Federal Updates

Trump’s 2020 budget proposal is released

Every year, the President of the United States submits a budget request to Congress, which includes a request for funds for the executive and independent agencies. The President’s Budget Request is not law. It can be accepted, rejected or otherwise changed as Congress goes through the appropriations process. But it does give the public a blueprint for the Executive Branch’s priorities.

Judging from his proposal, Trump’s priorities are 1) massively increasing defense spending to detain more migrants and ramp up military operations abroad, and 2) decimating the programs that lower and middle income Americans rely on for food, health care, housing, and more.

The proposed budget includes $8.6 billion to fund a border wall with Mexico and would increase defense spending by $750 billion, while calling for deep cuts to essential social programs, including $8.6 billion from public housing, more than $1 trillion from Medicaid, $845 from Medicare, and $220 billion from the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) over the next decade. The budget would include mandatory work requirements for SNAP and Medicare, and repeal the Affordable Care Act (ACA), including Medicaid expansion, health care subsidies, and protections for people with pre-existing conditions. On the global front, the proposal would cut funding for global HIV/AIDS programs by about 10%. As proposed, the budget would widen income inequality and exacerbate racial disparities in the US and severely affect our ability to address the HIV epidemic globally.

Never one to shy away from hypocrisy, while reducing HHS discretionary funding by 12%, Trump’s proposal simultaneously includes a $291 million investment in the 50 communities — 48 counties, Washington D.C., and San Juan, Puerto Rico — that the Department of Health and Human Services (HHS) will target as a part of their plan to end the HIV epidemic–as if they expect to end the epidemic while pushing for policies and funding structures that would radically undermine the health, safety and security of those who are most vulnerable.

The latest in HHS’s End the Epidemic Plan

As PWN-USA previously reported, the Department of Health and Human Services announced its Plan to End the HIV Epidemic last month. In furtherance of that Plan, the National Institutes of Health has submitted a request for eligible Centers for AIDS Research (CFARs) and National Institutes of Mental Health HIV/AIDS Research Centers (ARCs) to start developing projects in conjunction with local, county, and state health departments and community-based organizations. Eligible CFARs and ARCs have been  asked to submit a brief proposal that outlines a research project plan and budget to support local needs and opportunities to 1) advance HIV testing and access to PrEP and PEP, 2) link and retain those diagnosed to care, and 3) implement ways to detect and respond to HIV “clusters” through biomedical and behavioral interventions.

The last component indicates that HHS would like the proposals to include a reliance on components of molecular HIV surveillance, which raises serious concerns around informed consent, the protection of health data, and increased criminalization of people living with HIV. [Want to learn more about molecular HIV surveillance concerns? Register for a webinar series at this link.]

Congress rejects the state of emergency and Trump vetoes

On February 15, Trump declared a state of emergency at the U.S.-Mexico border, alleging that increased border crossings posed a threat to national security. In a stunning rebuke to the White House, the House and Senate voted overwhelmingly to reverse Trump’s declaration. Trump then used his first presidential veto to block the resolution. Overriding the veto would require a two-third majority vote in the House and Senate, which they do not appear to have.

There is, however, a lawsuit pending in a federal court that challenges the constitutionality of the declaration, and this suit could stop the Trump administration from building the border wall without the proper Congressional appropriations process.

Senate confirms more of Trump’s judicial nominees

The Senate has confirmed five more of President Trump’s nominees to the federal bench this month: Allison Jones Rushing (Fourth Circuit Court of Appeals); Chad Readler (Sixth Circuit Court of Appeals); Eric Murphy (Sixth Circuit Court of Appeals); Paul Matey (Third Circuit Court of Appeals); and Neomi Rao (D.C. Circuit Court of Appeals).

All are considered conservative judges, and some like Rushing, Murphey, and Readler, have solidly anti-LGBT records. Such lifetime confirmations show how Trump is quickly reshaping the federal judiciary — Supreme Court and beyond — for years to come. In just two years, Trump has filled 10% of the federal bench, and 20% of appellate judges.

Mother Jones reports that if McConnell reduces the Senate’s allotted debate time to from 30 hours to 2 per nominee (which he has threatened to do), Trump could appoint nearly one-third of the judiciary before the 2020 election.

