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COULD A ‘HEARTBEAT BILL’ TAKE DOWN ROE V. WADE? A handful of red states are placing bets on abortion bans in the hopes of having the Supreme Court reconsider Roe v. Wade, the landmark decision that legalized abortion nationwide for about 24 weeks into a pregnancy.

States are quickly passing laws banning abortion when a doctor can detect a fetal heartbeat, at about six weeks into a pregnancy and before many women know they're pregnant. Such "heartbeat bills" have passed this year in Georgia, Kentucky, Mississippi, and Ohio, and in previous years in Iowa and North Dakota.

Because the laws violate Roe's 24-week standard, they've been quickly struck down or put on hold everywhere they have been challenged, and abortion remains legal across the U.S. Still, advocates who push them hope they may eventually offer the opportunity to reverse Roe given that the Supreme Court's makeup has changed with President Trump's appointments of Brett Kavanaugh and Neil Gorsuch. If that were to happen , the decision over the legalization of abortion would fall to the states.

"Certainly the intent of these laws is to ask the court to revisit whether there is any constitutional right for abortion whatsoever," said Jennifer Dalven, director the Reproductive Freedom Project at the ACLU, which has brought challenges against the bans. "Whether the Supreme Court decides to take up one of these, we'll wait and see."

Having a six-week ban appealed to the Supreme Court would take years, and is unlikely. Still, it would be possible if lower court decisions are appealed or if circuit judges were to rule differently from one another. This would be unexpected: No federal court has upheld bans on abortion that are earlier in a pregnancy, and judges are likely to strike down six-week bans because lower court judges are compelled to apply Supreme Court precedence in their rulings.

"I think that scenario is the longest of longshots," Clarke Forsythe, senior counsel at Americans United for Life, said of lower courts upholding a six-week ban on abortion.

The justices already declined to hear cases on other abortion bans in recent years, causing them to be struck down. The judge who is hearing the Mississippi ban on May 21 already struck down a 15-week ban in the state, signaling he's likely to rule similarly on an even more restrictive ban. Still, the Supreme Court has a different makeup than it used to.

"It may be that anti-choice politicians hope they get a different result this time," said Hillary Schneller, staff attorney at the Center for Reproductive Rights. "But the Supreme Court has always come out the same way on this very core issue as to whether a person has the right to make this very core decision."

Both sides know the Supreme Court doesn't have to hear an abortion ban to overturn Roe. Other bills that limit abortion access can have a similar effect. For the Supreme Court, there are a multitude of potential outcomes in between outright upholding or fully overturning Roe that would allow for more restrictions on abortion.

Schneller called such a strategy "death by a thousand cuts to eliminate abortion in a more stealth way" and a "more subtle but very dangerous way of eliminating access to abortion without actually having to overturn Roe."

Read more .

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.





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SAVE THE DATE: The U.S. Court of Appeals for the 5th Circuit will tentatively hear Texas v. Azar, the case seeking to invalidate the Affordable Care Act, on July 8 in New Orleans.

GILEAD DONATES ANTI-HIV DRUG FOR 200,000 PEOPLE TO HELP TRUMP INITIATIVE: Pharmaceutical giant Gilead Sciences will donate the anti-HIV drug Truvada to the federal government so it can move toward its goal to eliminate HIV transmission in a decade .

The drug, which carries a list price of $20,000 annually, is highly effective at preventing the spread of HIV and will be key to halting the current trend of 40,000 people in the U.S. getting newly infected by HIV every year.

Gilead is providing the Centers for Disease Control and Prevention with up to 2.4 million bottles of Truvada every year until at least 2025, which will mean 200,000 more people will have access to the medication. The company is also working toward the approval of a similar drug called Descovy and may extend donations until 2030. The government will take on the costs of distributing the drugs.

TRUMP OUTLINES PLANS TO STOP SURPRISE MEDICAL BILLING: The administration says it is aiming to increase transparency about how health services are billed to help reduce surprise medical bills. In a White House event Thursday the president said that patients must be told ahead of treatment if a specialist, such as an anesthesiologist or radiologist, is out of their network and that patients should only be billed for out-of-network care if they consent to receiving treatment.

Bipartisan legislation expected this summer: Sen. Lamar Alexander, R-Tenn., said while appearing alongside Trump that he would be bringing forward a bill in July. Alexander's press secretary told the Washington Examiner the senator plans to move legislation out of committee by the summer.

HOUSE DEMS VOTE TO BLOCK TRUMP’S OBAMACARE ‘RELIEF’ IDEAS FOR STATES: House Democrats voted Thursday to block the Trump administration from letting states make changes to their healthcare programs, the first of several bills up for a vote this month attacking Republican efforts to gut Obamacare.

