vox--2020-09-24--Can Democrats pull off another Senate win in Arizona?

The Senate race in Arizona is giving a lot of people déjà vu .
Just two years after running — and narrowly losing — to Sen. Kyrsten Sinema , Sen. Martha McSally is running again , this time against retired astronaut Mark Kelly , in an attempt to keep her seat .
In a unique twist , McSally was appointed to an open Senate seat by Gov .
Doug Ducey to serve out the term of the late Sen. John McCain after she ’ d previously lost .
And experts say McSally ’ s candidacy isn ’ t the only @ @ @ @ @ @ @ would be willing to wager Sinema just handed Kelly her playbook and said , ‘ Here you go , here ’ s how you win the US Senate in Arizona , ’ ” quipped OH Predictive Insights pollster Mike Noble .
Many of the dynamics that defined 2018 — and contributed to the state ’ s shift to the left — have only become more apparent in the two years since .
Independent voters , which make up about a third of the state ’ s electorate , are still dissatisfied with President @ @ @ @ @ @ @ this fall .
In a recent ABC News/Washington Post poll , Democratic presidential nominee Joe Biden led Trump 57 percent to 38 percent among independent voters in the state .
Democrats are also making inroads with moderate Republicans , particularly suburban women , who are interested in less polarized leadership and concerned about Trump ’ s handling of the coronavirus .
And the state ’ s growing population of Latinx voters is continuing to skew Democratic .
“ The shift is these Ducey-Sinema voters .
You ’ re a Republican and you ’ @ @ @ @ @ @ @ .
That ’ s where I think the most growth has been , ” said Lorna Romero , a former communications director for McCain ’ s 2016 campaign .
There are some key differences this cycle that are poised to have major implications on the race , too .
The state , like the rest of the country , is still grappling with the public health and economic consequences of a devastating pandemic , which hit Arizona particularly hard this past summer .
Plus , the presidential election is poised to loom over @ @ @ @ @ @ @ in the state , driven by his divisive rhetoric and poor handling of the pandemic , could ultimately amplify the same trends already evident in the last two cycles .
Although Sen. Mitt Romney won Arizona by 9 points in the 2012 presidential race , Trump only took it by 3 in 2016 .
Sinema then won the state ’ s Senate seat by 2 points in 2018 .
Following her defeat that year , members of McSally ’ s team put out a memo that touched on the reasons behind her loss @ @ @ @ @ @ @ several issues — including her decision to align herself closely with the president — that could well lead to the same outcome again .
“ A significant segment of the AZ GOP was hostile to the President , ” the memo read .
“ This segment of moderate Republicans , especially [ women ] , proved very difficult to bring home to a Republican candidate that supported President Trump and the confirmation of Justice Kavanaugh.
” In addition to maintaining her steadfast backing for Trump , McSally is poised to take another potentially @ @ @ @ @ @ @ weeks , making some of the circumstances she ’ s dealing with very similar to 2018 .
Democrats are making gains with moderate Republicans in Arizona According to exit polling from the midterms , Sinema won 12 percent of Republicans as well as 50 percent of independents and an overwhelming majority of Democrats .
That same coalition of voters could be the ones to buoy Kelly to victory this cycle .
In the RealClearPolitics average , Kelly is ahead of McSally by more than 6 points .
And an OH Predictive Insights poll @ @ @ @ @ @ @ of Republicans and 55 percent of independents would support him .
“ Sinema voters — they are the Jeff Flake Republicans , they are the John McCain Republicans who want civility , ” says Derrik Rochwalik , a political consultant based in Phoenix who was previously chair of the Maricopa County Young Republicans .
Trump ’ s hardline stances on immigration and racist comments about Mexican immigrants are among the factors that have turned these voters away .
And McSally ’ s willingness to back Trump on issues including the national emergency for @ @ @ @ @ @ @ Court vacancy means many view her as just another extension of his administration .
“ I want a candidate that will represent my family and that will make decisions based on personal convictions and not just follow the President from their party , ” said Mark Tucker , a resident of Gilbert , Arizona , in a recent statement that included a hundred Republicans backing Kelly .
While McSally has made a more partisan appeal , experts in the state note Kelly ’ s messaging has been designed — much like Sinema ’ @ @ @ @ @ @ @ of crossover Republicans and independents .
“ When you look at his ads , he ’ s not talking about Democrat-this or Democrat-that .
He ’ s running largely as somewhat of an independent , ” says Joe Garcia , the executive director of the Chicanos Por La Causa Action Fund .
McSally herself nodded at Kelly ’ s approach in an August event , going so far as to suggest that some people may not be aware he is a Democrat .
“ Somebody actually could vote Trump-Kelly , ” she warned @ @ @ @ @ @ @ like his messaging , hew to the center : He ’ s supportive of a public option and reducing drug prices through Medicare negotiation , and he has called out the need to generate more clean energy jobs while stopping short of backing the Green New Deal .
Much like many Democrats did in 2018 , he ’ s made defending protections for people with preexisting conditions a centerpiece of his campaign .
Kelly is also married to former Arizona Rep. Gabby Giffords , and the two have been leading gun-control advocates in @ @ @ @ @ @ @ which a gunman shot Giffords in the head at a constituents ’ meeting in Tucson .
Presently , he backs universal background checks and red-flag laws , which enable law enforcement to bar individuals from accessing firearms if they are flagged as a danger to themselves or others .
“ I ’ m running — to be an independent voice for Arizona , ” Kelly has said .
Kelly ’ s campaign declined to make him available to Vox for an interview .
McSally ’ s campaign did not immediately respond to a @ @ @ @ @ @ @ focus on his independent streak echoes messaging Sinema once used about being able to work with “ literally anyone ” to get policy done , and it ’ s one that has played well with Arizona voters , who often boast about how independent they are .
McSally , meanwhile , has continued to link herself to Trump in a bet that this connection will be enough to rally members of the GOP ’ s conservative base in November , even as she ’ s lost moderates .
She ’ s focused some @ @ @ @ @ @ @ to fly in a combat mission for the Air Force , but much of her messaging has been dedicated to emphasizing her conservative bona fides .
Latinx voters are poised to have huge influence over the election , which could bode well for Democrats A big factor in Arizona ’ s leftward shift is the uptick in Latinx voters in the state .
In 2018 , Latinx voters overwhelmingly favored Democrats , with 70 percent supporting Sinema while 30 percent backed McSally .
And since the last presidential election , Latinx voter share @ @ @ @ @ @ @ percent to 24.6 percent , with thousands of younger voters reaching voting age .
According to Garcia , more than 100,000 new Latinx voters have turned 18 in recent years — and Latinx voters are younger , on average , than white voters in the state .
It ’ s important to note that Latinx voters are not a monolith ; the majority who live in Arizona are Mexican American and more likely to be left-leaning .
According to the ABC News/Washington Post survey this week , a higher proportion of Latinx voters @ @ @ @ @ @ @ , for example , a trend that ’ s indicative of the diversity among members of the group .
The pandemic is ultimately an issue at the forefront for all Arizonans , including Latinx voters , who have been disproportionately impacted by it .
“ For the most part , Covid-19 and the cost of health care are overwhelmingly top issues , ” says Edward Vargas , a researcher for polling firm Latino Decisions .
“ What we ’ ve seen in our polling is that they trust Democrats much more in addressing @ @ @ @ @ @ @ focused more of their efforts on reaching Latinx voters — including participating in a virtual forum that will air in October — who historically haven ’ t seen as much formal outreach from candidates .
In 2018 , because of more dedicated organizing driven by advocacy groups including LUCHA and Mi Familia Vota , Latinx voter turnout saw a spike compared to 2014 .
Experts say they expect this same energy — if not more — in 2020 .
“ I think it ’ s going to be a record-setting election , ” @ @ @ @ @ @ @ of the Senate and the presidency looms over this race Because of how she ’ s positioned herself , McSally ’ s fate is viewed as inextricably tied to Trump ’ s .
“ I do think that the strategy for the president — and Martha McSally — is making sure that the Trump supporters came out of the woodwork to support him in 2016 , the play right now is to make sure that those people turn out , ” says Romero .
McSally has also repeatedly emphasized that her seat is @ @ @ @ @ @ @ the Senate , an effort aimed at targeting those same Republicans , especially as the GOP seeks to confirm a Supreme Court nominee to take the late Justice Ruth Bader Ginsburg ’ s seat .
“ Arizona is the tipping point for whether Chuck Schumer is going to be in charge in the Senate , ” McSally said during an August appearance on CBS News .
“ A vote for Mark Kelly is a vote for ... the radical left agenda.
” In the past week , the two candidates provided a glimpse @ @ @ @ @ @ @ Supreme Court nomination : McSally swiftly backed a vote on Trump ’ s Supreme Court pick , while Kelly argued that a nominee should be put forth by whoever wins the general election .
One of McSally ’ s chief arguments is , “ Let ’ s make sure we don ’ t lose that second seat and that the Republicans don ’ t lose the Senate in 2020 , ” says Rochwalik , the Phoenix political consultant .
The pivotal role Arizona could play in determining control of the Senate has also @ @ @ @ @ @ @ has been flowing into this race , with Kelly , in particular , raising a staggering sum .
According to the Center for Responsive Politics , Kelly had raked in more than $ 45 million as of a July report , dwarfing McSally , who had brought in $ 30 million as of a September report .
If Kelly can channel this support as effectively as Sinema did , he could see a repeat of her success , too .
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The Senate race in Arizona is giving a lot of people déjà vu.
