Tag Archives: Kentucky

Trump administration will allow states to test Medicaid work requirements

U.S. President Donald Trump attends the Women in Healthcare panel hosted by Seema Verma (R), Administrator of the Centers for Medicare and Medicaid Services, at the White House in Washington, U.S., March 22, 2017.

By Yasmeen Abutaleb

WASHINGTON (Reuters) – The Trump administration said on Thursday it would allow states to test requiring some Medicaid recipients to work or participate in community activities such as volunteering or jobs training as a condition of eligibility for the government health insurance program for the poor.

The Centers for Medicare and Medicaid Services issued guidance making it easier for states to design and propose test programs that implement such requirements. States must propose such changes through waivers and receive federal approval.

Seema Verma, the agency’s administrator, said the policy guidance came in response to requests from at least 10 states that have proposed requiring some Medicaid recipients to work or participate in activities that may include skills training, education, job search, volunteering or caregiving. Those states include Kentucky, Maine, New Hampshire, Arizona, Indiana and Utah.

Certain Medicaid populations would be exempt from the rules, including those with disabilities, the elderly, children and pregnant women. Verma also said states would have to make “reasonable modifications” for those battling opioid addiction and other substance use disorders.

“This gives us a pathway to start approving waivers,” Verma said on a call with reporters on Wednesday. “This is about helping those individuals rise out of poverty.”

Under the 2010 Affordable Care Act, former Democratic President Barack Obama’s signature domestic policy achievement commonly known as Obamacare, 31 states expanded Medicaid to those making up to 138 percent of the federal poverty level, adding millions of people to the rolls.

Republicans have repeatedly failed to repeal and replace Obamacare, a top campaign promise of President Donald Trump. Instead, the Trump administration has sought to weaken the program through executive orders and administrative rules.

The Obama administration opposed state efforts to implement work requirements in Medicaid because it could result in fewer people having access to health insurance.

For instance, Kentucky last year proposed work requirements for able-bodied adults to get insurance and establishing new fees for all members based on income. A study found the proposal would reduce the number of residents on Medicaid by nearly 86,000 within five years, saving more than $330 million.

Republicans argue that Medicaid was created to serve the most vulnerable and has become bloated under Obamacare. Verma and other Republicans said implementing work and community engagement requirements could help improve health outcomes by connecting people with jobs and training.

(Reporting by Yasmeen Abutaleb; Editing by Peter Cooney)

Kentucky accuses Endo of contributing to opioid epidemic

Kentucky accuses Endo of contributing to opioid epidemic

By Nate Raymond

(Reuters) – Kentucky accused units of Endo International Plc on Monday of contributing to drug overdoses and an opioid epidemic by deceptively marketing its painkiller Opana ER, the latest lawsuit by state or local governments against the drugmaker.

Kentucky Attorney General Steve Beshear said the lawsuit would seek to hold Endo responsible for illegally building a market for the long-term use of opioids in the state as part of an effort to boost corporate profits.

The lawsuit, filed in a state court in Kentucky, said Endo sought to overstate the benefits of using Opana for the long-term treatment of chronic pain while downplaying the risk of addiction, helping to fuel a public health epidemic.

“My office refuses to sit back and watch families be torn apart while opioid manufacturers like Endo line their pockets at the expense of our communities and our future,” Beshear said in a statement.

Endo’s chief legal officer, Matthew Maletta, said in a statement that Beshear’s allegation that the drugmaker was trying to profit at the expense of people’s health was “patently offensive.”

“We intend to vigorously defend the company against the claims set forth in this lawsuit,” Maletta said.

According to the U.S. Centers for Disease Control and Prevention, opioids were involved in over 33,000 deaths in 2015, the latest year for which data is available. The death rate has continued rising, according to estimates.

Endo has faced a wave of similar lawsuits over the opioid epidemic by Louisiana, New Mexico, Missouri, Mississippi and Ohio, as well as several cities and counties. Many of those cases target other drugmakers as well.

In July, Endo agreed to withdraw the long-acting opioid painkiller Opana ER from the market after the U.S. Food and Drug Administration declared that its benefit did not outweigh public health risks associated with opioid abuse.

In a statement, Beshear called the removal of Opana ER from the market an important step but said that Endo’s practices had already by then harmed people in his state. His office’s lawsuit seeks penalties and compensatory and punitive damages.

