New York moves to enact statewide flavored e-cig ban


New York Gov. Andrew Cuomo is pushing to enact a statewide ban on the sale of flavored e-cigarettes amid growing health concerns connected to vaping, especially among young people.

The Democrat announced Sunday that the state health commissioner would be making a recommendation this week to the state Public Health and Health Planning Council. The council can issue emergency regulations that would go into effect as soon as they are voted on and start being enforced in as soon as two weeks, following a short grace period for retailers, officials said.

In announcing the action, Cuomo sharply criticized the flavors that are for sale, like bubble gum and cotton candy.

“These are obviously targeted to young people and highly effective at targeting young people,” he said.

Officials pointed to a significant increase of e-cigarettes by young people, which they said was driven by the flavors.

According to data from the state health department, nearly 40% of high school seniors and 27% of high school students overall in the state use e-cigarettes. High school use went from 10.5% in 2014 to 27.4% in 2018.

Nationwide, the 2019 National Youth Tobacco Survey showed traditional cigarette usage continuing to fall for students in 6th to 12th grade but vaping continuing to surge higher.

The biggest player in the industry, Juul Labs Inc., said it was reviewing the announcement, but agreed with the need for action.

The ban would not impact tobacco- and menthol-flavored e-cigarettes, but Cuomo said the Department of Health would continue evaluating and that could change.

Not including menthol brought criticism for Cuomo from some quarters.

Cuomo “had the opportunity to take decisive action, but instead left menthol e-cigarettes on the marketplace,” said Harold Wimmer, president and CEO of the American Lung Association, in an email statement. “While today’s announcement was well-intentioned, it will drive our youth to use menthol flavored products in even greater numbers.”

Cuomo signed legislation earlier this year raising the statewide smoking age to 21, and earlier this month signed a mandate that requires state anti-tobacco campaigns to also include vaping.

Vaping is also under a federal spotlight , as health authorities look into hundreds of breathing illnesses reported in people who have used e-cigarettes and other vaping devices.

In his first public comments on vaping, President Donald Trump proposed a similar federal ban last week.

The FDA has been able to ban vaping flavors since 2016, but hasn’t taken the step, with officials looking into whether flavors could help cigarette smokers to quit.

The global market is estimated to have a value of as much as $11 billion. The industry has spent a lot of money in states around the country to lobby against state-level flavored e-cigarette bans, in states including Hawaii, California, Maine and Connecticut.

Michigan Gov. Gretchen Whitmer earlier this month ordered that state’s health department to come out with emergency rules to prohibit flavored e-cigarette sales.

Juul reiterated Sunday the agreeable stance it had taken following Trump’s proposal.

In an emailed statement, spokesman Austin Finan said, “We strongly agree with the need for aggressive category-wide action on flavored products,” and “will fully comply with local laws and the final FDA policy when effective.”



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Women facing restrictions seek abortions out of state


Thousands of women in the U.S. have crossed state lines for an abortion in recent years as states have passed ever stricter laws and the number of clinics has declined.

Although abortion opponents say the laws are intended to reduce abortions and not send people to other states, at least 276,000 women terminated their pregnancies outside their home state between 2012 and 2017, according to an Associated Press analysis of data collected from state reports and the U.S. Centers for Disease Control and Prevention.

In New Mexico, the number of women from out of state who had abortions more than doubled in that period, while Missouri women received nearly half the abortions performed in neighboring Kansas.

While abortions across the U.S. are down, the share of women who had abortions out of state rose slightly, by half a percentage point, and certain states had notable increases over the six-year period, according to AP’s analysis.

In pockets of the Midwest, South and Mountain West, the number of women terminating a pregnancy in another state rose considerably, particularly where a lack of clinics means the closest provider is in another state or where less restrictive policies in a neighboring state make it easier and quicker to terminate a pregnancy there.

“In many places, the right to abortion exists on paper, but the ability to access it is almost impossible,” said Amy Hagstrom Miller, CEO of Whole Women’s Health, which operates seven abortion clinics in Maryland, Indiana, Texas, Virginia and Minnesota. “We see people’s access to care depend on their ZIP code.”

Thirteen states saw a rise in the number of out-of-state women having abortions between 2012 and 2017, according to the analysis of data from 41 states. Counts from nine states, including highly populated California and Florida, and the District Columbia were not included either because they were not collected or reported across the full six-year period.