Just two years after running — and narrowly losing — to Sen. Kyrsten Sinema, Sen. Martha McSally is running again, this time against retired astronaut Mark Kelly, in an attempt to keep her seat. In a unique twist, McSally was appointed to an open Senate seat by Gov. Doug Ducey to serve out the term of the late Sen. John McCain after she’d previously lost. And experts say McSally’s candidacy isn’t the only thing that feels familiar.
“I would be willing to wager Sinema just handed Kelly her playbook and said, ‘Here you go, here’s how you win the US Senate in Arizona,’” quipped OH Predictive Insights pollster Mike Noble.
Many of the dynamics that defined 2018 — and contributed to the state’s shift to the left — have only become more apparent in the two years since.
Independent voters, which make up about a third of the state’s electorate, are still dissatisfied with President Donald Trump and likely to favor Democrats this fall. In a recent ABC News/Washington Post poll, Democratic presidential nominee Joe Biden led Trump 57 percent to 38 percent among independent voters in the state. Democrats are also making inroads with moderate Republicans, particularly suburban women, who are interested in less polarized leadership and concerned about Trump’s handling of the coronavirus. And the state’s growing population of Latinx voters is continuing to skew Democratic.
“The shift is these Ducey-Sinema voters. You’re a Republican and you’re willing to vote for a Democrat. That’s where I think the most growth has been,” said Lorna Romero, a former communications director for McCain’s 2016 campaign.
There are some key differences this cycle that are poised to have major implications on the race, too. The state, like the rest of the country, is still grappling with the public health and economic consequences of a devastating pandemic, which hit Arizona particularly hard this past summer. Plus, the presidential election is poised to loom over any down-ballot races.
Strong anti-Trump sentiment in the state, driven by his divisive rhetoric and poor handling of the pandemic, could ultimately amplify the same trends already evident in the last two cycles. Although Sen. Mitt Romney won Arizona by 9 points in the 2012 presidential race, Trump only took it by 3 in 2016. Sinema then won the state’s Senate seat by 2 points in 2018.
Following her defeat that year, members of McSally’s team put out a memo that touched on the reasons behind her loss. In it, they summed up several issues — including her decision to align herself closely with the president — that could well lead to the same outcome again.
“A significant segment of the AZ GOP was hostile to the President,” the memo read. “This segment of moderate Republicans, especially [women], proved very difficult to bring home to a Republican candidate that supported President Trump and the confirmation of Justice Kavanaugh.” In addition to maintaining her steadfast backing for Trump, McSally is poised to take another potentially polarizing Supreme Court vote in the coming weeks, making some of the circumstances she’s dealing with very similar to 2018.
Democrats are making gains with moderate Republicans in Arizona
According to exit polling from the midterms, Sinema won 12 percent of Republicans as well as 50 percent of independents and an overwhelming majority of Democrats. That same coalition of voters could be the ones to buoy Kelly to victory this cycle.
In the RealClearPolitics average, Kelly is ahead of McSally by more than 6 points. And an OH Predictive Insights poll published in mid-September found that 15 percent of Republicans and 55 percent of independents would support him.
“Sinema voters — they are the Jeff Flake Republicans, they are the John McCain Republicans who want civility,” says Derrik Rochwalik, a political consultant based in Phoenix who was previously chair of the Maricopa County Young Republicans.
Trump’s hardline stances on immigration and racist comments about Mexican immigrants are among the factors that have turned these voters away. And McSally’s willingness to back Trump on issues including the national emergency for his border wall and the recent Supreme Court vacancy means many view her as just another extension of his administration.
“I want a candidate that will represent my family and that will make decisions based on personal convictions and not just follow the President from their party,” said Mark Tucker, a resident of Gilbert, Arizona, in a recent statement that included a hundred Republicans backing Kelly.
While McSally has made a more partisan appeal, experts in the state note Kelly’s messaging has been designed — much like Sinema’s — to reach a specific subset of crossover Republicans and independents.
“When you look at his ads, he’s not talking about Democrat-this or Democrat-that. He’s running largely as somewhat of an independent,” says Joe Garcia, the executive director of the Chicanos Por La Causa Action Fund. McSally herself nodded at Kelly’s approach in an August event, going so far as to suggest that some people may not be aware he is a Democrat. “Somebody actually could vote Trump-Kelly,” she warned.
Kelly’s policy positions, like his messaging, hew to the center: He’s supportive of a public option and reducing drug prices through Medicare negotiation, and he has called out the need to generate more clean energy jobs while stopping short of backing the Green New Deal. Much like many Democrats did in 2018, he’s made defending protections for people with preexisting conditions a centerpiece of his campaign.
Kelly is also married to former Arizona Rep. Gabby Giffords, and the two have been leading gun-control advocates in the wake of the 2011 shooting during which a gunman shot Giffords in the head at a constituents’ meeting in Tucson. Presently, he backs universal background checks and red-flag laws, which enable law enforcement to bar individuals from accessing firearms if they are flagged as a danger to themselves or others.
“I’m running — to be an independent voice for Arizona,” Kelly has said. Kelly’s campaign declined to make him available to Vox for an interview. McSally’s campaign did not immediately respond to a request for comment.
Kelly’s focus on his independent streak echoes messaging Sinema once used about being able to work with “literally anyone” to get policy done, and it’s one that has played well with Arizona voters, who often boast about how independent they are.
McSally, meanwhile, has continued to link herself to Trump in a bet that this connection will be enough to rally members of the GOP’s conservative base in November, even as she’s lost moderates. She’s focused some on her biography as the first woman to fly in a combat mission for the Air Force, but much of her messaging has been dedicated to emphasizing her conservative bona fides.
Latinx voters are poised to have huge influence over the election, which could bode well for Democrats
A big factor in Arizona’s leftward shift is the uptick in Latinx voters in the state.
In 2018, Latinx voters overwhelmingly favored Democrats, with 70 percent supporting Sinema while 30 percent backed McSally. And since the last presidential election, Latinx voter share in the electorate has grown from 19.6 percent to 24.6 percent, with thousands of younger voters reaching voting age. According to Garcia, more than 100,000 new Latinx voters have turned 18 in recent years — and Latinx voters are younger, on average, than white voters in the state.
It’s important to note that Latinx voters are not a monolith; the majority who live in Arizona are Mexican American and more likely to be left-leaning. According to the ABC News/Washington Post survey this week, a higher proportion of Latinx voters in Arizona favored Biden than in Florida, for example, a trend that’s indicative of the diversity among members of the group.
The pandemic is ultimately an issue at the forefront for all Arizonans, including Latinx voters, who have been disproportionately impacted by it. “For the most part, Covid-19 and the cost of health care are overwhelmingly top issues,” says Edward Vargas, a researcher for polling firm Latino Decisions. “What we’ve seen in our polling is that they trust Democrats much more in addressing issues toward Covid-19.”
Both campaigns have focused more of their efforts on reaching Latinx voters — including participating in a virtual forum that will air in October — who historically haven’t seen as much formal outreach from candidates. In 2018, because of more dedicated organizing driven by advocacy groups including LUCHA and Mi Familia Vota, Latinx voter turnout saw a spike compared to 2014. Experts say they expect this same energy — if not more — in 2020.
“I think it’s going to be a record-setting election,” says Vargas.
The fight for control of the Senate and the presidency looms over this race
Because of how she’s positioned herself, McSally’s fate is viewed as inextricably tied to Trump’s. “I do think that the strategy for the president — and Martha McSally — is making sure that the Trump supporters came out of the woodwork to support him in 2016, the play right now is to make sure that those people turn out,” says Romero.
McSally has also repeatedly emphasized that her seat is a bulwark against potential Democratic control of the Senate, an effort aimed at targeting those same Republicans, especially as the GOP seeks to confirm a Supreme Court nominee to take the late Justice Ruth Bader Ginsburg’s seat.
“Arizona is the tipping point for whether Chuck Schumer is going to be in charge in the Senate,” McSally said during an August appearance on CBS News. “A vote for Mark Kelly is a vote for ... the radical left agenda.”
In the past week, the two candidates provided a glimpse of how they’d handle the Supreme Court nomination: McSally swiftly backed a vote on Trump’s Supreme Court pick, while Kelly argued that a nominee should be put forth by whoever wins the general election.
One of McSally’s chief arguments is, “Let’s make sure we don’t lose that second seat and that the Republicans don’t lose the Senate in 2020,” says Rochwalik, the Phoenix political consultant.
The pivotal role Arizona could play in determining control of the Senate has also meant that an overwhelming amount of funding has been flowing into this race, with Kelly, in particular, raising a staggering sum. According to the Center for Responsive Politics, Kelly had raked in more than $45 million as of a July report, dwarfing McSally, who had brought in $30 million as of a September report.
If Kelly can channel this support as effectively as Sinema did, he could see a repeat of her success, too.


vox--2020-09-24--The election result the stock market is really afraid of

Wall Street ’ s nightmare scenario on Election Day isn ’ t really a Donald Trump or a Joe Biden victory .
It ’ s one where there ’ s no clear winner , or a result one side refuses to accept .
“ We ’ re kind of preparing for Armageddon on November 3 , ” one senior vice president at a major quant firm , who asked for anonymity in order to speak freely about the matter , told me .
“ If it ’ s close , there ’ s a decent chance that , like , @ @ @ @ @ @ @ going to be down 20 percent on Wednesday ?
” One of the higher-ups at his firm recently sent an email asking about a what-if scenario where President Donald Trump sends in the National Guard post-election .
At the very least , there are some concerns about possible presidential tweets .
Investors are bracing for volatility .
Most of the time , markets are not super impacted by who is in the White House , at least in the long term .
