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The push to defund Planned Parenthood hit other clinics in Maine. Now their group is suing.

The push to defund Planned Parenthood hit other clinics in Maine. Now their group is suing.

Boston Globe5 hours ago
Vanessa Shields-Haas, a nurse practitioner, said the organization's clinics have been seeing all patients as usual and completing Medicaid paperwork for visits — but not submitting it because it appears the provision took effect as soon as the law was signed.
'Knowing how hard it is to access care in this state, not allowing these community members to access their care, it's cruel,' Shields-Haas said.
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Maine clinics appear to be only others included in cuts
Republican lawmakers targeted Planned Parenthood in one piece of what President Donald Trump dubbed the 'big beautiful' bill that Congress passed and the president signed earlier this month.
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While advocates focused on Planned Parenthood, the bill did not mention it by name. Instead, it cut off reimbursements for organizations that are primarily engaged in family planning services — which generally include things such as contraception, abortion and pregnancy tests — and received more than $800,000 from Medicaid in 2023.
The U.S. Senate's parliamentarian rejected a 2017 effort to defund Planned Parenthood because it was written to exclude all other providers by barring payments only to groups that received more than $350 million a year in Medicaid funds. The not-for-profit Maine organization asserts in its legal challenge that the threshold was lowered to $800,000 this time around to make sure Planned Parenthood would not be the only affected entity.
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It is the only other organization that has come forward publicly to say that its funding is at risk, too.
Federal law already bars taxpayer money from covering most abortions. Instead, the money in question involves other health services, such as cancer screenings and tests, and treatment for sexually transmitted infections.
Proponents of that wrinkle in the law say abortion providers use Medicaid money for other services to subsidize abortion.
'This has never been just about Planned Parenthood,' Autumn Christensen, vice president of public policy for Susan B. Anthony Pro-Life America, said in a statement. 'It's about any Big Abortion business or network that performs abortions. Taxpayers should never be forced to prop up an industry that profits from ending human lives.'
The Associated Press has sought comment from the U.S. Department of Health and Human Services, which is named in the lawsuit.
Maine Family Planning goes beyond abortion
Maine Family Planning operates 18 clinics across the state.
In 2024, it had about 7,200 family planning patients, including 645 who obtained abortions. Services include pregnancy testing, contraception, family planning counseling, breast exams, cancer screenings and treatment of sexually transmitted infections.
Some of the sites also offer primary care services, where there are another 600 or so patients. There are about 800 gender-affirming care patients and about 200 who use its upstart mobile clinic, said George Hill, the president and CEO of the organization.
Hill said that for about two-thirds of its patients, Maine Family Planning is the only place they get medical care in a typical year.
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About half of the patients not seeking abortions are enrolled in Medicaid, and the clinics have been receiving about $1.9 million a year in reimbursements, which accounts for about one-fourth of the organization's budget.
'It's a difficult state to provide care in and now we're facing this,' Hill said. In its lawsuit, the group says it has enough reserves to keep seeing patients covered by Medicaid without reimbursement only through October.
Finding health care can be a struggle in this rural state
Maine Family Planning says that if it had to turn away patients, it would be more complicated for them than simply finding another provider. There aren't enough in rural areas, the group notes — and many don't accept Medicaid.
One patient, Ashley Smith, said she started going to Maine Family Planning about five years ago when she could not find other health care she could afford. While she's not enrolled in Medicaid, she fears clinics could be shuttered because of cuts.
'I am so worried that if my clinic closes, I don't know what I'll do or if I'll be able to see another provider,' Smith said.
Maine Family Planning also supports care at more than 40 other health care facilities. Other than the Planned Parenthood locations that receive money from Maine Family Planning, those other providers don't stand to lose their Medicaid reimbursements.
But, Hill said, the loss of Medicaid funding for Maine Family Planning would mean the group would have less to send to partners.
The Maine clinics say the law violates their right to equal protection
The Center for Reproductive Rights, which is representing Maine Family Planning in the challenge, says in its legal filing that the defunding denies it equal protection under the law because it would have funding cut off, but organizations that provide similar services would not.
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'The administration would rather topple a statewide safety network than let a patient get a cancer screening at a facility that also offers abortion care,' Meetra Mehdizadeh, a Center for Reproductive Rights lawyer, said in an interview.
Planned Parenthood already sued and won a reprieve from a judge, preventing its Medicaid payments cutoff — at least until July 21 — while a court considers that case.
Planned Parenthood has warned that the law could put 200 of its affiliates' roughly 600 clinics across the U.S. at risk of closing.
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Lupita Nyong'o Revealed She Has Painful Uterine Fibroids. Here's What That Means.
Lupita Nyong'o Revealed She Has Painful Uterine Fibroids. Here's What That Means.