New Mexico’s share of abortions performed on women from out of state more than doubled from 11% to roughly 25%. One likely reason is that a clinic in Albuquerque is one of only a few independent facilities in the country that performs abortions close to the third trimester without conditions.

In Illinois, the percentage of abortions performed on non-residents more than doubled to 16.5% of all reported abortions in 2017. That is being driven in large part by women from Missouri, one of six states with only a single abortion provider.

Even that provider, in St. Louis, has been under threat of closing after the state health department refused to renew its license. Missouri lawmakers also passed a law this year that would ban almost all abortions past eight weeks of a pregnancy, although it faces a legal challenge.

It was one of 58 abortion restrictions passed by lawmakers this year primarily in the Midwest, Plains and South — almost half of which would ban all, most or some abortions, according to the Guttmacher Institute, a research organization that supports abortion rights.

Abortion opponents say the intent of laws limiting the procedure is not to push women to another state but to build more time for them to consider their options and reduce the overall number of abortions.

“I have been insistent in telling my pro-life colleagues that’s all well and good if the last abortion clinic shuts down, but it’s no victory if women end up driving 10 minutes across the river to Granite City, Illinois, or to Fairview Heights,” said Sam Lee, director of Campaign Life Missouri and a longtime anti-abortion lobbyist.

Before the recent wave of legislation focused on limiting when an abortion can be performed, opponents largely worked to regulate clinics. Critics say these regulations contributed to more clinics closing in recent years, reducing access to abortion in parts of the country and pushing women farther for care.

Nationwide, 168 independent abortion clinics have closed since 2012, and just a handful opened over that time, according to the Abortion Care Network, a clinic advocacy group. But not all closures are tied to restrictive laws. Some result from provider retirements and an overall decline in unplanned pregnancies.

Advocates say that if the U.S. Supreme Court upholds the latest restrictive laws, it will become more common for women to seek an abortion in another state.

“The intent of these lawmakers is to completely outlaw abortion and force people not to have abortions. But in reality, it pushes people farther and wider to access the care they want and need,” said Quita Tinsley, deputy director of Access Reproductive Care Southeast, a group that supports women seeking abortions in six states.

A third of women calling the group’s hotline for assistance end up traveling out of state for abortions, Tinsley said.

Georgia’s share of abortions involving out-of-state women rose from 11.5% to 15%, while North Carolina saw its share increase from 16.6% to 18.5%. North Carolina had one of the highest shares of out-of-state abortions in 2017. While both states have passed restrictive laws, experts and advocates say they are slightly more accessible than some of their surrounding states.

Hevan Lunsford, a nurse in Alabama, was five months pregnant when a doctor told her that her fetus was severely underdeveloped and had only half of a heart. She was told the boy, whom she and her husband decided to name Sebastian, would need care to ease his pain and several surgeries. He may not live long, they were told.

Lunsford, devastated, asked about ending the pregnancy. But the doctor said Alabama law prohibits abortions after five months. He handed Lunsford a piece of paper with information for a clinic in Atlanta, a roughly 180-mile (290-kilometer) drive east.

“The procedure itself was probably the least traumatic part of it,” Lunsford said. “Most of the laws I navigated, there was no reason for them. None of them prevented my abortion. It just made it where I had to travel out of state.”

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Associated Press Data Editor Meghan Hoyer contributed to this report. Also contributing were AP writers John D. Hanna in Topeka, Kansas, and Susan Montoya Bryan in Albuquerque, New Mexico.

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Follow Christina Almeida Cassidy on Twitter at http://twitter.com/AP—Christina



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Back to School: Checking the Boxes



By Parth Thakkar, 16, Staff Writer


September 5, 2019

Could summer have gone by any quicker?

Yep, it’s time to go back to school, and we all know what that means: shopping for books and clothes, signing up for courses and making sure that all of the boxes are checked before that first bell rings on the first day. We all want to make sure that everything is in order; we know how exciting (and nerve-racking) back-to-school time can be.

But as you head back to school just remember that when it comes to relationships, coming out and exploring sexual orientation or gender identity (whatever it may be), nothing has to be “in order” and no boxes have to be checked. Heading back to school is a wonderful opportunity to check in with yourself (see what I did there?).

Is this the year when you start a new relationship? Have your first kiss? Are you ready to think more about how you identify in terms of sexual orientation or whether it’s the right time to come out? Going back to school can be a perfect time to explore these possibilities. What’s even better is that you’re not alone when it comes to this exploration. There are classmates, teachers, counselors and even clubs that can support you. It’s important to find people you feel like you can trust.

