Tapped: The Prospect Group Blog

“The Full Spectrum of the Republican Party”

In his victory speech Tuesday night after winning the Wisconsin primary, Senator Ted Cruz pointed to his endorsements from former GOP presidential candidates former Texas Governor Rick Perry, Senator Lindsey Graham, former Florida Governor Jeb Bush, Carly Fiorina, and Wisconsin Governor Scott Walker, as proof that he has the “full spectrum of the Republican Party coming together and uniting behind this campaign.”

But what’s most striking about these political figures is how much they have in common. They differ in height, weight, charisma, and personality, but there’s hardly any distance between them when it comes to what they believe about government and public policy. On a scale of one to ten—with ten being the most reactionary—every candidate rates an eight or above.

Here’s where Cruz and those ex-rivals who now support him stand on the major issues facing the country:

·       Obamacare—against

·       Raising the minimum wage—against

·       Raising taxes on the super-rich—against

·       Overturning Citizens United—against

·       Abortion and Planned Parenthood—against

·       Same-sex marriage—against

·       President Obama’s executive actions to protect Dreamers and the parents of children who are citizens or legal permanent from deportation—against

·       Strengthening regulations on Wall Street—against

·       Tightening gun control laws—against

·       Allowing Syrian refugees to enter the U.S.—against

·       Eliminating the death penalty—against

·       Promoting green jobs—against

·       Reducing military spending—against

·       Making voter registration easier—against

·       Labor unions—against

The “full spectrum” of Cruz supporters covers an extremely narrow ideological niche that is out of sync with the vast majority of the American public.

Supreme Court Case That Almost Busted Public-Sector Unions is Dead. What Now?

A dark cloud that’s loomed large over public-sector unions has cleared away—for now.

The Supreme Court split 4-4 Tuesday in its decision on Friedrichs v. California Teachers Association, a case centering on the legality of “fair-share” fees, which non-union members are required to pay to cover collective bargaining costs.

And while the decision came down Tuesday, Friedrichs’s fate was largely sealed when Justice Antonin Scalia unexpectedly died in February, ending the conservative majority on the high court.

Predictably, labor leaders were relieved, yet reserved.

“Millions of working people who understand the importance of their unions in bettering their lives and the well-being of their communities are breathing a sigh of relief,” American Federation of Teachers President Randi Weingarten said in a statement. “Even so, we know this fight is far from over. Just as our opponents won't stop coming after us, we will continue full speed ahead in our effort to mobilize our members and their neighbors around a shared vision to reclaim the promise of America.”

The case was highly controversial. Labor advocates contended that fair-share fees are crucial to keeping public-sector unions afloat; conservatives say it’s an affront to free speech. Friedrichs was pushed by right-wing legal activists in an attempt to overturn the 40 years of legal precedent that stood between public-sector unions and more restrictive right-to-work laws.

As the case moved through the federal courts, the larger public sector unions scrambled to shore up the rank-and-file and recruit non-members. But despite last-ditch efforts, labor leaders like Service Employees International Union President Mary Kay Henry were less than optimistic.

“By next summer, we’re going to lose another two million because of a Supreme Court case for the public sector where public sector workers’ organizations will no longer be allowed to have union shops,” Henry said. “Everyone will be a voluntary member. And I think that means another chunk of the movement will be gone.”

But that all turned on a dime with Justice Scalia’s death. Now public-sector unions are suffering from strategic whiplash and are likely still sorting out how to proceed now that the current legal threat has been thwarted.

However, Friedrichs isn’t the only case attacking fair-share fees, and unions more broadly. There are a handful of similar cases currently working through the courts that focus on the same argument as Friedrichs—that mandatory union fees are unconstitutional. Illinois Governor Bruce Rauner, who launched one of those cases, said yesterday that he fully expects his case to reach the Supreme Court.

Those circumstances make the current Supreme Court confirmation battle all the more important. President Obama’s nominee, Merrick Garland, is largely viewed as a pro-labor judge who would hesitate to overturn 40 years of precedent.