The Protecting Americans with Preexisting Conditions Act from Rep. Ann Kuster, D-N.H., would block the Trump administration's guidance on programs, known as 1332 waivers, that allow states to make changes to Obamacare.

MONTANA RENEWS MEDICAID EXPANSION: Montana will continue having Medicaid expansion under a bill signed Thursday by Democratic Gov. Steve Bullock, though it will add work requirements into the mix.

The expansion in Montana had been scheduled to sunset in July because that’s how the state had chosen to expand it initially and voters during the midterm elections struck down a measure that would have paid for the extension through a tobacco tax. Lawmakers agreed to fund Medicaid expansion through a hospital tax, and Republicans came onboard once the work requirements were added.

The renewal will allow for 96,000 Montanans to stay on Medicaid, though the work requirements — if approved by the Trump administration — are expected to result in about 4,000 people being kicked off the program, according to a state analysis.

WISCONSIN REJECTS MEDICAID EXPANSION: Republicans in the Wisconsin legislature on Thursday rejected Democratic Gov. Tony Evers’ budget of Obamacare’s Medicaid expansion.

An estimated 82,000 people would be put onto Medicaid if the state were to expand.

NH GOV VETOES PAID LEAVE BILL: New Hampshire Gov. Chris Sununu vetoed a bill Thursday that would have allowed for paid medical and family leave in the state through a payroll tax. “The Democrats’ solution to paid leave… is an income tax and make no mistake, the people of New Hampshire do not support that approach,” tweeted Sununu, a Republican.

ALABAMA SENATE DELAYS STRICTEST ABORTION BILL IN CHAOTIC SESSION: The Alabama Senate tabled an abortion bill Thursday when a shouting match broke out across the aisle after Republicans removed provisions to allow abortions in the cases of rape or incest. When Republicans requested a voice vote, Democrats said this was a means for the other side to vote without attaching their names to the nation’s most restrictive abortion measure. The bill is meant to challenge Roe in Supreme Court, and the ACLU has already stated it will sue the state if the bill becomes law.

WALMART BOWS TO FDA PRESSURE WITH CRACKDOWN ON TOBACCO SALES: Walmart, the world's largest retailer, will stop selling fruit- and dessert-flavored vaping products and require all tobacco purchasers to be 21 or older after scrutiny from the Food and Drug Administration over illegal sales to children. The Bentonville, Ark.-based company, which has more than 5,000 stores in the United States and Puerto Rico, failed about 17% of government checks on its compliance with a law banning the sale of tobacco products to children under 18.

HEALTH GROUPS URGE FDA TO INVESTIGATE JUUL: Six leading public health organizations, including the American Heart Association and the Cancer Action Network, urged the Food and Drug Administration to investigate Juul’s unauthorized claims that the device is a smoking cessation tool. The groups wrote a letter asking the FDA to crack down on the company for launching a marketing campaign, appearing in television and radio ads and newspapers, telling smokers to “make the switch” from cigarettes to Juul devices. The claims have been unproven, and the groups point out the Juul calls itself a “switching tool,” which is not the same as a cessation tool.

WYDEN, GRASSLEY DEMAND ANSWERS ABOUT ABUSE OF MIGRANT CHILDREN: Senate Finance Committee members Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., demanded an explanation Thursday for reports of sexual abuse of unaccompanied migrants in taxpayer-funded detention facilities at the border. The committee members wrote to Health and Human Services demanding answers about whether the department is holding directors of the centers accountable for abuse of migrant children as well as misuse of federal funds.

DENVER APPROVES REFERENDUM DECRIMINALIZING MAGIC MUSHROOMS: A slim majority of voters in Denver voted to decriminalize hallucinogenic mushrooms on Wednesday. Although it initially appeared that voters rejected the grassroots ballot initiative Tuesday afternoon, Denver election officials later shared that final numbers revealed 50.56% of voters backed the initiative.

The Rundown

Los Angeles Times California teachers must pay for cost of their substitute if sick leave runs out

Salt Lake Tribune ‘Health care on wheels’: Fourth Street Clinic unveils mobile clinic to serve Utah’s dispersed homeless population

The Hill Public confidence in GOP on healthcare down by 6 points since Trump joined anti-ObamaCare lawsuit

Houston Chronicle A health care reshuffling: insurers open clinics in Houston area

CNN A measles outbreak where you live? Study ranks US places at highest risk

Calendar

FRIDAY | May 10

1 p.m. National Press Club. 529 14th St. NW. Dr. Scott Gottlieb, former director of the Food and Drug Administration, speaks at headliners luncheon. Details .

TUESDAY | MAY 14

May 14-15. Hyatt Centric. Arlington, Va. Population Health Payer Plan Innovations for Medicaid, Medicare, and Duals. Details .

WEDNESDAY | May 15