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Dr. Daniel Grossman @DrDGrossman
, 18 tweets, 6 min read Read on Twitter
Hi @adamliptak. I understand that you were explaining legal theories to overturn Roe v. Wade, but there's a lot missing about what accessing abortion is actually like now. What you say we can imagine, is the reality for many patients. Roe has already been decimated. I'll explain.
Let's start at the beginning: Shortly after Roe v. Wade legalized abortion Congress passed the Hyde Amendment barring Medicaid recipients, military personnel, Peace Corps volunteers, incarcerated women, and federal employees from using their health insurance to cover abortion.
You concluded the video by saying that if Roe v. Wade were overturned, "Women in red states, particularly poor women will have a much harder time getting abortions as each successive abortion restriction is sustained..." This is true, and has been the case for decades.
The Hyde Amendment has been passed as a budgetary amendment every year since 1976, and leaves Medicaid recipients scrambling for funding to pay for abortions. This was the biggest gut to the right to an abortion for low-income patients, and effectively makes it inaccessible.
While it wasn't in your video, the Supreme Court upheld the Hyde Amendment in 1980 in Harris v. McRae (…). Justice Thurgood Marshall dissented noting the law was "designed to deprive poor and minority women of the constitutional right to choose abortion."
Talk to abortion providers or patients or @AbortionFunds. We'd be happy to tell you that the Hyde Amendment and funding barriers have always been the biggest challenge to people seeking care, in addition to the restrictions, since Roe v. Wade passed.
In the video, @adamliptak, you mention if Roe v. Wade were to be overturned, it would flip to the states. That's true, but we've already seen how that plays out with Planned Parenthood v. Casey; states are restricting access and shuttering clinics. There's nothing to imagine.
For example, Roe v. Wade guarantees the right to an abortion until viability, which is widely believed to be 24-28 weeks. However, states have been banning abortion at 20 weeks, earlier than Roe v. Wade guarantees, and others have attempted as early as 6 weeks.
The attempts to dismantle Roe v. Wade through legal strategies and ban access earlier than Roe v. Wade guarantees are in full effect. Again, none of this is an imaginary scenario for the future -- it has been happening for years.
In the video you said, “Much more severe restrictions on abortion rights are a perfectly imaginable scenario when we have a new Supreme Court.” But, did you know the examples you gave are things my patients deal with every day when trying to get abortions?
You used the shuttering of clinics in Texas as an example, but nearly half a dozen states are down to 1 abortion clinic. In the entire state. States are banning medical technology like telemedicine to increase access. These things are already happening.
.@adamliptak, you explain in this imaginable future after Roe v. Wade is overturned, that the nearest abortion clinic "could be hundreds of miles away." At @ANSIRH, researchers like @cartwrightalice & @UshmaU looked into this.…
In fact, in their research, they found there are huge swaths of the nation where patients have to travel hundreds of miles and out of state, to the nearest abortion clinic. You can read the study here:
While you said, "It’s hard to imagine what access would look like in a given state because we’ll have a patchwork of laws.” It's actually not that hard to imagine. We know patients are self-managing their own abortions because they don't have access:…
We also know that patients are being forced to travel out of state because they aren't able to get abortions when they want, and are pushed later into gestation and have to travel for a later abortion:…
We also know that the medically unnecessary restrictions and shuttering of clinics is leading to more abortions in the second trimester because patients aren't able to access them earlier.…
We actually know exactly what will happen if Roe v. Wade is overturned based on the legal theories you outlined, because they're already happening in many states. Reproductive rights advocates are correct to be nervous because they're seeing what patients are experiencing now.
While the right to an abortion remains legal across the nation, it is in effect inaccessible for many patients. Between financial barriers, logistical challenges, and thousands of restrictions, we're already seeing what you imagine. It's not a thought experiment. It's real.
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