If Garland is able to win confirmation from the Senate or if a Democratic president gets a liberal justice on the high court, then unions will rest easier with a liberal Supreme Court majority and largely pro-labor lower courts.

The real danger for public-sector unions lies with another scenario: a Republican who captures the White House in 2016 and secures the confirmation of a conservative justice, a development that would invite a fresh slate of anti-worker cases.

Lester Thurow, an Economist Ahead of His Time

Lester Thurow, one of the leading economists to challenge American inequality before that view became fashionable, died last week at 77. He spent most of his career at MIT, where he also served as dean of the Sloane School of Management between 1987 and 1993.

Born in Montana, he was a Rhodes Scholar, an avid mountain climber, and a full professor by age 30. And he was a genuinely nice person.

I got to know Les Thurow because we were part of a fairly small cohort of non-Marxian, left-of-center thinkers on economics.

Thurow joined Robert Reich, Ray Marshall, Jeff Faux, Barry Bluestone, and myself in 1986, to found the Economic Policy Institute.

We acted because virtually the entire mainstream economics profession had become something of a commercial for the proposition that markets are almost invariably efficient. Marxian economists, of course, had an entirely different view. But among non-Marxists, Thurow was perhaps the most eminent and well credentialed of those who challenged market verdicts as neither necessarily efficient nor just.

We founded EPI in part because there was a huge hole in the world of think tanks. Before EPI, there were outfits like the American Enterprise Institute on the right and the Brookings Institution in the center but no real left-liberal institution committed to high quality research.

Thinking about the years when Thurow was a well known public intellectual, one recalls what an uphill climb it was to get the American economics profession to take seriously the proposition that market outcomes could be wrong. Thurow lived long enough to see inequality become the leading economic issue.

He was criticized by many in the economics profession not only for his views, but for his insistence on writing clear prose that could be read by a broad audience. For this he was damned in some quarters as a mere popularizer.

His first major book, The Zero Sum Society, was written in 1980, a time when the economy was in big trouble from stagflation and the run-up of energy prices, and widening inequality first began to show up in the statistics. Thurow’s ingenious argument was that the economy was stuck because any reform that would make the economy as a whole better off would make some people worse off. Hence, the zero-sum conundrum.

And of course, the people who stood to lose were mainly the wealthy and the powerful. Thus was reform blocked.

The solution? More public sector intervention to override failed market outcomes—more reliance on democracy.

Thurow was writing at time when the conventional wisdom went in the opposite direction, but he stood his ground. Today, his views have a lot more company. His next book, Dangerous Currents: the State of Economics, published in 1983, was a careful critique of mainstream economic principles.

Thurow, like John Kenneth Galbraith or Albert Hirschman, was something of a loner in his profession. His method was historical and institutional, not rigorously quantitative. Though he had students, there was not really a Thurow “school” of economics.

Nonetheless, in the work of EPI and in the much broader legions of today’s economists who recognize the inefficiencies of markets, the role of political power, and the needless extremes of inequality, Thurow has plenty of company.

Group Drafts Secret Proposal to End Taxpayer-Funded Veteran Care

Deliberations by the Department of Veterans Affairs Commission on Care, the congressionally mandated group planning the future of the Veterans Health Administration, have, as The American Prospect has reported, become increasingly marred by controversy. When the 15-member commission met in Washington in mid-March, another furor erupted. A recently uncovered proposal to privatize the VHA set off a firestorm of protest within the veterans community.

Several members of the commission learned that seven of their colleagues had been secretly meeting to draft a proposal to totally eliminate the Veterans Health Administration by 2035 and turn its taxpayer-funded functions over to the private sector. Those commissioners dubbed the plan “The Strawman Document.”

The authors of the Strawman Document insist that the VHA is so “seriously broken” that “there is no efficient path to repair it.” Although the commission’s work is supposed to be data-driven and done by the all the commissioners together, the faction meeting independently of the full commission has ignored many of the studies that indicated that treatment at the VHA is often better and more cost-effective than the care available in the private sector.

