Analysis | Abortion ballot measures won’t automatically undo existing laws (2024)

Abortion waiting periods, required counseling pose hurdles to ballot measures

On Tuesday, a judge in Michigan blocked some of the state’s lingering restrictions on abortion access, including a mandatory 24-hour waiting period. The ruling comes 19 months after voters added abortion rights to the state constitution in November 2022.

Michigan was one of the first states to protect abortion access at the ballot box after the Supreme Court overturned federal abortion protections in Dobbs v. Jackson Women’s Health Organization in 2022. But the amount of time some abortion restrictions in the state have remained on the books serves as a caution to other states holding similar votes. Election results may not be as clear-cut as you might think.

This year, voters in as many as 12 more states, including Missouri, could weigh in on abortion. Here, as in most of those states, a likely ballot measure would add abortion protections to the state constitution.

Abortions in Missouri have been banned in nearly every circ*mstance since the Dobbs ruling. But the procedure was largely halted here years earlier by a series of laws designed to make abortions scarce. These laws are sometimes called “targeted regulation of abortion providers,” or TRAP, laws.

By 2021, the last full year before Dobbs opened the door for Missouri’s ban, the state recorded only 150 abortions, down from 5,772 in 2011.

Even if Missouri voters enshrine abortion protections in the state constitution this year, state regulations such as a 72-hour waiting period and minimum dimensions for procedure rooms and hallways in clinics that provide abortions would remain on the books.

Such laws likely wouldn’t be overturned legislatively under a Republican-controlled legislature and governor’s office. But they will surely face legal challenges, which could take a while.

The lawsuit that led to Tuesday’s ruling in Michigan, for example, was filed 15 months after voters added abortion protections to the state’s constitution.

The delay had a purpose, according to Elisabeth Smith, state policy and advocacy director at the Center for Reproductive Rights, which filed the lawsuit: It afforded the Democratic-led legislature time to act. It’s often more effective to change laws through the legislature than through litigation because the courts can only strike down a law, not replace one.

Michigan did pass an abortion rights package that was signed into law by the state’s Democratic governor, Gretchen Whitmer, in December. But the package left some regulations intact, including the mandatory waiting period, mandatory counseling and a ban on abortions by non-doctor clinicians, such as nurse practitioners and midwives.

Abortion opponents such as Katie Daniel, state policy director for Susan B. Anthony Pro-Life America, are critical of the Michigan lawsuit and such policy unwinding efforts.

“The litigation proves these amendments go farther than they will ever admit in a 30-second commercial,” Daniel said.

Of the seven states that have voted on abortion since Dobbs, Ohio may be the most politically similar to Missouri.

Last year, Ohio Attorney General Dave Yost, an antiabortion Republican, said passing an amendment to protect abortion rights would upend at least 10 state laws limiting abortions.

Voters passed the measure with nearly 57 percent of the vote, but most of those state laws — including a 24-hour waiting period and a 20-week abortion ban — continue to govern Ohio health providers.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism.

Biden, Trump spar over abortion, Medicare, covid in first debate

Health care got some airtime in last night’s first general election debate between President Biden and former president Donald Trump in Atlanta. Here’s a snapshot of some key moments:

On abortion: Biden offered a meandering response in reiterating his support for abortion as outlined in Roe v. Wade, while Trump said the issue should be left to the states and backed exceptions for rape, incest and the life of the mother.

When asked directly, Trump said he would not block access to the abortion pill. But antiabortion activists are already circulating names of staunch antiabortion advocates to run a Trump Food and Drug Administration, which could unilaterally reinstitute restrictions on mifepristone, our colleague Caroline Kitchener writes.

On Medicare: After appearing to argue that Americans need their government to strengthen the health-care system, Biden stumbled on his words and ended with the line: “We finally beat Medicare,” our colleagues Patrick Svitek, Maegan Vazquez and Mariana Alfaro report.

“He’s right, he did beat Medicaid, beat it to death,” Trump responded, claiming without evidence that Biden was destroying Social Security and Medicare “because millions of people are pouring into our country.”

On covid: Trump chided Biden for vaccine and mask mandates during the pandemic, but it’s worth noting that Trump lost the 2020 election, in part, because of his mishandling of the coronavirus, The Post’s Yasmeen Abutaleb notes.

The battle brewing over 1-800-MEDICARE

New this a.m.: The White House’s decision to abruptly cancel a $6.6 billion contract to run the Medicare call line has sparked a bitter feud between a powerful labor union, a prominent federal contractor and politicians on Capitol Hill, our colleague Dan Diamond reports.

Catch up quick: Officials at the Centers for Medicare and Medicaid Services cited concerns about customer service when it severed ties with Maximus Federal Services in December, just 15 months after it signed a 9-year contract with the McLean, Va., company.

The agency also amended the contract to add a “labor harmony agreement,” essentially a pledge by participating companies that they will make peace with unions and not experience a labor stoppage affecting the call centers. Bids on the revised contract are due today.

The response: Maximus filed a protest with the Government Accountability Office last week, urging the federal watchdog to investigate the decision to rebid a contract the company spent years working to win. The Biden administration has defended its decision, pointing to walkouts at Maximus-run call centers last year.

News of the rebid has also landed with a thud with congressional Republicans, who have accused the White House of delivering an election-year favor to the Communications Workers of America. The union has thrown its support behind Biden.

Democrats appear split on the matter. Some have raised concerns that switching to a new contractor could be disruptive. But others say the action is overdue and that Maximus had long mistreated its workers by offering low wages and limited benefits.

SCOTUS rejects Purdue Pharma opioid settlement plan

A divided Supreme Court blocked a controversial proposed Purdue Pharma bankruptcy plan set to provide billions of dollars to help address the toll of opioids in exchange for protecting the family that owns the company from future lawsuits, The Post’s David Ovalle and Justin Jouvenal report.

In a 5-4 decision that scrambled ideological lines on the Supreme Court, the majority found that the U.S. bankruptcy code doesn’t allow parties who didn’t file for bankruptcy to be shielded from lawsuits by claimants who didn’t consent to give up their rights to sue. The ruling means states and other parties suing Purdue will restart negotiations.

In a fiery dissent, Justice Brett M. Kavanaugh said the ruling “is wrong on the law and devastating for more than 100,000 opioid victims and their families.” He was joined by conservative Chief Justice John G. Roberts Jr. and liberal Justices Sonia Sotomayor and Elena Kagan.

Meanwhile …

Hospitals in Idaho that receive federal funds must allow emergency abortion care to stabilize patients for now, despite the state’s strict ban on the procedure, the Supreme Court officially ruled yesterday, one day after the opinion was prematurely posted on its website.

For more: Our colleagues Ann E. Marimow and Dan Diamond published a closer look on the decision and what comes next in the ongoing legal battle. For insights into how the ruling will affect patients and doctors, check out this dispatch from Caroline Kitchener and Dan.

Our colleague Fenit Nirappil sends this note:

North Carolina will reinstate restrictions on masking after state lawmakers voted to override a veto by Gov. Roy Cooper (D), who said the bill threatens to criminalize masking for health reasons despite an exception in the bill.

The vote came as a movement to restore pre-pandemic mask restrictions gains steam in response to pro-Palestinian protests. New York Mayor Eric Adams (D) on Thursday lent his support to a campaign to crack down on masking in response to Jewish people being harassed by people concealing their faces, while Los Angeles Mayor Karen Bass (D) said this week that she was exploring ways to penalize masking at protests.

We wrote this week about the debate over mask restrictions and its impact on public health and civil liberties. Read the full story here.