(Reporting by Nate Raymond in Boston; Editing by Tom Brown and Grant McCool)

Senator Rand Paul suffers five broken ribs after assault

Senator Rand Paul (R-KY) speaks to reporters as he arrives for a vote on Capitol Hill in Washington, U.S., October 18, 2017.

By Bernie Woodall and Pete Schroeder

(Reuters) – U.S. Senator Rand Paul’s return to Washington may be delayed after he suffered five broken ribs during an assault at his Kentucky home, media reported on Sunday, citing a senior adviser to the Republican lawmaker.

Paul’s neighbor, Rene Boucher, has been charged with one count of fourth-degree assault causing minor injury in connection with the incident on Friday, according to authorities. Boucher, 59, was released on bond.

“Senator Paul has five rib fractures including three displaced fractures. This type of injury is caused by high velocity severe force,” Doug Stafford, a senior adviser to Paul, said in a statement, according to multiple media reports.

“It is not clear exactly how soon he will return to work, as the pain is considerable as is the difficulty in getting around, including flying,” the reports quoted Stafford as saying. He added that the senator’s type of injury could lead to life-threatening injuries.

Paul, 54, also has lung contusions, Stafford said in the statement, according to the reports.

The Bowling Green Daily News, citing an arrest warrant, said Paul told police his neighbor came on to his property in a gated community just east of Bowling Green and tackled him from behind. Paul had injuries to the face and trouble breathing because of a rib injury, the newspaper said.

It was not clear what motivated the altercation and Paul did not go to the hospital, police said. Paul was mowing his lawn at the time of the attack, television station WAVE-TV in Kentucky reported.

“Kelley and I appreciate the overwhelming support after Friday’s unfortunate event. Thank you for your thoughts and prayers,” Paul said on Twitter on Sunday morning, referring to his wife.

A man who answered Boucher’s phone on Sunday, when a Reuters reporter asked to speak with him, said: “I’m sorry. I can’t talk.”

Kentucky State Police said on Saturday that Paul and Boucher were acquaintances. The suspect is a retired physician, the Bowling Green Daily News said.

The New York Daily News reported that a Facebook page for Boucher contained numerous postings critical of Republican President Donald Trump.

Paul, an ophthalmologist, ran for the Republican presidential nomination before dropping out of the race in February 2016.

 

(Reporting by Bernie Woodall in Fort Lauderdale, Florida; Editing by Peter Cooney and Paul Simao)

 

Listeria risk prompts Meijer to recall produce in six U.S. states

Listeria risk prompts Meijer to recall produce in six U.S. states

NEW YORK (Reuters) – Retailer Meijer Inc said it was recalling packaged vegetables in six U.S. states because of possible contamination from Listeria monocytogenes bacteria, which can cause fatal food poisoning in young children, pregnant women and elderly or frail people.

Meijer, based in Grand Rapids, Michigan, said there were no illnesses reported as of Sunday.

The recall affects 35 products and includes vegetables such as broccoli, cauliflower and asparagus as well as party trays sold in Meijer-branded plastic or foam packaging in Michigan, Ohio, Indiana, Illinois, Kentucky and Wisconsin between Sept. 27 and Oct. 20, the company said on Saturday.

In February, Meijer recalled its Meijer-branded Colby and Colby Jack cheese sold through its deli counters because of potential contamination with Listeria monocytogenes.

The U.S. Centers for Disease Control and Prevention estimated that 1,600 people develop a serious form of infection known as listeriosis each year, and 260 die from the disease, making it the third most deadly form of food poisoning in the United States.

“The infection is most likely to sicken pregnant women and their newborns, adults aged 65 or older and people with weakened immune systems,” the CDC said on its website. Symptoms include fever and diarrhea and can start the same day of exposure or as much as 70 days later.

(Reporting by Alwyn Scott; Editing by Lisa Von Ahn and Peter Cooney)

Kentucky city removes two Confederate statues

Kentucky city removes two Confederate statues

(Reuters) – Statues of two leaders of the Confederacy will be moved from public places in Lexington, Kentucky, to a cemetery where the men they represent are buried, an action that began quietly on Tuesday in the midst of a national debate about memorials to those who fought for the South in the U.S. Civil War.

The city council in August voted to remove the statues of Confederate General John Hunt Morgan and John C. Breckinridge, a U.S. vice president and Confederate secretary of war, the Lexington Herald Leader reported, showing video of the removal work that began without advance notice.

