, Donald Trump has aggressively targeted universities such as Harvard and Columbia over alleged antisemitism and diversity initiatives, using federal contracts that fund research as leverage. And just recently, the NIH passed a new rule banning any university from receiving future federal grants if the universities use DEI programs or boycott Israeli firms.Medical research is a wonkish issue usually kept far away from political discussions. Even popular initiatives like former presidents Barack Obama and Joe Biden’s cancer moonshot require long-term vision in a political landscape rarely concerned with anything beyond the day’s news. But in recent years, public and private investments in medical research have seeded a wave of potential cures across major disease areas. Now, just as that wave is about to crest, RFK Jr and the Trump administration’s incursion against the NIH threatens to ensure these cures are never finished.For me, the promise of those cures is personal. At three days old, I was diagnosed with a rare version of the most common type of birth defect: congenital heart disease. CHD affects one in every 100 babies born in the US and is the leading cause of birth defect-related deaths. Congenital heart problems can range from a small hole in the heart to being born with only one ventricle. Many defects are underdiagnosed, and chances are good that you know somebody who lives with one. Even JD Vance does: his relative was born with Ebstein’s anomaly, a deformity of the tricuspid valve that has resulted in her now needing a heart transplant at the age of 12.When I was six weeks old, doctors performed the first in a series of three surgeries aimed at correcting the circulation of blood within my heart and between the other organs of my body. The final surgery in that sequence had first been described in medical journals in 1971, and crucial refinements had been made only a few years before I was brought under the knife.Before the surgery’s advent, the prognosis was grim. Many children like me died before their first birthday. Of congenital patients in the 1950s, “half died before the age of twenty”, writes cardiologist Sandeep Jauhar in his book Heart: A History. “In short, they were cardiac cripples, their existence doomed.” But after the surgery, more of us started living into adulthood. Today, most of these patients live at least another 30 years after the operation. My survival past infancy was an accident of history, the product of being born at the right moment in the lifespan of medical research. “Don’t worry,” my first surgeon told my parents when I was a child. “He’s going to long outlive you both.”But my future and the future of others like me is not guaranteed. As I grew up, my doctors acknowledged that the surgery was merely palliative, not curative – a stopgap, medicine’s way of buying me some time. With medicine advancing so quickly, though, we could hope that new solutions would be brought into existence by the time I needed them. In the decades since, we have come to understand the surgery’s long-term consequences: likely progressive damage across organ systems, leading to the need for heart or multi-organ transplants in most patients by the age of 40. Last year, shortly after turning 31, I was formally diagnosed with cardiac cirrhosis and informed that I will need a combined heart-liver transplant within the decade. The time that those early developments bought me seems to be running out.In recent years, as the patient population has grown, more of us have been able to advocate for the need for new solutions. Private foundations have started pouring tens of millions of dollars into research aimed at discovering new treatments and identifying the root causes of birth heart defects so they can be prevented. These foundations have also begun correcting an imbalance in funding – historically, pediatric cancer has received five times the amount of funding that CHD does, despite similar prevalence and mortality rates.I volunteer on the patient board of one such organization, a privately funded non-profit aimed at curing heart defects like mine. With the help of researchers and hospital systems across the country, the organization has been making remarkable progress in a short period of time. But this work relies on the infrastructure of university labs. Even before Kennedy took office, the Trump administration ordered that the NIH change how grant funding is allocated by limiting what are known as “indirect costs”, which go beyond the direct needs of a given study. But often, these costs go into funds that help universities keep their labs running: things like building operations and upgrades, legal compliance and paying researchers. Even with this support, university labs struggle to keep the lights on, and researchers are constantly fighting to secure and retain funding. (The order has since been paused by a federal judge and is the subject of continuing litigation.)Some insist the US