At a press conference in September , President Trump said that @ @ @ @ @ @ @ cause “ stocks to crash like you ’ ve never seen before.
” But many people predicted the same thing about a potential Trump win in 2016 , and about Barack Obama years before .
Under both men , stocks climbed , and Wall Street did just fine .
“ Markets don ’ t give a shit about who ’ s president , ” Barry Ritholtz , the founder of Ritholtz Wealth Management and a columnist at Bloomberg Opinion , told me .
In recent weeks , I spoke with multiple insiders , @ @ @ @ @ @ @ on Trump vs. Biden .
The takeaway is a complex one — after all , Wall Street is hardly a monolith , and they ’ re not all giving off Gordon Gekko vibes .
Most acknowledged that Trump has been largely favorable to the markets because of tax cuts and his administration ’ s deregulatory bent .
A Biden win would likely mean an increase in taxes , which investors wouldn ’ t love .
And even if the anti-billionaire rhetoric hasn ’ t been flowing from Biden directly , they ’ ve @ @ @ @ @ @ @ “ Rich white guys watch way too much cable news and think everyone is after them ” “ Rich white guys watch way too much cable news and think everyone is after them .
I don ’ t get it , but these guys are all doing fine in the markets and live in their bubble , ” one Palm Beach private equity associate said in an email with regard to their bosses ’ dislike of Biden .
“ They really only care about taxes and it ’ s quite infuriating.
” But @ @ @ @ @ @ @ potential Biden win as a doomsday scenario .
There are plenty of sectors that could do well under the former vice president — green energy , for example — and investors think a Biden administration would likely cool it on tensions with China and be more dovish on immigration , both welcome moves .
Plus , markets and big corporations like stability , which it ’ s hard to argue the current administration is consistently delivering .
“ Wall Street sees advantages and disadvantages to both candidates , ” said Kristina Hooper , @ @ @ @ @ @ @ “ It ’ s not as clear cut as you might normally see in an election.
” What Wall Street is weighing isn ’ t really “ Trump vs. Biden , ” it ’ s “ Trump vs. Biden vs .
?
?
?
, ” and that third option is the scariest , though not the likeliest .
“ A recipe for the market getting shellacked ” Wall Street prefers certainty , and an undecided election means anything but .
Imagine the United States hits November 4 , 14 , 24 , @ @ @ @ @ @ @ still not clear who won the presidential election or which party will have control of Congress .
Especially with mail-in voting , it ’ s a real possibility .
Or , say there is an outcome but one side refuses to accept it .
Trump and Republicans are already starting to set the stage for casting doubt about a Biden victory , and there are concerns about domestic and foreign actors potentially confusing the outcome of the election .
Some Democrats say they won ’ t trust the results if Trump wins .
@ @ @ @ @ @ @ democracy is fair and objective voting , and if that ’ s now not perceived to be the case , then who knows , ” said Jack Ablin , founding partner of Cresset Capital .
There is recent precedent for an uncertain outcome : George W. Bush vs. Al Gore in 2000 .
The weeks after the election , while the country turned its attention to the outcome in Florida , was not a great time for investors , as Stephen Mihm at Bloomberg recently explained .
By the end of November of @ @ @ @ @ @ @ 500 was down by 10 percent , though markets were bouncy , depending on the news of the day .
Once the Supreme Court issued its decision in the matter , the markets recovered , at least for a while ( they later declined , but for other reasons ) .
As Mihm outlines , it sort of comes down to a philosophical divide between risk you can measure and uncertainty you can not , outlined by economist Frank Knight in 1921 .
“ The first could be calculated and a wager made @ @ @ @ @ @ @ was a genuine shot in the dark , ” Mihm wrote .
“ The stock market would rather be handed what is perceived as bad news so that people can make an educated decision , ” said Ken Greene , a financial adviser based in Nevada .
In the 2000 election , the issue wasn ’ t really figuring out the risk of a Gore presidency compared to the risk of a Bush presidency , it was that nobody had any idea what was going to happen day to day or how things @ @ @ @ @ @ @ , we could see something even more chaotic .
Isaac Boltansky , director of policy research a Compass Point Research & Trading , told me that he has discussed a number of election-related issues with clients : what ’ s going on with deal-making and antitrust scrutiny , what to expect from the housing market , how to think about the banking industry and trade and taxes .
“ The No .
1 worry that I ’ ve heard over the last few weeks is not knowing who will be the winner , @ @ @ @ @ @ @ ’ t just the presidency .
The outcome of the Georgia US Senate race might not be known until 2021 — and , therefore , potentially which party controls Congress .
“ The No .
1 worry that I ’ ve heard over the last few weeks is not knowing who will be the winner ” “ If everybody is adult and calm and rational and says let ’ s count all the votes and figure out who won , it will be fine , ” Ritholtz said .
“ If the crazies @ @ @ @ @ @ @ lot of crazies … Mr. Market will not be happy with that at all.
” His takeaway : “ That kind of unrest and turmoil , that ’ s a recipe for the market getting shellacked.
” Donald Trump has been good for the stock market .
Joe Biden will probably be fine , too .
President Trump would like everyone to believe that he is 100 percent responsible for the stock market when it goes up and that he has nothing to do with it when it goes down .
The truth @ @ @ @ @ @ @ by a lot of things day to day , some related to politics , some not .
Trump , overall , has been favorable to corporate America and Wall Street .
In 2017 , he signed into law a $ 1.5 trillion tax cut bill that disproportionately benefited corporations and the wealthy .
( After signing the law , he literally told friends at his Mar-A-Lago resort that they “ just got a lot richer.
” ) His administration has also taken a deregulatory approach to most industries .
A Biden administration is @ @ @ @ @ @ @ that .
He has proposed increasing the corporate tax rate from 21 percent to 28 percent ( Trump reduced it from 35 percent ) and increasing the top individual income tax rate , among other measures .
The former vice president has pledged not to raise taxes on anyone making under $ 400,000 a year .
A Biden administration would also likely bring about tougher regulations on certain industries , such as fossil fuels and coal .
“ When you implement a higher corporate tax , that means [ corporations ] are not @ @ @ @ @ @ @ which means the multiple on the market might compress , ” said Luke Lloyd , a wealth adviser at Strategic Wealth Partners .
Ablin estimates that a corporate tax increase of the size Biden is proposing could be worth about 10 percentage points in the market .
“ That said , if Vice President Biden were to win , he would need Congress ’ s help , ” he said , and it ’ s not clear Democrats will have a majority .
“ I think investors are taking more of a wait-and-see @ @ @ @ @ @ @ market does indeed contract around a Biden win , if past serves as precedent , it will eventually come back and do just fine .
In fact , historically , investors have done better under Democratic leadership .
Getting past the top line , Trump and Biden mean different things for different sectors .
Trump has done a lot of defense spending ; Biden would likely be better for green energy .
Those in private equity would rather not see an increase in capital gains taxes that could potentially come under Biden .
@ @ @ @ @ @ @ also benefit from an administration with a less rocky relationship with the country — Wall Street has reacted negatively to the US-China trade war .
“ If you look at Chinese equities over the last couple of months , they ebbed and flowed with Biden ’ s improving or trailing chances , ” Ablin said .
“ Both candidates present risks , ” Hooper said .
She also noted that much of what ’ s been driving Wall Street , especially lately , has nothing to do with the president at all but @ @ @ @ @ @ @ Reserve , which has made enormous efforts to boost markets .
“ It has very little , if anything , to do with the occupant of the White House.
” White House chaos is not fun for anyone — and election chaos could be even worse The conventional wisdom is often that Republicans mean good for Wall Street and business and Democrats mean bad , but that ’ s not necessarily the case .
And not everyone in the arena agrees .
As some billionaires were lighting their hair on fire over the @ @ @ @ @ @ @ Democratic primary , she was amassing plenty of fans in finance , too .
Despite his working-class roots , the former vice president was largely Wall Street donors ’ preferred candidate among the 2020 Democrats , and he and the Democrats are doing quite well with them in the general election , too .
Paul Thornell , a former managing director for federal government affairs at Citigroup , told Politico that part of it is that the big banks , for example , aren ’ t just worried about taxes .
“ They @ @ @ @ @ @ @ these two conduct themselves as leaders , ” he said .
Billionaire hedge funder Leon Cooperman , who during the primary crusaded against Warren , in a recent interview with CNBC said that while he thinks Trump has “ good economic ideas , ” he also has “ limited character.
” Cooperman said he hasn ’ t made up his mind on who to support and added that he ’ s not sure what Biden stands for — a coded , but not uncommon , sentiment among investors worried about how much progressives @ @ @ @ @ @ @ ear .
When I emailed him asking him if he had made up his mind , he responded , “ I have a firm view but no need to go public !
” The Biden campaign is leaning into the theme that Trump is too erratic for anyone to stomach , rich or poor .
“ Like everything else that ’ s been handed to him , Trump inherited a strong economy and squandered it , plunging us into a recession , ” said Biden campaign spokesperson Rosemary Boeglin in an emailed statement @ @ @ @ @ @ @ former vice president “ knows that the words of a president matter and have the power to move markets , which is why Americans — regardless of their pocketbooks — are crying out for his stable leadership.
” The Trump campaign did not respond to a request for comment .
It ’ s hard to look at the Trump presidency objectively and think it hasn ’ t been good for corporate America and Wall Street ’ s bottom line .
It ’ s also impossible not to recognize it ’ s been chaotic @ @ @ @ @ @ @ dead in a pandemic , and the economy is deeply troubled — millions of people are out of a job , small businesses are suffering , and state and local governments are flailing .