The Kentucky vote came soon after a rally in Charlottesville, Virginia, where white nationalists angered at the planned removal of a statue of Confederate General Robert E. Lee clashed with counter-protesters.

The Kentucky statues, which have been in the city for about 130 years, will be taken to a private storage facility as the city works on an arrangement with the Lexington Cemetery about placing them there, it said.

The Lexington mayor’s office was not immediately available for comment.

Breckinridge and Morgan are buried at the cemetery, and private donors are providing funds to pay for the upkeep and security of the statues there, the newspaper reported.

Opponents of Confederate memorials view them as tributes to the South’s slave-holding past, while supporters argue that they represent an important part of history.

Kentucky was a slave-holding state at the time of the Civil War but it did not join the Confederacy.

(Reporting by Jon Herskovitz)

Weakening Nate brings rain, tornado warnings to U.S. South

A man sits on a bench overlooking a beach covered in debris scattered by Hurricane Nate, in Biloxi, Mississippi, U.S.,

By Rod Nickel and Jessica Resnick-Ault

BILOXI/PASCAGOULA, Miss. (Reuters) – Hurricane Nate weakened to a tropical depression on Sunday after coming ashore in Mississippi, flooding roads and buildings but sparing the state from catastrophic damages.

Maximum sustained winds from Nate, the fourth major storm to hit the United States in less than two months, dropped to 35 miles per hour (55 km per hour) as it moved through Alabama and into Tennessee.

The remnants of the storm spawned tornado warnings in those states and the western portions of North Carolina and South Carolina. It is forecast to bring gusty winds and up to 4 inches (10 cm) of rain to parts of Ohio, Pennsylvania and New York on Monday.

The storm made landfall as a Category 1 hurricane, the weakest designation by the U.S. National Hurricane Center. Only a few hours earlier, its winds had been blowing at 70 mph (113 kph) but appeared to lack the devastating punch of its recent predecessors.

Mississippi Governor Phil Bryant told reporters there had been no deaths or reports of catastrophic damage. “We are very fortunate this morning and have been blessed,” he said.

Nate killed at least 30 people in Central America before entering the warm waters of the Gulf of Mexico and bearing down on the U.S. South. It has also shut down most oil and gas production in the Gulf.

Nate follows hurricanes Harvey, Irma and Maria, which have devastated areas of the Caribbean and southern United States.

The tropical depression’s center will move up through Alabama into Tennessee and Kentucky through Monday, the hurricane center said. Heavy rainfall and storm-surge flooding remained a danger across the region, and the hurricane center said Florida’s Panhandle and parts of Alabama and Georgia might feel tropical storm-force wind gusts.

The storm was expected to bring three to six inches of rain to parts of western North Carolina through midday Monday, with up to 10 inches possible in isolated spots. Power outages, damaged homes and roads closed by debris were all reported in the region.

Nate made its first U.S. landfall on Saturday evening near the mouth of the Mississippi River and then made a second one early on Sunday near Biloxi, Mississippi.

In Biloxi, water surged over roads during the storm and quickly receded on Sunday, leaving a boat that broke loose marooned on the beach. At a Waffle House restaurant, the storm surge deposited a dumpster in its parking lot.

Jeff Pickich, a 46-year-old wine salesman from D’Iberville, Mississippi, was counting his blessings. Heavy winds left only minor damage, blowing down part of a fence on his rental property in Biloxi.

“I’m just glad,” he said, digging fresh holes for fence posts. “I was afraid of the water. The water is Mother Nature. You can’t stop it.”

Water flowed through Ursula Staten’s yard in Biloxi, pushing over part of her fence and scattering debris, but did not breach her house.

“I have a mess,” the retired massage therapist said. “If we had got Irma, I would have lost everything.”

At the Golden Nugget Casino, one of eight Biloxi gaming establishments, workers rushed to clean up mud, debris and minor damage from 3 feet (1 m) of water sloshing into an entrance and the parkade. The gaming room stayed dry.

Three hundred guests remained in the hotel, some eager to try their luck after surviving Nate.

But dangers from the storm remain, with Florida Governor Rick Scott warning of tornadoes springing up in the Panhandle region and Alabama Governor Kay Ivey urging residents to prepare for strong winds and storm surges.

U.S. President Donald Trump declared federal emergencies in Alabama and Florida on Sunday, which provides additional funding for disaster relief.