shouldn’t be funding research with taxpayer dollars at all. Instead, they would leave the task to pharmaceutical companies and biotech firms. But this fundamentally misunderstands the reality: in the decade leading up to 2020, researchers found, government funding played a role in the development of every new pharmaceutical drug; these drugs are then sold back to patients at a premium. The research that for-profit companies do fund is narrowly focused on things that are guaranteed to make money, or to advance discoveries begun in the public sector. For example, the new blockbuster medication category of GLP-1s – Ozempic, Wegovy, Mounjaro – would not exist without a discovery that was first made by an NIH scientist. When people debate the American healthcare system, they often point to the innovations and cutting-edge treatments we’ve pioneered to support the idea that our system, while flawed, is the best in the world. That impression of a world-class system is due almost entirely to the quality and breadth of our university research infrastructure and our medical schools.Private non-profits, like the one I volunteer with, already fund a large amount of medical research. If more university labs start closing, there will be nowhere for this money to go or for this research to be performed. As Dr Kimryn Rathmell, former director of the National Cancer Institute, told the AP: “Discoveries are going to be delayed, if they ever happen.” The result will be both patients and the government spending even more money on emergency and palliative healthcare. That will only benefit the healthcare profiteers Kennedy claims to be going after: pharmaceutical companies, hospital systems and healthcare entrepreneurs such as Brad Smith, who, by some accounts, has been leading Doge’s firings within HHS.My disease isn’t the only one that will be affected by these cuts. Ongoing research has indicated that targeted mRNA vaccines may show promise in preventing or treating Aids and certain types of cancers. The technology is also being studied for its ability to treat cystic fibrosis, heart failure, sickle cell anemia and other genetic birth defects. But scientists working in these areas through the NIH have already been instructed to strike mention of mRNA vaccines from grant applications and materials, perhaps owing to Kennedy’s hostility towards vaccines and his repeated lies about mRNA technology.If the proposed funding cuts and changes at the NIH are allowed to proceed, Kennedy’s mandate to lower chronic disease rates will fail, and his failure will be obvious. We will see it in rising rates of cancer, birth defects, diabetes and other chronic illnesses. We will see it in the exodus of medical experts to other countries, and the collapse of the researcher pipeline in US universities. We will see the quality of our supposed world-class medical system crash as treatments stagnate. We will pay for this cruelty in blood and lives and lost generations.In truth, today’s congenital heart research has arrived too late to save my own life. My future is at the whim of our broken transplant system, itself already showing signs of strain under Kennedy. But I continue championing the work being done because of the hope that future children won’t be consigned to the same fate. The only thing that will have made the suffering I’ve faced worth it is if I’m a part of the last generation to do so.
Jameson Rich is a writer and film-maker from Massachusetts who covers healthcare and culture More
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Trump to continue Biden’s court defense of abortion drug mifepristone
by Evelyn Reynolds 5 May 2025, 22:16
Donald Trump’s administration on Monday pushed forward in defending US rules easing access to the abortion drug mifepristone from a legal challenge that began during Democratic former president Joe Biden’s administration.The US Department of Justice in a brief filed in Texas federal court urged a judge to dismiss the lawsuit by three Republican-led states on procedural grounds.While the filing does not discuss the merits of the states’ case, it suggests the Trump administration is in no rush to drop the government’s defense of mifepristone, used in more than 60% of US abortions.Missouri, Kansas and Idaho claim the US Food and Drug Administration acted improperly when it eased restrictions on mifepristone, including by allowing it to be prescribed by telemedicine and dispensed by mail.The justice department and the office of Missouri’s attorney general, Andrew Bailey, did not immediately respond to requests for comment.Trump said while campaigning last year that he did not plan to ban or restrict access to mifepristone. Robert F Kennedy Jr, the health and human services secretary, told Fox News in February that Trump has asked for a study on the safety of abortion pills and has not made a decision on whether to tighten restrictions on them.Last year, the US supreme court rejected a bid by anti-abortion groups and doctors to restrict access to the drug, finding that they lacked legal standing to challenge the FDA regulations.Those plaintiffs dropped their case after the high court ruling, but US district judge Matthew Kacsmaryk, a Trump appointee, allowed the states to intervene and continue to pursue the lawsuit.The US justice department moved to dismiss their claims days before Trump took office in January.In Monday’s filing, government lawyers repeated their arguments that Texas is not the proper venue for the lawsuit and that the states lack standing to sue because they are not being harmed by the challenged regulations.