It is not surprising that the Strawman group has chosen to ignore this research—its members have a vested interest in dismantling the VHA. The Strawman authors include Darin S. Selnick, a part-time employee of the Koch-funded group Concerned Veterans for America, as well as Stewart M. Hickey, a former leader of Amvets, a group that broke away from a coalition of large veterans service organizations because of its support for Concerned Veterans’  interest in dismantling  the VHA.

The Strawman authors acknowledge that private-sector health-care systems do not provide integrated care, high-quality mental-health treatment, or many other specialized services that the VHA currently delivers. But if the VHA became an insurer—paying the bills instead of providing direct care—it could spend more money trying to “incentivize” providers to give better care in these areas.

Private hospitals would also get federal funding to run what are now VHA Centers of Excellence, which treat epilepsy, Parkinson’s disease, and other conditions veterans face.

Representatives of veterans service organizations (VSOs) believe the secret meetings of the Strawman group may violate the Sunshine and Federal Advisory Committee Acts, as well as the commission’s agreed-upon processes. The commission had set up working groups to consider key VHA issues. Unlike the secret Strawman meetings, the subcommittee members were well known by all members and the public. Meeting times were posted, and discussion minutes were recorded. 

The Strawman faction engaged in another end run around their colleagues when they met with Republican Representative Jeff Miller, chair of the House Veterans’ Affairs Committee, and Speaker Paul Ryan. One representative of a major VSO, who asked not to be identified, observes: “If the authors requested the meeting with the House leadership, that constitutes lobbying. If they were invited by the House leadership, that constitutes more interference into the commission’s deliberations. Either way, this meeting, funded by the U.S. taxpayer, was totally inappropriate.”

“The plan does represent a complete deflection of responsibility to subject these men and women to an alternative ‘payer-only’ system of care that not only is ill-equipped to absorb the demand but is also, at best, minimally equipped in terms of expertise and the ability to coordinate such complex care over a veteran's lifetime,” says Sherman Gillums Jr., acting executive director of Paralyzed Veterans of America.

Before the Strawman proposal became public, Disabled American Veterans (DAV) launched Setting the Record Straight—a social media campaign against proposals that would privatize some or all of the VHA. Garry Augustine, DAV’s Washington executive director told the Prospect, “Although we have voiced our views about VA health care for the future, it seems many on the commission are committed to [doing] away with the VA health-care system and turn veterans over to private health care, which we believe would result in uncoordinated and fragmented care for veterans.”

The commission would do far better to consider the views of VA Undersecretary of Health David Shulkin and commission member Phillip Longman. Shulkin has argued for strengthening the VHA and giving it a more active role in directing and coordinating any care veterans receive in the private-sector system. Longman believes that the VHA should serve all veterans—not just those with service-related conditions or those who are low-income veterans.

House Veterans Affairs Chairman Blasts Health-Care Commission Member

The VA Commission on Care, the 15-member bipartisan body created by Congress to make recommendations about the future of the Veterans Health Administration (VHA), has been meeting for months and plans to publish its findings in June. Until this week, Congress had not interfered with the commission’s supposedly independent deliberations.

That all changed on March 14 when Republican Congressman Jeff Miller, the House Veterans’ Affairs Committee chairman and a staunch advocate of privatizing the Veterans Health Administration, wrote an angry letter to the commission chairwoman Nancy Schlichting. In this unprecedented missive, Miller personally attacked Phillip Longman, a commission member who has advocated not only preserving but strengthening the veterans’ health-care agency in part by eliminating its cumbersome eligibility requirements, and expanding health-care services to veterans’ families. 