Mississippi Power had restored electricity to 10,000 customers, but 4,800 were still without it. More than 1,000 people had arrived at shelters, the state Emergency Management Agency said.

Alabama Power said it had restored electricity to 58,000 of 146,000 customers who lost it.

Rainfall of 3 to 6 inches (8 to 15 cm), with a maximum of 10 inches (25 cm), was expected east of the Mississippi River in Alabama and Tennessee, the hurricane center said.

Residents walk down a street covered in debris scattered by Hurricane Nate, in Biloxi, Mississippi, U.S., October 8, 2017.

Residents walk down a street covered in debris scattered by Hurricane Nate, in Biloxi, Mississippi, U.S., October 8, 2017. REUTERS/Jonathan Bachman

NEW ORLEANS THREAT DOWNGRADED

Forecast at one point to make landfall in Louisiana, Nate headed farther east and spared many New Orleans parishes that were devastated by Hurricane Katrina 12 years ago.

“I had prayed for this – that we would be spared,” said Amos Cormier, president of Plaquemines Parish, Louisiana’s equivalent to a county.

Bernice Barthelemy, a 70-year-old Louisiana resident, died from cardiac arrest overnight after telling Reuters on Saturday that she did not mind having to evacuate, Cormier said on Sunday. He attributed her death to the stress of the move.

New Orleans Mayor Mitch Landrieu said he expected that evacuated residents could return home soon.

Vessel traffic and port operations at New Orleans resumed on Sunday afternoon, while the Port of Mobile in Alabama remained closed. Oil ports, producers and refiners in Louisiana, Mississippi and Alabama were planning reopenings as the storm moved inland on Sunday.

Heavy rain is seen at Orange Beach, Alabama, U.S. as Hurricane Nate approaches, on October 7, 2017 in this still image taken from a video obtained via social media. Jacob Kiper, Owensboro, KY/Social Media via REUTERS

Heavy rain is seen at Orange Beach, Alabama, U.S. as Hurricane Nate approaches, on October 7, 2017 in this still image taken from a video obtained via social media. Jacob Kiper, Owensboro, KY/Social Media via REUTERS

The storm curtailed 92 percent of daily oil production and 77 percent of daily natural gas output in the Gulf of Mexico, more than three times the amount affected by Harvey.

The storm doused Central America with heavy rains on Thursday, killing at least 16 people in Nicaragua, 10 in Costa Rica, two in Honduras and two in El Salvador.

 

(Reporting by Rod Nickel in Biloxi, Miss. and Jessica Resnick-Ault in Pascagoula, Miss.; Additional reporting by Marianna Parraga, Erwin Seba and Gary McWilliams in Houston; Jonathan Allen in New York; Writing by Lisa Shumaker; Editing by Lisa Von Ahn and Peter Cooney)

 

Federal court strikes down abortion ultrasound law in Kentucky

(Reuters) – A federal court struck down a law in Kentucky on Wednesday that requires women seeking an abortion to first undergo an ultrasound and hear a description of the embryo or fetus.

The U.S. District Court Western District of Kentucky ruled that the state law is unconstitutional because it violates the free-speech rights of the patient and doctor, court documents showed.

The law “does not advance a substantial governmental interest, is not drawn to achieve the government’s interests, and prevents no actual harm,” U.S. District Judge David Hale wrote in his ruling.

The ACLU filed the lawsuit against the state on behalf of EMW Women’s Surgical Center, which the complaint said is the state’s sole licensed abortion facility, days after the measure was passed in January by Republican lawmakers in Kentucky.

“We are pleased that Kentucky women will no longer be subjected to this demeaning and degrading invasion into their personal health care decisions,” said Alexa Kolbi-Molinas, an ACLU attorney, in a statement.

The law requires a physician or qualified technician to perform the ultrasound and position the screen so the woman may view the images. The medical staff were required to describe what the images show, including the size of the fetus and any organs or appendages visible.

The law does not contain exceptions for women who are facing medical complications or are victims of rape or incest.

The requirement violates the speech rights of doctors and patients by forcing them to deliver and listen to a government-mandated message, according to the lawsuit.

The law was part of a renewed effort by abortion opponents nationwide to restrict the procedure.

Some 26 states have laws regarding ultrasounds and abortions, according to the Guttmacher Institute, which tracks reproductive policy.

