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WAUKESHA, WI - MAY 1st: Former president Donald Trump speaks at a campaign rally on Wednesday May 1st, 2024.  (Photo by Sara Stathas for the Washington Post)

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Good morning from the nation’s capital, where it’s cherry blossom-watch season. I’m Rachana Pradhan, correspondent for KFF Health News. Send your best secret viewing spots: <a href="mailto:rachanap@kff.org">rachanap@kff.org</a>. Not a subscriber? <a href="https://www.washingtonpost.com/newsletters/the-health-202/">Sign up here.</a>

Today’s edition: The White House is mounting a new effort to lower health-care costs. A group of House Democrats is calling for closer monitoring of the public health of new fathers to reduce infant mortality. But first …

State laws often protect hospitals that refuse to perform abortions — even where it's legal

Rogelio V. Solis

Many states that tout themselves as protectors of reproductive health care, including California, Michigan and Pennsylvania, have little-noticed laws on the books protecting hospitals that refuse to provide it.

The laws shield at least some hospitals from liability for not providing care they object to on religious grounds, leaving little recourse for patients. The providers — many of them Catholic hospitals — generally refuse to perform abortions and sterilizations because the services run contrary to their religious beliefs, but their objections can extend to other kinds of care.

<a href="https://kffhealthnews.org/news/article/catholic-hospitals-affiliates-ethical-religious-directives-reproductive-care/">In our recent reporting on Catholic hospitals</a>, we found that 35 states grant such legal protections to at least some hospitals that won’t provide abortions. About half of those laws don’t include exceptions for emergencies, ectopic pregnancies or miscarriages. <a href="https://www.washingtonpost.com/abortion/" target="_blank" class="contextual_link">Abortion</a> remains broadly legal in 25 of those states.

Sixteen states prohibit lawsuits against hospitals for refusing to perform sterilization procedures.

These laws, many first enacted in the 1960s and 1970s, have flown under the radar following the Supreme Court’s 2022 decision overturning Roe v. Wade. But they carry significant consequences for patients.

“It’s one thing to say that a health-care provider can refrain from providing certain care because of their sincerely held religious beliefs. It’s another thing altogether to say because you have these beliefs you can harm people and face no repercussions for it,” said Elizabeth Sepper, a law professor at the University of Texas at Austin and an expert on religious liberty and health law.

State liability shield laws go further than conscience protections enforced by the federal government. They can limit what’s possible under the Emergency Medical Treatment and Labor Act, the 1986 federal law protecting patient access to emergency care, said Katherine Kraschel, assistant professor of law and health sciences at Northeastern University.

Hospitals that violate EMTALA can be sued by patients, but <a href="https://journalofethics.ama-assn.org/article/which-legal-approaches-help-limit-harms-patients-clinicians-conscience-based-refusals/2020-03">the federal law also relies on states’ civil liability standards</a>, she said. That means if state law shields a provider from lawsuits over refusing to provide an abortion, EMTALA “won’t always provide relief” to harmed patients, Kraschel said.

Supporters of medical conscience rights have recently had success in broadening protections in several states.

“Faith is meant to be lived out, and it’s meant to be lived out in the professions in which these individuals work,” said David Trimble, vice president for public policy and education at the Religious Freedom Institute, a nonprofit that <a href="https://religiousfreedominstitute.org/medical-conscience-rights-initiative/#:~:text=Five%20states%20%E2%80%94%20Arkansas%2C%20Ohio%2C,versions%20of%20this%20model%20legislation">launched an effort</a> in 2020 alongside other groups to advance state medical conscience laws. If providers are “subject to ruinous lawsuits” for not performing procedures that violate their beliefs, “this not only inflicts significant harm on that individual health-care provider but on the [health-care] system,” he said. Unlike some of the decades-old shield statutes, the newer laws say conscience rights don’t mean providers may deny patients emergency care required by federal law.

Arkansas, Florida, Montana, Ohio and South Carolina <a href="https://kffhealthnews.org/news/article/medical-conscience-bills-montana-florida-abortion/">have expanded conscience laws</a> to apply to just about any kind of health care. Trimble said Oklahoma, Kentucky, Iowa and Idaho are among the states the group is focused on in 2024.