And again, remember: nothing has to be certain. While parents and teachers may be advising you to identify the colleges you’re applying to or the courses you’re taking, nothing has to be a clear-cut decision when it comes to how you identify or what you’re ready and not ready for. So try not to be flustered if you see people around you who seem to have their lives in order. You’re just fine. You can take your time, and use the beginning of the school year to think about yourself and what makes you tick!

Reading sexual health stories on Sexetc.org. from teens just like you might help you figure out what’s right for you.



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Mumps sickens hundreds of detained migrants in 19 states


Mumps has swept through 57 immigration detention facilities in 19 states since September, according to the first U.S. government report on the outbreaks in the overloaded immigration system.

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The virus sickened 898 adult migrants and 33 detention center staffers, the Centers for Disease Control and Prevention said in its report Thursday.

New cases continue as migrants are taken into custody or transferred between facilities, the report said. As of last week, outbreaks were happening in 15 facilities in seven states.

In response to the report, Immigration and Customs Enforcement spokesman Bryan Cox said medical professionals at detention facilities screen all new detainees within 24 hours of their arrival to ensure that highly contagious diseases are not spread.

Cox said some detainees come from countries where communicable diseases are less controlled than in the U.S. and carry with them the risk of spreading infection.

The CDC report said more than 80% of patients were exposed while in custody. Mumps is a contagious virus that causes swollen glands, puffy cheeks, fever, headaches and, in severe cases, hearing loss and meningitis.

In the U.S., vaccines have drastically reduced the number of mumps cases. Only a few hundred cases are reported most years, with periodic outbreaks involving colleges or other places where people are in close contact.

In the migrant center outbreaks, at least 13 people were hospitalized, the CDC reported.

A large portion of the cases have been in Texas. The Texas Department of State Health Services raised the alarm in December, followed by six other state health departments in early January, prompting what the CDC report calls “a coordinated national outbreak response.”

ICE has given more than 25,000 doses of measles-mumps-rubella vaccine in the affected facilities.

The CDC did not identify detention facilities, but said 34 of them are operated by private companies. The report said migrants were being held in 315 facilities in mid-August.

Nashville immigration attorney R. Andrew Free has been tracking facilities with mumps outbreaks from reports of advocates and lawyers representing detainees.

“This has all the makings of a public health crisis,” Free said. “ICE has demonstrated itself incapable of ensuring the health and safety of people inside these facilities.”

An influx of migrants at the U.S.-Mexico border earlier this year has taxed the immigration system. The CDC report dealt only with mumps, not other health problems in detention facilities. At least two migrant children have died of complications of the flu after being detained by U.S. Border Patrol.

The CDC report said detention facilities should follow guidance from state and local health departments when responding to mumps.

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Follow AP Medical Writer Carla K. Johnson on Twitter: @CarlaKJohnson

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.



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Illinois patient's death may be first in US tied to vaping


Health officials said Friday that an Illinois patient who contracted a serious lung disease after vaping has died and that they consider it the first death in the United States linked to the smoking alternative that has become popular with teens and young adults.

The Illinois Department of Public Health the adult patient was hospitalized after falling ill following vaping, though it didn’t give other information about the person, including the patient’s name, age, hometown or date of death.

The state received the report of the death Thursday, said Dr. Jennifer Layden, the Illinois agency’s chief medical officer.

Officials with the Centers for Disease Control and Prevention said Friday that 193 people in 22 states have contracted severe respiratory illnesses after vaping. However, they said a clear-cut common cause of the illnesses hasn’t been identified and that they are being called “potential cases” that are still under investigation.

All of the sickened have been teens or adults who had used an electronic cigarette or some other kind of vaping device. Doctors say the illnesses resemble an inhalation injury, with the lungs apparently reacting to a caustic substance. So far, infectious diseases have been ruled out.

The illnesses have been reported since late June, but the total count has risen quickly in the past week. That may be partly because cases that weren’t initially being linked to vaping have begun to be grouped that way.

Among the newest reports are two in Connecticut, four in Iowa and six in Ohio. Health officials are asking doctors and hospitals to tell state health officials about any possible vaping-related lung disease cases they encounter.

In its news release, the Illinois agency said the number of people who contracted a respiratory illness after vaping had doubled in the past week, to 22.

“The severity of illness people are experiencing is alarming and we must get the word out that using e-cigarettes and vaping can be dangerous,” IDPH Director Dr. Ngozi Ezike said in the release.