One investment bank vice president who focuses on commodities and oil laid out how he sees the stakes even for giant oil companies : “ A Green New Deal or what have you is an existential threat to the fossil fuels business , but the thing is , what ’ s much more likely to happen is the pandemic @ @ @ @ @ @ @ anywhere , ” slowing consumption of those fossil fuels anyway .
He is a Biden supporter and has given money to Democrats this election cycle .
But a Biden loss isn ’ t his worst-case scenario .
“ I would much rather Trump win handily and demonstrably than any kind of ambiguity , ” he said .
“ It is the worst possible thing.
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@ @ @ @ @ @ @ are able to access clear , concise information on what the outcome of the election could mean for their lives , and the lives of their families and communities .
That is our mission at Vox .
But our distinctive brand of explanatory journalism takes resources .
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Wall Street’s nightmare scenario on Election Day isn’t really a Donald Trump or a Joe Biden victory. It’s one where there’s no clear winner, or a result one side refuses to accept.
“We’re kind of preparing for Armageddon on November 3,” one senior vice president at a major quant firm, who asked for anonymity in order to speak freely about the matter, told me. “If it’s close, there’s a decent chance that, like, who the fuck knows? Are markets going to be down 20 percent on Wednesday?”
One of the higher-ups at his firm recently sent an email asking about a what-if scenario where President Donald Trump sends in the National Guard post-election. At the very least, there are some concerns about possible presidential tweets. Investors are bracing for volatility.
Most of the time, markets are not super impacted by who is in the White House, at least in the long term. At a press conference in September, President Trump said that a Biden victory for the presidency would cause “stocks to crash like you’ve never seen before.” But many people predicted the same thing about a potential Trump win in 2016, and about Barack Obama years before. Under both men, stocks climbed, and Wall Street did just fine.
“Markets don’t give a shit about who’s president,” Barry Ritholtz, the founder of Ritholtz Wealth Management and a columnist at Bloomberg Opinion, told me.
In recent weeks, I spoke with multiple insiders, analysts, and experts about their take on Trump vs. Biden. The takeaway is a complex one — after all, Wall Street is hardly a monolith, and they’re not all giving off Gordon Gekko vibes.
Most acknowledged that Trump has been largely favorable to the markets because of tax cuts and his administration’s deregulatory bent. A Biden win would likely mean an increase in taxes, which investors wouldn’t love. And even if the anti-billionaire rhetoric hasn’t been flowing from Biden directly, they’ve heard it from other prominent Democrats.
“Rich white guys watch way too much cable news and think everyone is after them”
“Rich white guys watch way too much cable news and think everyone is after them. I don’t get it, but these guys are all doing fine in the markets and live in their bubble,” one Palm Beach private equity associate said in an email with regard to their bosses’ dislike of Biden. “They really only care about taxes and it’s quite infuriating.”
But many aren’t looking at a potential Biden win as a doomsday scenario. There are plenty of sectors that could do well under the former vice president — green energy, for example — and investors think a Biden administration would likely cool it on tensions with China and be more dovish on immigration, both welcome moves. Plus, markets and big corporations like stability, which it’s hard to argue the current administration is consistently delivering.
“Wall Street sees advantages and disadvantages to both candidates,” said Kristina Hooper, chief global market strategist at Invesco. “It’s not as clear cut as you might normally see in an election.”
What Wall Street is weighing isn’t really “Trump vs. Biden,” it’s “Trump vs. Biden vs. ???,” and that third option is the scariest, though not the likeliest.
“A recipe for the market getting shellacked”
Wall Street prefers certainty, and an undecided election means anything but. Imagine the United States hits November 4, 14, 24, even December, and it’s still not clear who won the presidential election or which party will have control of Congress. Especially with mail-in voting, it’s a real possibility.
Or, say there is an outcome but one side refuses to accept it. Trump and Republicans are already starting to set the stage for casting doubt about a Biden victory, and there are concerns about domestic and foreign actors potentially confusing the outcome of the election. Some Democrats say they won’t trust the results if Trump wins.
“One of the foundations of a democracy is fair and objective voting, and if that’s now not perceived to be the case, then who knows,” said Jack Ablin, founding partner of Cresset Capital.
There is recent precedent for an uncertain outcome: George W. Bush vs. Al Gore in 2000. The weeks after the election, while the country turned its attention to the outcome in Florida, was not a great time for investors, as Stephen Mihm at Bloomberg recently explained. By the end of November of that year, the S&P 500 was down by 10 percent, though markets were bouncy, depending on the news of the day. Once the Supreme Court issued its decision in the matter, the markets recovered, at least for a while (they later declined, but for other reasons).
As Mihm outlines, it sort of comes down to a philosophical divide between risk you can measure and uncertainty you cannot, outlined by economist Frank Knight in 1921. “The first could be calculated and a wager made based on the odds; the second was a genuine shot in the dark,” Mihm wrote.
“The stock market would rather be handed what is perceived as bad news so that people can make an educated decision,” said Ken Greene, a financial adviser based in Nevada.
In the 2000 election, the issue wasn’t really figuring out the risk of a Gore presidency compared to the risk of a Bush presidency, it was that nobody had any idea what was going to happen day to day or how things might shake out. This time around, we could see something even more chaotic.
Isaac Boltansky, director of policy research a Compass Point Research & Trading, told me that he has discussed a number of election-related issues with clients: what’s going on with deal-making and antitrust scrutiny, what to expect from the housing market, how to think about the banking industry and trade and taxes. “The No. 1 worry that I’ve heard over the last few weeks is not knowing who will be the winner,” he said.
And it isn’t just the presidency. The outcome of the Georgia US Senate race might not be known until 2021 — and, therefore, potentially which party controls Congress.
“The No. 1 worry that I’ve heard over the last few weeks is not knowing who will be the winner”
“If everybody is adult and calm and rational and says let’s count all the votes and figure out who won, it will be fine,” Ritholtz said. “If the crazies come out, and there are a lot of crazies … Mr. Market will not be happy with that at all.”
His takeaway: “That kind of unrest and turmoil, that’s a recipe for the market getting shellacked.”
Donald Trump has been good for the stock market. Joe Biden will probably be fine, too.
President Trump would like everyone to believe that he is 100 percent responsible for the stock market when it goes up and that he has nothing to do with it when it goes down. The truth is neither. The market is influenced by a lot of things day to day, some related to politics, some not.
Trump, overall, has been favorable to corporate America and Wall Street. In 2017, he signed into law a $1.5 trillion tax cut bill that disproportionately benefited corporations and the wealthy. (After signing the law, he literally told friends at his Mar-A-Lago resort that they “just got a lot richer.”) His administration has also taken a deregulatory approach to most industries.
A Biden administration is likely to change course on some of that. He has proposed increasing the corporate tax rate from 21 percent to 28 percent (Trump reduced it from 35 percent) and increasing the top individual income tax rate, among other measures. The former vice president has pledged not to raise taxes on anyone making under $400,000 a year. A Biden administration would also likely bring about tougher regulations on certain industries, such as fossil fuels and coal.
“When you implement a higher corporate tax, that means [corporations] are not going to be investing as quickly, which means the multiple on the market might compress,” said Luke Lloyd, a wealth adviser at Strategic Wealth Partners.
Ablin estimates that a corporate tax increase of the size Biden is proposing could be worth about 10 percentage points in the market. “That said, if Vice President Biden were to win, he would need Congress’s help,” he said, and it’s not clear Democrats will have a majority. “I think investors are taking more of a wait-and-see approach on that one.”
If the market does indeed contract around a Biden win, if past serves as precedent, it will eventually come back and do just fine. In fact, historically, investors have done better under Democratic leadership.
Getting past the top line, Trump and Biden mean different things for different sectors. Trump has done a lot of defense spending; Biden would likely be better for green energy. Those in private equity would rather not see an increase in capital gains taxes that could potentially come under Biden. Companies with more exposure to China may also benefit from an administration with a less rocky relationship with the country — Wall Street has reacted negatively to the US-China trade war. “If you look at Chinese equities over the last couple of months, they ebbed and flowed with Biden’s improving or trailing chances,” Ablin said.
“Both candidates present risks,” Hooper said. She also noted that much of what’s been driving Wall Street, especially lately, has nothing to do with the president at all but instead has been tied to the Federal Reserve, which has made enormous efforts to boost markets. “It has very little, if anything, to do with the occupant of the White House.”
White House chaos is not fun for anyone — and election chaos could be even worse
The conventional wisdom is often that Republicans mean good for Wall Street and business and Democrats mean bad, but that’s not necessarily the case. And not everyone in the arena agrees. As some billionaires were lighting their hair on fire over the prospect of a Warren presidency during the Democratic primary, she was amassing plenty of fans in finance, too.
Despite his working-class roots, the former vice president was largely Wall Street donors’ preferred candidate among the 2020 Democrats, and he and the Democrats are doing quite well with them in the general election, too. Paul Thornell, a former managing director for federal government affairs at Citigroup, told Politico that part of it is that the big banks, for example, aren’t just worried about taxes. “They’re looking at character and how these two conduct themselves as leaders,” he said.
Billionaire hedge funder Leon Cooperman, who during the primary crusaded against Warren, in a recent interview with CNBC said that while he thinks Trump has “good economic ideas,” he also has “limited character.” Cooperman said he hasn’t made up his mind on who to support and added that he’s not sure what Biden stands for — a coded, but not uncommon, sentiment among investors worried about how much progressives have the former vice president’s ear. When I emailed him asking him if he had made up his mind, he responded, “I have a firm view but no need to go public!”
