WOULD TRUMP DARE LIMIT ABORTION ACCESS ?
Growth of telehealth prescriptions
Donald Trump promised "not to touch" Medicaid, a tax bill focused on the middle and working class while ending some tax breaks for rich private equity executives, a non-interventionist foreign military policy and an apolitical Justice Department.
Instead he signed a bill that cuts $1 trillion from Medicaid over the next decade, along with more than $4 trillion in tax cuts principally for the rich, while private equity keeps its tax loophole; bombed Iran in an effort to cripple its nuclear development, and he presides over the most political and White House-obsequious Justice Department in memory.
That's in less than six months.
What else might be on the agenda ? Possibly abortion, a crackdown on telehealth prescriptions of abortion pills.
After the Dobbs decision three years ago, overturning the Roe v Wade protections, pro-life activists envisioned a precipitous drop in abortions. Initially that was right.
But abortions rose last year to an estimated 1.14 million, the second straight annual increase. A factor was telehealth in states with shield laws that protect clinicians prescribing and distributing abortion medication, mifepristone and misoprostol, to the more than a dozen states that have severely restricted abortions.
Texas, for instance, has an almost total ban on abortions. Yet there were over 3,000 abortions in the Lone Star state last July.
Both Texas and Louisiana have tried, unsuccessfully, to take action against a New York doctor who prescribes abortion pills. New York has a shield law.
As abortions rise, aided by Telehealth prescriptions, the opposition is stirring. Marjorie Dannenfelser, the leader of the anti-abortion Susan B. Anthony Pro-Life America, has said curtailing the availability of abortion pills and telehealth prescriptions are her top priorities.
Missouri Republican Sen. Josh Hawley has implored FDA commissioner Marty Makary to "restore the critical safeguards on the use of mifepristone." He cited a study by a conservative think tank that showed that more than 10% of women who take the abortion pill have suffered troubling side effects.
That is at variance with almost every other credible study.
Mifepristone was first approved almost a quarter century ago. It has been taken, usually with misoprostol, by seven million women with extraordinary effectiveness and very little risk.
Makary, however, says he is looking at the safety issues. HHS Secretary Robert F. Kennedy, Jr., for years a pro-choice Democrat, basically indicates, as usual, he'll go along with whatever President Trump wants.
Trump sees abortion only as a political matter and having finessed it in 2024 election -- declaring it should be left to the states -- would like to deep six any consideration now. Still I don't underestimate the anti-abortion activists after reading a compelling book, The Fall of Roe, by Lisa Lerer and Elizabeth Dias. These forces were more intense, more committed and more strategic than the other side leading to their ultimate victory at the Supreme Court.
Right wing activists will pressure the White House claiming with abortions rising it's turning off their base for the midterm elections.
Trump, no doubt, would reject any direct attack on Mifepristone, which would be a political loser, as the pill has strong political support. Clamping down on telehealth prescriptions, especially across state lines, might be more feasible if they can spin it as a states rights issue.
But it would face enormous legal and political challenges.
I spoke with several Democrats, already salivating over the political opportunities the Republicans' big tax and budget bill offers, with cuts in Medicaid paying for tax breaks for the rich, and they say this would be a bonus for next year's elections.
It's true that Kamala Harris made little headway on abortion last year as Trump effectively neutralized it as a settled issue. That would change if some access is taken away.