“Regardless of the merits of the States’ claims, the States cannot proceed in this Court,” they wrote.The three states are challenging FDA actions that loosened restrictions on the drug in 2016 and 2021, including allowing for medication abortions at up to 10 weeks of pregnancy instead of seven, and for mail delivery of the drug without first seeing a clinician in person. The original plaintiffs initially had sought to reverse FDA approval of mifepristone, but that aspect was rebuffed by a lower court.The Republican-led states have argued they have standing to sue because their Medicaid health insurance programs will likely have to pay to treat patients who have suffered complications from using mifepristone.They have also said they should be allowed to remain in Texas even without the original plaintiffs because it would be inefficient to send the case to another court after two years of litigation. More
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Private firms are trying to fill research gaps, but their ‘puny’ budgets are no match for federal funds
by Evelyn Reynolds 1 May 2025, 11:00
The federal government has slashed research since Donald Trump took office – hacking away at the National Institutes of Health (NIH) and its grants, staff and long-held partnerships with academia.Now, some private companies said they want to pick up strands of research that might have otherwise been funded by the federal government. The effort has stoked little optimism among experts, who caution that private efforts cannot remotely replicate the breadth, depth or public service provided by federal funding.“We can’t wait four years to do any women’s health research,” said Priyanka Jain, co-founder and the CEO of the startup Evvy. The company sells at-home vaginal microbiome tests – a product the company argues can help women better understand common conditions such as bacterial vaginosis.Jain said Evvy is funding a small trial to identify biomarkers, or physical indicators, of how the vaginal microbiome can impact in vitro fertilization (IVF) success rates.“There are companies like Evvy raising venture dollars and doing the work the government is not doing,” said Jain. “Women step up and actually solve this problem.”In contrast, health policy insiders such as Sean Tipton, the chief policy officer at the American Society for Reproductive Medicine, said the many small projects that hope to keep research alive cannot remotely match the retreat of federal government research.“It is absolutely not realistic to think that the resources of the federal government can be replaced through some combination of philanthropic and for-profit entities trying to fill the gap,” said Tipton.The NIH is the world’s largest public funder of biomedical and behavioral research. When Trump took office, the agency had a $48bn budget and funded projects into nearly every area of medicine imaginable – including administration bugbears such as fluoride and vaccine safety.In the first few months of the administration, the health secretary Robert F Kennedy Jr and billionaire Elon Musk’s unofficial “department of government efficiency” have fired 1,300 NIH employees, canceled $2bn in grants, and slowed new grant approval by nearly one-third, pumping $2.3bn less into research.View image in fullscreenA leaked budget proposal would further shrink the NIH by 40% – or tens of billions less that will not go into research. HHS has also canceled more than $11bn in state grants and frozen billions in grants slated for research at Ivy league colleges such as Harvard University. In the latest move, the National Science Foundation, which finances basic research in areas such as astronomy and quantum computing, canceled $2bn more in funding.“In the research space, my organization is proud because we’re now spending in excess of $3m a year on research grants – that is literally a rounding error compared to what the federal government spends,” Tipton said. “We’re very proud of that, and worked very hard to get it up to that level, and that level is puny and inadequate.”The federal government’s backing of scientific research has been fundamental to modern drug discovery. NIH research contributed to 354 of 356 of the drugs approved by the US Food and Drug Administration (FDA) between 2010-2019, a JAMA Health Forum study found.That money has gone to advance blockbuster drugs such as Wegovy and Ozempic – first identified by an NIH-funded researcher and isolated from gila monster saliva by Veterans Affairs researchers – and to the hundreds lesser known FDA-approved treatments.