Missouri ramps up the fight against abortion access

Mar 21, 2022

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QUICK FIX

— A proposed law would target people who help residents of Missouri get abortions, even if they're not in Missouri. It's a major escalation in the conservative push to limit abortion access.

— The CDC is asking staff to help overhaul its data surveillance system, part of the agency's push to improve its public health data infrastructure.

— Nearly all the 50 U.S. counties with the highest Covid-19 death tolls were in rural areas, according to a new POLITICO investigation.

WELCOME TO MONDAY PULSE — It's official. We're at stage 5 — better known as the "puffy white" phase — of cherry blossom season, according to the National Park Service. Send your tidal basin selfies, news and tips to kmahr@politico.com and sowermohle@politco.com.

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ICYMI: A majority of Americans reject so-called government "negotiation" once they learn it could restrict access and choice and chill the innovation of new treatments and cures. The survey also shows a majority find health care coverage costs unreasonable and a top priority health care issue for policymakers to address today.

Driving The Day

THE ABORTION FIGHT ESCALATES — A proposed amendment in Missouri would allow citizens to sue individuals who help Missouri residents get an abortion — even if they live outside the state, write POLITICO's Alice Miranda Ollstein and Megan Messerly.

The proposed policy comes as a growing number of women seek abortions outside their home states amid tightening abortion access. It marks a major escalation of the conservative push to limit abortion access ahead of a Supreme Court ruling this year that could sharply limit or overturn Roe v. Wade.

The Missouri legislation would allow people to sue out-of-state doctors who perform abortions and people who provide transportation to women seeking abortions. The amendment attempts to evade legal challenges by adopting the same private enforcement mechanism as Texas' six-week abortion ban. Both policies allow a judge to award at least $10,000 in damages if the citizen's suit is successful.

Republican state Rep. Mary Elizabeth Coleman says the policy is designed to target a Planned Parenthood clinic in Illinois across the river from St. Louis. It opened in 2019 with the explicit goal of serving patients from Missouri, which has one of the nation's strictest abortion laws.

If successful, the proposed legislation could serve as a model for other states seeking to stop their residents from accessing abortion out of state.

CDC GETS SERIOUS ABOUT DATA — Leaders at the Centers for Disease Control and Prevention are urging staff to get behind the Data Modernization Initiative, a far-reaching plan to strengthen the agency's health surveillance infrastructure, write POLITICO's Erin Banco and Krista.

In a March 16 email, Dan Jernigan, the CDC's deputy director for Public Health Science and Surveillance, points his staff to a letter from CDC Director Rochelle Walensky that asked agency employees to back the plan to overhaul how public health data is shared and accessed.

It's an important sign that the CDC is getting serious about fixing the data gaps that hampered its Covid-19 response, due in large part to an antiquated and aggregate public health data infrastructure.

Jernigan told POLITICO the modernization effort will include unifying state and federal public health data systems, ensuring the CDC is relying on up-to-date information that can be used in real time and helping states hire staffers to work on data collection and analysis.

"The data issues are real," former CDC director Jeffrey Koplan said during a panel hosted by Yale University last week. "It's really inconceivable that we're unable to get common measures from state to state to federal. This undermines what we're trying to do and that needs to be corrected."

WHERE RURAL HOSPITALS CLOSED , COVID DEATHS FOLLOWED — A new POLITICO investigation lays bare the high cost rural Americans have paid during the pandemic as their access to health care has dwindled.

Of the 50 U.S. counties with the highest Covid-19 deaths per capita, nearly all are in rural areas and 24 are within 40 miles of a closed hospital, POLITICO's Daniel Payne reports.

After the local hospital closed in Haywood County, Tennessee, for instance, residents' access to care dropped sharply. And when the pandemic hit, it hit hard. The number of people who died of Covid-19 in Haywood County is in the 97th percentile nationally and well above many nearby counties.

