“Roe Hanging On By A Thread”: Planned Parenthood President Alexis McGill Johnson on Imminent Threat To Reproductive Rights

Alexis McGill Johnson

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Female: Welcome to Conversations on Health C are with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health innovation, health policy, care delivery and the great minds
who are shaping the healthcare of the f u ture.

This week Mark and Margaret speak with Alexis McGill Johnson,
President and CEO of the Planned Parenthood Federation of America,
talking about the increasing number of serious legal challenges to Roe
V . Wade with more than 100 laws , restricting abor tion being passed in
the past year. She also addresses the controversial SB 8 law in Texas ,
banning all abortions there after six weeks a nd discusses a
Conservative Supreme Court's upcoming decision to hear aspects of
the law.

L ori Robertson checks in , Man aging Editor of F act C heck.org looks at
mis s tate ment s spoken about health policy in the public domain
separating the fake from the facts . We end with a bright idea that's
improving health and well - b eing in everyday lives.

If you have comments, please email us at [email protected] or
find us on Facebook, Twitter, or wherever you listen to podcasts. Y ou
can also hear us by asking Alexa to play the program. Now stay tuned for our interview with Alexis McGill Johnson here on Conversations on
Health Care.

Mark Masselli: W e're speaking today with Alexis McGill Johnson, President and CEO of Planned Parenthood Federation of America , n ow in it ’ s Centennial
Year ; and Planned Parenthood Action Fund .

Margaret Flinter: A seasoned a ctivist and organi z er , she serves on the Board of Color of
Change and the Leadership Council for Civil and Human Rights . Alexis,
welcome to Conversations on Health Care .

Alexis M. Johnson: Thank you so much for having me. It's a delight to be here.

Mark Ma sselli: Well, Alexis, we're approaching the 50th anniversary of Roe vs . Wade,
the Supreme Court decision which legali z ed abortion , but never since
that time have American Reproductive Rights seems so imperil . And
we can simply start with the most recent Te xas Law , SB 8, banning all
of abortions after six weeks . The law allows average citizens to sue
anyone connected to such abortions. And late last week, the Supreme Court State d its intent to uphold certain aspects of SB 8. Can you bring
our listeners up to speed on the intent of the law and the latest
developments around it?

Alexis M. Johnson: Well, last week, the Supreme Court granted both our and the Biden Administration's request to hear the challenges to SB 8 on November
of 1st , and that is significant. We were looking forward to our patients

Alexis McGill Johnson

and providers , finally having our day in court that they have allowed
this law, as you have named , not just unusual, but particularly cruel to
remain in effect despite the devastating harm that we have already
seen.

SB 8 is a six - week blatantly unconstitutional ban against abortion.
Normally, when you have an unconstitutional law, you are able to
appeal , sue the State , lawmakers , who put it into place. Instead, what
Texas has done is created a provision where the Sta te actually cannot
enforce the law that they created . An instead empowers average
citizens, even outside of Texas , to enforce the law with what's been
called a bounty - hunting provision, that if they find out that someone
has had an abortion after six weeks in Texas, anyone who has helped
them secure that access to abortion can be charged with a $10,000
fine.

So it is incentivized in the most perverse way , b ehavior that p its
citizens against citizens, neighbors against neighbors, and has in effect
stopped th e provision of abortion care , after six weeks sending
thousands of people seeking access to care , outside of Texas into
neighboring State s , all the way up to where I am in the Northeast. So
it's abominable.

Margaret Flinter: Well, Alexis, while these legal questions play out around SB 8 , Texas is
not alone , right. And according to the Guttmacher Institute, more
than a hundred laws restricting abortion have passed in State s , all
around the country this past year . Help us understand the full impact
these laws are having on impeding access to reproductive health
services , across the country. And we understand also maybe there's a
diminishing in the number of the clinicians prepared to provide such
services that have resulted from this as well.