Health Care Access

Trump administration argues the ACA is unconstitutional in its entirety

The Trump administration has changed course in a a lawsuit challenging the constitutionality of the Affordable Care Act (ACA), Texas v. United States. In December, a Texas district court judged ruled that the ACA was unconstitutional. At the time, the Trump administration held the position that the protections for people with pre-existing conditions should be struck down. The administration shifted to a more extreme position in a short letter to the 5th Circuit Court of Appeals, the conservative court with which the case now sits. The Department of Justice states that it agrees with the lower court judge that the ACA should be deemed unconstitutional as a whole.

For more information, read PWN-USA’s statement against this egregious change here.

Medicaid work requirements struck down in Kentucky and Arkansas

On March 27, a judge stuck down the Trump administration’s plan to kick some Medicaid recipients in Arkansas and Kentucky off the program if they do not prove that they worked or volunteered enough. Medicaid work requirements are counterproductive, worsen access to care, health outcomes, and financial security, and can create administrative barriers that even cause those who work to lose coverage.

Indeed, Arkansas has shown how cruel work requirements can be, with 18,000 people losing coverage so far and tens of thousands more on the horizon. The outcome of a third lawsuit, filed against the Trump administration on March 20, is still pending. This case challenges HHS’s approval of New Hampshire’s work requirement proposal.

Health care reform to strengthen the ACA introduced

The day after the Trump administration signaled it will argue to invalidate the ACA, House Democrats presented a forceful response. They unveiled a bill called “Protecting Pre-existing Conditions & Making Health Care More Affordable Act of 2019.”

The bill would make coverage more affordable by expanding health care subsidies that help people pay for their premiums. It would also reverse a number of harmful Trump administration policies, such as the deep cuts in advertising and outreach funding and the expansion of “junk health” plans that do not meet ACA standards and can discriminate against people with pre-existing conditions.

Civil Rights

House passes For the People Act

On March 9, House Democrats passed the For the People Act, H.R. 1, which could have far-reaching implications for all future elections by expanding voting rights, transforming campaign finance law, and strengthening government ethics requirements.

Among other things, the bill includes provisions to increase campaign finance transparency; encourage small donations by creating a 6-to-1 federal match for donations under $200 (paid for by fines and fees against banks and corporations who committed malfeasance); require the president, vice president, and candidates for those offices to disclose 10 years of tax returns; prohibit members of Congress from using taxpayer money to settle sexual harassment or discrimination cases; create an automatic, opt-out voter registration system; make election day a federal holiday; end partisan gerrymandering; and prohibit voter roll purges.

Senator Mitch McConnell (R-KY) has already signaled that he will not bring H.R. 1 for a vote in the Senate, meaning the bill is very unlikely to become law.

Trump administration uses surveillance to squelch opposition

This month we also learned that ICE had a secret list — the “anti-Trump protest” sheet — of New York City activist groups that protested the Trump administration’s deportation policies, the National Rifle Association, or supported abolishing ICE. Another secret surveillance list was compiled at the U.S.-Mexico border to track 59 activists and journalists who were documenting the caravan of migrants in Tijuana the winter of 2018.

This is reminiscent of the Federal Bureau of Investigation’s secret “Black Identity Extremist” report, leaked October 2017, that suggested that Black activists were being tracked and policed simply because they were Black and critical of the police.

Sexual and Reproductive Health, Rights and Justice

Reproductive Rights are Human Rights Act is introduced

Congressional Democrats introduced a bill, S. 707, on March 7 that would require the U.S. State Department to include reproductive rights in its annual human rights reports. The “Reproductive Rights Are Human Rights Act” addresses the Trump administration’s decision to remove analysis of women’s reproductive health and rights (including maternal mortality and contraceptive need) from the reports. Excluding important information about how state policies and practices harm women’s rights and health worldwide implies that reproductive rights and health are not a human right and renders these human rights violations more difficult to document.  

Global Gag Rule expanded

On March 26, the State Department announced that it would significantly expand the global gag rule. U.S. law has prohibited foreign aid from being used for abortion-related activities since 1973. The global gag rule is a separate rule that prohibits foreign non-governmental organizations (NGOs) from using U.S. global health funds to 1) provide abortions, 2) counsel patients about or refer them to abortions, or 3) advocate for laws that uphold abortion rights.