Overall, Tennessee lost more than 1,200 staffed hospital beds between 2010 and 2020, despite a population that grew by over half a million, according to the American Hospital Directory and census data.

It's part of the larger national trend that has put rural areas at higher Covid-19 risk during the past two years. In the last decade, 138 rural hospitals have either partially or completely closed, according to data from the University of North Carolina. And well over three times that many are currently at risk of closure, according to a 2020 analysis from the Chartis Center for Rural Health.

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Coronavirus

SURGEON GENERAL: DON'T PANIC — Surgeon General Vivek Murthy said Americans shouldn't worry about the latest spike in Covid-19 cases in Europe, despite the Biden Administration's own concerns about the surge.

"Our focus should be on preparation, not on panic," Murthy said on "Fox News Sunday," POLITICO's David Cohen writes.

Over the pandemic's course, surges in Europe have usually preceded a surge in the U.S. by a few weeks. The CDC has warned that the new Omicron BA.2 subvariant driving the spike in countries like Britain, Germany, Finland and the Netherlands is not yet the dominant variant in the U.S. but probably will be in the next few weeks.

"We should be prepared that Covid hasn't gone away," Murthy said. "There may be rises and falls in the months ahead, but here's the key: Our goal is to keep people out of the hospital; it's to save their lives. We have more tools to do that than ever before."

MAKING YOUR COVID-19 COMPLAINTS EASIER — U.S. health officials are trying to figure out how to improve the way Americans can file Covid-19 safety complaints, after POLITICO reported last week that some hospitals are asking patients to remove their N95 masks and replace them with less-protective surgical masks.

Federal officials are now concerned that many patients aren't aware of how to report hospital safety issues to regulators, a process that takes place through state agencies, reports POLITICO's Rachael Levy.

The hospitals that require patients to swap their N95s said they're enforcing quality control and following CDC guidelines, though the CDC doesn't say patients must do so. Public health experts have urged the Biden administration for more than a year to recommend N95s for all, but so far, the CDC has not done so.

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Around the Nation

LAUSD DITCHES MASKS — After weeks of intense negotiation, Los Angeles Unified School District and its unions have agreed to lift its mask mandate on Wednesday, writes POLITICO's Susannah Luthi.

Parents and students have held protests over the continued mask mandate, which has remained in place even after the CDC said indoor masking is no longer needed as long as Covid-19 cases remain low.

LAUSD had been one of the last remaining California districts to keep the mandate in place. Oakland Unified School District, another holdout, said Friday it's dropping its outdoor mandate but keeping its indoor requirement into April.

THE WEED BOOM ON RESERVATIONS — Pot dispensaries are thriving on several Native American tribal reservations in New York, as entrepreneurs have swung into action after the state legalized recreational marijuana last year, POLITICO's Meghan Brink writes.

The retail businesses, popping up in gas stations, roadside stops and main street shops, are permitted to operate without licenses on the reservations, while would-be cannabis retailers in the rest of New York have to wait for the state lawmakers to pass a law to regulate marijuana sales, expected later this year.

The tribal governments in New York join others in Washington, California, Nevada, New Mexico, Wisconsin, Minnesota and Montana, which have also leveraged their sovereignty from state governance to begin cannabis cultivation and sales.

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What We're Reading

Doctors fighting disparities in America's health care system face new attacks, from hate mail to lawsuits to death threats, NBC reports.

Malawi is launching a massive polio vaccination campaign n Monday after a 4-year-old girl contracted the wild poliovirus, STAT writes . It's the country's first case in three decades and a worrying sign for the global polio eradication effort.

The Wall Street Journal reports on a new study that found ivermectin doesn't reduce hospital admissions in patients with serious Covid-19, just like public health authorities have been saying. Are we naive to hope this case may now finally be closed?

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We need to make the cost of medicine more predictable and affordable. Government price setting is the wrong way. The right way means covering more medicines from day one, making out-of-pocket costs more predictable and sharing negotiated savings with patients at the pharmacy counter.

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