Electronic cigarettes have been described as a less dangerous alternative to regular cigarettes, but health officials have been worried about kids using them. Most of the concern has focused on nicotine, which health officials say is harmful to developing brains and might make kids more likely to take up cigarettes.

But some vaping products have been found to contain other potentially harmful substances, including flavoring chemicals and oils used for vaping marijuana, experts say.

A number of the people who got sick had vaped products containing THC, the high-inducing ingredient in marijuana. CDC officials said they do not have a breakdown of how many of the sick people vaped THC.

The American Vaping Association, an advocacy group, issued a statement arguing that “tainted, black market THC products” are to blame. The group called on federal officials to clear nicotine vaping products of suspicion.

Matthew Myers, the head of the Campaign for Tobacco-Free Kids, said the illnesses underscore why the U.S. Food and Drug Administration should be looking into e-cigarettes and their impact on health before they can be sold to the public.

Health officials said they need to gather more information.

“Investigators haven’t identified any specific product or compound that is linked to all of the cases,” Ileana Arias, a CDC official who oversees non-infectious disease, said during a Friday call with reporters. She also said the sickened might be dealing with different illnesses that have similar symptoms.

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AP Medical Writer Mike Stobbe reported from New York.



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EPA reverses approval for poison traps used by ranchers


The Environmental Protection Agency on Thursday reversed its preliminary decision allowing continued use of deadly sodium cyanide traps, blamed for injuring people and pets as well as their intended targets of coyotes and other predators.

EPA head Andrew Wheeler said in a statement he had decided the agency needed to do more analysis and consulting regarding the so-called M-44 traps, devices embedded in the ground that look like lawn sprinklers but spray cyanide when triggered by animals attracted by bait.

“I look forward to continuing this dialogue to ensure U.S. livestock remain well-protected from dangerous predators while simultaneously minimizing off-target impacts on both humans and non-predatory animals,” Wheeler said.

Environmental groups had blasted the agency’s preliminary decision last week reauthorizing the cyanide traps, saying they were impossible to use safely.

Federal officials decided against using the devices in Idaho after a then 14-year-old boy was injured in 2017 when he encountered an M-44 with his dog on federal land near his house on the outskirts of Pocatello. His Labrador retriever died.

The U.S. Department of Agriculture’s Wildlife Services uses the devices to kill coyotes and other livestock predators, mostly in the Western U.S.

In 2018, M-44s killed about 6,500 animals, mainly coyotes and foxes. That was down from about 13,200 animals in 2017.



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Is pot safe when pregnant? Study seeks answer, draws critics


An increase in U.S. women using pot during pregnancy has prompted new government-funded research aiming to resolve questions about whether it might harm the fetus and lead to brain damage.

One of the studies is at the University of Washington in Seattle. Researchers there are enrolling women who are already using pot early in pregnancy. At 6 months, their babies will have brain scans to be compared with scans of infants whose moms didn’t use pot.

For government and university authorities, it’s worthy research that takes advantage of a booming trend. But critics contend it is bogus research that endorses drug use and needlessly endangers fetuses.

Ethicists say the dispute shows why studying how drugs affect pregnant women and babies can be so challenging.



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E-cigarette giant Juul's campaign donations favor Democrats


E-cigarette giant Juul Labs gave nearly $100,000 to members of Congress during the first half of 2019 as the company faced the bulk of the blame for a surge of underage vaping and calls for tighter government regulation of the industry.

The donations from Juul’s political action committee represent a sharp increase over last year’s total, according to a Federal Election Commission report released Thursday that shows most of the money went to Democrats.

The boost in contributions is the latest sign of the company’s expanding influence operation in Washington and around the country. An explosion of underage vaping has put Juul in the crosshairs of a number of Democrats, who have accused the company’s early advertising and marketing of leading to the current wave of vaping by American teens.

Juul is ramping up its political giving as Congress considers legislation to raise the minimum age to purchase all tobacco and vaping products from 18 to 21.

Juul and cigarette maker Altria — which controls 35% of the vaping company — have backed a Senate bill that raises the age nationally. The bill does not include additional measures that anti-tobacco groups say are needed to curb youth use, such as banning flavored products and online sales.

Ted Kwong, a spokesman for Juul, said in a statement the company strongly prefers to support bills to raise the purchase age that are free of additional provisions, “as we believe it is one of the most effective ways to prevent underage use.”

The new FEC figures show that Democrats, who won control of the House during last year’s elections, received $74,000 from Juul’s PAC between Jan. 1 and June 30 while Republicans received $22,500.