“Tell taxpayers we’re studying gila monsters in a lab – they’ll laugh you out of town, but the first GLP-1 was exenatide, which is a gila monster protein,” said Dr Fred Ledley, the author of the JAMA Health Forum study. Ledley’s favorite example of basic research comes from worms – publicly funded studies of their intestinal development led to the discovery of a trigger of cell death, which now underpins nearly one-third of the new cancer drugs on the market.His research found that for every “first in class” innovative drug brought to market, the NIH funded roughly $1.4bn in research. If government investment was calculated as industry calculates its investment – to include failure and the cost of capital – it is closer to $2.8bn in public funding, or about the equivalent of what industry spends to bring an innovative drug to market.Without NIH’s basic research, there is little hope that the private market will pick up the tab, said Ledley.“It’s too expensive for them,” Ledley said. “What you’ll see industry do is develop more ‘me too’ drugs,’” and “incremental tweaking … This is not what the public wants”.“The public wants something to treat Alzheimer’s with, they want something to prevent diabetes in the first place, and they desperately need better treatments for cancer and heart disease – still the number one killer,” said Ledley.Another indicator of the low likelihood of the industry picking up basic research is in job listings. Since 1 January, listings for research and development positions have fallen 25% based on a “before times” baseline of January 2020 baseline, according to data from job hiring site Indeed. Instead, the private health sector is dominated by demand for services – such as nurses and surgeons.“The government can step in and correct that kind of market failure when something is going to be positive for the society but not necessarily profitable in the market,” said economist Allison Shrivastava, an economist with Indeed. “A lot of this research falls into that category.”Put another way by the Democratic US senator Patty Murray at a recent press conference: “Our public health folks who go out and track measles or track whooping cough or track a new pandemic aren’t going to work for a private company … There isn’t a profit-making course in this.”“In last year’s world we were hoping to get funding” from the federal government for her company’s study, said Jain. She noted that women’s health research has been especially hard-hit by cuts, a victim of “diversity, equity and inclusion” cancellations.“I personally don’t think we should have to raise venture capital money to do this study – that is not the typical use of venture capital money,” said Jain. “Our hope is we survive another four years and the tides turn.” More
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The United States is witnessing the return of psychiatric imprisonment | Jordyn Jensen
by Evelyn Reynolds 27 April 2025, 11:00
Across the country, a troubling trend is accelerating: the return of institutionalization – rebranded, repackaged and framed as “modern mental health care”. From Governor Kathy Hochul’s push to expand involuntary commitment in New York to Robert F Kennedy Jr’s proposal for “wellness farms” under his Make America Healthy Again (Maha) initiative, policymakers are reviving the logics of confinement under the guise of care.These proposals may differ in form, but they share a common function: expanding the state’s power to surveil, detain and “treat” marginalized people deemed disruptive or deviant. Far from offering real support, they reflect a deep investment in carceral control – particularly over disabled, unhoused, racialized and LGBTQIA+ communities. Communities that have often seen how the framing of institutionalization as “treatment” obscures both its violent history and its ongoing legacy. In doing so, these policies erase community-based solutions, undermine autonomy, and reinforce the very systems of confinement they claim to move beyond.Take Hochul’s proposal, which seeks to lower the threshold for involuntary psychiatric hospitalization in New York. Under her plan, individuals could be detained not because they pose an imminent danger, but because they are deemed unable to meet their basic needs due to a perceived “mental illness”. This vague and subjective standard opens the door to sweeping state control over unhoused people, disabled peopleand others struggling to survive amid systemic neglect. Hochul also proposes expanding the authority to initiate forced treatment to a broader range of professionals – including psychiatric nurse practitioners – and would require practitioners to factor in a person’s history, in effect pathologizing prior distress