<a href="https://kffhealthnews.org/">KFF Health News</a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at <a href="https://www.kff.org/">KFF</a> — an independent source of health policy research, polling, and journalism.

White House to launch task force targeting health-care costs

Demetrius Freeman

New this a.m.: The Biden administration is launching a new federal task force that seeks to lower costs for Americans by cracking down on unfair and illegal business practices. &nbsp;

Co-chaired by the Justice Department and the Federal Trade Commission, the panel will focus its efforts on key sectors where corporations may be violating the law and keeping prices high, including prescription drugs and health care, according to the White House.&nbsp;

Manufacturers of the 10 prescription drugs selected for the first round of Medicare price negotiations all <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/04/statement-from-president-joe-biden-on-progress-on-medicare-drug-price-negotiations/">submitted counteroffers</a> on a maximum fair price, <a href="https://www.washingtonpost.com/elections/candidates/joe-biden-2024/" target="_blank" class="contextual_link">President Biden</a> announced yesterday.&nbsp;

First in The Health 202: House lawmakers urge closer monitoring of new dads to improve infant health

Ricky Carioti

New this a.m.: Eighteen members of the Congressional Dads Caucus and the Black Maternal Health Caucus are urging federal regulators to support an initiative aimed at better monitoring the public health of fathers to reduce infant mortality.&nbsp;

In a letter sent to Health and Human Services Secretary Xavier Becerra yesterday, lawmakers requested $5 million in the agency’s fiscal year 2025 budget to support a pilot program in six states that would survey new fathers over a three-year period. HHS didn’t immediately respond to a request for comment.&nbsp;

A closer look: The initiative is an extension of the Pregnancy Risk Assessment Monitoring System (PRAMS), which traditionally collects data from women about their pregnancies and postpartum experiences to inform public health strategies.

Dubbed “PRAMS for Dads,” the survey includes questions on fathers’ mental and physical well-being, interactions with medical providers, substance use disorders, reproductive health, and views on practices like breastfeeding and safe sleep.&nbsp;

🗳️ California votes on Proposition 1

Terry Chea

On tap today: Californians vote on <a href="https://www.gov.ca.gov/2023/10/12/governor-newsom-puts-historic-mental-health-transformation-on-march-2024-ballot/">Proposition 1</a>, an initiative championed by Democratic Gov. Gavin Newsom and aimed at overhauling the state’s approach to mental health treatment and substance use disorder.&nbsp;

If approved, the <a href="https://voterguide.sos.ca.gov/propositions/1/title-summary.htm">ballot measure</a> would authorize a $6.38 billion bond for thousands of new treatment beds and supportive housing units for homeless people with mental illness or addiction challenges. It would also require counties to spend more of their existing mental health funds on housing services.&nbsp;

Yes, but: Opponents of the ballot measure say diverting money for housing would <a href="https://www.counties.org/sites/main/files/file-attachments/csac_issues_statement_on_proposed_mental_health_services_act_reform.pdf">reduce funding</a> for existing community-based mental health programs. Civil rights groups have also panned the proposal because it allows some money to be spent on <a href="https://www.disabilityrightsca.org/latest-news/disability-rights-california-opposes-proposition-1">involuntary treatment facilities</a>.&nbsp;

First over-the-counter birth control pill to hit the U.S. shelves soon

Americans will be able to purchase birth control pills without a prescription for the first time later this month.

Manufacturer Perrigo <a href="https://www.prnewswire.com/news-releases/perrigo-commences-shipments-of-opill-to-retailers-nationwide-empowering-millions-to-enter-a-new-era-of-reproductive-health-access-in-the-united-states-302077710.html">announced yesterday</a> that it has started shipping Opill, a daily progestin-only medication, to major retailers and pharmacies nationwide. Preorders are available this week from select retailers and online.&nbsp;

Perrigo suggests pricing Opill at $19.99 for a one-month supply and $49.99 for a three-month pack, though costs may vary across retailers.&nbsp;

The bigger picture: The launch gives women another birth control option in a tumultuous reproductive health landscape. But the cost of Opill may still be a hurdle, as insurers <a href="https://www.cms.gov/files/document/faqs-part-54.pdf">aren’t required</a> to cover items available without a prescription.&nbsp;

