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The Next Abortion Battlegrounds
The Supreme Court may have overturned Roe v. Wade, but it has not ended legal battles over abortion.
The Supreme Court's decision in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade and concluded that the Fourteenth Amendment's Due Process clause does not protect a fundamental right to terminate a pregnancy. This will put an end to cases questioning whether a given set of abortion regulations constitute an "undue burden" on a woman's right to an abortion, but (as Ilya notes below) it will not put an end to abortion-related litigation.
One consequence of the Dobbs decision is that much abortion litigation will shift from federal to state court. Just because there is no right to abortion in the federal constitution does not mean there is no such right to be found under state constitutions. Just as (to take one example) the Ohio Supreme Court has concluded that the Ohio Constitution provides greater protection for private property against eminent domain than does the Fifth Amendment to the U.S. Constitution, state supreme courts may conclude that state constitutional provisions protect abortion rights through state-level rights to privacy (as in Montana) or other liberty-protecting provisions. Of course, such claims will not always be successful. The Iowa Supreme Court recently issued a state-level Dobbs decision, rejecting prior decisions that had recognized a state-level abortion right.
Many of the post-Dobbs legal fights over abortion will involve questions about the scope of federal and state power over abortion, such as whether states can limit the ability to cross state lines to obtain abortions or whether federal drug regulation constrains the ability of states to limit access to medication abortions.
A forthcoming article in the Columbia Law Review by Professors David S. Cohen, Greer Donley, and Rachel Rebouché surveys some of the new abortion "battlegrounds" we can expect to see. In this article they write:
In this post-Roe world, states will attempt to impose their local abortion policies as widely as possible, even across state lines, and will battle one another over these choices; at the same time, the federal government may intervene to thwart state attempts to control abortion law. In other words, the interjurisdictional abortion wars are coming. . . .
The article provides a useful overview of many of the legal issues that will arise in these "interjurisdictional abortion wars," in which the central legal questions will not concern substantive due process, but the scope of federal preemption, the autonomy of federal lands and enclaves, and the ability of states to limit interstate shipment of abortion medications, constrain interstate travel, or otherwise extraterritorialize their abortion laws. As I noted here, the White House has been consulting with academics to examine some of these questions, and I expect we will see the first rounds of litigation on some of these questions quite soon.
Perhaps anticipating some of these issues, it is notable that (as my co-bloggers have noted) Justice Kavanaugh made explicit reference to the constitutional right to interstate travel in his Dobbs concurrence. It may also be notable that Court's conservative justices tend to split on questions of federal preemption (as we saw in Virginia Uranium v. Warren in 2019).
One issue the article does not discuss is the extent to which the so-called "Comstock Laws" could constrain the interstate distribution of abortion medications. 18 U.S.C. Section 1461, for instance, makes it illegal to mail "obscene or crime-inciting matter," and defines such materials to include "Every paper, writing, advertisement, or representation that any article, instrument, substance, drug, medicine, or thing may, or can, be used or applied for producing abortion, or for any indecent or immoral purpose."
Much like state laws limiting or prohibiting abortion have come back into force after Dobbs, I saw some claim that this would be true of the Comstock Laws as well. As this would be quite a staggering result (about which I had seen little discussion), I asked Profs. Cohen, Donley, and Rebouché about this, and here was Prof. Cohen's response (which I repost with permission):
We didn't mention these laws because the circuit courts long ago declared that they only apply to unlawful items. So, since abortion is legal and the FDA has approved distribution of mifepristone as safe and effective, including by mail, these are lawful activities and items, thus the law, as interpreted by the courts, doesn't apply. Even now that some states have made abortion illegal, the pills still are legal under federal law. This is why no one in any of the litigation, regulatory comments, or other advocacy around medication abortion for the past decades has raised these laws, even the Trump administration in the litigation about mailing pills that went to the Supreme Court.
To put a finer point on it, any contrary interpretation than what I explained here would ban abortion everywhere because every device used to perform an abortion in a clinic (forceps, cannulas, etc.) would be banned from being shipped to the clinics (none of the clinics make their own!). These are lawful items for lawful procedures so they can be sent in the mail.
As Professor Cohen notes (and the paper discusses) there will be legal wrangling over whether states can impose restrictions on mifepristone above and beyond those restrictions the FDA has determined are necessary to ensure that it is safe and effective under the Food, Drug and Cosmetic Act, but he does not foresee the Comstock Laws constraining the FDA.
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"As Professor Cohen notes (and the paper discusses) there will be legal wrangling over whether states can impose restrictions on mifepristone above and beyond those restrictions the FDA has determined are necessary to ensure that it is safe and effective under the Food, Drug and Cosmetic Act, but he does not foresee the Comstock Laws constraining the FDA."