as grounds for future detention.This is not a fringe proposal. It builds on a growing wave of reinstitutionalization efforts nationwide. In 2022, New York City’s mayor, Eric Adams, directed police and EMTs to forcibly hospitalize people deemed “mentally ill”, even without signs of imminent danger. In California, Governor Gavin Newsom’s Care courts compel people into court-ordered “treatment”.Now, these efforts are being turbocharged at the federal level. RFK Jr’s Maha initiative proposes labor-based “wellness farms” as a response to homelessness and addiction – an idea that eerily echoes the institutional farms of the 20th century, where disabled people and people of color were confined, surveilled and exploited under the guise of rehabilitation.Just recently, the US Department of Health and Human Services (HHS) announced a sweeping restructuring that will dismantle critical agencies and consolidate power under a new “Administration for a Healthy America” (AHA). Aligned with RFK Jr’s Maha initiative and Donald Trump’s “department of government efficiency” directive, the plan merges the Substance Abuse and Mental Health Services Administration (SAMHSA), the Health Resources and Services Administration (HRSA) and other agencies into a centralized structure ostensibly focused on combating chronic illness. But through this restructuring – and the mass firing of HHS employees – the federal government is gutting the specialized infrastructure that supports mental health, disability services and low-income communities.The restructuring is already under way: 20,000 jobs have been eliminated, regional offices slashed, and the Administration for Community Living (ACL) dissolved its vital programs for older adults and disabled people scattered across other agencies with little clarity or accountability. This is not administrative streamlining; it is a calculated dismantling of protections and supports, cloaked in the rhetoric of efficiency and reform. SAMHSA – a pillar of the country’s behavioral health system, responsible for coordinating addiction services, crisis response and community mental health care – is being gutted, threatening programs such as the 988 crisis line and opioid treatment access. These moves reflect not just austerity, but a broader governmental strategy of manufactured confusion. By dissolving the very institutions tasked with upholding the rights and needs of disabled and low-income people, the federal government is laying the groundwork for a more expansive – and less accountable – system of carceral “care”.This new era of psychiatric control is being marketed as a moral imperative. Supporters insist there is a humanitarian duty to intervene – to “help” people who are suffering. But coercion is not care. Decades of research show that involuntary (forced) psychiatric interventions often lead to trauma, mistrust, and poorer health outcomes. Forced hospitalization has been linked to increased suicide risk and long-term disengagement from mental health care. Most critically, it diverts attention from the actual drivers of distress: poverty, housing instability, criminalization, systemic racism and a broken healthcare system.The claim that we simply need more psychiatric beds is a distraction. What we need is a complete paradigm shift – away from coercion and toward collective care. Proven alternatives already exist: housing-first initiatives, non-police and peer-led crisis response teams, harm reduction programs, and voluntary, community-based mental health services. These models prioritize dignity, autonomy and support over surveillance, control and confinement.As Liat Ben-Moshe argues, prisons did not simply replace asylums; rather, the two systems coexist and evolve, working in tandem to surveil, contain and control marginalized populations. Today, reinstitutionalization is returning under a more therapeutic facade: “wellness farms”, court diversion programs, expanded involuntary commitment. The language has changed, but the logic remains the same.This moment demands resistance. We must reject the idea that locking people up is a form of care. These proposals must be named for what they are: state-sanctioned strategies of containment, rooted in ableism, racism and the fear of nonconformity.Real public health does not rely on force. It does not require confining people or pathologizing poverty. It means meeting people’s needs – through housing, community care, healthcare and support systems that are voluntary, accessible and liberatory.As budget negotiations in New York continue to drag on – with expansions to involuntary commitment still on the table – and as RFK Jr advances carceral care proposals at the federal level, we face a critical choice: will we continue the long history of institutional violence, or will we build something better – something rooted in justice, autonomy and collective wellbeing?The future of mental health care – and of human dignity itself – depends on our answer.