(Reporting by Brendan O’Brien in Milwaukee, editing by Larry King)

Fate of Kentucky’s last abortion clinic goes to judge

FILE PHOTO: Escorts who ensure women can reach the clinic lineup as they face off protesters outside the EMW Women's Surgical Center in Louisville, Kentucky, U.S. on January 27, 2017. P REUTERS/Chris Kenning/File Photo

By Chris Kenning

(Reuters) – The fate of Kentucky’s last remaining abortion clinic is in the hands of a federal judge following a three-day trial that could make it the first U.S. state without a single clinic.

Kentucky’s anti-abortion Republican governor, Matt Bevin, earlier this year moved to revoke the license of the EMW Women’s Surgical Center clinic in Louisville, citing deficiencies in its transfer agreements with local hospitals.

The clinic filed suit and was joined by Planned Parenthood of Indiana and Kentucky, which said the state has used the same rules to block it from providing abortions in the city. The groups are asking U.S. District Judge Greg Stivers to overturn regulations they argue are medically unnecessary and create an unconstitutional barrier to abortion.

A ruling could take months, since both sides have 60 days to present post-trial briefs the judge.

“The state is trying to shut down the only abortion clinic in Kentucky by enforcing regulations that have nothing to do with women’s health,” EMW attorney Don Cox said during the trial according to WLKY-TV.

Lawyers for the Bevin administration, which waged a licensing battle in 2016 that led to the shutdown of a Lexington clinic, argued the transfer agreements in question were meant to protect women.

During the trial, a state health regulator blamed hospitals, saying they failed to provide sufficient agreements, the Courier-Journal reported. EMW and Planned Parenthood alleged the Bevin administration pressured or intimidated hospital officials into refusing to enter such agreements.

The trial has drawn anti-abortion activists and abortion rights demonstrators outside the courthouse in a city that has become a flashpoint for the debate over abortion.

If the court rules in the state’s favor and the clinic is forced to close, it would leave Kentucky the only U.S. state with no abortion provider. Six other states have only one clinic.

Conservative legislatures and Republican governors have sought in recent years to tighten regulations on abortion clinics and forced closures in states such as Texas.

But courts have pushed back. Last year, the U.S. Supreme Court struck down parts of a Texas law that required clinics to meet hospital-like standards and for clinic doctors to have admitting privileges at nearby hospitals.

The American Civil Liberties Union is providing legal help to the Kentucky clinic.

(Reporting by Chris Kenning; Editing by David Gregorio)

Kentucky trial could make state first in U.S. with no abortion clinic

Kentucky trial could make state first in U.S. with no abortion clinic

By Chris Kenning

(Reuters) – Kentucky’s “unapologetically pro-life” governor and the state’s last abortion clinic will square off on Wednesday in a federal courtroom in a case that could make it the first U.S. state without an abortion provider.

In a three-day trial, the state will argue before a U.S. District judge in Louisville that EMW Women’s Surgical Center does not have proper state-required agreements with a hospital and an ambulance service in case of medical emergencies.

The clinic, which earlier this year filed suit to stop the state from revoking its license, wants to overturn the regulations it says are unnecessary and create an unconstitutional barrier to abortion.

“In 37 years providing abortion, I’ve seen more than a dozen clinics close down in our state, and now ours is the last clinic standing in the entire state,” Ernest Marshall, a doctor and EMW clinic founder, said in a statement.

“The very right to access legal abortion in the state of Kentucky is on the line,” he added.

The case could test court interpretations of last year’s U.S. Supreme Court ruling that struck down parts of a Texas law that required clinics to meet hospital-like standards and for clinic doctors to have admitting privileges at nearby hospitals.

Despite that ruling, conservative legislatures and Republican governors such as Kentucky’s Matt Bevin have continued to tighten new regulations on abortion clinics.

U.S. state legislatures enacted 41 new abortion restrictions in the first half of 2017, according to the Guttmacher Institute, a reproductive health think tank that supports abortion rights.

Abortion rights groups say that has reduced access to abortion, particularly in rural areas of the South and Midwest. Kentucky is among seven U.S. states with just one clinic left.

Bevin, whose administration waged a licensing battle in 2016 that led to the shutdown of a Lexington clinic, argued the transfer agreements in question were meant to protect women.

“It is telling that the abortion industry believes that it alone should be exempt from these important safety measures,” said Bevin spokeswoman Amanda Stamper.

EMW, which is the site of almost daily protests, argues that hospitals are already legally bound to accept any patient in an emergency and local EMS will transport patients without such agreements.