We have a Supremacy Clause. The federal government can safeguard access by making a medical license in one state valid in all states. A woman can get on video, have a medical exam. An internal examination is not necessary, except to rule out cervical cancer, and is irrelevant to termination of pregnancy. She could then have her prescription mailed from outside the restrictive state.
See what the ob says:
https://parenting.firstcry.com/articles/internal-checkup-during-pregnancy/#Reasons_for_Internal_Examination_During_Pregnancy
The federalizing of medical licenses would enforce the Full Faith and Credit Clause. There are no differences in standards of care between states. Restrictive state licenses are medical rent seeking to reduce competition and to raise prices. State licensing is a form of armed robbery, and should not be tolerated. Federal licensure can likely drop medical costs 10% and alleviate maldistribution of medical services. Bring competition to the medical profession. Rural Congress members should lead on this question.
If lawyer rent seeking is costly and toxic, doctor rent seeking is twice as costly and 10 times as lethal, with 150000 people dying by medical error. Lawyers only kill 15000 murder victims a year by protecting their client and source of jobs, the criminal. Medicine now cost $3.5 trillion a year, with half being wasted and worthless.
In fairness to the doctors, half that waste would require the crushing of the lawyer profession. 10% is wasted on defensive medicine. An act that is not medically necessary but legally necessary is medical fraud, and should be prosecuted. The defendant doctor should file a cross claim for a $trillion against the malpractice bar. Then, doctors are intimidated by the lawyers of emotional familes insisting everything be done for an old moribund patient. So a 90 year old with kidney failure will get a painful, worthless kidney biopsy, instead of being let go. Doctors are afraid of being sued by the family. Crush the scumbag families and their scumbag lawyer. Transplant donations should be presumed, to save 50000 people a year. Again, crush the scumbag, mass murdering, cruel, lawyer profession. That is the most toxic occupation in the country, 1000 times more toxic than organized crime.
My understanding is that except for Rhode Island, state supreme justices are not given lifetime appointments, and a majority of states have some mechanism to allow voters to determine the composition of the supreme court, either by direct election (and periodic re-election), via the legislature, or via the Missouri Plan.
So, unlike the whole country, states are not stuck with the justices they have until they either die or voluntarily retire. Expect state supreme court decisions to hew to the red/blue culture war divisions since the justices are subject to removal by the democratic process.
The "democratic control" offered by Missouri plan systems is largely illusory, and the selection of candidates (including those to replace any judges non-retained) is delegated to the legal establishment, which is almost certain to be overwhelmingly pro-choice. So even in a deep red state, there's a lot of room for the courts to effectively police these things.
Several posts have promoted the meme that the Dobbs case does not end litigation over abortion.
That is not unexpected -- many SCOTUS decisions, particularly Constitutional ones, spawn much additional litigation as courts try to apply it to various situations, and grapple with its affects. I don't think anyone seriously thought that Dobbs would settle all abortion cases forever.
There's a lot of folks who don't even understand what the Dobbs decision means.
There's a lot of folks (too many on the left), who don't understand much at all.
One of my pet peeves is the failure of pols (who create laws) and courts (who interpret laws) often fail to acknowledge the reality on the ground. Two classic examples are the DCMA and the current silly laws about home made guns. It is trivial to get on thepiratebaydotcom and down the latest Hollywood movie; same goes for getting on the internet and getting plans for a CNC machine to make weapons. The laws prohibiting these actions are like pissing into the wind.
The same is true for any crazy law trying to stop abortion. Enough states will allow it, along with Plan B, that buying Plan B or traveling to a liberal state can not be stopped.
I suspect there will be a reduction in the total number of abortions mainly due to travel issues but that is really the only result of the Dobbs decision. It will still be possible to get abortions. Another huge consideration is that in places like CA, NY, IL, and other big population liberal states nothing will really change. It will be interesting to see how this affects folks voting with their feet as well.
That's kinda how it should be, though. Decentralize and let people migrate to places where they are comfortable with the laws, or "vote with their feet" and go to a place where they have a chance to change those laws by adding their vote to an existing movement in that place. This is the beauty of the way the American system was set up to run. By decentralizing, we make the lawmakers more accountable (a single vote has more power in local elections than it does in federal elections) and make them escapable (one can travel/move to other states/localities with different laws.)
Sure, if you ignore how people behave over abortion laws.
The hypocrisy of anti-abortion culture warriors driving their daughters/mistresses to abortion clinics is well-known. Simply put, this isn't an issue that people move over, it's an issue that wealthy white women take vacations over and poor POC women order black-market pills over.