Jordyn Jensen is the executive director of the Center for Racial and Disability Justice at Northwestern Pritzker School of Law More
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How idea of charging women with murder infiltrated the anti-abortion movement
by Evelyn Reynolds 23 April 2025, 16:05
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View image in fullscreenSo far this year, lawmakers in at least 12 states have introduced legislation that would treat fetuses as people and leave women who have abortions vulnerable to being charged with homicide – a charge that, in several of these states, carries the death penalty.Once seen as politically toxic, this kind of legislation has become more popular in the years since Roe v Wade fell, erasing the national right to abortion. This likely comes as no surprise to Mary Ziegler, a professor at the University of California, Davis School of Law and one of the foremost commentators on the US abortion wars. The anti-abortion movement, she writes in her new book Personhood: The New Civil War Over Reproduction, has really “always been a fetal-personhood movement” – one that is so emboldened, it is increasingly unconcerned with public opinion or even democratic norms.Fetal personhood is the belief that embryos and fetuses deserve the legal rights and protections afforded to people. If taken to its logical conclusion in US law, this belief would not only totally outlaw abortion, but also risk pitting the rights of fetuses against the rights of the women carrying them in all kinds of circumstances. In the first year after the US supreme court overturned Roe, at least 200 people were prosecuted for conduct relating to their pregnancies. Most of these cases involved charges of child endangerment, abuse or neglect – language that treats fetuses as children.A Guggenheim fellow who has published seven books on reproduction and abortion, Ziegler has long seen the fight for fetal personhood as the throughline in the anti-abortion movement’s centuries-long history. In recent years, with Roe gone, she grew convinced that the movement was no longer willing to pull punches in that fight. “The trajectory has been more and more punitive, more focused on saying: ‘Justice for the fetus means punishing a larger group of people that encompasses not just doctors, but people who assist them, and potentially abortion seekers themselves,’” she said in an interview.View image in fullscreenPersonhood, which was released Tuesday, argues that the anti-abortion movement did not have to be so punitive. While anti-abortion activists have never agreed on how to best implement fetal personhood, they over time started to take more cues from Republican politicians, whose own veneration of “law and order” grew alongside its antagonism toward a social safety net. Those developments ultimately paved the way for the more extreme anti-abortion activists to grab more power within the movement.After Roe legalized abortion nationwide in 1973, anti-abortion activists organized in support of an amendment to the US constitution that would recognize embryos and fetuses as people. (The effort never gained the political traction it needed to become a serious possibility.) Around the same time, some activists broke with mainstream anti-abortion groups to push for policies that would offer more support for pregnant women, rather than just ban abortion.Yet the voices advocating for better daycare and housing for mothers faded away as the anti-abortion movement tightened its alliance with the Republican party. Anti-abortion activists understood that, by portraying fetuses as defenseless victims of the ultimate crime, they could energize conservative voters – and open their pockets.“The Republican party, from the Reagan era onward, has really equated a kind of justice and equality with punishing wrongdoers,” Ziegler said. “It’s a natural fit for the anti-abortion movement: the more its fortunes relied on Republican politicians, the more it framed things the same way.”State-level bans on abortion still do not technically punish abortion patients. (Instead, it’s abortion providers, long positioned by the movement as coercing or confusing women into the procedure, and sometimes the people who help them, who are at risk of criminal consequences.) But, over the last few years, self-described “abortion abolitionists” have slowly migrated out of the fringes of the anti-abortion movement and moved towards its center. Unlike mainstream “pro-lifers”, “abolitionists” believe that, if a fetus is a person and abortion is the murder of that person, women should be punished accordingly: as murderers.Neither “pro-lifers” nor “abolitionists” are particularly popular. After Roe’s collapse enabled states to make their own abortion laws, several states – including GOP strongholds like Ohio and Missouri – passed ballot measures to protect abortion rights. According to Gallup, 85% of Americans think that abortion should be legal in all or some circumstances, while a 2024 survey from the 19th News and SurveyMonkey found that 41% of Americans think “a fetus has rights starting at conception that should be protected by the government.”Even people who support fetal personhood can have tangled, even contradictory views on the matter. Only 9% of people think that the government should restrict access to in vitro fertilization, or IVF, even though IVF as it is currently practiced frequently involves the destruction or abandonment of embryos.None of the bills that allow abortion patients to be charged with homicide are likely to pass this year, but Ziegler doesn’t think “abolitionists” are going anywhere, for two reasons. First, the anti-abortion movement maintains a strong grip in southern Republican-dominated state legislatures, where many of these bills have emerged. Second, Ziegler believes that the anti-abortion movement is embracing “a conviction that it matters less what voters think and more what judges think”.