Biden Health Secretary: There is no “magic bullet” to maintain access to abortion

WASHINGTON — So far, Democrats and reproductive rights advocates have pressed President Biden to vigorously oppose the Supreme Court’s decision to overturn Roe v. USA. Wade, his Health Secretary Xavier Becerra, stepped up to the pulpit on Tuesday to list steps his department will take to maintain and expand access to abortion.

The list, at least for now, is short.

“There is no magic bullet,” Mr. Becerra said at a morning press conference, “But if we can do something, we’ll find it and do it.”

Friday’s Supreme Court decision repealing the constitutional right to abortion was not unexpected, but neither the White House nor Mr. Becerra’s agency prepared immediate policy responses. Administration officials say they are still grappling with the prospect of the main area of ​​women’s health suddenly becoming illegal in about half of the country, and they will need time to sort out their options.

Yet Mr. Biden is under intense political pressure to act, and after his press conference, some advocates accused Mr. Becerra of sounding cool. Some Democrats, such as Senator Elizabeth Warren of Massachusetts and Rep. Alexandria Ocasio-Cortez, are pushing the Biden administration to explore the prospect of building abortion clinics on federal soil and paying people from other states to travel there for the procedure.

This was not among the measures that mr. Becerra announced. Instead, he said that in Mr. At Biden’s direction, he directed his agency to take measures such as ensuring that federal insurance programs cover medical abortion in cases of rape or incest, or when the mother’s life is in danger. Although the Hyde Amendment prohibits taxpayer funding of abortion, it includes exceptions for these three cases.

“We can’t meet scorched earth with milk toast,” said Andrea Miller, President National Institute of Reproductive Health, human rights organization. “I’m not asking for scorched earth, but I’m saying that you have to be willing to stop drawing within the boundaries. You have to be willing to take some risks.”

In addition to setting up abortion clinics on federal lands, Ms. Miller said the administration must find ways to support abortion clinics that are on the verge of closing, perhaps repurposing them as logistics centers to help women who need to cross state lines. About half of the states are expected to allow bans or other restrictions on procedure to take effect after the decision is made or have already taken effect.

RS. Miller acknowledged the administration has limits and said she sympathized with Biden officials. But the country is in crisis, she said, adding: “Why not push the envelope?”

mr. Becerra said his agency will work with the Department of Justice to ensure women have access to abortion pills — a pair of two different drugs taken 24 to 48 hours apart and allowed for the first 10 weeks of pregnancy — in places where state laws conflict with law. . a decision by the Food and Drug Administration that approved the use of drugs and determined their safety and efficacy.

The secretary did not go into details. But in December the FDA approved the position permission to prescribe abortion pills during telemedicine visits and distribute them by mail. Some advocates also want the FDA to say its rules take precedence over state anti-abortion laws, a move the Justice Department may have to defend in court.

It will also require hospital emergency departments to comply with federal law requiring them to stabilize patients in need of emergency medical care, including by providing abortions if necessary. And the agency will take steps to ensure the confidentiality of patient records so that state or local officials cannot identify women who have had abortions.

Cautioning about what the administration can and can’t do, Mr. Becerra said he still has difficult legal issues to resolve to make sure he doesn’t violate the Dobbs v. USA ruling. Jackson Women’s Health Organization.

“It was a long decision and it turned a 50-year-old precedent on its feet and so you want to make sure that what you are doing is within the law,” Mr. J. Becerra said. “We’re not interested in being a scammer.”

He called the decision “despicable” and at one point said he wanted to offer an “apology” that the administration couldn’t do more.

The administration has studied, but still skepticalidea allowing abortions to be performed in federal enclaves, such as military bases and national parks, where prosecutors have no jurisdiction, in states where abortion is or will be criminalized.

White House press secretary Karine Jean-Pierre on Tuesday dismissed the idea, telling reporters aboard Air Force One that it could have “dangerous consequences” for women and doctors.

The problem, according to officials familiar with the internal discussions, is that the federal government cannot guarantee that doctors who are not federal employees on official duty, and possibly patients, will not be at risk of prosecution.

This is because the Department of Justice has the power to prosecute certain state crimes. If a Republican won the presidency in 2024, his or her Justice Department could charge people with abortion-related crimes starting in 2022 because the statute of limitations would not expire. States can deprive doctors of medical licenses. And state prosecutors may try to charge people with relevant behavior that took place outside the enclave – such as helping women get there – in line with the theory of aiding and abetting or conspiracy.

Offering financial assistance to women crossing state lines to have an abortion could also be problematic for the administration as it could violate the Hyde Amendment, which would ban federal funds from paying for abortions except in cases of rape, incest, or where the mother’s life is in danger. .

When asked on Tuesday if the Department of Health and Human Services could provide such financial assistance, Mr Becerra said that once officials know “exactly what we think we can do and we have for this money, we will inform you about it.” He added, “But until then, I can just tell you that all the options are on the table.”

After Friday’s decision, members of Mr. Biden’s own party is increasingly demanding action from him. More than 30 Democratic MPs in the Senate on Saturday send him a letter telling him that “there is no time to waste” and insisting that he use “every power of the federal government” to protect access to abortion services.

“Now is the time for bold action to protect the right to abortion,” they wrote, adding, “You have the opportunity to fight back and lead a nationwide response to this devastating decision.”

One area where the administration can act is to ensure that women have access to emergency contraception, including so-called “morning pills” such as “Plan B” and IUDs. Both are common methods of contraception, but opponents of abortion consider them “abortive remedies” and tried in some states to restrict access to them.

Some family planning clinics in states that ban abortion say their “Plan B” supplies are now running low because women stock up on them, fearing the pill will be outlawed. Hayley Kramer, a nurse practitioner at Tri-Rivers Family Planning in Rolle, Missouri, said Monday that the clinic’s supplier was struggling with rising demand and the pills were ordered before a version of the report refuting Rowe was leaked last month. .

Missouri is one of 13 states that passed anti-abortion laws after Rowe’s ouster; mr. Becerra was visiting a Planned Parenthood clinic in the state when abortion suddenly became illegal there. Missouri is also one of four states that has excluded Planned Parenthood, the primary contraceptive provider, from Medicaid family planning programs that reimburse such services.

Planned Parenthood said the move violated federal law. mr. Becerra said Tuesday that he has instructed Medicaid and Medicare service centers to “make it clear that family planning providers can participate in the Medicaid program.”