It is an issue that responds to people's rhetoric, not their behavior.
Having Plan B available is not necessarily a defeat. Depends on how each individual feels about when a formerly unfertilized egg deserves protection -- fertilization, implantation, heartbeat, quickening, viability, etc.
That conservatives don't want to leave to it to "how each individual feels" is a fundamental part of the conflict: anti-abortion folk are absolutely against people deciding for themselves whether to get an abortion. Their explicit goal is removing that decision from play.
It means poor people, who lack the resources to easily organize and arrange travel out of state, are the ones most affected.
Unsurprisingly they're also the ones with the least political influence.
Unsurprisingly they're also the ones with the least political influence.
Only if they don't vote.
"We didn't mention these laws because the circuit courts long ago declared that they only apply to unlawful items. "
Has the Supreme Court agreed?
Also, isn't the point that those medications WOULD be unlawful in those states? Unlike forceps, which are lawful items that could be used for unlawful means, abortion medications would themselves be unlawful items. Not advocating one way or the other, just pointing out what seems to be a flaw in the argument.
I think that generally there aren't any medications used for abortions that lack any lawful use. At least, none I know of.
Let's take the abortion issue out of the equation. What if the feds FINALLY legalized marijuana on the federal level, but individual states continued to outlaw it for recreational use? If somebody from a state where recreational use is legal were to send it to a state where it is illegal for recreational use, would they be guilty of a crime? Obviously the end user would be, but would the sender? In this example, Marijuana would be a lawful item if used for medical reasons. It would be legal on the federal level. It would be legal for recreational use in the jurisdiction from which it was sent. But I have a feeling the sender would still be subject to prosecution for violating the laws in the state to which they sent it.
You raise a good point. What if the same item (forceps) can be used for both lawful and unlawful uses? Seems to me that is outside the statute.
It's based on the sender's intent, according to the historical note I read. Is the drug approved for something innocuous and is occasionaly used off label for abortions, and most of the recipients are pharmacies and hospitals? Is it FDA approved for a form of abortion or contraception that is illegal in the destination state and you are mailing it mainly to women's clinics? If you are on inquiry notice and avoid knowing you can still be convicted. One of my favorite legal terms is "ostrich instruction".
I don't support banning interstate travel for abortions. I think one of the perks of the way our system was designed is that, when power is decentralized and given to states and local governments rather than the federal government, it is escapable. So, with this question, I am not trying to make an argument. It is not rhetorical. I am worried about the law of unintended consequences and I am genuinely seeking understanding here...
Wouldn't Justice Kavanaugh and others' views on the issue of banning interstate travel for abortion potentially undermine the law (I think it's called the Mann Act) which bans interstate travel to a state with a lower age of consent for the purpose of having sex with somebody who is underage in your own state?
Looking up the Mann act, I see that it was amended back in '86 so that it now does not apply to consensual sex which is legal where it takes place. Or at least that's how I'm interpreting it.
https://www.law.cornell.edu/wex/mann_act
Hmm, without a clear requirement that the act be chargeable in the jurisdiction where the act takes place, it could still potentially be used/abused in the case of minors.
Also what about states with equivalent state laws?
That's my point. It seems to me that Kavanaugh's opinion, if adopted by the whole court, would make those laws illegitimate. Not advancing an opinion on whether that would be good or bad (I see support for both perspectives), simply observing the possible unintended consequences of such a ruling...
My understanding is that most states have state law equivalents to the Mann act.
I don't see how an administrative action by the FDA finding a certain drug to be safe and effective for inducing abortion could preempt a statute explicitly declaring such drugs to be illegal in the mail or common carrier delivery service. The historical notes on 18 USC 1461 quote a court decision requiring "an intent on the part of the sender that the article mailed or shipped by common carrier be used for illegal contraception or abortion or for indecent or immoral purposes". The FDA finding that such drugs do induce abortions could be evidence of criminal intent.
18 USC 1461 bans immoral items from the mail and 18 USC 1462 bans them from an "express company or other common carrier" in interstate commerce. You can carry all the immoral material you want in your car without violating those sections.
I think you could find 51 votes in the Senate to repeal the abortion part of these laws. Not necessarily to make it explicitly legal to mail abortion drugs into an unwilling state, but to make it not explicitly illegal.
"I don't see how an administrative action by the FDA finding a certain drug to be safe and effective for inducing abortion could preempt a statute explicitly declaring such drugs to be illegal in the mail or common carrier delivery service."
The mail being explicitly a federal responsibility, I don't see how state laws can affect what is/is not legal in the mail.
I don't see the US Congress passing a law barring FDA approved drugs from mail shipment.