“If you don’t worry about what you’re doing being unpopular, and you believe that ideological consistency, or even logical consistency, is paramount, you would be more inclined to go with an abolitionist argument, and you might worry less about that having political fallout in a politically uncompetitive state,” Ziegler said. “You don’t need to convince most Americans you’re right. You only need to convince five justices on the supreme court.”With abortion bans proving deeply unpopular in the US, circumventing popular will has become a necessity for an increasingly hardline movement. And by relying on the courts rather than voters, the anti-abortion movement can afford to ignore voters’ misgivings.The movement has abandoned its earlier goal of amending the US constitution to recognize fetal personhood; instead, the anti-abortion movement is now seeking to convince courts that the 14th amendment, which guarantees the right of due process and equal protection, already recognizes embryos and fetuses as people from the moment of conception. It is, according to Ziegler, yet another sign of the movement’s drift away from democratic norms.View image in fullscreenThis interest in the 14th amendment is also something of an about-face for the anti-abortion movement, which is predominantly white and has had a convoluted relationship with race for more than a century. At the time that the amendment passed, as part of a post-civil war effort to recognize Black people’s rights, anti-abortion leaders “didn’t want to talk about race because they weren’t sure that people of color were persons with rights”, Ziegler said. Over time, the anti-abortion movement began using the language of civil rights and affirmative action – but primarily to argue that fetuses are the greatest victim of discrimination.“I think that’s one of the reasons fetal personhood language has been resonant for so long,” Ziegler said of the movement’s co-option of civil rights rhetoric. “It gives people a way to talk about equality and a way to elevate somebody as a victim of discrimination in a way that makes sense to a largely white group of conservatives.”As Roe recedes further into the rearview mirror, Ziegler expects the movement to become even more committed to some of the most unpopular implications of fetal personhood, such as restrictions on IVF. Although Republican politicians have shied away from limiting access to the treatment, the anti-abortion movement has grown more strident on the topic. Some of its leaders even condemned Donald Trump for his recent executive order supporting IVF.“I think the anti-abortion movement is going to be still full steam ahead,” Ziegler said. “There’s an increasing sentiment in the movement that this is not about pleasing Republicans. This is not about pleasing voters. This is about the importance of this, ideologically, to the people involved.” More
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RFK Jr’s autism study collecting Americans’ private medical records
by Evelyn Reynolds 22 April 2025, 16:19
The National Institutes of Health (NIH) is collecting the private medical records of many Americans from several different federal and commercial databases to give to researchers for US health secretary Robert F Kennedy Jr’s new autism study.With this information being included in the database, the NIH is also reportedly crafting a new registry to track those with autism, per CBS News.The health agency claims it was doing so to fulfill a controversial promise the secretary of health made to root out the cause of autism by September, despite some experts saying that Kennedy’s goal is not even feasible.“If you just ask me, as a scientist, is it possible to get the answer that quickly? I don’t see any possible way,” Dr Peter Marks said on CBS’s Face the Nation earlier this month.On the collection of data, the director of NIH, Jay Bhattacharya, told advisers during a presentation on Monday that the aim was to help researchers study autism by giving them access to “comprehensive” patient data and health records.He added that these records would cover a “broad range” of people across the US.“The idea of the platform is that the existing data resources are often fragmented and difficult to obtain. The NIH itself will often pay multiple times for the same data resource,” he said in the presentation. “Even data resources that are within the federal government are difficult to obtain.”Bhattacharya added that the NIH was also discussing a potential expansion of the agency’s access to data from the Centers for Medicare and Medicaid Services.The study also plans to link medication records from pharmacies, lab testing and genomics data from patients treated by the Department of Veterans Affairs and Indian Health Service, claims from private insurers and data from smartwatches and fitness trackers.Between 10 and 20 outside research teams will be selected and given grants to study the data, according to CBS News.Bhattacharya said that compiling this data could also potentially give health agencies a window into “real-time health monitoring” on Americans for studying other health problems beyond autism.“What we’re proposing is a transformative real-world data initiative, which aims to provide a robust and secure computational data platform for chronic disease and autism research,” he said.Bhattacharya echoed Kennedy’s words that some answers as to the cause of autism would be discovered by September, but he added that the study would be “an evolving process”.The news followed Kennedy’s first press conference in which he claimed that a significant and recent rise in autism diagnoses was evidence of an “epidemic” caused by an “environmental toxin” despite the evidence collected by health researchers.The Guardian has contacted the NIH for comment. More