Yahoo

time14 minutes ago

  • Yahoo

Lupita Nyong'o Revealed She Has Painful Uterine Fibroids. Here's What That Means.

Actress Luptia Nyong'o shared on Instagram that the same year she won an Academy Award for her role in '12 Years A Slave' (2014)she was also diagnosed with chronic uterine fibroids, a common yet understudied medical issue in women — and particularly, Black women. In the Instagram post, Nyong'o said she had 30 fibroids removed only to be told there is nothing she can do to keep them from coming back. Her post is part of a campaign to raise awareness for uterine fibroids, support research funding and push forward Congressional bills. Nyong'o shared this news as a way to break the 'silent suffering' that's forced on women. And while Nyong'o is a well-known person dealing with the often-painful condition, millions of other women deal with it, too. Both in silence and at endless doctor's appointments. For instance, Tanika Gray Valbrun started experiencing extremely heavy periods early in her teen years. 'I was that girl who always had to carry pads with her, felt like I was always on my period, had to wear two panties and biker shorts, always had an extra bag with me,' she told HuffPost. In addition to the heavy bleeding, Valbrun also experienced painful periods, her abdomen protruded and she felt a constant need to use the bathroom. It wasn't until she was about 25 that she received a diagnosis: uterine fibroids. Many doctors appointments and treatments followed, and though she is still on this medical journey, the source of her issues is no longer a mystery. Although fibroids are quite common, they remain relatively unknown or misunderstood for many. 'Uterine fibroids are benign tumors that grow from smooth muscle cells, so they're often found in the uterus,' said Dr. Sawsan As-Sanie, an associate professor in the department of obstetrics and gynecology at the University of Michigan Medical School. 'They can be in the lining of the uterus, the wall of the uterus or on the surface.' Also called leiomyomas or myomas, fibroids vary in shape, size and number. Some grow slowly over many years while others might remain the same size for a long time and then start to grow rapidly. 'Looking back, I think about how many times I had accommodated my life for fibroids,' Valbrun said. 'I was always strategizing what to bring or how to dress because I would be bleeding. I never wore white clothing, even though I love whites and light colors.' Below, experts break down the facts and misconceptions around uterine fibroids. Who is most likely to have fibroids? 'Fibroids are highly prevalent, and they become more common as patients get older,' As-Sanie noted. The National Institutes of Health estimates that up to 70% of white women and 80% to 90% of Black women will develop fibroids by the age of 50. 'Really, anyone with a uterus can experience uterine fibroids, but they disproportionately impact Black women at a higher rate,' Valbrun said. 'Black women are more likely to experience them, and their fibroids are more likely to occur when they're younger, grow more quickly and cause more symptoms.' Age is a big risk factor with fibroids, as their prevalence increases as patients grow older and then declines in post-menopausal women. Although fibroids are most common in women ages 30 to 40 and in Black women, As-Sanie said that she sees them in patients of all ages, races and ethnicities. 'Mine started in my teenage years, so it's not just an issue for women in their childbearing years,' Valbrun added. 'And even though race is a risk factor, it's not just a Black woman's disease ― just like endometriosis is not just a white woman's thing.' There are genetic factors as well. A family history of fibroids is associated with a three times greater risk of developing fibroids compared with women without that history, As-Sanie explained. She noted that obesity and nulliparous (the medical term for having never given birth) can also be factors. What are the symptoms? Despite their prevalence, fibroids don't cause symptoms in the majority of people who have them. 'Only about a quarter of women who have uterine fibroids have symptoms that are bothersome enough that they end up needing intervention,' As-Sanie said. The most common symptoms are related to menstruation, such as heavy bleeding and pelvic pain. 'Any amount of bleeding that interferes with quality of life deserves an evaluation,' As-Sanie noted. 'We tell patients if they're soaking through a pad or tampon more frequently than every one to two hours, that should warrant evaluation. That amount can lead to anemia, low blood counts.' Valbrun said that she's had to have at least five blood transfusions over the years to address her severe anemia. 'I was always craving ice and soap, so much that I would be constantly trying to smell them,' she recalled. 'My doctor told me it's called pica, and it's what happens when your body is deficient in iron.' In addition to menstrual pain, fibroids can also cause pain during sex and at random times. As Valbrun reported, they may lead to swelling in the uterus and abdomen as well. 'Patients can also have what we call 'bulk symptoms' ― pressure from fibroids if they get large enough, feelings of bloating, urinary frequency and urgency, and even constipation or other bowel issues,' As-Sanie said. 'Fibroids are also associated with pregnancy-related complications like miscarriage and infertility.' How are fibroids diagnosed? 'In terms of diagnosis, fibroids are generally diagnosed or at least suspected during a pelvic exam,' As-Sanie said, noting that the uterus often feels enlarged. If fibroids are suspected, then the next step usually involves imaging, commonly with a pelvic ultrasound ― though tests including sonohysterography, hysteroscopy, hysterosalpingography and laparoscopy can also offer information. 'Some patients come in reporting symptoms, but for others it might be diagnosed during a routine exam,' As-Sanie noted. 'They may have had no clinical symptoms. Or if they're having trouble becoming pregnant, fibroids may be discovered as they look into their fertility problems.' What is the treatment for fibroids? If you're diagnosed with uterine fibroids, the next steps depend on your symptoms. You might not need treatment if your fibroids are small and aren't causing symptoms or if you're nearing menopause. 'If someone's not having symptoms, we typically just survey them over time,' As-Sanie said. 'They should get regular checkups to monitor for development of symptoms if they're not having them. Often we'll get repeat imaging every year or couple years to monitor for fibroid growth.' For patients with symptoms, it's important to examine the symptoms they're having and what their goals are. 