The Biden campaign is leaning into the theme that Trump is too erratic for anyone to stomach, rich or poor.
“Like everything else that’s been handed to him, Trump inherited a strong economy and squandered it, plunging us into a recession,” said Biden campaign spokesperson Rosemary Boeglin in an emailed statement to Vox. She added that the former vice president “knows that the words of a president matter and have the power to move markets, which is why Americans — regardless of their pocketbooks — are crying out for his stable leadership.”
The Trump campaign did not respond to a request for comment.
It’s hard to look at the Trump presidency objectively and think it hasn’t been good for corporate America and Wall Street’s bottom line. It’s also impossible not to recognize it’s been chaotic. Hundreds of thousands of Americans are dead in a pandemic, and the economy is deeply troubled — millions of people are out of a job, small businesses are suffering, and state and local governments are flailing.
One investment bank vice president who focuses on commodities and oil laid out how he sees the stakes even for giant oil companies: “A Green New Deal or what have you is an existential threat to the fossil fuels business, but the thing is, what’s much more likely to happen is the pandemic rages indefinitely, and no one goes anywhere,” slowing consumption of those fossil fuels anyway.
He is a Biden supporter and has given money to Democrats this election cycle. But a Biden loss isn’t his worst-case scenario. “I would much rather Trump win handily and demonstrably than any kind of ambiguity,” he said. “It is the worst possible thing.”


vox--2020-09-24--The Trump administration’s war on birth control

As an OB-GYN in the San Francisco Bay Area , Jenn Conti prescribes birth control to many patients every day , for many different reasons .
Some want to prevent pregnancy .
Others need a way to regulate painful or irregular periods .
One patient has premenstrual dysphoric disorder , a very severe form of PMS .
“ Every single month , in the days leading up to her period , she gets this debilitating depression and anxiety , such that she ’ s been suicidal on several occasions , ” Conti , a fellow with the group Physicians for @ @ @ @ @ @ @ patient sees a psychiatrist and takes antidepressants , but hormonal contraception is also a key part of her treatment .
“ With that , over the course of several months , we ’ ve been able to take her to a place where she ’ s no longer suicidal , ” Conti said .
“ She ’ s able to enjoy her life.
” While her patients ’ stories vary , one thing is constant : Under the Affordable Care Act , patients with employer-sponsored insurance get their birth control without a copay @ @ @ @ @ @ @ after the law went into effect in 2011 , has seen that make a huge difference .
She thinks of another patient , for whom she recently prescribed a hormonal IUD to help treat painful cramps .
The IUD can cost more than $ 1,000 without insurance , but because of the ACA , her patient was able to get it at no out-of-pocket cost .
If they had been responsible for the full $ 1,000 , Conti said , “ I know for sure that person would not have been able to @ @ @ @ @ @ @ ACA was supposed to work : ensuring widespread access to a variety of contraceptive methods , including the most reliable , like IUDs and contraceptive implants .
And for a while , it looked like it was working .
Thanks in part to the mandate that employers offer insurance covering contraception , the use of these methods rose around the US , more than quadrupling between 2002 and 2017 .
Meanwhile , the median out-of-pocket cost for birth control among insured patients fell to $ 0 after the ACA was passed , with @ @ @ @ @ @ @ device at no charge .
Then came the Trump administration .
In Trump ’ s first year in office , federal agencies weakened the ACA ’ s contraceptive mandate , allowing employers to deny birth control coverage if they had a religious or moral objection .
Though the rollback was quickly tied up in the courts , dozens of employers signed separate settlements with the administration allowing them to refuse to cover birth control .
Meanwhile , the Trump administration took aim at other federal programs designed to promote reproductive health and access @ @ @ @ @ @ @ , which funds services like contraceptive counseling and cervical cancer screenings for low-income Americans .
The result was that when Covid-19 hit , the country ’ s safety net was already weakened , with shuttered clinics and reduced hours making it harder to provide the low-cost care that Americans — many of them facing layoffs and loss of health insurance — needed more than ever .
Then , in the midst of the pandemic , the Supreme Court dealt another blow to birth control access : The justices upheld the administration ’ s @ @ @ @ @ @ @ July , a ruling that could mean the loss of contraceptive coverage for 126,000 American workers .
Conti thinks of her patient with PMDD .
She wonders what would happen if that patient ’ s employer chose not to cover birth control .
“ What if she couldn ’ t afford that monthly cost because she was also raising her family at home and all the costs that that incurs ?
No one ’ s thinking about that when they make these rulings , and if they are , they ’ re just @ @ @ @ @ @ @ a systematic dismantling of federal programs and requirements intended to ensure contraceptive access , has turned back the clock on years of successful public health policy and jeopardized countless Americans ’ ability to control their reproductive lives .
“ The best word to describe it is catastrophic , ” Conti said .
The Affordable Care Act helped millions of Americans access the most effective birth control Long-acting reversible contraceptives , also known as LARCs , are among the biggest public health success stories of the past 20 years .
These methods , like @ @ @ @ @ @ @ skin , work for years without the need for the user to remember a daily pill .
That ease has been a boon to women , many of whom have shouldered the burden of preventing pregnancy in their relationships .
But unlike more permanent methods of birth control like tubal ligation , LARCs can be quickly removed if a patient wants to get pregnant .
And they are highly effective , with failure rates of less than 1 percent , compared with about 7 percent for typical use of birth control pills .
@ @ @ @ @ @ @ for decades because an early version , the Dalkon Shield , led to serious side effects , including infertility and even death .
Even after safer versions became available , doctors were reluctant for many years to prescribe them for younger patients .
The “ more traditional view ” among doctors was that IUDs were for “ after you ’ ve had your children , ” Alina Salganicoff , senior vice president and director of women ’ s health policy at the Kaiser Family Foundation , told Vox .
Starting in 2007 , @ @ @ @ @ @ @ popular , perhaps due to the advent of new products like the Mirena , an IUD with an added , non-pregnancy-related bonus — it can reduce menstrual bleeding .
Even then , however , there was a problem : cost .
While birth control pills cost between $ 20 and $ 50 per month without insurance , an IUD insertion can cost more than $ 1,000 — an unmanageable amount for many patients , especially if they are low-income .
But the Affordable Care Act changed the calculation for many patients .
The @ @ @ @ @ @ @ that employer-sponsored insurance plans cover certain preventive care services without a copay or other cost-sharing .
And in 2011 , the Obama administration designated contraception as one of the services that had to be covered , in what is often called the contraceptive mandate .
That meant that the millions of Americans who got health insurance through their jobs could get birth control at no extra charge beyond their monthly premiums .
The law had a significant impact .
The share of insured women who got birth control without a copay rose from @ @ @ @ @ @ @ to 67 percent by the spring of 2014 .
For all forms of contraception , but especially for the costlier LARCs , “ the guarantee of that coverage made a tremendous difference , ” Salganicoff said .
Indeed , one 2016 study found that the reduction in contraceptive cost due to the ACA was associated with a 2.3 percent increase in the use of any prescription birth control , with the biggest effect seen on LARCs .
Another study found that privately insured patients ’ odds of getting a LARC inserted increased 3 @ @ @ @ @ @ @ .
And while these percentages may seem small , researchers point out that , given the millions of patients of reproductive age in the US , they have a big impact on public health .
The rate of unintended pregnancy in the US had fallen to historic lows by the time the ACA was passed , likely due to the rise of LARCs , but it remained far higher than rates in many other wealthy countries .
Experts hoped that greater access to the most effective methods of contraception would further drive down @ @ @ @ @ @ @ is little nationwide data on how rates have changed since 2012 , there have been encouraging signs .
The rate of teen pregnancy , for example , falling for some time , dropped to a record low of 22.3 births per 1,000 in 2015 .
Going into the fall of 2016 , a lot of reproductive health experts were praising the benefits of the ACA mandate and trying to figure out how to extend the benefits of LARCs to even more patients .
The Trump administration set about dismantling the ACA — and @ @ @ @ @ @ @ campaigned on getting rid of the ACA , one of President Barack Obama ’ s signature achievements .
He also brought into his administration many social conservatives who opposed both abortion and some methods of contraception .
Katy Talento , for example , one of his top health care advisers , has falsely claimed that birth control pills cause miscarriage and can “ ruin your uterus.
” And in his first year in office , Trump took on both the health care law and birth control access , issuing new rules that created @ @ @ @ @ @ @ Under the rules , announced in October 2017 , employers could refuse to provide copay-free birth control coverage if they had a religious or moral objection to doing so .
Religious employers and their advocates praised the decision .
In requiring religious employers to cover birth control , the Obama administration “ was giving them a really tough choice , ” Maria Montserrat Alvarado , executive director of Becket , a law firm that represented the Catholic order Little Sisters of the Poor in suits challenging the mandate , told Vox .
For @ @ @ @ @ @ @ in what they consider to be a moral wrong actually makes a big difference to them , because it ’ s about consistency in their religious witness.
” But reproductive health and women ’ s rights groups decried the move to broaden exemptions to the mandate .
“ This will leave countless women without the critical birth control coverage they need to protect their health and economic security , ” Fatima Goss Graves , president of the National Women ’ s Law Center , said in a statement at the time .
The @ @ @ @ @ @ @ by the state of Pennsylvania , which said it would end up having to pay for contraception for many of the patients who lost coverage under the new exemptions , according to the New York Times .
The suits would keep the rules tied up in court for years .
But more than 70 religious employers signed a separate settlement agreement with the Trump administration allowing them to stop offering birth control coverage even before those suits were resolved .
The University of Notre Dame , for example , ceased covering copper IUDs @ @ @ @ @ @ @ , employees , and their families beginning in July 2018 and began charging copays for other forms of contraception .