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US supreme court hears challenge to Obamacare free preventive healthcare
by Evelyn Reynolds 21 April 2025, 19:11
The US supreme court on Monday heard arguments in a case that could threaten Americans’ access to free preventive healthcare services under the Affordable Care Act, commonly known as Obamacare.At issue is the constitutionality of the US preventive services taskforce, which plays a critical role in determining which preventive services health insurers must cover without cost to patients. The 16-member panel of medical experts, appointed by the health secretary without Senate confirmation, has designated dozens of life-saving screenings and treatments as essential preventive care.If the justices uphold the lower court’s ruling, health associations said in a filing, life-saving tests and treatments that have been cost-free would become subject to co-pays and deductibles, deterring many Americans from obtaining them.The case represents the latest in a long series of legal challenges to Barack Obama’s signature healthcare legislation to reach the nation’s highest court since its passage in 2010. A big critic of the program during his first term, Trump and his administration have now taken over the case after the Biden administration initially filed the appeal.In oral arguments, the justices posed sharp questions over whether the law gives the HHS secretary the appropriate level of supervision over the taskforce, including the power to influence its recommendations and fire members at will, or if the group operates as a largely independent governmental body whose recommendations effectively have the force of law.Jonathan Mitchell, the conservative lawyer representing the plaintiffs who previously represented Trump in ballot access litigation, insisted that taskforce members are “principal officers” because “their preventive care coverage mandates are neither directed nor supervised by the Secretary of Health and Human Services”.Mitchell’s argument hinges on interpreting statutory language requiring the task force to be “independent” and “protected from political pressure”, which he argues is incompatible with secretary oversight: “We don’t see any way that statutory language can be squared with the regime envisioned by the government,” he told the justices.Several justices appeared skeptical of Mitchell’s reading of the statute, with Justice Elena Kagan questioning whether Congress would create a board without specifying who appoints its members: “I mean, it would be an odd statute. I doubt you could find another where Congress has set up a board and … just not said who should appoint.”The taskforce is made up of medical experts who serve four-year terms on a volunteer basis. It reviews medical evidence and public feedback and issues recommendations about which preventive services would be most effective for detecting illnesses earlier or addressing ailments before a patient’s condition worsens.The taskforce has identified dozens of preventive services as having a high or moderate net benefit to patients including screenings to detect diabetes and various types of cancer, statin medications to lower the risk of heart disease and stroke, and interventions to help patients quit smoking or unhealthy alcohol use.The New Orleans-based fifth US circuit court of appeals ruled in 2024 that the taskforce’s structure violates the constitution, as the plaintiffs claimed. The government’s appeal of the fifth circuit’s decision initially was filed by Biden’s administration before being taken up by Trump.Trump’s administration argued in a supreme court brief that the taskforce’s preventive care recommendations cannot become legally binding on insurers without the HHS secretary’s permission.“The secretary can remove them at will, and the threat of removal is the ultimate tool for control over final decisions on recommendations,” justice department lawyers wrote.For this and other reasons, justice department lawyers argued, the taskforce’s members should be seen as so-called “inferior officers”, meaning they can be lawfully appointed by an executive branch department head – like the HHS secretary – and do not require Senate confirmation under the constitution.In a supreme court filing, the plaintiffs argued that the Affordable Care Act has transformed the longstanding taskforce from an advisory body into one that now issues “decrees” to insurers, adding that the HHS secretary has no authority to stop taskforce recommendations from becoming binding law.The taskforce’s lack of supervision, they argued, makes its members “principal officers” who must be presidentially appointed and Senate confirmed under the constitution.Before the case was narrowed to the appointments issue, the lawsuit included a religious objection to being required to cover pre-exposure prophylaxis for HIV. They claimed that such drugs “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use”.The fifth circuit’s ruling also rejected the government’s request to remove certain offending words from the Obamacare provision at issue – a process called severing – in order to make that part of the law conform to the constitution. That issue was also part of the appeal before the supreme court.The supreme court’s decision was expected by the end of June. More

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