Miller accused Longman, a Washington Monthly senior editor and author of a sympathetic appraisal of the VHA, Best Care Anywhere: Why VA Health Care is Better than Yours, of personally editing a recent article by former Wall Street Journal reporter Alicia Mundy. Mundy criticized Miller for his singular focus on VHA wait times and his insistence that 40 veterans had died because they were waiting for care. She also detailed the role that Miller and other congressional conservatives have played in the Koch brothers’ campaign to privatize veterans’ health care. Mundy warned that private hospital systems, which have representatives on the commission, are “circling like vultures over the idea of dividing up the VA’s multibillion-dollar budget.”

Miller said Longman helped spread “blatantly false propaganda in an attempt to minimize the wait-times scandal at the Department of Veterans Affairs” through the Mundy magazine article. Longman “either believes the article’s false claims or he—as an editor of the piece—signed off on them knowing they were untrue,” Miller wrote. He warned the commissioners “to take anything Longman says with an extremely large grain of salt.”

A subsequent Washington Monthly blog post by Paul Glastris, who actually edited Mundy’s article, rebutted Miller’s claims about patient deaths and other issues.  Longman, who is a part-time staff member at the magazine, also reviewed Mundy’s piece but did not edit it. (However, members on the commission, which includes health-care industry executives, veterans’ advocates, and a representative of the Koch brothers-backed Concerned Veterans for America, can continue to perform their professional duties as long as they do not claim to be acting on behalf of or speaking for the commission.)

Veterans advocates say that Miller’s tirade was the first time any of them could remember a congressman attacking a commission member.

Retired Army captain Steve Robertson, a former Senate Veterans’ Affairs Committee staff director, told The American Prospect that, in his 30 years working on veterans issues, he couldn’t “recall a member of Congress ever instructing members of a commission or advisory group to ignore one of their members.” Robertson said, “Miller is way out of line.” Another representative of a major veterans service organization who did not wish to be identified, called Miller’s letter an attempt to “intimidate an independent commission and politicize their recommendations”

One week later, Miller appeared before the commission and continued his critique of the agency. In his hour-long comments, Miller had nothing good to say about the VHA. He ignored the findings of an independent assessment commissioned by Congress that found that the VHA delivers care that is often superior to the private sector. When commission member Michael Blecker of San Francisco-based Swords to Plowshares tried to defend the VHA’s model of integrated care and worried that many veterans would fall through the cracks of a private health-care system, Miller barely let Blecker finish his comments. The congressman argued that the VHA is “holding veterans inside” the system and must allow them to move into private sector care. Miller concluded by encouraging the commission to offer “bold ideas” on overhauling the system in their upcoming report.

The congressman may want to “empower veterans,” as he terms it. But moving them into a private health-care sector that has primary care physician shortages, coordination of care difficulties, serious wait-time challenges, and hundreds of thousands of deaths due to preventable medical errors poses risks that the commission can ill-afford to ignore.

Legislative Primary May Help Tighten Democrats' Supermajority in Illinois

Illinois Democrats’ ability to thwart Republican Governor Bruce Rauner’s right-wing, union-busting agenda has just been enhanced by the defeat of a state representative who regularly broke party ranks on key union votes.

Incumbent state representative Ken Dunkin, a Democrat whose defections on key votes often thwarted the party’s slim supermajority in the house, lost by more than two-to-one against Juliana Stratton in last night’s primary. His opponent received high-profile endorsements, including from Illinois House Speaker Michael Madigan and even President Barack Obama.

The local race served as a proxy war between the union-busting governor and his Democratic opponents in the legislature, who are deadlocked over a nine-month budget impasse. As I reported last week in the Prospect, the disagreements between Rauner and his Democratic opponents have centered on the governor’s insistence that spending measures be tied to anti-union measures. 

Dunkin, who has served in the House since 2002, raised eyebrows over the past year with a series of stunts aimed at Speaker Madigan and his colleagues. In September of last year, after missing a vote that would have hampered Rauner’s negotiating powers with a state workers’ union, Dunkin claimed he was “out of town,” and accused Madigan of running a “plantation” (Ken Dunkin is African American). In January, he brought a sleeping bag to a news conference, telling his colleagues he would not leave the chambers until he and his colleagues passed a budget deal.