In the years that followed , the Trump administration would take several other actions that limited Americans ’ contraceptive access .
For example , in March 2019 , the administration issued a rule barring Planned Parenthood and any other health care providers that perform abortions from receiving funding under Title X , a federal program established under President Richard Nixon to provide family planning services to low-income and other underserved Americans .
The @ @ @ @ @ @ @ from paying for most abortions ; instead , Title X dollars went to services like contraceptive counseling and screening for cancer and sexually transmitted infections .
Many Title X providers also provide routine medical services like blood pressure checks , and for some low-income patients , a Title X clinic is the only medical facility they visit all year .
Under the Trump administration rule , however , any provider that offered abortions — or even just referred patients elsewhere for the procedure — had to either stop doing so or exit the @ @ @ @ @ @ @ many other providers — a total of 981 clinics , according to a Guttmacher Institute analysis — chose the latter option .
“ Planned Parenthood ’ s withdrawal from Title X shows it will always choose abortion over health care for vulnerable women , ” Vice President Mike Pence tweeted in August 2019 .
“ Taxpayer dollars should never go to an org that recklessly disregards the sanctity of life.
” But many reproductive health advocates say the rule has had effects far beyond abortion , making contraceptive services harder to get .
@ @ @ @ @ @ @ to provide the kind of care that we wanted to provide , ” Lisa David , CEO and president of Public Health Solutions , a New York City nonprofit that exited the Title X program , told Vox last year .
The group ’ s clinics didn ’ t provide abortions but did refer patients elsewhere for them , and a rule limiting the information its doctors could give “ was unacceptable to us , ” David said .
In some cases , clinics had to shut down when they stopped getting Title @ @ @ @ @ @ @ their hours or change their schedules .
“ Let ’ s say you have a day a week or two days a week where they were doing LARC insertion .
Now maybe it ’ s every other week , ” Salganicoff said .
That can make it harder for patients to get the birth control of their choice , especially if they ’ re juggling jobs , school , child care , or all of the above .
Overall , the Title X rule — called the “ domestic gag rule ” by @ @ @ @ @ @ @ 46 percent reduction in the program ’ s ability to provide contraception , or about 1.6 million patients who could no longer get free or low-cost birth control through the program , according to Guttmacher .
And patients who already face obstacles to getting contraception , including young people and people of color , have been disproportionately affected , many say .
“ It ’ s definitely having a devastating impact on communities of color , ” Margie Del Castillo , director of field and advocacy at the National Latina Institute for Reproductive @ @ @ @ @ @ @ the Trump administration rule , about half of patients receiving services under Title X were people of color , and about one-third were Latinx .
Now , many of those patients have fewer places to go for care .
“ What it looks like is people , real people in our community , not getting birth control , ” Del Castillo said .
And the Title X rule was only one of many actions by the Trump administration that affected Americans ’ contraceptive access .
In May 2019 , for example , the @ @ @ @ @ @ @ ” rule , allowing health care providers such as doctors or pharmacists to refuse to provide contraception to patients if they have a religious or moral objection .
Such rules , also in place in some states , can mean patients have to travel to more than one pharmacy to find someone willing to fill a birth control prescription , making it less likely they will actually be able to obtain the medication .
In some cases , pharmacists will decline to fill prescriptions if they find out a patient got them at @ @ @ @ @ @ @ prescription is for birth control .
“ What that looks like for us is pharmacies refusing to fill patient prescriptions because they have our location ’ s name on there or our physician ’ s name on there , ” Katie Caldwell , a staff patient advocate at the Shreveport , Louisiana , clinic Hope Medical Group for Women , told Vox earlier this year .
While the Trump administration denied federal family planning funds to the clinics many patients rely on for contraception , it also directed some of that money to @ @ @ @ @ @ @ control , a crucial part of family planning .
In 2019 , the administration granted Title X funds to Obria , a network of facilities run by an anti-abortion activist that do not provide hormonal contraception but do spread misinformation about such contraceptives , cancer risk , and abortion .
The Trump administration also promoted teen pregnancy prevention programs that use an abstinence-only approach , even though such programs have been shown to be less effective than comprehensive sex education that includes lessons about birth control .
Overall , “ instead of giving @ @ @ @ @ @ @ to birth control , “ the administration has made the decision on who gets it , ” and prioritized the rights of employers and other groups to deny access if they choose , Salganicoff said .
The administration has weakened reproductive health providers ’ ability to respond to Covid-19 The arrival of the Covid-19 pandemic has limited patients ’ birth control choices even further .
In a Guttmacher survey conducted in April and May , 33 percent of women reported that they had trouble getting birth control due to the pandemic , or @ @ @ @ @ @ @ an appointment for reproductive health care .
Difficulties were more common among women of color , with 38 percent of Black women and 45 percent of Latinx women reporting problems getting birth control , compared with 29 percent of white women .
They were also more common among queer women , 46 percent of whom reported problems with contraceptive care , compared with 31 percent of straight women .
There are likely many reasons for these difficulties .
Many reproductive health clinics have had to reduce the number of patients they see in @ @ @ @ @ @ @ , making it more difficult to get an appointment .
Public transit schedules have also been cut back during the pandemic , making travel to an appointment more difficult .
Moreover , “ people are afraid to come see the doctor right now , because they ’ re afraid of exposure , or they may live in a place where the normal access they had to care is shut down or severely limited because the people who staff and run those clinics aren ’ t able to come into work , ” said @ @ @ @ @ @ @ , Latinx , and Indigenous patients , whose communities have been disproportionately impacted by the virus , may be especially likely to face these barriers .
In addition to all these factors , the economic crisis brought on by the pandemic has made it harder to pay for birth control .
Low-wage workers already faced many barriers to birth control access , from lack of paid time off to the difficulty of getting to a pharmacy to supervisors unwilling to give them time to go to the doctor , Leng Leng Chancey , @ @ @ @ @ @ @ s advocacy group 9to5 , told Vox .
“ All those are just the barriers on top of , now , bigger barriers.
” Millions of Americans — a disproportionate share of them women and people of color — have lost jobs since March , and the employer-sponsored health insurance that comes with them .
“ People are forgoing reproductive health care to be able to make ends meet and to support their families , ” Del Castillo said .
Indeed , lower-income women were more likely than higher-income women to report pandemic-related @ @ @ @ @ @ @ survey .
And 27 percent of women said that because of the pandemic , they worry more than they used to about paying for or obtaining contraception , with Latinx and queer women more likely to report this concern than white and straight respondents .
Overall , it ’ s a time when more people than ever need low-cost contraceptive services , but family planning clinics around the country — many of them now missing a major source of funding — are less able to provide them .
“ You just have to @ @ @ @ @ @ @ through over the past three or four years , ” Salganicoff said .
“ It has been a consistent challenge and erosion of protections.
” Indeed , the Trump administration ’ s actions and the pressures of Covid-19 are combining to put these facilities — and patient access to contraception — at greater risk than ever .
Clinics still adapting to the loss of Title X funds are now , like many medical providers around the country , facing a loss of revenue as patients stop coming for appointments due to the pandemic @ @ @ @ @ @ @ shortages that make it harder to see patients , even if those patients are willing to come in .
“ It really has been very , very difficult for many clinics to continue to operate , ” Salganicoff said .
Some have already closed or cut staff , with Planned Parenthood of Greater New York temporarily closing 11 of its 28 branches in April and laying off or furloughing more than 240 employees .
The concern , for many , is that such closures could proliferate and become permanent as the pandemic drags @ @ @ @ @ @ @ options for affordable care .
Amid all this , the Trump administration scored a major victory .
In the case Little Sisters v. Pennsylvania , the Supreme Court upheld the administration ’ s exemptions to the contraceptive mandate .
The Affordable Care Act grants the federal government “ virtually unbridled discretion to decide what counts as preventive care and screenings , ” and to “ identify and create exemptions from its own Guidelines , ” Justice Clarence Thomas wrote in his opinion in the case .
The exemptions don ’ t take effect @ @ @ @ @ @ @ ruled that the Trump administration had the right to issue the exemptions under the ACA , it referred the relevant cases back to lower courts to resolve any other issues .
But if the exemptions make it through those courts , experts say , they will have big implications for American workers , whose employers will have broad freedom to curtail birth control coverage or eliminate it altogether .
And low-wage workers , who can ill afford to pay out of pocket for contraception , will face the biggest impact , many say @ @ @ @ @ @ @ just because you have employer insurance , you are in a job that pays you what you ’ re worth , ” Mara Gandal-Powers , director of birth control access and senior counsel at the National Women ’ s Law Center , told Vox .
But in fact , many employees at Little Sisters of the Poor , the religious order that was the plaintiff in the Supreme Court case and that offers care to low-income older patients , are low-paid workers like medical assistants , cooks , and custodians , she said @ @ @ @ @ @ @ who have a lot of resources , and many are women of color and immigrant women , ” Gandal-Powers said .
When it comes to affordable birth control , “ that ’ s who I am particularly concerned about.
” ( Alvarado , the Becket executive director , told Vox that no employees at Little Sisters have complained about the lack of birth control coverage , and that they are able to get the medications for reasons other than contraception , such as treating endometriosis . )
And by stripping away employer coverage @ @ @ @ @ @ @ to the Title X program — which has already been decimated by the Trump administration .
“ There are going to be people who aren ’ t going to be able to get their birth control , ” Gandal-Powers said .
“ That is going to be the bottom line.
