SMFM Health Policy and Advocacy Updates (March 2024)

A Health Policy and Advocacy Update - March 2024

Thank you for your participation in the Society for Maternal-Fetal Medicine’s State Liaison Network (SLN). Our quarterly newsletter brings you the latest advocacy, policy, and public health updates, happenings, and actions from the Society.

In this issue, you'll find:

Update on Mifepristone Court Cases
State Liaisons in Action
SMFM Actions and Updates
State Happenings
Action Opportunities
SMFM and Partner Resources
What We're Reading

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UPDATE ON MIFEPRISTONE COURT CASES

On March 26, the United States Supreme Court heard oral arguments for Food and Drug Administration v. Alliance for Hippocratic Medicine, the case that could upend access to mifepristone. Several justices were skeptical of the plaintiff’s arguments, questioning the extent of the claimed injury.

SMFM members, staff, and friends joined hundreds of our allies at a rally in front of the court to proudly show our support for mifepristone and abortion access. Speakers at the rally included patient and provider storytellers, state legislators and attorneys general, and more.

The Supreme Court is expected to issue a decision in the case this June.

STATE LIAISONS IN ACTION

Maryland – Dr. Clark Johnson advocated for several bills, including one to amend reimbursement for maternal fetal medicine services.

Idaho – Dr. Stacy Seyb continued to advocate for the reinstatement of Idaho’s maternal mortality review committee. His efforts were successful, as the Governor signed H.399 on March 18!

Indiana – Dr. Carrie Rouse spoke at the Indiana State House on multiple bills, including in opposition to SB 98 which would have established a tax credit for a fetus.

Iowa – Drs. Emma James and Andrea Greiner continue to advocate for postpartum Medicaid extension without lowering eligibility, as current legislation would.

Tennessee – Dr. Sarah Osmundson was featured in The Atlantic’s “Inside a Hospital’s Abortion Committee.”

Washington – Dr. Dale Reisner advocated for several bills, including HB 2115, which would allow providers to replace their names with clinic names on prescriptions used for medication abortion.

Have you been advocating for reproductive and perinatal health in your state? Share your work with SMFM by emailing Samantha Berg at [email protected].

SMFM ACTIONS AND UPDATES

Amicus Briefs

SMFM continues to submit friend of the court briefs to protect access to health care services critical to our mission. In January, we filed an amicus brief in a district court in Iowa outlining the importance of abortion access and opposing their 6-week ban.

In February, we filed two amicus briefs with the Supreme Court of Montana. The first brief argues the importance Medicaid coverage of abortion, and the second brief outlines the safety of dilation and evacuation abortions.

We also continue to file briefs outlining the safety of mifepristone as its FDA approval is battled out in court. One amicus brief was filed in the Fourth Circuit Court of Appeals for Gen Bio Pro v. West Virginia, while another amicus brief was submitted to the Supreme Court for Food and Drug Administration v. Alliance for Hippocratic Medicine.

STATE HAPPENINGS

Perinatal health advancements

As of the beginning of 2024, only four states had yet to extend postpartum Medicaid to 12 months. After Idaho's Governor signed H.633 this week, only 3 states remain – Arkansas, Iowa, and Wisconsin.

In Iowa, the Senate passed SF 2251, which would extend postpartum Medicaid to 12 months but reduce eligibility from 300% of the federal poverty limit (FPL) to 215% FPL. The bill is currently in the House.

On the other side of the spectrum, Washington passed a law to expand Medicaid eligibility for pregnant and postpartum people to 210% FPL.

Following the sunsetting of their maternal mortality review committee last year, the Idaho legislature passed H.399, a bill that authorizes the Board of Medicine to reestablish the committee.

Celebrating abortion access wins

In the last three months, several states have taken action to protect and expand access to abortion care.

In early March, the Washington legislature passed HB 2115, which would allow providers to replace their names with clinic names on prescriptions used for medication abortion. The bill is currently with the Governor.

A few days later, the Virginia legislature passed two bills. The first, SB 15, is a shield law that protects Virginia citizens who violate other state laws around providing or assisting with reproductive health care services as long as actions do not violate Viriginia state law. The second, SB 716, prohibits the Board of Medicine from taking disciplinary action against a physician who provides or receives abortion care that is not prohibited under state law, regardless of where the care was provided or received. This bill also prohibits the Board from refusing to issue a certificate or license to an applicant for providing or receiving an abortion that is not prohibited under state law. Both bills are with the Governor.