'With heavy bleeding, this can often be managed with medications ― like hormonal birth control pills, progestin-only birth control methods, other pills and injections,' As-Sanie said. Although those methods are effective for many patients, they don't work for others. And over time other interventions might become necessary. Myomectomy is the surgical removal of fibroids, and uterine artery embolization (sometimes called uterine fibroid embolization) is a less-invasive procedure that involves injecting tiny particles into the blood vessels to stop blood flow to the fibroids and cause them to shrink. 'There are also different types of ablations where you can use forms of energy to basically burn them away or make them smaller,' Valbrun said. She added that the recovery process after fibroid-related procedures can be lengthy, noting that it took her about eight weeks to recovery from her myomectomy. Some fibroids are too small to be removed, and even after you've had fibroids removed or shrunk, there's always a possibility of regrowth or new ones appearing. And some patients have so many fibroids that it wouldn't be feasible to remove all of them. As a result, the only total cure is hysterectomy. 'The choice of what treatment is appropriate in patients very much depends on both a combination of things, like their age and desire to preserve fertility, as well as fibroid size and location,' As-Sanie said. 'Hysterectomy is generally considered a last resort when other things haven't worked, but it is considered curative and it's quite common in the U.S. And uterine fibroids and abnormal bleeding are the most common non-cancerous reasons that women have hysterectomies.' What should you do if you suspect fibroids? 'Any symptoms of heavy bleeding and/or pelvic pain that are bothersome enough that they're interfering with your quality of life warrant evaluation,' As-Sanie said. 'There's no amount of bleeding or pain we would say is automatically 'normal.' If you're not able to work as effectively or enjoy your life, that is by definition considered abnormal and deserves evaluation.' Fibroids are relatively common, but they're also just one of many potential causes for increased levels of pain and bleeding. It's important to see a medical professional to help figure out what might be at the root of your problems and determine the best course of treatment. Many experience pregnancy complications or infertility related to fibroids, but medical interventions can help. So if you're hoping to give birth someday, know that fibroids don't necessarily prevent that. 'For many women who have fibroids but no symptoms, we don't automatically recommend treatment in order to get pregnant or have a successful or healthy pregnancy,' As-Sanie said. 'The relationship between fibroids and fertility and pregnancy is complicated, but there are many women who have fibroids ― even fibroids that cause symptoms ― that can become pregnant and carry a healthy pregnancy without needing intervention.' And remember that there's nothing shameful about fibroids or any other gynecological issue. 'Patients often feel like it's embarrassing, and their families ― or even physicians they've seen ― have dismissed or minimized their pain as being a normal part of a woman's experience,' As-Sanie said. 'This is unfair and unhelpful to women.' She urged patients and medical providers to help break down the stigma around menstrual disorders. 'We need to improve awareness and diagnosis, as well as reduce the bias and stigma by talking about pain and bleeding so that young girls and women don't dismiss it as normal or think it's too shameful to talk about,' As-Sanie emphasized. 'That way they can get earlier diagnoses and treatments.' What else should people know about uterine fibroids? Valbrun is dedicated to raising awareness and clearing up misconceptions about uterine fibroids. In 2014, she launched The White Dress Project to spread the word, increase funding for medical research and offer support to other people who are living with fibroids. 'I want to make people feel like they are not alone,' she said. 'And I wanted the support for myself because I never saw any organized walks or runs or people asking me to buy a T-shirt about fibroid awareness. It feels very lonely to feel like you're the only one on the bathroom floor in the fetal position. You're the only one canceling on your girlfriends, the only one not spending the night at a guy's house even though you want to.' The name stems from her desire to reclaim the color white as a symbol of hope and empower herself and others to feel comfortable wearing white ― or to do it anyway in an act of rebellion against the limits fibroids can impose. The White Dress Project hosts community events, offers educational resources, supports research and advocates for policy in support of fibroid awareness. Michigan state Rep. Kyra Harris Bolden (D) has also gotten involved in advocacy after being diagnosed with fibroids in 2020 and undergoing a myomectomy. 'It took me seven weeks to get back to what I felt was 100%, but ever since then, I've been on this quest to just bring more awareness to fibroids,' she told HuffPost. 'After I shared my story on the House floor during Uterine Fibroid Awareness Month, I got an outpouring of messages from women sharing their fibroid experience and how horrific it had been.' Bolden has also partnered with organizations to spread awareness, worked on legislation and even helped get funding allocated for fibroid research in the Michigan state budget. 'This condition affects so many women but isn't widely talked about,' she said. 'If I had known it was so common, I probably wouldn't have waited until my condition got so bad to seek treatment and could've had a less invasive surgery.' Valbrun also wants to spread the word about the different treatment options for fibroids. 'A lot of times, hysterectomy is the only option offered for women to deal with fibroids,' she said. 'Black women are more likely to be offered hysterectomy. I was told to have a hysterectomy when I was 26 and use a surrogate if I wanted children, and it was really disheartening. Fortunately, I found another doctor who told me about my other options.' Of course, many patients are great candidates for a hysterectomy, especially if they are done having children or don't want to give birth, but Valbrun wants to make sure people feel informed and empowered about this decision rather than pressured. 'Remember that you are powerful and have a say,' she said. 'Nobody knows your body like you do.' Related... 9 Red Flags You May Have PCOS, According To Experts Are 'Dropsies' During Your Period A Real Thing? 4 Signs Your Period Pain Isn't Normal