Under the extended global gag, NGOs receiving U.S. aid cannot give their own (non-U.S.) funds to any partner if that partner engages in abortion-related work (even if that work is done with their own funding). Basically, the rule gags foreign NGOs that receive U.S. global health funds and the partners they support.

EACH Woman Act is introduced

Democratic lawmakers in the U.S. House of Representative and Senate introduced the EACH Woman Act , H.R. 1692/S. 758, which would repeal the Hyde Amendment, an annual budget rider that prohibits federal money from funding abortion. Congress has passed the Hyde Amendment every year for more than 40 years. Abortion coverage restrictions disproportionately impact low-income people, women of color, immigrants, and people of trans experience, often forcing those who can least afford it to pay out-of-pocket. The EACH Woman Act would stop this political interference and ensure that all people enrolled in government health plans have the abortion coverage they need, regardless of income.

Lawsuit is filed against the Title X domestic gag rule

Last month, the Trump administration issued its final Title X domestic gag rule, which would prohibit Title X providers from referring their patients to abortion services and try to push health care facilities that provide abortion (like Planned Parenthood, which serves 41% of the Title X patients) off the program. In March, medical groups, reproductive rights groups, and 21 states filed lawsuits around the nation against the administration to block the rule. Plaintiffs argue that the rule is in violation of the U.S. constitution and federal law that protects full and open communication between doctors and patients.

FDA is trying to make access to abortion harder

The U.S. Food and Drug Administration (FDA) has ordered a European organization (Aid Access) that provides doctor-prescribed medication abortion pills to the U.S. by mail to stop importing the pills. Self managed abortions are on the rise in the U.S., and the pills that Aid Access delivers have been proven 97% effective. The organization uses telemedicine to ensure that healthy women less than nine weeks pregnant can have access to safe, effective and affordable medication abortion.

Although the FDA cites larger online drug regulation concerns, this administration’s hostility towards abortion access and the safety record of these pills suggest a different motive.

NATIONWIDE TREND: Courts and state legislatures push constitutionally suspect abortion restrictions

In the courts, we have seen shocking outcomes in two abortion-related cases. In Whole Woman’s Health v. Paxton, a case about a Texas law that would ban the most common method of abortion later in pregnancy, Fifth Circuit Court of Appeals would rather refuse to issue a holding than affirm the right to an abortion.  In Alabama, a probate judge allowed a man to sue a medication abortion pill manufacturer and abortion clinic after his girlfriend exercised her legal right to an abortion. This dangerous decision purports to recognize legal rights for an fetus and threatens to give third parties veto power over the reproductive decisions of pregnant people.

Meanwhile, a number of troubling anti-abortion bills have successfully moved through state legislatures. Mississippi’s governor signed a law that would prohibit abortion when a fetal heartbeat can be detected, essentially a six-week ban that would often take effect before a person even knows they are pregnant.

At least 11 other states have introduced similar abortion bans this year; many of the bills have passed at least one chamber. Georgia’s H.B. 481 is especially close to passing. Kentucky’s governor signed two anti-abortion measures into law in March: a similar six-week ban and one that would prohibit abortion if sought because of race, color, national origin, sex, or disability. The state only has one abortion clinic already, and both laws were swiftly blocked by a federal court (once again, promising a Supreme Court challenge).

Governors in Arkansas and Utah both signed 18-week abortion bans into law, enacting some of the strictest abortion regulations in the county (for now). Both will likely be challenged in court. South Dakota’s Governor signed a bill into law that would force physicians to offer patients the opportunity to view a sonogram and hear the heartbeat of the fetus prior to an abortion. Arkansas’s governor signed a “trigger law,” which which would immediately become a state-wide abortion if Roe v. Wade is overturned. Many more bills have been introduced or moved though at least one chamber. For more, see Rewire’s Legislative Roundups.

What’s the big takeaway? Many of these discrete decisions and new bills are constitutionally suspect at best and form a part of a larger nationwide effort to erode abortion rights and push the Supreme Court to undermine or overturn Roe v. Wade.

