The big abortion number we don’t know

The ideas and innovators shaping health care

Jun 27, 2023 View in browser   By Evan Peng, Ben Leonard, Carmen Paun and Erin Schumaker DATA DIVE Abortion pills are now the most common method of ending a pregnancy in the U.S. | Charlie Riedel/AP Photo A year after the Supreme Court’s Dobbs decision ended the constitutional right to abortion, the impact on the number of abortions in the U.S. is unknown. The Centers for Disease Control and Prevention releases yearly totals, but its latest figure, 615,911, is from 2020. It includes both surgical abortions and medication abortions using pills. But it’s not only more than two years out of date, it also doesn’t cover the entire country. How’s that? — The agency compiles reports from state health agencies, whose methodologies and timelines differ. — Reporting to the CDC is voluntary. California and New Hampshire haven’t reported since 1997, and Maryland hasn’t since 2006. In fact, those states no longer collect abortion data. Other estimates: The Guttmacher Institute, an advocacy and research group that supports abortion rights, compiles annual numbers with a different methodology, but it, too, has figures that cover only through 2020. Its 2020 number, 930,160, is greater largely because it includes all states. Guttmacher surveys every known abortion provider, including clinics, hospitals and doctors’ offices, and supplements the tally with government data and estimates. Like the CDC, Guttmacher counts both surgical and medication abortions. Post-Dobbs numbers: The Society of Family Planning, a nonprofit organization that advocates for abortion access, launched its #WeCount project in 2021 in anticipation of the court’s decision. It, too, relies on surveys sent to all known abortion providers and pays them to respond. The society has released numbers from April 2022 through March 2023, finding 959,480 abortions for that year. The society believes nearly 26,000 fewer abortions were performed since the Dobbs decision through March 2023 compared with a pre-Dobbs baseline. The data also shows different impacts across states, with some states that still permit abortion seeing increases. The Kansas Department of Health and Environment, for example, reported preliminary 2022 numbers on Friday that showed a 57 percent increase in abortions in the state, to 12,318. The agency said the rise was driven by out-of-state patients coming to Kansas from states where abortion is banned or restricted. Even so: The number of abortions in the U.S. had been declining before the Dobbs decision, according to the CDC’s tally, from a peak of 1.4 million in 1990. Guttmacher’s total has also dropped from a 1990 peak of 1.6 million, but it found abortions increasing since 2017 after hitting a low of 862,000 that year. What’s next? CDC data for 2022 should be released in 2024 if the agency’s past practice holds. Guttmacher plans to change its methodology for counting abortions. Instead of surveying every abortion provider nationwide, it will draw random monthly samples of providers to build a statistical model. The first report is expected this fall. “It’s always been difficult to collect abortion data,” Rachel Jones, who oversees Guttmacher’s abortion census, told Evan. “The concern is that it’s going to become even more so as abortion becomes even more politicized and there’s reasons for people to be even more wary of external parties asking them for information.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WELCOME TO FUTURE PULSE Elephant Butte Reservoir, N.M. | Erin Schumaker This is where we explore the ideas and innovators shaping health care. Talk about a pickle: Pickleball injuries might cost people in the U.S. close to $400 million this year, UBS analysts said. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ben talks with Erin about the future of psychedelic drug research now that the FDA has issued its first draft guidance for designing clinical trials for the drugs. Listen to today’s Pulse Check podcast TECH MAZE Artificial intelligence is on Schumer's agenda. | AP “When it comes to AI, we cannot be ostriches sticking our heads in the sand.” — Senate Majority Leader Chuck Schumer Senate Majority Leader Chuck Schumer has released a framework for potential legislation regulating artificial intelligence. The New York Democrat provided few specifics but laid out broad principles to bolster national security, tackle misinformation and bias, and determine transparency levels from the makers of the nascent technology. What’s in it for health? The framework wasn’t specific, but the health care industry so far has expressed openness to it. Brian Anderson, co-founder of the Coalition for Health AI and chief digital health physician at MITRE, a nonprofit corporation that conducts research for government agencies, told Ben that a number of Schumer’s principles aligned with the coalition’s, such as transparency. “If it’s not explainable, if it’s not transparently developed, it’s not going to be trusted,” Anderson said. Earlier this year, the Coalition for Health AI, an alliance of major health systems and tech companies, including Mitre, Google and Stanford, released a blueprint to facilitate trust in artificial intelligence’s use in health care. Even so: Industry leaders hope any legislation strikes a balance between mitigating risk and preserving innovation. “While the most important element for any action is to protect people, it is also equally important that the government does not impede positive innovation and progress,” said Adam Landman, chief information officer at Mass General Brigham. What’s next? Schumer plans to host forums with AI experts this fall. Any comprehensive AI legislation, he said, has to be bipartisan. He touted ongoing efforts to build an alliance between three senators with interest in the issue: Mike Rounds (R-S.D.), Todd Young (R-Ind.) and Martin Heinrich (D-N.M.).   SUBSCRIBE TO POWER SWITCH: The energy landscape is profoundly transforming. Power Switch is a daily newsletter that unlocks the most important stories driving the energy sector and the political forces shaping critical decisions about your energy future, from production to storage, distribution to consumption. Don’t miss out on Power Switch, your guide to the politics of energy transformation in America and around the world. SUBSCRIBE TODAY.     WORLD VIEW Kerry wants governments to prepare for the health consequences of climate change. | Getty Images Vanessa Kerry’s task as the World Health Organization’s new envoy for climate and health is to help governments prepare for the dangers the Earth’s warming poses to humans. “The urgency is so real,” Kerry, the CEO of the nonprofit Seed Global Health and the daughter of U.S. Climate Envoy John Kerry, told Carmen. But the amount of money governments spend to prepare doesn’t reflect that seriousness, she said. “Less than about 5 percent of total adaptation financing and less than 0.5 percent of multilateral climate adaptation financing has been allocated to health overall … and that's nothing,” she said. Kerry will lobby world leaders to improve health systems, particularly in the world’s poorest countries. Preparations she’d like to see include: — Moving medications from areas prone to floods to higher ground — Incorporating solar energy to boost the reliability of power grids when major storms hit — Improving the efficiency of air ventilation and cooling systems in health care facilities The challenge ahead: Seed Global Health trains health care workers in Malawi, Sierra Leone, Uganda and Zambia, and Kerry said she has seen firsthand how much of a health threat climate change has become. “One in four deaths is already from a preventable environmental cause. And you're going to see an additional 250,000 deaths a year coming from climate change each year, cumulatively,” she said.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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