Kwong said the company “strives to support candidates on both sides of the aisle” as part of its mission to “improve the lives” of smokers and “combat underage use.”

Juul contributed $2,500 to Rep. Sanford Bishop, D-Ga. Bishop has co-sponsored legislation to exempt most e-cigarettes on the market from health reviews by the Food and Drug Administration.

Rep. Cedric Richmond, D-La., received $7,500, the largest donation to a single lawmaker. Richmond is co-chairman of Democratic presidential candidate Joe Biden’s campaign and a former chairman of the Congressional Black Caucus.

The company gave $5,000 each to the Congressional Black Caucus and the Congressional Hispanic Caucus’ political action committees. The company also gave $2,500 to the ASPIRE political action committee that raises money for Asian American candidates for Congress.

Juul donated $5,000 each to Sens. Kyrsten Sinema, D-Ariz., and Jeanne Shaheen, D-N.H. Shaheen has called e-cigarette companies the “culprits of this epidemic” of underage vaping. Legislation introduced by Shaheen would force manufacturers to fund anti-vaping education and prevention efforts for teenagers through federal user fees.

The company reported giving $2,500 to a left-leaning group called VoteVets. But Jon Soltz, chair of VoteVets, said the organization didn’t accept the money. Sen. Catherine Cortez Masto, D-Nev., also didn’t want Juul’s donation. Ryan King, the senator’s spokesman, said Friday her campaign did not accept the $5,000 contribution “and has promptly returned the check.”

Juul executives have said the company never intended its e-cigarettes to be adopted by underage teenagers. During a congressional hearing last week, Juul co-founder James Monsees testified that Juul developed its blockbuster vaping device and flavor pods for adult smokers who want to stop. “Combating underage use” is the company’s highest priority, Monsees added.

Most health experts say that e-cigarettes are probably less harmful than traditional paper-and-tobacco cigarettes, which can cause cancer, lung disease and strokes. But neither Juul nor any other e-cigarette has yet been approved by the FDA to help smokers quit.

Juul has assembled an extensive network of lobbyists amid mounting concern over e-cigarettes and warnings from the FDA that regulatory steps may be inevitable to combat what public health officials and anti-smoking groups have described as an epidemic of youth vaping.

The company also has become a generous political donor, giving tens of thousands of dollars over the last 18 months to candidates for state and national offices as well as political organizations, according to the FEC data and state campaign finance records.

During the first half of 2019, Juul spent $1.9 million on lobbying Congress, the White House and the FDA as the company expanded its pool of Washington insiders with ties to Republicans and Democrats in positions of authority.

Among those lobbying on Juul’s behalf are Jim Esquea, who worked during the Obama administration as an assistant secretary at the Department of Health and Human Services, and Ted McCann, who was a top policy aide to former House Speaker Paul Ryan. Juul hired Fulcrum Public Affairs in January, adding to its lobbying ranks former aides to Obama-era Labor Secretary Hilda Solis and Rep. Maxine Waters, the California Democrat who chairs the House Financial Services Committee.

In California, where Juul is headquartered, the company has donated close to $99,000 since early last year to members of the state legislature, political action committees and committees set up to influence the outcome of ballot measures.

About a third of the money went to Assemblymember Adam Gray, a Democrat from Merced who chairs the powerful Governmental Organization Committee. Gray’s reelection campaign received $8,800 from Juul, and the company gave $25,000 to Valley Solutions, Gray’s ballot measure committee.

Legislation introduced by Gray and other assemblymembers earlier this month to curb youth use of vaping products was criticized by the American Cancer Society’s Cancer Action Network as an industry-friendly measure that should be called the “Juul Market Share Protection Act.”

Gray said in a statement sent by his spokesman that the financial support he receives “plays zero role in how I represent my district or how I make decisions on public policy.”

Despite Juul’s public commitment to keeping its products out of teens’ hands, the company has fought in California and other states against legislation that anti-tobacco groups have argued would help to move toward that goal.

Juul and the Vapor Technology Association, a trade group that lists Juul as a platinum member, opposed a California bill that would have banned flavored tobacco products, arguing such a prohibition would only hurt adults trying to quit smoking.

Juul and Altria lobbyists in Arizona supported legislation to raise the minimum buying age for tobacco products and e-cigarettes to 21 but which included language that would bar cities and counties from imposing regulations on tobacco and e-cigarettes. Local governments often impose stricter rules than the state does. Kwong said this was the only bill that had a hearing and “provided us an opportunity to publicly support.”