Alexis M Johnson: I mean look, we know that what's happening in Texas is not going to
stay in Texas . As many as 12 State s are already threatening to pass
copycat Bill s thus far. We know a Bill has been prefiled in Florida .
Politicians in Arkansas are also threatening the s ame. And I think they
have been , the lawmakers have been very clear. We ha ve had
Governor Hutchinson in Arkansas , sending a clear note to the
Supreme Court that they wanted the court to consider overturning
Roe in this process.

So abortion is consistently under attack , r ight . As you mentioned a
100 restrictions in 2021 alone, the most restrictions on record since
Roe was decided in 197 3 . T hese onerous barriers, what are called
Trap Laws , targeted regulation specifically of abortion providers have
made it in creasingly difficult for providers to provide care. And we
also know that these laws have very little to do with protecting
patient safety . Everything to do with shutting down he alth cent e rs by
subjecting providers to unnecessary restrictions. And that mea ns that

Alexis McGill Johnson

far too many people , the right to access abortion is a write in name
only.

Part of the tactic that undergirds these bans is not just to shame the
person seeking access to abortion care, but also the people around
them who are doing that. And I thin k that's what we're seeing, not
just in Texas, but in the neighboring State s that are also poised to
enact similar bans.

Mark Masselli: Alexis, I want to pull the thread on your State ment about the impact ,
this is having on women's health. And at last chec k hundreds of Texas
Women have been forced to cross State lines , to gain access to
abortion. And I think everybody knows Texas is a very large State . And
women can't necessarily afford the time to travel with all their
responsibilities that they have. And it's really become a serious
impediment to clinicians practi c ing in Texas and causing strains that I
would imagine in all the bordering State s, as you just mentioned, all
the way up to the Northeast , women are seeking assistance. Tell us a
little more abou t what you're seeing on the ground, paint a picture for
us.

Alexis M. Johson: So as you can imagine, right , in rendering the right to access abortion
is effectively meaningless in the State . Six weeks is the terminology ,
but we're really talking about two weeks after this period. So the
logistical nightmare that patients are going through on top of what
Texas already had in place t hey had a 24 hour mandatory waiting
period , mandatory ultrasound and counselling. So the whole process
of getting an appointment , not just one appointment, but two
appointments prior to cardiac activity, that they are allegedly
legislating the abortion against , means that it is not just an a logistical
challenge, it is an emotional challenge for those who need Access to
Care .

D urin g the month of September, Planned Parenthood Health Cente r s
in surrounding State s saw 1000% increase in patients in Texas . And
more Texans were being seen in Oklahoma than Oklahomans. And
that means that people are being forced significant travel distances
outside of State for access to abortion . Some of these other State s
have their own restrictions, right. So it means we had one patient who
travelled twice to Mississippi from Texas , to get an abortion at
Jackson Women's Health Organi z ation. And they are a lso facing,
different mandatory waiting periods having to come back in three
days’ time . What does that mean? That means people have to take off
from work, they have to get childcare, they have to get access to
travel funds and resources. And we're also st ill asking them to travel
during COVID. So it really is incredibly cruel.

We had another patient who travelled hundreds of miles to Colorado,
but she didn't want to put any of her family members at risk , because

Alexis McGill Johnson

she didn't know how to interpret the new law . So she drove by
herself . I t’s the isolation, it's the stigma, it is that emotional barrier
that we are looking at. And I think really understanding who is most
harmed by these restrictions, right . These are going to be the people
who had, likely the leas t resources in the first place . Communities of
color , folks who've already faced significant discrimination and other
barriers to healthcare that we've just seen laid bare over the last
couple of years.

So it is hard to put in words, just how incredibly em otional it's been.
And I think about the providers all the time who have taken these
vows to provide care , no matter what, who ha ve to deny their own
impulses, to provide that care and really the trauma that they are
experiencing as well.

Margaret Flinter: Well, Alexis , reproductive health is women's health and the health of
women is being compromised in a myriad of ways by these actions.
And as certainly really all across the country , Planned Parenthood has
been an essential healthcare provider for decades , for as long as
we've been engaged in healthcare. And it would seem that there's a
real deterrent effect for women being able to access even the non -
abortion services, but the health services, the routine birth control,
the help less spac e in families , the health screening s that Planned
Parenthood has done such an effective job of ; what are you seeing in
terms of the sort of a spillover effect of the focus on the abortion laws
in terms of just being a deterrent to people , getting the primary
health care , fa mily planning care that they've come to count on
Planned Parenthood for?