Immigrant Rights

Sprawling surveillance database targets immigrants

U.S. Immigration and Customs Enforcement (ICE) has been using a mass surveillance database containing billions of records on license plate locations to fuel the ICE deportation machine. The nationwide surveillance dragnet gathers time, date, and location coordinates from license plate readers (like those on traffic cameras, toll booths, parking lots, etc.) and stores that information for years with little or no federal oversight. Over 80 local law enforcement agencies, including some sanctuary cities, worked with ICE to informally share personal information, in some cases violating local privacy laws and ICE policy. The American Civil Liberties Union (ACLU) sued to obtain the records under Freedom of Information Act, and urges the practice be immediately stopped.

In addition, a recent Rewire report revealed that U.S. Citizenship and Immigration Services (USCIS) has been coordinating with ICE at an unprecedented level. USCIS is supposed to be the service arm of the immigration system, responsible for processing immigration and naturalization applications. The close coordination with ICE, one of the primary enforcement arms, is deeply troubling. It could have a chilling effect, discouraging people from applying for immigration benefits (like waivers to leave the country) or adjustments in immigration status. If they do and are denied, ICE could be informed and deportation proceedings begun.

Dream and Promise Act is introduced

On March 12, House Democratic lawmakers introduced the Dream and Promise Act, H.R. 6. The act would provide a pathway to citizenship for some 2.5 million people whose immigration statuses and lives were thrown into uncertainty because of the current administration’s anti-immigrant policies.  DREAMers and people with temporary humanitarian protections (i.e., Temporary Protected Status (TPS) holders and Deferred Enforcement Departures (DED) recipients) would be allowed to apply for permanent legal status.

The bill falls short of comprehensive immigration reform, but reflects movement in House towards more ambitious immigrant justice policies. H.R. 6 is expected to pass in the House but has a more difficult path through the Senate and White House. The Center for American Progress has more resources on H.R. 6 here.

U.S. Supreme Court expands scope of 2020 census citizenship question review to include constitutionality

Following a recent federal judge ruling that the administration violated federal administrative and constitutional law by deciding to add a citizenship question to the U.S. census, the U.S. Supreme Court has decided to expand the scope of their review to include the constitutional issue. Previously, they had intended to review and finally resolve whether the federal government can bring back the citizenship question. Oral arguments will begin April 23, 2019.

LGBTQ Rights

The Equality Act is introduced

Democrats in the House and Senate introduced the Equality Act, H.R. 5/S. 788, on March 13, 2019 with 287 co-sponsors, a record amount for pro-LGBTQ legislation. The bill would amend existing civil rights law to include consistent and explicit federal non-discrimination protections on the basis of sexual orientation and gender identity. This bill would protect the rights and dignity of millions of people who currently live in states without LGBT-inclusive non-discrimination protections in employment, education, public accommodations, housing, federal jury service, and credit.

Trans military ban will go into effect

The Trump administration has ordered the Armed Services to discharge or refuse to enlist service members of trans experience who have transitioned beginning April 12, 2019. People of trans experience who were diagnosed with gender dysphoria and who enlisted before that date can qualify for gender-affirming care and continue in the military. After April 12, however, the prohibition is complete: people of trans experience will not be allowed to enlist if they are taking hormones or have received other gender-affirming care. If a service member is diagnosed with gender dysphoria after April 12, they will be prohibited from transitioning and required to serve as their sex assigned at birth.

This is a cruel, spiteful policy that requires transgender service members to deny who they are in order to be in the military. The ban reverses gains that have been made by the roughly 14,700 trans service members currently serving by politicizing essential health care.

NATIONWIDE TREND: Anti-LGBTQ bills threaten rights

“Religious refusal” bills around the nation essentially legalize LGBT discrimination by empowering people to deny services or opportunities (like health care, adoption, marriage, or access to student organizations) to others based on their own moral convictions.

Such bills are pending in multiple states including (but not limited to) Texas, Tennessee, Kansas, and Montana. A bill in Alaska, H.B. 5, would prohibit any state funds from going to gender affirming care. In Tennessee, companion “bathroom bills,” H.B. 1151/S.B. 1297, would criminalize people of trans experience for using bathrooms that match their gender identity. Similar bills are being considered in Massachusetts, HB 1427/H.B. 1504, and Washington, H.B. 2088.

For more legislation affecting LGBT rights across the county, see the American Civil Liberties Union helpful 2019 Legislative Tracker.