In Montana, Juul opposed measures to require convenience stores that sell e-cigarettes to keep them behind the counter and to apply the state’s tobacco tax to e-cigarettes. Juul didn’t testify against the tax measure in Montana, but several Montana vape shop owners did.

“Taxing a product that helps people? I don’t see the point in that,” said Ron Marshall of Freedom Vapes.



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Saudi Arabia suspends visas to people from Congo over Ebola


Saudi Arabia has stopped issuing visas to people from Congo while citing the Ebola outbreak there, even as the World Health Organization recommends against travel restrictions.

Some Muslims in Congo had planned to take part in the annual hajj pilgrimage in Saudi Arabia next month. A letter from the Saudi foreign ministry to Congo’s embassy in Riyadh, obtained by The Associated Press and dated Wednesday, says the kingdom made the decision to protect pilgrims and others.

The letter refers to the WHO decision this month to declare the year-long Ebola outbreak in eastern Congo a global health emergency. More than 1,700 people have died in the second-worst Ebola outbreak in history.

Saudi Arabia also suspended visas during West Africa’s Ebola outbreak a few years ago in which more than 11,000 people died.

The new decision affects anyone coming from Congo, including non-citizens.

Congo’s government has not responded publicly.

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Follow Africa news at https://twitter.com/AP—Africa



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AP sources: Trump officials weigh delay of abortion curbs


The Trump administration has told federally funded family planning clinics it is considering a delay in enforcing a controversial rule that bars them from referring women for abortions. That comes after clinics had vowed defiance.

Two people attending meetings this week between the Department of Health and Human Services and clinic representatives told The Associated Press that officials said the clinics should be given more time to comply with the rule’s new requirements. The people spoke on condition of anonymity because they weren’t authorized to speak publicly before any decision has been announced.

HHS said Friday that its policy has not changed.

On Monday, agency officials announced that the government would immediately begin enforcing the rule, catching the clinics off-guard and prompting an outcry. Planned Parenthood said its 400 clinics would defy the requirement. Some states, including Illinois and Maryland, backed the clinics. The family planning program serves about 4 million women a year, and many low-income women get basic health care from the clinics.

The administration’s abortion restrictions, cheered by social and religious conservatives, are being challenged in court by groups representing the clinics, several states, and the American Medical Association. The litigation is still in its early stages. An enforcement pause may allow for a clearer indication of where the court cases are headed.

The people who spoke to AP said that HHS Office of Population Affairs Director Diane Foley told representatives of the clinics the administration is considering rewinding the clock on enforcement. Instead of requiring immediate compliance, the administration would issue a new timetable and start the process at that point.

Some requirements would be effective in 60 days, others in 120 days, and others would take effect next year.

The clinics had complained to HHS that the agency gave them no guidance on how to comply with the new restrictions, while expecting them to do so immediately.

The rule bars the family planning clinics from referring women for abortions. Abortion could still be discussed with patients, but only physicians or clinicians with advanced training could have those conversations. All pregnant patients would have to be referred for prenatal care, whether or not they request it. Minors would be encouraged to involve their parents in family planning decisions.

Under the rule, facilities that provide family planning services as well as abortions would have to strictly separate finances and physical space.

Known as Title X, the family-planning program funds a network of clinics, many operated by Planned Parenthood affiliates. The clinics also provide basic health services, including screening for cancer and sexually transmitted diseases. The program distributes about $260 million a year in grants to clinics, and those funds cannot be used to pay for abortions.

The family planning rule is part of a series of Trump administration efforts to remake government policy on reproductive health to please conservatives who are a key part of its political base.

Other regulations tangled up in court would allow employers to opt out of offering free birth control to women workers on the basis of religious or moral objections, and grant health care professionals wider leeway to opt out of procedures that offend their religious or moral scruples.

Abortion is a legal medical procedure, but federal laws prohibit the use of taxpayer funds to pay for abortions except in cases of rape, incest, or to save the life of the woman.

Planned Parenthood is also the nation’s leading abortion provider, and abortion opponents see the family-planning money as a subsidy, even if federal funds cannot be used to pay for abortions.

Planned Parenthood is in the midst of a leadership upheaval, after its board abruptly ousted the organization’s president this week. Leana Wen, a physician, had sought to reposition Planned Parenthood as a health care provider. In her resignation letter, she said the organization’s board has determined the top priority should be to “double down on abortion rights advocacy.”



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