In response, some Senate Democrats are <a href="https://www.murray.senate.gov/murray-hirono-cortez-masto-statement-on-first-ever-over-the-counter-birth-control-pill-hitting-shelves-in-the-u-s/">pushing for the bicameral Affordability is Access Act</a>, which would compel health plans to cover FDA-approved over-the-counter birth control products.&nbsp;

New data supports use of a morning-after pill to prevent bacterial sexually transmitted infections and bolsters the case for deploying it to turn the tide on a surge of syphilis, chlamydia and gonorrhea, The Post’s Fenit Nirappil reports.&nbsp;

The Centers for Disease Control and Prevention is <a href="https://www.washingtonpost.com/health/2023/07/24/doxypep-std-sti-prevention/">finalizing guidance</a> to prescribe doxycycline as a post-exposure prophylaxis, or DoxyPEP, to reduce the odds of contracting an STI after unprotected sex.&nbsp;

Distribution is already widespread in San Francisco, where the health department just announced chlamydia and early syphilis infections among men who have sex with men and transgender women decreased by 50 percent compared with modeled projections, but gonorrhea infections did not decline.

The findings were presented yesterday at the Conference on Retroviruses and Opportunistic Infections. Other DoxyPEP research presented at CROI conferences in recent years backed the efficacy of DoxyPEP for men who have sex with men, a group at heightened risk for STIs. But the medication hasn’t proved effective is cisgender women, who are also contracting STIs at higher rates and passing syphilis onto infants in <a href="https://www.washingtonpost.com/health/2023/04/01/congenital-syphilis-babies/">a crisis that has alarmed public health officials</a>. DoxyPEP also raises concerns about antibiotic resistance, which researchers say must be monitored closely.

The White House <a href="https://apnews.com/article/white-house-covid-testing-biden-masks-7a68a0588700d1c3cd0b6f800be805a9">lifted its coronavirus testing requirement</a> for people who plan to be in close proximity to Biden, Vice President Harris and their spouses, marking an end to one of its last remaining pandemic safety measures, Zeke Miller reports for the Associated Press.&nbsp;

On the move: The Association of State and Territorial Health Officials <a href="https://www.prnewswire.com/news-releases/astho-appoints-joseph-kanter-md-mph-as-new-chief-executive-officer-302078883.html#:~:text=ARLINGTON%2C%20Va.%2C%20March%204,%2C%20effective%20April%208%2C%202024.">has tapped</a> Joseph Kanter as its new chief executive. Kanter, a board-certified physician who previously served as state health officer and medical director for the Louisiana Department of Health, will join the organization on April 8.&nbsp;

The Democratic Congressional Campaign Committee <a href="https://www.usatoday.com/story/news/politics/2024/03/04/dccc-house-democrats-memo-ivf-republicans-alabama/72830294007/">is circulating a memo</a> hitting vulnerable House Republicans as “all talk, no action” on federal protections for in vitro fertilization following the Alabama Supreme Court ruling that frozen embryos are people, Ken Tran reports for USA Today.&nbsp;

<a href="https://www.propublica.org/article/how-federal-government-fails-stop-syphilis-babies-pregnancy" target="_blank">Syphilis is killing babies. The U.S. government is failing to stop the disease from spreading. (By Anna Maria Barry-Jester | ProPublica)</a>

<a href="https://kffhealthnews.org/news/article/whistleblower-upcoding-medicare-aledade-lawsuit-aco-accountable-care/" target="_blank">Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud - KFF Health News (By Fred Schulte | KFF Health News)</a>

<a href="https://www.statnews.com/2024/03/05/opioid-addiction-treatment-methadone-buprenorphine-restrictions/" target="_blank">How the U.S. is sabotaging its best tools to prevent deaths in the opioid epidemic (By Lev Facher | STAT)</a>

Rachana Pradhan

American University, BA in journalism

McKenzie Beard is a researcher for The Health 202, a morning newsletter and daily guide to Washington's health-care policy debate. She started at the Post as an American University practicum student on the investigative desk in 2021 and has previously reported for Voice of America and Teen Vogue.

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