Alexis M. Johnson: Yeah, absolutely. And look, I mean, you know this from just seeing
what's happened during the pandemic , the number of folks who ha d
just delayed getting care becaus e they haven't wanted to come out or
they haven't had access to the Telehealth care, and you know other
ways of providing access to information and education. So, we are all
kind of in a prolonged period of needing more care than ever. And
Planned Parentho od is a critical part of that public health
infrastructure. Every year, millions of people , all identities come to
Planned Parenthood for abortion and birth control, STI testing and
treatments, gender affirming care, all of these services that I think we,
in this moment have become critically important as people are being
very intentional, deliberate in how they are organi z ing their lives.

And so it is important, right that our door s stay open . It is important
that we continue to expand a ccess to c are , a cce ss to oral care, in
places where we may be the first point of entry into the healthcare
system. So my biggest fear around some of these horrific bans and
laws is the impact on our ability to continue to provide the broad
spectrum of healthcare that we do. Because we know that in this

Alexis McGill Johnson

time, it's ever more critical, and ensuring that people have access to
the full spectrum of sexual and reproductive health care, and that
they have the full spectrum of, quite frankly, I think the agency that
comes with being a ble to control and determine your future , is such a
critical part of what we also provide. And so we are definitely
concerned and are just fighting as hard as we can to make sure that
that our doors will stay open no matter what .

Mark Masselli: We're speak ing today with Alexis McGill Johnson, President and CEO
of Planned Parenthood Federation of America and Planned
Parenthood Action Fund. You know, Alexa since the 2016 Election ,
we've watched a surge of activism and protest against assaults on
rights, wheth er it's women's health, voting rights, civil rights, and you
run Planned Parenthood's Action Fund and have really a strong
background, personal background in political activism. Aside from
providing advocacy for patients and for women's health, what's the
prescription or the collective action you're calling for?

Alexis M. Johnson Yes, I was raised from the cradle to the march right now, to believe in
securing rights for everyone that we , none of us will be free until
we're all free. But I think what's becom e even more apparent and true
in the last year , and a half or so is that the intersection of all of our
movements are fighting for the same freedoms, right, the freedoms
around our bodies, our rights, our ability to not just survive, but to
thrive. And wha t we have seen is that, the intersection of so many, so
many issues around abortion rights, around racial justice, around our
ability to participate in democracy, that these things are inextricably
linked .

Y ou know, our patients come to us, perhaps, as I said for an STI
screening or Access to Family Planning or Abortion . But when they
leave, they don't just carry that identity with them , r ight. The fact that
they came for a medical procedure, they leave and they may face
police officer stopping their car, like one of our patients who was
denied an abortion in Texas and had to drive to Oklahoma for care.
We talked about this in our Amicus brief that we filed with the
Supreme Court . You know on her way there , she and her boyfriend
who are B lack, you know, the y were pulled over by the police and
questioned about where they were going and why they were going ,
and they were scared.

And so I think it is our responsibility to stand with our patients and the
many experiences that they are having to demonstrate that this
movement for freedom has to recogni z e the ways in which our
identities intersect and fight for the policies that will continue to
protect them in the same way that their healthcare will.

Margaret Flinter: Well, Alexis, I'm going to maybe try to inject a little bit of good news
in some of this, and that is that the Biden Administration has revoked

Alexis McGill Johnson

the Trump - era ruling that barred health clinics receiving Title X
funding which I think is family planning, funding generically , from
offering patients inform ation on how to end a pregnancy.

Wonder if you would share with our listeners how that so called
abortion Gag Rule impacts access to full reproductive health , for our
patients ? A nd what do you think we wi ll see once the Biden reversal
goes into effect on N ovember 8 ? I t's hard to build something up after
you've kind of taken it down. Be curious, your thoughts on that?