Congress has said that drugs to induce illegal abortions may not be mailed. I don't doubt that it is within the authority of Congress to require compliance with the laws of the destination state when mailing drugs. Personally, I think that part of the law should be repealed, but it is well within the authority granted to Congress by courts of generations past.
"One consequence of the Dobbs decision is that much abortion litigation will shift from federal to state court."
So matters that are clearly a state's exclusive purview under the Constitution will be returned to . . . the purview of the states. Good.
A few educated, productive, reasoning states -- the ones with more people than cows, for example -- could lead the way by declaring that their state constitutions safeguard a right to abortion.
A church that celebrates abortion as a sacrament might become quite popular, too. I just read that a bunch of Catholic churches in my area are being consolidated (a loss of 70 percent of the churches) because of declining attendance . . . maybe there is a way that organized religion could die off more slowly, by embracing abortion?
Funnily enough, Alaska, a red state with more moose than people, has found that their state constitution protects the right to abortion...
The next “abortion battlegrounds” is a two-front maneuver. Anti-abortion forces working the “swing states” that have legal abortion simultaneously with the gop in congress attempting a national ban.
With medical associations coming out with strident statements against the correct interpretation of the Constitution, in support of killing unborn persons, and all sorts of other deranged things like trans ideology and Orwellian speech requirements, how can these institutions be taken seriously any more?
I know someone who was trying to have children, but the fetus had a severe genetic disorder. It effectively had no brain and if it survived to birth it would have had a very short life.
They made the difficult, but obvious decision to abort rather than carry that non-viable fetus for several more months before giving birth.
Perhaps some women might willingly go through with that pregnancy, but the thought of forcing it upon a woman, as several states in the US now attempt to do, is beyond horrific.
If your constitution truly allows that then your constitution is junk.
The vast majority of pro-life advocates make exceptions for threat to the life of mother or child, as in your example. Some states are currently engaged in what might be termed as "over-correcting," but I think that those laws, if passed, will be short-lived as even pro-life advocates will oppose them and vote for people who will amend them to be more realistic (like the law that would ban ending ectopic pregnancies even though there is absolutely no viability for that baby, which has drawn ire from pro-life advocates for delegitimizing their views...). Furthermore, this is the beauty of returning it to the states. Those women have recourse to escape those bad laws.
The question of whether a policy is morally good or desirable, has precisely zero relevance to the question of whether the policy is required or permitted by the Constitution.
Moreover, your suggestion that a constitution must right all wrongs and encapsulate all morally good and desirable law and policy, is incredibly asinine for many reasons.
A constitution doesn't decide those questions. It just establishes who decides and how.
I hope you are not laboring under a delusion that medical associations are 'taken seriously'. The AMA membership is around 15% of the nation's doctors and fully 77% of the nation's doctors say the AMA does not represent them.
Maybe more to the point somewhere around 7% of the OBGYNs perform abortions. As I have noted before insurance for doctors who perform abortions is sky high. Many women seeking an abortion lack insurance or the ability to pay for one making it even more of a money losing proposition.
It is all well and good to talk about the morals and ethics involved with abortions but in the famous words of James Carville 'Its the economy, stupid'.
I didn’t realize the Comstock law had language on abortion. I would think it would be valid after Dobbs unless Congress chose to amend it.
I also don’t see how the FDA’s general authority to regulate drugs could possibly override a specific criminal statute. One could imagine a drug used to cure insanity by people driven crazy by their spouses. Killing the spouse might in fact be safe (with respect to the patient, to whom a doctor might have sole duty) and highly effective for the purpose treating this particular medical disgnosis, and the FDA might so find. But I don’t see how its opinion would override a specific criminal statute prohibiting the specific purpose the drug was approved for, however therapeutic it might be from a medical point of view.
And to the extent members of the present administration actively encourage and facilitate violations of the law, as distinct from merely exercising discretion not to prosecute, I would think a future administration could prosecute them.
The next abortion battlegrounds will be the state legislatures, as it should be.
As a feminist, I certainly don't think it's appropriate for a majority-male court to tell a bunch of majority-female electorates what kind of reproductive policies they're allowed to have.
Too true. Unlike Federal law or Supreme Court rulings, State Legislation is accountable and escapable. This is why our system was set up so that the majority of the power would rest, not in the federal government, but in the State and Local governments where a small number of votes hold much more power to affect change, and where an individual can easily escape bad laws. Sadly we have corrupted this system with a great many illegitimate Federal laws and regulations and supreme court rulings. Whatever your opinion of abortion, overturning Roe was a step towards reasserting the original federalist model our country was meant to be based on...