Last week, the Governor of Wyoming vetoed HB 0148, which would have established any “surgical abortion facility” as an ambulatory surgical center, requiring additional licensing.

Monitoring abortion bans and restrictions

Earlier this month, South Carolina’s Governor enacted HB 4159, banning the use of telehealth to prescribe medication abortion.

Last week, the Idaho legislature passed H. 666, which prevents abortion providers from also providing materials or instructions related to sex education curricula.

This week, South Dakota’s Governor enacted HB 1224, which requires the state to create an informational video and other materials describing the state’s abortion laws and medical care for pregnant patients experiencing health- and life-threatening conditions.

As of March 25, 2024, 21 states have abortion bans up to 20 weeks gestation currently or soon to be in effect: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, and West Virginia.

14 of these states (Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, North Dakota, South Dakota, Tennessee, Texas, West Virginia) have total bans.

For up to date information on state abortion policies, see resources from Abortion Finder, Guttmacher Institute and the New York Times. You can also track pending state legislation alongside SMFM staff on our Advocacy Hub .

TAKE ACTION

Share Anonymous Stories of Clinical Care

SMFM is regularly approached by policymakers and reporters who want to better understand the impacts of abortion restrictions on high-risk pregnant people and MFMs. One powerful way for MFMs to influence public policy and public understanding of abortion is to share their lived experiences. Recognizing that many MFMs may not be permitted to and/or are hesitant to describe what is happening with their patients in public forums, SMFM has created an anonymous story collection tool. Learn more and share your story here.

Track Policies and Submit a Request for Advocacy Support

Get more involved in advocacy in your state by tracking policies alongside SMFM staff and using our Request Support form to get assistance from Advocacy staff.

SMFM AND PARTNER RESOURCES

SMFM's Advocacy Blog

SMFM members and partners continue to publish pieces on our Advocacy Blog.

The latest blog comes from our partners at Democracy Forward. They outline what's at stake in the mifepristone case that was recently heard at the Supreme Court.

Another recent post, "No Politician Should Play Doctor," was written by Drs. Justin Lappen and Leilah Zahedi-Spung in response to the Texas lawsuit on behalf of Kate Cox.

Guttmacher Monthly Provision Study

Guttmacher Institute’s Monthly Provision Study tracks monthly estimates of medication and procedural abortions provided within the formal US health care system. It currently shows monthly data for all of 2023 and is designed to help measure the impacts of abortion policies on state-level abortion incidence and trends. According to the data from 2023, medication abortion accounted for 63% of all abortions last year.

National Partnership for Women and Families and Physicians for Reproductive Health Issue Brief

This week, the National Partnership for Women and Families and Physicians for Reproductive Health (PRH) released a new analysis on the impact of the Dobbs v. Jackson Women’s Health Organization decision on the abortion provider workforce ).

The Issue Brief features individual stories from PRH fellows from across the country and provides critical context and data to the experiences PRH’s provider network has been sharing both before and following the Supreme Court’s decision.

Society of Family Planning: New #WeCount Report

#WeCount is a time-limited reporting effort that aims to capture the shifts in abortion volume, by state, by month, following the Dobbs v Jackson’s Women’s Health Organization Supreme Court decision to overturn Roe. At the end of February, the Society of Family Planning released its latest report, outlining changes in abortion volume over the last 15 months.

WHAT WE'RE READING

“Abortion rights clashes with NIMBYism in California,” Politico

“Children Born to Mothers With Pregnancy Complications Face Higher Heart Risks,” The New York Times

“CVS and Walgreens Will Begin Selling Abortion Pills This Month,” The New York Times

“Did an abortion ban cost a young Texas woman her life?” The New Yorker

“‘Fleeing under the cover of darkness’: How Idaho’s abortion ban is changing pregnancy in the state,” CNN

“Google promised to delete location data on abortion clinic visits. It didn’t, study says,” The Guardian

“'I wasn’t allowed to get the healthcare I needed': the women suing Tennessee for being denied abortions,” The Guardian

“In the fight over abortion rights, the government bans its first company from tracking medical visits,” Politico

“‘Jane Roe’ is anonymous no more. The very public fight against abortion bans in 2023,” NPR

“The Least Understood Impact of Abortion Bans,” Slate

“Man accused of putting abortion-inducing drug in wife’s water takes deal, to serve 180 days in jail,” ABC13 News