Alexis M. Johnson: Yeah. I mean, look, I think that it is tremendous to have a partner in
the White House and throughout the administration th at truly
understands the importance of basic family planning healthcare, why
it plays such a critical role in our communities. You know, health
education, the ability to provide people with the full scope of Sexual
and Reproductive Healthcare services, lik e that is essentially what was
being denied under the Title X, Gag Rule that had been in place for
two years by the Trump administration. Prior to 2019 , e very year,
Planned Parenthood Health Cent e rs served about 40% of the 4 million
patients that rely on T itle X . It was harmful to have the Gag Rule . I t
was deeply unpopular. It really again, going back to my point about
providers in SB 8 , it was asking providers to provide substandard care .
It was asking providers to withhold information to patients on all t he
options available to them , its last provider capacity in half and created
more barriers to affordable health care.

So our ability I think, in this moment, you know, we're grateful in our
network that a number of State s stepped in and backfield resource s
to Title X, in a moment, when we were also facing significant concerns
around the pandemic. So the infrastructure is still there, and the work
that the Biden Administration is doing to also build in kind of equity
metrics , to ensure that we are making su re that the very patients that
we're seeing , we see them in the most equitable way . And hopefully
building Title X back better right moderni z ing it , thinking about the
variety of patients that should be seeing and the number of services
that should be incl uded in Sexual and R eproductive Health care.

So I'm hopeful , I really appreciate that, that bright spot, because it has
been a dark month for sure. But it is great to have partners who are
really understanding how critical expanding access to healthcare
bro adly is going to be for this country.

Mark Masselli: Alexis , Supreme Court has signaled twice now that it's unlikely to
move in any meaningful way towards protecting Roe v s . Wade, at
least in its current configuration. And we know that Justice Kagan and
So tomayor have spoken out harshly against the overt reluctance of
the High Court to step in , and protect women's constitutional right.
And there has been talk about expanding the number of justices on
the Supreme Court. I'm wondering what position you all ha ve taken

Alexis McGill Johnson

and what you expect may happen.

Alexis M. Johnson We are certainly planning for every scenario win , loss and in - between ,
but as you indicated, there is a lot to be concerned about . You know,
it is particularly grave time for abortion rights. And t here is no
question that Roe is hanging on by a thread. It has also been
meaningless in many State s , f or a long time. I think what we are
seeing in response to particularly to SB 8 in Texas, and the idea that
the court is taken up Mississippi in such a way that goes to the
essence of Roe , whether or not we get to make decisions, pre - viability
versus the State lawmakers . I t means that people are waking up to
the idea that Roe could no longer exist , after half a century .

And as you said, just before, it's har d when you take a ride away that
has existed for a really long time . You know, people are going to fight
back . There you already feel the energy and the hurt. So we're
preparing , we're working with our partners to do whatever comes
next.

What is true , is t hat there is literally no State in the Union where
banning access to abortion, getting rid of Roe is popular. What we
have right now are a number of State s , 26 State s in particular, that
have essentially, a l ocal minority of lawmakers who are creating laws
that go against the will of the people. And I have to believe that when
these protections, these federal protections are potentially gone
under Roe, that people will be pushing for proactive legislation to
protect ab ortion fighting, you know, ensuring the ir lawmakers have
respect for our health and rights.

It means that we have to continue doing the work of abortion stigma ,
to make sure that people understand it as the common e ssential
h ealth procedure that it is . And making sure that people are
connecting the dots between what they expect to be protected on , in
terms of their constitutional rights, that they understand how they
have been consistently undermined , not just by their lawmakers, but
also by the courts that are intended to be there to protect th em as
well.