His most notable and recent antic came in February, when Obama delivered a speech to the legislature. As the president extolled the need for a degree of bipartisanship and argued that occasionally crossing the aisle “doesn't make me a sellout to my own party,” Dunkin stood up and yelled “that’s right!”

Obama paused, looked toward the representative, and responded, “Well, we’ll talk later, Dunkin,” drawing enormous laughter and applause from the chamber.

If not for his repeated frustrations of his party’s agenda, Democrats might miss Dunkin as a source of mild amusement. Bruce Rauner, on the other hand, may have more to worry about. In the most expensive legislative race in Illinois’s history, “dark money” and super-PAC contributions made up more than 99 percent of the $3.4 million in donations to Dunkin’s campaign. Dunkin received $500,000 alone from a Rauner-aligned PAC, the largest single primary contribution in the state’s history. Stratton, by contrast, received about $1.8 million, largely from labor groups and political committees, but also from corporate interests and law firms. Almost none of the contributions to either campaign came from individual donors in the narrow district that snakes through from Chicago’s downtown business core to its poorer South Side.

Rauner found little solace in other state proxy races. Republicans failed to oust union-friendly Republican Senator Sam McCann downstate, and were also disappointed that insurgent efforts to unseat Madigan, who has occupied his chair since 1970, failed in the Democratic primary.

Through his communications director Lance Trover, Rauner issued a statement claiming many races where “special interests backed by Speaker Madigan” were also failures, though he did not mention any campaigns by name. Rauner then called on Madigan to “end his month long vacation and begin working with the Governor to enact a balanced budget alongside structural reforms that grow our economy.”

But Tuesday’s results suggest Madigan will have the upper hand in future negotiations, whether on union negotiations or the budget. Emboldened by a more secure supermajority, Madigan’s released his own statement last night. At face value conciliatory, it also appeared to signal a warning of sorts to Rauner:  

“With the clear message sent by voters Tuesday, I am hopeful we can use this framework moving forward to implement a state budget and work together to get things accomplished for the people we serve.” 

Clinton Wins Illinois, but Chicago Feels the Bern

Hillary Clinton carried Illinois, swept through three other states, and kept Bernie Sanders at bay in a too-close-to-call race in Missouri. But Chicago Mayor Rahm Emanuel, who endorsed Clinton, cannot revel in the presumptive Democratic nominee’s home state victory anytime soon. Instead, he will face questions about the blowout defeat of the incumbent Cook County State’s Attorney Anita Alvarez. The county prosecutor and ally of the mayor became the target of Chicagoans’ fury after a video of the death of Laquan McDonald, a black teenager shot 16 times by a Chicago police officer, was released to the public late last year, more than a year after the shooting occurred.

The state’s attorney race turned into a referendum on Emanuel himself, exposing the political vulnerabilities of a man who was once a key Democratic Party operative. Alvarez lost to challenger Kim Foxx in the Democratic primary by nearly 20 percentage points. Voters did not take kindly to the mayor’s defense of Alvarez, who charged the officer with murder only after the local outrage attracted national attention. After he was forced to comply with a Freedom of Information Act request for footage of McDonald’s death residents accused Alvarez and Emanuel of a cover-up. In the months following the video’s release, the city’s police superintendent stepped down and a series of protests calling for Alvarez’s and Emanuel’s resignations engulfed the city.

Sanders seized on this political turmoil to close Tuesday’s gap to two points in a state where Clinton led by a two-to-one margin as recently as last week. In a series of relentless attacks on the mayor, Sanders made clear that Clinton’s former surrogate’s brand was toxic. “Hillary Clinton proudly lists Mayor Rahm Emanuel as one of her leading mayoral endorsers,” Sanders told reporters at a news conference in the city. “Well, let me be as clear as I can be: Based on his disastrous record as mayor of the city of Chicago, I do not want Mayor Emanuel’s endorsement if I win the Democratic nomination.”

