KHN’s ‘What the Health?’: Roe v. Wade on the Rocks

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Judging by oral arguments this week, the Supreme Court appears ready to uphold a Mississippi law barring most abortions after 15 weeks of pregnancy — and possibly to overrule Roe v. Wade in the process, which has guaranteed American women the right to an abortion for nearly a half-century.

Meanwhile, Congress is struggling to keep the lights on for the federal government, with a small group of Republicans threatening to block further spending unless the Biden administration agrees to drop its vaccine mandates.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet and Shefali Luthra of The 19th.

Among the takeaways from this week’s episode:

• During Supreme Court arguments over the Mississippi abortion law, some liberal justices questioned whether anything had changed in the country that should cause the court to reverse the long-standing precedent. One historic event, however, did play a key role in the case: the September 2020 death of Justice Ruth Bader Ginsburg, who was a staunch defender of the right to abortion, and her subsequent replacement by Justice Amy Coney Barrett, who has written about her concerns with the Roe opinion. In fact, the court delayed for months a decision on whether to take the Mississippi case, doing so only after Ginsburg’s death.
• When Mississippi initially petitioned for relief from the Supreme Court — after its abortion law had been overturned by lower federal courts — the state said it sought only the ability to reduce the time frame for permissible abortions from the current standard of roughly 24 weeks to 15 weeks. But once the case was accepted, Mississippi changed its arguments and asked the court to overturn the full effect of the Roe decision.
• The attorney representing Mississippi’s abortion clinic and the U.S. solicitor general argued to the court that if Mississippi is allowed to ban most abortions after 15 weeks, there will be nothing to stop other states from establishing even tighter time frames.
• The justices just last month rushed to hear a case in which Texas is seeking to ban abortions after six weeks. Those arguments had more to do with the legal process for appealing the law and the unusual enforcement of that law, so a decision in the Texas case won’t necessarily indicate much about the justices’ thinking on the Mississippi law or abortion rights in general.
• Nonetheless, the Texas situation is affecting Mississippi’s sole abortion clinic. The court allowed the Texas law to go forward during the legal review, effectively shutting down most abortion services in the state. Many Texas residents seeking abortions must now travel to get the procedure, and many are heading to Mississippi’s clinic.
• Congress has a long to-do list before heading home at the end of the year: It has not yet resolved spending bills or extended the debt ceiling. Those priorities could force Senate Majority Leader Chuck Schumer to push back final votes until 2022 on the Build Back Better legislation, which would fund President Joe Biden’s social policy agenda.
• The Senate parliamentarian is going through that massive bill to make sure each provision is primarily about federal spending; otherwise, the legislation could be subject to a filibuster.
• The emergence of a new covid variant is raising questions, but public health officials say it is too early to know whether the omicron mutation will prove more virulent or transmissible. Concerns, however, might jump-start efforts to get vaccinated people to seek a booster shot.
• One thing public health officials are sure of is the need to bolster testing. The Biden administration is set to announce that, starting in January, it will require insurers to cover the cost of at-home tests for plan members. Excluded from that mandate: Medicare and Medicaid beneficiaries.
• That insurance mandate would help many people given the tests’ significant costs in the U.S. But a bigger problem seems to be getting access to the tests. At this point, they are not in adequate supply.

Also this week, Rovner interviews Blake Farmer of Nashville Public Radio, who reported and wrote the latest KHN-NPR “Bill of the Month episode” about a couple and their very different emergency room bills. If you have an outrageous medical bill you’d like to send us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: KHN and PBS NewsHour’s “How Unresolved Grief Could Haunt Children Who Lost a Parent or Caregiver to COVID,” by Sarah Varney and Jason Kane.

Alice Miranda Ollstein: The Washington Post’s “Long Overstretched, Abortion Funds in D.C., Maryland and Virginia Mobilize for an Uncertain Future,” by Rebecca Tan.

Sarah Karlin-Smith: Axios’ “The Push to Revive an Industry-Backed Medical Device Rule,” by Bob Herman.

Shefali Luthra: The 19^th’s “‘Am I Even Fit to Be a Mom?’ Diaper Need Is an Invisible Part of Poverty in America,” by Chabeli Carrazana.

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