Margaret Flinter: Thank you so much for that. And we'd like to think that policy would
follow the evidence right, and where there i s good evidence for
something we'd see replication . And o ne of those that was really very
impressive to me was th e experience in Colorado, of making
contraception, particularly long - acting, reversible contraception,
basically available free of charge to young women, particularly who
would face barriers. The outcome was a very sharp decline in the
number of abortions, a sharp decline, as I understand it, also in the
number of teen pregnancies, and even outcome measures like
admissions to newborn Intensive Care Units . What are you seeing in
terms of States basically invest in maybe a little more upstream

Alexis McGill Johnson

around trying t o make effective and safe contraception , much more
readily available to people regardless of their economic means.

Alexis M. Johnson: Absolutely. Look, and I think that's why we're thrilled by the Biden
Administration on Title X , to make sure it's also equ itable, right, and
that people are getting significant access to contraception . This is
going to be a really critical part of how we are navigating in a ,
particular in a potentially post Roe era. And we also know
contraception is not a 100% foolproof . And so it does mean that we
will need to continue to fight for access to abortion.

But Colorado is a terrific example. LA County is a wonderful example.
We have 50 well - being cente r s in high schools, where, students are
able to leave A lgebra and Geometry class and walk down the hall , and
talk to a nurse practitioner about the choices that they want to make
with respect to their bodies , asked for counselling around
contraception without you know, losing a moment's a way from their
desks. There's a Communities Hea lth Cent e rs that are also serving the
community. So the parents are able to come in and ask their own
questions for themselves.

And so I think there are so many models out there that are both
advancing from a medical standards and guidelines practices, but also
what is best for community. And I think that those are the things , that
is going to be the responsibility for State s that have the capacity to
expand a ccess to healthcare in this way, particularly Sexual and
R eproductive Healthcare . Their biggest job right now, in addition to
seeing the patients that may come to them from the South and the
Midwest, because of these bans . They have to be exporting that
imagination back into the State s that people are leaving because we
have to give people a vision of w hat is possible.

Mark Masselli: Alex is thinking about Women's Reproductive Rights. It's not only a
national issue, it's a global issue. And I'm wondering, what's the
landscape look like for abortion rights , a s you look around the globe ,
i s there anything t hat you're hopeful for or concerned about?

Alexis M. Johnson: Oh, thank you for this question Mark. Yeah , it's been -- reminded
Planned Parenthood has a global arm to it, right . We have a Planned
Parenthood global work. And we just finished listening to a number of
our leaders. I mean, we're seeing (inaudible 00:22:15) in Argentina .
You know, Mexico has reversed its policies. No w to the North of us in
Canada, we have a Prime Minister who has empowered a minister
focus solely on implementing a feminist polic y framework in their
work.

So from Ireland to Argentina, the work that is happening to really shi ft
norms, in some ways, they are going forward leaps and bounds while
we are retracting. So we have so much to learn, I think from our

Alexis McGill Johnson

colleagues abroad, about changes in healthcare delivery, which we
know is going to shift as the impact on the number of health cent e rs,
both during the , with the pandemic or with some of these restrictions,
how we moderni z e our healthcare delivery and ensure that we can
get to pe ople that most need access . And also how we continue to
strengthen and build our movements to fight and show up in the
p a laz zo s , and make sure that we are linked globally.

And I think that's our work , r ight now, our tagline with our Planned
Parenthood Glo bal is “ How do we continue to back the brave ” . And I
think about that all the time because that is the work that we're doing
right here right now ‘ Backing the Brave ’ as part of the globe, that the
U . S . is making sure that they're the people who are trying to take our
rights away , are no match for the people who are going to continue to
defend , and do everything they can to maintain them.

Margaret Flinter: We've been speaking today with Alexis McGill Johnson, President and
CEO of the Planned Parenthood Feder ation of America. You can learn
more about their c omprehensive healthcare services and their
advocacy work by going to www.plannedparenthood.org or follow
them on Twitter @ PPFA . Alexis, we want to thank you for your
tenacity and the fight for women's reproductive health over a lifetime , for your activism, your advocacy for health equity. And thank
you so much for joining us today on Conversations on Health Care .

Alexis M. Johnson: Thank you so much for having me here. It's been wonderful.