That aggressive strategy worked: Barack Obama’s first chief of staff and a former senior advisor to Bill Clinton (who was even rumored to be a potential running mate for Hillary) couldn’t even get face time with the Democratic frontrunner when she campaigned in the city.

Sanders’s attacks were part of a shrewd strategy to score points with the city’s African American voters, after the mayor’s February approval ratings dropped to 20 percent among blacks. Sanders has struggled with black voters, especially in Southern states where he has experienced deep losses.

Sanders lost the Prairie State by only two percentage points, and Chicago by eight. These margins were much smaller than those in other large minority-majority cities in the Midwest. Last week in Detroit, Sanders lost by nearly 60 percentage points and in Cuyahoga County (Cleveland) he lost by nearly 30 percentage points.

Emanuel’s fall from grace in the Democratic Party also underscores the growing clout of the Black Lives Matter movement. With Alvarez out of the county prosecutor’s office, local youth activists will undoubtedly focus their attention on a weakened Emanuel as they set their sights on the 2019 mayor’s race.

Sanders's Chances in November: A Bloomberg Addendum

An update to "Why Bernie May Have a Better Shot at Winning Than Hillary"

In the past, I’ve written that if Bernie Sanders were the Democratic nominee, Michael Bloomberg would enter the race and thereby win enough electoral votes to throw the election into the House, which, assuming it’s still under Republican control, would elevate the GOP nominee—that is, Donald Trump or Ted Cruz—to the presidency. So why didn’t I raise that possibility in assessing Bernie’s strengths and weaknesses should he become the Democrats’ nominee?

Chiefly because the one thing even Michael Bloomberg can’t buy is time.

When Bloomberg announced last week that he wasn’t going to run, one of the reasons behind his announcement—one he didn’t articulate—was time. If he were going to become a candidate, he’d have to start the process of collecting signatures to get on various state ballots right away. Perceiving that Hillary Clinton would almost surely be the Democrats’ choice, and not wishing to tilt a Clinton-Trump contest to Trump, he bowed out.

Clinton’s path to the nomination has become longer and more tortuous in the wake of Sanders’s Michigan victory, but she’s still the prohibitive favorite. Looking at the delegate numbers, even if Sanders were to somehow overtake her, it wouldn’t be until California votes in early June. By then, it would be too late for Bloomberg to change his mind. Indeed, even today, it may be too late for Bloomberg to change his mind.

The last gazillionaire to wage an independent campaign for the White House, Ross Perot, understood this perfectly. He declared his candidacy very early in the 1992 process and had time to collect the signatures to get his name on every state’s ballot. Then he dropped out in mid-summer, announcing, in effect, that he thought Bill Clinton would be a good enough president. He re-entered the race in the fall—but he already had his name on the ballots because he’d secured his ballot lines in the spring.

Even if Bloomberg believes he could theoretically prevail in a three-way race against Trump and Sanders, he couldn’t do it if his name wasn’t on a host of different states’ ballots. If a late Sanders surge causes him to rethink, it will be too late for him to run unless he’s resigned to winning an insufficient number of states to get to 270 electoral votes. In which case, the election would almost surely be thrown to the House, and thence to Trump or Cruz—the very scenario he’s stated he cannot in good conscience countenance.

Senate Bill Targets Corporations Moving Overseas to Dodge Taxes

Senator Sherrod Brown, a Democrat from Ohio, has introduced a new bill that would force deserting corporations to pay taxes before they head overseas—The Pay What You Owe Before You Go Act of 2016. U.S. multinational corporations have been evading paying U.S. taxes by renouncing their corporate citizenship and formally becoming formal foreign corporations (though they often don’t relocate any of their facilities)—a loophole that enables them to save billions. One example is Pfizer, the pharmaceutical corporation, which could avoid as much as $35 billion in taxes if these inversion loopholes are not closed.

Brown says his bill would prevent corporations “from sticking middle-class working people with their tab.” He calls it a “commonsense step” to increasing domestic investment and leveling the playing field for all American companies. The long-term solution, he says, will be to pass international corporate tax reform.