AI, Musk, & Trump's Plan to Make Canada The 51st State: Sen. Klobuchar (D-MN)
AI, Musk, & Trump's Plan to Make Canada The 51st State: Sen. Klobuchar (D-MN)

The Hill

time15 minutes ago

  • The Hill

AI, Musk, & Trump's Plan to Make Canada The 51st State: Sen. Klobuchar (D-MN)

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900 DOJ attorneys urge Senate to reject Bove nomination
900 DOJ attorneys urge Senate to reject Bove nomination

The Hill

time15 minutes ago

  • The Hill

900 DOJ attorneys urge Senate to reject Bove nomination

More than 900 former Justice Department attorneys are urging the Senate Judiciary Committee to reject the nomination of Emil Bove for a lifetime judicial appointment. Bove, who previously served on President Trump's criminal defense team, is now in the No. 3 role at the Department of Justice (DOJ) and has been nominated for a judgeship on the Third Circuit Court of Appeals. The extraordinary outpouring came from attorneys from the Kennedy administration to the current Trump administration who pinpointed Bove as a key figure behind numerous firings and policy shifts, calling him a 'leader in this assault' on the Justice Department. 'Emil Bove has been an architect and enforcer of many of the attacks on DOJ and its employees,' said Stacey Young, executive director and founder of Justice Connection, which organized the letter. 'His nomination to the Third Circuit Court of Appeals sent shockwaves across DOJ's workforce, and should alarm all Americans concerned about the Department's future and the survival of the rule of law.' The Senate Judiciary Committee is set to consider Bove's nomination Thursday, as well as that of Fox News host Jeanine Pirro to serve as a U.S. Attorney. The letter runs through a string of recent controversies in which Bove has played a role. He was central in pushing the dismissal of the bribery charges brought against New York Mayor Eric Adams, prompting a wave of resignations from members of the department's Public Integrity Section. He was behind terminations of prosecutors who worked on Jan. 6 cases and a request to turn over a list of FBI agents who investigated riot cases. It also focuses on recent allegations from a DOJ whistleblower who said Bove told top department officials they may need to consider saying 'f— you' to judges who might block the administration's invocation of the Alien Enemies Act to send migrants to Salvadoran prison. Bove has said he couldn't recall whether he used the expletive, but told lawmakers during his confirmation hearing that he 'certainly conveyed the importance of the upcoming operation.' 'Each one of the undersigned would testify, under oath, that we have never — and would never — tell a Justice Department attorney to consider defying a court order. Moreover, the Justice Department's later defiance of judicial mandates in the cases where Mr. Bove previewed doing so further suggests that disregarding court orders was Mr. Bove's intent all along,' the letter states. Bove's nomination looks poised to proceed, as Sen. Thom Tillis (N.C.), the only Republican on the panel to previously oppose a Trump nominee, has said he would follow the staff recommendation. 'We ask that before the Judiciary Committee votes on this nomination, you rigorously examine the actions Mr. Bove has taken at DOJ and the effects they've had on the Department's integrity, employees, and mission-critical work,' the attorneys wrote. 'It is intolerable to us that anyone who disgraces the Justice Department would be promoted to one of the highest courts in the land, as it should be intolerable to anyone committed to maintaining our ordered system of justice.'

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