” All told , the administration ’ s actions , coupled with a pandemic and an economic recession , threaten to erode many of the gains of the past 10 years when it comes to reducing unintended pregnancy and ensuring that people have @ @ @ @ @ @ @ birth control .
Nationwide data on unintended pregnancies during the Trump administration is not yet available , but experts say actions at the state level provide a glimpse of what could happen to the entire country .
In 2011 , for example , Texas began a multi-pronged campaign to strip funding from Planned Parenthood , by cutting the state ’ s entire family planning budget , excluding Planned Parenthood from Medicaid , and ultimately exiting the federal Title X program .
One in four family planning clinics around the state ( many of @ @ @ @ @ @ @ Parenthood ) closed .
And counties that lost a Planned Parenthood clinic saw a 36 percent reduction in the provision of LARCs .
The cuts increased both teen birth and abortion rates , according to an analysis by economist Analisa Packham .
Now , the entire country may be moving in the direction of Texas .
And by the time the effects of Trump administration policies show up in nationwide data , it may be too late to reverse them — even if a future administration wanted to .
After all , Salganicoff @ @ @ @ @ @ @ , it ’ s not like you flip a switch and they start again.
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As an OB-GYN in the San Francisco Bay Area, Jenn Conti prescribes birth control to many patients every day, for many different reasons.
Some want to prevent pregnancy. Others need a way to regulate painful or irregular periods. One patient has premenstrual dysphoric disorder, a very severe form of PMS.
“Every single month, in the days leading up to her period, she gets this debilitating depression and anxiety, such that she’s been suicidal on several occasions,” Conti, a fellow with the group Physicians for Reproductive Health, told Vox. The patient sees a psychiatrist and takes antidepressants, but hormonal contraception is also a key part of her treatment. “With that, over the course of several months, we’ve been able to take her to a place where she’s no longer suicidal,” Conti said. “She’s able to enjoy her life.”
While her patients’ stories vary, one thing is constant: Under the Affordable Care Act, patients with employer-sponsored insurance get their birth control without a copay. Conti, who practiced before and after the law went into effect in 2011, has seen that make a huge difference. She thinks of another patient, for whom she recently prescribed a hormonal IUD to help treat painful cramps. The IUD can cost more than $1,000 without insurance, but because of the ACA, her patient was able to get it at no out-of-pocket cost. If they had been responsible for the full $1,000, Conti said, “I know for sure that person would not have been able to afford it.”
This is how the ACA was supposed to work: ensuring widespread access to a variety of contraceptive methods, including the most reliable, like IUDs and contraceptive implants. And for a while, it looked like it was working. Thanks in part to the mandate that employers offer insurance covering contraception, the use of these methods rose around the US, more than quadrupling between 2002 and 2017. Meanwhile, the median out-of-pocket cost for birth control among insured patients fell to $0 after the ACA was passed, with 91.5 percent of IUD recipients getting the device at no charge.
Then came the Trump administration.
In Trump’s first year in office, federal agencies weakened the ACA’s contraceptive mandate, allowing employers to deny birth control coverage if they had a religious or moral objection. Though the rollback was quickly tied up in the courts, dozens of employers signed separate settlements with the administration allowing them to refuse to cover birth control.
Meanwhile, the Trump administration took aim at other federal programs designed to promote reproductive health and access to birth control, including Title X, which funds services like contraceptive counseling and cervical cancer screenings for low-income Americans. The result was that when Covid-19 hit, the country’s safety net was already weakened, with shuttered clinics and reduced hours making it harder to provide the low-cost care that Americans — many of them facing layoffs and loss of health insurance — needed more than ever.
Then, in the midst of the pandemic, the Supreme Court dealt another blow to birth control access: The justices upheld the administration’s rollback of the ACA contraceptive mandate in July, a ruling that could mean the loss of contraceptive coverage for 126,000 American workers.
Conti thinks of her patient with PMDD. She wonders what would happen if that patient’s employer chose not to cover birth control. “What if she couldn’t afford that monthly cost because she was also raising her family at home and all the costs that that incurs? No one’s thinking about that when they make these rulings, and if they are, they’re just cruel.”
The Trump administration, through a systematic dismantling of federal programs and requirements intended to ensure contraceptive access, has turned back the clock on years of successful public health policy and jeopardized countless Americans’ ability to control their reproductive lives.
“The best word to describe it is catastrophic,” Conti said.
The Affordable Care Act helped millions of Americans access the most effective birth control
Long-acting reversible contraceptives, also known as LARCs, are among the biggest public health success stories of the past 20 years. These methods, like IUDs and contraceptive implants inserted under the skin, work for years without the need for the user to remember a daily pill. That ease has been a boon to women, many of whom have shouldered the burden of preventing pregnancy in their relationships.
But unlike more permanent methods of birth control like tubal ligation, LARCs can be quickly removed if a patient wants to get pregnant. And they are highly effective, with failure rates of less than 1 percent, compared with about 7 percent for typical use of birth control pills.
IUDs had something of a bad name for decades because an early version, the Dalkon Shield, led to serious side effects, including infertility and even death. Even after safer versions became available, doctors were reluctant for many years to prescribe them for younger patients. The “more traditional view” among doctors was that IUDs were for “after you’ve had your children,” Alina Salganicoff, senior vice president and director of women’s health policy at the Kaiser Family Foundation, told Vox. Starting in 2007, however, LARCs began to become more popular, perhaps due to the advent of new products like the Mirena, an IUD with an added, non-pregnancy-related bonus — it can reduce menstrual bleeding.
Even then, however, there was a problem: cost. While birth control pills cost between $20 and $50 per month without insurance, an IUD insertion can cost more than $1,000 — an unmanageable amount for many patients, especially if they are low-income.
But the Affordable Care Act changed the calculation for many patients. The legislation, passed in 2010, requires that employer-sponsored insurance plans cover certain preventive care services without a copay or other cost-sharing. And in 2011, the Obama administration designated contraception as one of the services that had to be covered, in what is often called the contraceptive mandate. That meant that the millions of Americans who got health insurance through their jobs could get birth control at no extra charge beyond their monthly premiums.
The law had a significant impact. The share of insured women who got birth control without a copay rose from 15 percent in the fall of 2012 to 67 percent by the spring of 2014. For all forms of contraception, but especially for the costlier LARCs, “the guarantee of that coverage made a tremendous difference,” Salganicoff said.
Indeed, one 2016 study found that the reduction in contraceptive cost due to the ACA was associated with a 2.3 percent increase in the use of any prescription birth control, with the biggest effect seen on LARCs. Another study found that privately insured patients’ odds of getting a LARC inserted increased 3 percent after the contraceptive mandate took effect. And while these percentages may seem small, researchers point out that, given the millions of patients of reproductive age in the US, they have a big impact on public health.
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The rate of unintended pregnancy in the US had fallen to historic lows by the time the ACA was passed, likely due to the rise of LARCs, but it remained far higher than rates in many other wealthy countries. Experts hoped that greater access to the most effective methods of contraception would further drive down unintended pregnancy rates, and although there is little nationwide data on how rates have changed since 2012, there have been encouraging signs. The rate of teen pregnancy, for example, falling for some time, dropped to a record low of 22.3 births per 1,000 in 2015.
Going into the fall of 2016, a lot of reproductive health experts were praising the benefits of the ACA mandate and trying to figure out how to extend the benefits of LARCs to even more patients.
Then Trump was elected.
The Trump administration set about dismantling the ACA — and federal family planning infrastructure
Donald Trump had campaigned on getting rid of the ACA, one of President Barack Obama’s signature achievements. He also brought into his administration many social conservatives who opposed both abortion and some methods of contraception. Katy Talento, for example, one of his top health care advisers, has falsely claimed that birth control pills cause miscarriage and can “ruin your uterus.”
And in his first year in office, Trump took on both the health care law and birth control access, issuing new rules that created broad exemptions to the contraceptive mandate. Under the rules, announced in October 2017, employers could refuse to provide copay-free birth control coverage if they had a religious or moral objection to doing so.
Religious employers and their advocates praised the decision. In requiring religious employers to cover birth control, the Obama administration “was giving them a really tough choice,” Maria Montserrat Alvarado, executive director of Becket, a law firm that represented the Catholic order Little Sisters of the Poor in suits challenging the mandate, told Vox. For the Little Sisters, “being complicit in what they consider to be a moral wrong actually makes a big difference to them, because it’s about consistency in their religious witness.”
But reproductive health and women’s rights groups decried the move to broaden exemptions to the mandate. “This will leave countless women without the critical birth control coverage they need to protect their health and economic security,” Fatima Goss Graves, president of the National Women’s Law Center, said in a statement at the time.
The rules soon faced lawsuits, including one by the state of Pennsylvania, which said it would end up having to pay for contraception for many of the patients who lost coverage under the new exemptions, according to the New York Times. The suits would keep the rules tied up in court for years.
But more than 70 religious employers signed a separate settlement agreement with the Trump administration allowing them to stop offering birth control coverage even before those suits were resolved. The University of Notre Dame, for example, ceased covering copper IUDs and emergency contraception for some 17,000 students, employees, and their families beginning in July 2018 and began charging copays for other forms of contraception.
In the years that followed, the Trump administration would take several other actions that limited Americans’ contraceptive access.
For example, in March 2019, the administration issued a rule barring Planned Parenthood and any other health care providers that perform abortions from receiving funding under Title X, a federal program established under President Richard Nixon to provide family planning services to low-income and other underserved Americans. The program was already barred by federal law from paying for most abortions; instead, Title X dollars went to services like contraceptive counseling and screening for cancer and sexually transmitted infections.