This is not the first time Brown has introduced the bill; the first time was in 2014, co-sponsored by Richard Durbin, a Democrat from Illinois. Though corporate inversions are not a new problem, more attention has been paid to them in recent years, so this time around his bill could be more politically opportune.

Frank Clemente, the executive director of Americans for Tax Fairness calls Brown’s bill “a victory for tax fairness.”

Oral Arguments Open in Supreme Court Challenge to Texas Law

On Wednesday morning, the Supreme Court will hear oral arguments for Whole Woman’s Health v. Hellerstedt, the most significant reproductive rights case to reach the Supreme Court in a generation. The outcome of the case will, to put it plainly, determine whether a woman’s constitutional right to access safe and legal abortion is merely theoretical, or means anything in the real world.

At issue is a controversial Texas law enacted in 2013 that critics say has diminished abortion access throughout the state. The law mirrors a national trend; since 2011, state legislators have passed an onslaught of abortion restrictions that have made it increasingly difficult for women to safely terminate unwanted pregnancies.

Attorneys representing Texas abortion providers are challenging two main provisions of the Texas law, known as HB2—requirements that every abortion provider obtain admitting privileges at a local hospital, and that all abortion clinics meet ambulatory surgical center building standards.

The GOP state legislature argues that the law’s mandates are there to protect women’s health. But critics say the real objective of HB2 is to make accessing abortion services more difficult, something that has certainly turned out to be the case.

Across the state, facilities have been forced to shut down, unable to afford the costs of complying with the new regulations. Though Texas has 5.4 million women of childbearing age living within its borders, the number of facilities that provide abortion services has dropped by more than half, from 40 to 19, in less than three years. If the Supreme Court upholds HB2, that number is expected to drop even further—to ten clinics or fewer.

The salutatory health claims made by the law’s authors have not been substantiated by evidence. Abortion is an unusually safe medical procedure—researchers have found that complications following abortions in the first trimester are less frequent than after tonsillectomies or wisdom tooth extractions, among other procedures. (More than 90 percent of abortions occur during the first trimester.) The American College of Obstetricians and Gynecologists and the American Medical Association have also said that there is “simply no medical basis to impose a local admitting privilege on abortion providers.” Moreover, the Texas Policy Evaluation Project, a reproductive health research organization housed at the University of Texas at Austin, found no evidence to suggest that surgical abortion complications following first-trimester abortions are less frequent in facilities that meet ambulatory surgical center building standards.

Since HB2’s enactment, Texas women face longer waiting periods to access abortion care. There is also evidence to suggest that more women are attempting to self-induce their own abortions. In November, the Texas Policy Evaluation Project published a study which estimated that between 100,000 and 240,000 Texas women ages 18 to 49 have attempted in their lifetimes to end their pregnancies without medical help. The researchers say they expect those numbers to rise further if Texas continues to erect barriers to safe and legal abortion.

Dr. Willie Parker, a medical doctor and abortion provider in Alabama, Georgia, and Mississippi, told the Associated Press that if Texas’s law stands, “it won’t mean fewer unintended pregnancies. It won’t mean fewer fatally flawed pregnancies. It will mean women will be left without a safe and legal means of ending pregnancy.”

The Supreme Court case has galvanized advocates around the country. Over a dozen buses from cities across the country, including Atlanta, Cleveland, and New York City—among others, will be transporting reproductive rights supporters to the nation’s capital to unite around the banner of #StopTheSham. Upwards of 1,000 reproductive rights activists are expected to rally outside the Supreme Court for safe and legal abortion access, from 8 a.m. until 12 p.m. on Wednesday. At the rally, women will be publicly sharing their own abortion stories, abortion providers will give speeches about their work, and members of Congress, local elected officials, faith leaders, and civil-rights activists will also be making public remarks.

The stakes of today’s case couldn’t be higher, and the Court’s decision will have reverberations for women across America—even in blue states and liberal cities.

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