Mark Masselli: At C onversations on Health Care we want our audience to be truly in
the know when it comes to the facts about healthcare reform and policy . Lori R obertson is an award winning journalist and Managing
Editor of F act C heck .org a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in U . S . politics.
L ori , what have you got for us this week?

Lori Robertson: Former Secretary of State , Colin Powell died from complications of
COVI D - 19. Although he was fully vaccinated , h e was also 84 years old
and was a cancer patient , who had undergone treatment for multiple
myeloma, a rare blood cancer that weakens the immune system. Those factors put him at higher risk of a serious breakthrough illness. Powell also ha d prostate c ancer in 2003 and was being treated for
e arly s tage Parkinson's disease , a ccording to his longtime assistant .
His death does not mean the COVID - 19 vaccines don't work as many
social media posts suggest.

Experts say Powell ’s death underscores the need for more people to
be vaccinated , to help protect not only themselves, but also
transmitting the disease to others, especially the most vulnerable. Experts told us that multiple myeloma patients are more susceptible

Alexis McGill Johnson

to infecti ons in general, because both the disease and treatments
affect the immune system.

Data show that the vaccines are doing remarkably well at protecting
people from infection, severe disease and death. According to the
CDC, in the month of August, unvaccinate d people were six times
more likely to test positive for infection with the Coronavirus and 11
times more likely to die from COVID - 19 , then the fully vaccinated . But
no vaccine is foolproof and some number of breakthrough infections
even some leading to de ath are expected.

Preliminary research shows that multiple myeloma patients and those
with other blood cancers are less likely to mount strong immune
responses to vaccination. Evidence also shows that some
immunocompromised people can benefit from an extra dose of the
COVID - 19 vaccines. For this reason, the FDA had authori z ed a third
booster shot of the Pfizer - BioNTech and M o derna vaccines for this
population, as well as older people who are also at increased risk of
serious breakthrough infections.

Powell got his second dose of the Pfizer vaccine in February, but had
not yet gotten a booster shot. And that's my fact check for this week.
I'm L ori Robertson, Managing Editor of FactCheck. org .

Margaret Flinter: FactCheck.org is committed to factual accuracy fr om the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, email us at C HCR adio .com we'll have F act C heck.org ’s
Lori Robertso n , check it out for you here on C onversations on H ealth
C are.

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Mark Masselli: Each week C onversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Of the 6.6
million births per year in this country, over half are unintended. And
among teens, those rates are even higher. Colorado has been
conducting an experiment for several years to examine what might
happen if sexually active teens and poor women were offered the
option of long - term birth control such as IUDs, or implants . T he first
question to answer would they take the offer ?

Dr. Larry Wolk: What was so striking was the word of mouth amongst these young
women to each other and the network of support that was built to
access this program through these clinics , to help the 10s of 1000s of
women over the course of the four to five years , really did result in
the significant decreases in unintended pregnancies and abortions.

Mark Masselli: Dr. L arry Wolk , Medical Director of the Colorado Department of
Health and Envi ronment .

Alexis McGill Johnson

Dr. Larry Wolk: The result in decrease is 40% plus or minus in both categories ,
pregnancy and abortion , w hen you extend this out over an additional
year, to more than 50 % , even approaching 60% reduction in those
unintended pregnancies and abortion s .

Mark Masselli: There was a significant economic benefit to the State as well.

Dr. Larry Wolk: We've seen a significant decrease in the number of young moms and
kids applying for and needing public assistance. You know, we hope
that then longer term this will translate into better social and
economic outcomes for these folks.

Mark Masselli: The incidence of sexually transmitted diseases dropped in this
population as well.

Dr. Larry Wolk: And amongst young women 15 to 24 , we 've seen a decrease in
sexually transmitted infections, and the rates are now below the
national averages.

Mark Masselli: A free long - term contraception program offered to at - risk teens and
women trying to avoid the economic hardship of unplanned
pregnancies, leading to a number of posit ive health and economic
outcomes for all involved. Now that's a bright idea.

[ Music ]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health .

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Female : Conversations on Health Care is recorded at WESU at Wesleyan
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