Many Title X providers also provide routine medical services like blood pressure checks, and for some low-income patients, a Title X clinic is the only medical facility they visit all year. Under the Trump administration rule, however, any provider that offered abortions — or even just referred patients elsewhere for the procedure — had to either stop doing so or exit the Title X program.
Planned Parenthood and many other providers — a total of 981 clinics, according to a Guttmacher Institute analysis — chose the latter option.
“Planned Parenthood’s withdrawal from Title X shows it will always choose abortion over health care for vulnerable women,” Vice President Mike Pence tweeted in August 2019. “Taxpayer dollars should never go to an org that recklessly disregards the sanctity of life.”
But many reproductive health advocates say the rule has had effects far beyond abortion, making contraceptive services harder to get. The rule “would not allow us to provide the kind of care that we wanted to provide,” Lisa David, CEO and president of Public Health Solutions, a New York City nonprofit that exited the Title X program, told Vox last year. The group’s clinics didn’t provide abortions but did refer patients elsewhere for them, and a rule limiting the information its doctors could give “was unacceptable to us,” David said.
In some cases, clinics had to shut down when they stopped getting Title X funds. Others had to reduce their hours or change their schedules. “Let’s say you have a day a week or two days a week where they were doing LARC insertion. Now maybe it’s every other week,” Salganicoff said. That can make it harder for patients to get the birth control of their choice, especially if they’re juggling jobs, school, child care, or all of the above.
Overall, the Title X rule — called the “domestic gag rule” by reproductive rights advocates — led to a 46 percent reduction in the program’s ability to provide contraception, or about 1.6 million patients who could no longer get free or low-cost birth control through the program, according to Guttmacher. And patients who already face obstacles to getting contraception, including young people and people of color, have been disproportionately affected, many say.
“It’s definitely having a devastating impact on communities of color,” Margie Del Castillo, director of field and advocacy at the National Latina Institute for Reproductive Justice, told Vox. Prior to the Trump administration rule, about half of patients receiving services under Title X were people of color, and about one-third were Latinx. Now, many of those patients have fewer places to go for care. “What it looks like is people, real people in our community, not getting birth control,” Del Castillo said.
And the Title X rule was only one of many actions by the Trump administration that affected Americans’ contraceptive access. In May 2019, for example, the administration finalized a “refusal of care” rule, allowing health care providers such as doctors or pharmacists to refuse to provide contraception to patients if they have a religious or moral objection. Such rules, also in place in some states, can mean patients have to travel to more than one pharmacy to find someone willing to fill a birth control prescription, making it less likely they will actually be able to obtain the medication.
In some cases, pharmacists will decline to fill prescriptions if they find out a patient got them at an abortion clinic, even if the prescription is for birth control. “What that looks like for us is pharmacies refusing to fill patient prescriptions because they have our location’s name on there or our physician’s name on there,” Katie Caldwell, a staff patient advocate at the Shreveport, Louisiana, clinic Hope Medical Group for Women, told Vox earlier this year.
While the Trump administration denied federal family planning funds to the clinics many patients rely on for contraception, it also directed some of that money to clinics that don’t provide birth control, a crucial part of family planning. In 2019, the administration granted Title X funds to Obria, a network of facilities run by an anti-abortion activist that do not provide hormonal contraception but do spread misinformation about such contraceptives, cancer risk, and abortion. The Trump administration also promoted teen pregnancy prevention programs that use an abstinence-only approach, even though such programs have been shown to be less effective than comprehensive sex education that includes lessons about birth control.
Overall, “instead of giving women the choices” when it comes to birth control, “the administration has made the decision on who gets it,” and prioritized the rights of employers and other groups to deny access if they choose, Salganicoff said.
The administration has weakened reproductive health providers’ ability to respond to Covid-19
The arrival of the Covid-19 pandemic has limited patients’ birth control choices even further.
In a Guttmacher survey conducted in April and May, 33 percent of women reported that they had trouble getting birth control due to the pandemic, or that they had to delay or cancel an appointment for reproductive health care. Difficulties were more common among women of color, with 38 percent of Black women and 45 percent of Latinx women reporting problems getting birth control, compared with 29 percent of white women. They were also more common among queer women, 46 percent of whom reported problems with contraceptive care, compared with 31 percent of straight women.
There are likely many reasons for these difficulties. Many reproductive health clinics have had to reduce the number of patients they see in a day due to social distancing restrictions, making it more difficult to get an appointment. Public transit schedules have also been cut back during the pandemic, making travel to an appointment more difficult.
Moreover, “people are afraid to come see the doctor right now, because they’re afraid of exposure, or they may live in a place where the normal access they had to care is shut down or severely limited because the people who staff and run those clinics aren’t able to come into work,” said Conti, the California OB-GYN.
Black, Latinx, and Indigenous patients, whose communities have been disproportionately impacted by the virus, may be especially likely to face these barriers.
In addition to all these factors, the economic crisis brought on by the pandemic has made it harder to pay for birth control. Low-wage workers already faced many barriers to birth control access, from lack of paid time off to the difficulty of getting to a pharmacy to supervisors unwilling to give them time to go to the doctor, Leng Leng Chancey, executive director of the working women’s advocacy group 9to5, told Vox. “All those are just the barriers on top of, now, bigger barriers.”
Millions of Americans — a disproportionate share of them women and people of color — have lost jobs since March, and the employer-sponsored health insurance that comes with them. “People are forgoing reproductive health care to be able to make ends meet and to support their families,” Del Castillo said.
Indeed, lower-income women were more likely than higher-income women to report pandemic-related difficulties getting birth control in the Guttmacher survey. And 27 percent of women said that because of the pandemic, they worry more than they used to about paying for or obtaining contraception, with Latinx and queer women more likely to report this concern than white and straight respondents.
Overall, it’s a time when more people than ever need low-cost contraceptive services, but family planning clinics around the country — many of them now missing a major source of funding — are less able to provide them.
“You just have to think about what these clinics have gone through over the past three or four years,” Salganicoff said. “It has been a consistent challenge and erosion of protections.”
Indeed, the Trump administration’s actions and the pressures of Covid-19 are combining to put these facilities — and patient access to contraception — at greater risk than ever. Clinics still adapting to the loss of Title X funds are now, like many medical providers around the country, facing a loss of revenue as patients stop coming for appointments due to the pandemic. They’re also facing staffing shortages that make it harder to see patients, even if those patients are willing to come in. “It really has been very, very difficult for many clinics to continue to operate,” Salganicoff said.
Some have already closed or cut staff, with Planned Parenthood of Greater New York temporarily closing 11 of its 28 branches in April and laying off or furloughing more than 240 employees. The concern, for many, is that such closures could proliferate and become permanent as the pandemic drags on, leaving patients with even fewer options for affordable care.
A Supreme Court victory could magnify the coverage losses
Amid all this, the Trump administration scored a major victory. In the case Little Sisters v. Pennsylvania, the Supreme Court upheld the administration’s exemptions to the contraceptive mandate. The Affordable Care Act grants the federal government “virtually unbridled discretion to decide what counts as preventive care and screenings,” and to “identify and create exemptions from its own Guidelines,” Justice Clarence Thomas wrote in his opinion in the case.
The exemptions don’t take effect just yet. Though the Supreme Court ruled that the Trump administration had the right to issue the exemptions under the ACA, it referred the relevant cases back to lower courts to resolve any other issues. But if the exemptions make it through those courts, experts say, they will have big implications for American workers, whose employers will have broad freedom to curtail birth control coverage or eliminate it altogether.
And low-wage workers, who can ill afford to pay out of pocket for contraception, will face the biggest impact, many say. “People have this conception that just because you have employer insurance, you are in a job that pays you what you’re worth,” Mara Gandal-Powers, director of birth control access and senior counsel at the National Women’s Law Center, told Vox. But in fact, many employees at Little Sisters of the Poor, the religious order that was the plaintiff in the Supreme Court case and that offers care to low-income older patients, are low-paid workers like medical assistants, cooks, and custodians, she said.
“They’re not people who have a lot of resources, and many are women of color and immigrant women,” Gandal-Powers said. When it comes to affordable birth control, “that’s who I am particularly concerned about.” (Alvarado, the Becket executive director, told Vox that no employees at Little Sisters have complained about the lack of birth control coverage, and that they are able to get the medications for reasons other than contraception, such as treating endometriosis.)
And by stripping away employer coverage, the decision could drive more patients to the Title X program — which has already been decimated by the Trump administration. “There are going to be people who aren’t going to be able to get their birth control,” Gandal-Powers said. “That is going to be the bottom line.”
All told, the administration’s actions, coupled with a pandemic and an economic recession, threaten to erode many of the gains of the past 10 years when it comes to reducing unintended pregnancy and ensuring that people have access to the most effective forms of birth control.
Nationwide data on unintended pregnancies during the Trump administration is not yet available, but experts say actions at the state level provide a glimpse of what could happen to the entire country. In 2011, for example, Texas began a multi-pronged campaign to strip funding from Planned Parenthood, by cutting the state’s entire family planning budget, excluding Planned Parenthood from Medicaid, and ultimately exiting the federal Title X program.
One in four family planning clinics around the state (many of which were not even operated by Planned Parenthood) closed. And counties that lost a Planned Parenthood clinic saw a 36 percent reduction in the provision of LARCs. The cuts increased both teen birth and abortion rates, according to an analysis by economist Analisa Packham.
Now, the entire country may be moving in the direction of Texas. And by the time the effects of Trump administration policies show up in nationwide data, it may be too late to reverse them — even if a future administration wanted to.
After all, Salganicoff said, “when services go away, it’s not like you flip a switch and they start again.”