Planned Parenthood of Indiana and Kentucky joined the suit because it said the same transfer agreements were used to block a license for a facility in Louisville. The American Civil Liberties Union is providing legal help to the clinic.

(Reporting by Chris Kenning; Editing by Andrew Hay)

U.S. abortion support groups put on more public face

A protester (L) and an escort who ensures women can reach the clinic stand outside the EMW WomenÕs Surgical Center in Louisville, Kentucky, U.S. January 27, 2017. REUTERS/Chris Kenning

By Chris Kenning

LOUISVILLE, Kentucky (Reuters) – Patricia Canon drives poor rural Kentucky women to distant abortion clinics each week, part of a national army of volunteers who are growing bolder even as abortion foes ratchet up opposition to the activists they have branded as “accomplices to murder.”

The Kentucky Health Justice Network, where she volunteers, is one of dozens of non-profit U.S. abortion funds providing money for procedures or covering travel costs to help women obtain abortions, particularly in states where Republican-backed laws have narrowed options.

For years, such organizations kept a low profile to avoid being targeted by abortion opponents. But now, as abortion foes have succeeded in shrinking access, advocates are working harder to grow grassroots support and taking a more public stance.

The anti-abortion movement won a victory with the election of President Donald Trump, who has promised to appoint U.S. Supreme Court justices who would overturn the Roe v. Wade decision protecting a woman’s right to abortion. Critics of the decision say states should decide.

That worries pro-choice advocates, including support groups in states where Republicans control legislatures.

“There is a volume and aggressiveness of anti-choice legislation and legislators who feel empowered by the administration,” said Yamani Hernandez, executive director of the National Network of Abortion Funds, which represents 70 funds in 38 states.

Kentucky is a flashpoint in the national debate. The state had 17 abortion providers in 1978 but one today. It could become the first U.S. state without any clinics this fall, when a court will determine whether its anti-abortion Republican governor wins a licensing fight.

Anti-abortion protesters will converge on Louisville starting Saturday ahead of a week of demonstrations. Some have vowed to broadcast footage of abortions on an 8-by-16-foot “Pro-Life JumboTron” screen.

In response, a judge has ordered a temporary buffer zone around the state’s only abortion clinic.

NEW RESTRICTIONS

Kentucky is not alone in making access to abortion tougher. There are six other U.S. states with only one clinic each.

The Guttmacher Institute, a reproductive health think tank that supports abortion rights, said U.S. state legislatures enacted 41 new abortion restrictions in the first half of 2017, even after a 2016 U.S. Supreme Court decision struck down restrictive abortion laws in Texas.

Many more restrictions were proposed, ranging from waiting periods to 20-week abortion bans. The number of U.S. abortion providers dropped from 2,434 in 1991 to 1,671 in 2014, according to Guttmacher data. This year, Iowa blocked abortion providers from receiving public money for family planning services.

Medicaid restrictions and a decline in the number of hospitals providing services have also curtailed access, the National Abortion Federation said.

Advocates say poor and rural women are hurt most by such laws. The biggest impact is in the South and Midwest, where the number of abortion providers has dwindled. Nearly half of the 40 clinics in Texas closed after laws enacted in 2013. Only a few have reopened since last year’s court ruling.

The National Network of Abortion Funds met last month in Arizona to map a strategy that in part aims to open 10 new support fund programs across the country, expand its network of more than 2,000 volunteers and leverage rising donations to fill more than 100,000 annual requests for financial or travel aid, Hernandez said.

The groups spent roughly $3.5 million to aid abortion access in 2015, she said, the latest year for which data was available.

Kentucky Health Justice leaders hope to double volunteers and funding. Fund Texas Choice, an abortion travel aid group formed in 2014, and Arkansas Abortion Support Network, opened a year ago, are also among those working to expand.

The abortion support groups face fierce opposition, especially from religious groups. Joseph Spurgeon, an Indiana pastor and activist with the fundamentalist Christian group Operation Save America, called abortion access volunteers “accomplices to murder.”

Such rhetoric has not stopped some support groups from taking a more public stance resisting pressures to curtail abortion access.

“When we started two years ago, a lawyer told us to make sure your mission is kind of vague, don’t use the A-word,” said Maia Elkana, who started Missouri’s Gateway Women’s Access Fund several years ago. “We’re a lot more out there now.”

(Reporting by Chris Kenning, Editing by Ben Klayman and David Gregorio)