Economic Justice

Puerto Rico faces a crisis amid cuts to food stamps

On March 25, the Washington Post reported that cuts in food stamps have left more than 1 million Puerto Rican residents at risk of food insecurity. A big part of the problem is that social services in Puerto Rico are funded differently than those on the U.S. mainland. Rather than the Supplemental Nutrition Assistance Program (SNAP), they have the Nutritional Assistance for Puerto Rico (NAP) Program, which needs to be renewed regularly and provides food stamp benefits about 40% lower than on the mainland. Following Hurricane Maria in 2017, the federal government provided additional food stamp funding to Puerto Rico, raising their benefits about the same level as SNAP. Congress should have re-authorized the emergency funding in March, but missed the deadline.

Food stamp benefits in Puerto Rico have fallen precipitously this month as residents continue to struggle with the immense fallout from Hurricane Maria in 2017. Senator Sanders and Representative Velazquez have introduced the Equitable Nutrition Assistance for the Territories Act of 2019, which would bring Puerto Rico and other U.S. territories back into SNAP, but it is unlikely to pass the Republican-controlled Senate.

Banks are divesting from private prison industry

The largest bank in the U.S. announced on March 5 that it would no longer finance private prisons and immigrant detention centers. This victory is the result of years of pro-immigrant rights groups, grassroots campaigns, and activists pressuring banks to divest and stop profiteering from the injustice of mass incarceration and detention.

Since J.P. Morgan’s decision was announced, two other major banks committed to pulling back from the private prison industry. Wells Fargo has said it would not sign new contracts or renew existing ones. US Bank committed to continue reducing its bankrolling of private prisons. Representative Ocasio-Cortez called for congressional hearings to hold banks accountable for investing in private immigration detention facilities.  

State Updates

Florida

There are two exciting bills to watch in Florida. The state’s HIV modernization bill, H.B. 79, has been voted out of two committees. A companion bill in the senate, S.B. 846, is awaiting its first vote in the Health Policy committee. It must be approved by the House Judiciary Committee before going to a full house vote, and must pass three committees in the senate as well as a full senate vote.

Additionally, companion bills in the house and senate, H.B. 1279/S.B. 438 would revise the state’s anti-discrimination law to include protections against discrimination based on gender identity and sexual orientation in employment, housing and public accommodation. The House bill was filed on March 5, and both have been referred to committee.

Iowa

On March 8, the Iowa Supreme Court unanimously ruled that the state Medicaid program could not deny people of trans experience coverage for gender affirming surgery. The court held that the state Medicaid coverage ban constituted discrimination based on gender identity and was in violation of state law. With this decision, 11 states and Washington, D.C., now cover transition-related surgeries through their public health insurance programs.

Maine

Maine passed an emergency measure to codify core ACA protections on March 19. An Act To Protect Health Care Coverage for Maine Families, L.D. 1, requires insurance companies on the state health care marketplace to include certain basic protections, like coverage for essential health benefits, a ban on lifetime and annual coverage caps, allowing people to stay on their parents’ insurance until 26 years old, and protections for pre-existing conditions.

Missouri

In two separate rulings late last month, the state Supreme Court recognized that Missouri law protects against discrimination based on sexual orientation and gender identity. This case is a significant victory for LGBT rights and equality, but the state could do more by passing the Missouri Nondiscrimination Act, which would help codify this decision.

North Carolina

A federal judge in struck down a 1973 state law that banned abortion in the state after 20 weeks with certain, limited exceptions. The state amended the law in 2015 to narrow those exceptions, and reproductive rights groups challenged it as unconstitutional. The judge agreed, holding that under Supreme Court precedent, “state legislatures may never fix viability at a specific week but must instead leave this determination to doctors.”

Texas

A Texas federal judge blocked the secretary of state, David Whitley, from initiating a massive purge of voter rolls late last month. Whitley flagged the names of nearly 100,000 registered voters who had reported themselves as non-citizens when they applied for their driver’s licenses. But Latinx civil rights groups accused Whitely of voter intimidation and bad faith in the process. Most of the people on the list were recently naturalized and then registered to vote. In his ruling, the federal judge seemed to agree, citing no evidence of widespread voter fraud and calling the way the list was compiled “ham-handed.”