Archives for category: Health

Chalkbeat reports that the Center for Disease Control is easing up on its COVID recommendations:

Schools can end quarantines and regular screening tests for COVID, but students and staff should keep masks on in areas with high levels of COVID spread, according to guidelines released Thursday by the Centers for Disease Control and Prevention.

The new, more limited recommendationscome as districts across the country are starting a new school year — and in many cases reflect decisions to ease up on COVID precautions that schools have already made. Almost no districts are starting the year with a mask mandate, and in-school quarantine rules are on the retreat.

“This latest guidance from the CDC should give our students, parents, and educators the confidence they need to head back to school this year with a sense of joy and optimism,” Secretary of Education Miguel Cardona said in a statement. “While COVID continues to evolve, so has our understanding of the science and what it takes to return to school safely.”

Democrats needed 60 votes to pass a $35 monthly cap on the price of insulin. Republicans, led by Senator Lindsey Graham, made sure that there would not be 10 Republican votes for the measure.

The Washington Post reported:

Republican lawmakers on Sunday successfully stripped a $35 price cap on the cost of insulin for many patients from the ambitious legislative package Democrats are moving through Congress this weekend, invoking arcane Senate rules to jettison the measure.

The insulin cap is a long-running ambition of Democrats, who want it to apply to patients on Medicare and private insurance. Republicans left the portion that applies to Medicare patients untouched but stripped the insulin cap for other patients. Bipartisan talks on a broader insulin pricing bill faltered earlier this year.

The Senate parliamentarian earlier in the weekend ruled that part of the Democrats’ cap, included in the Inflation Reduction Act, did not comply with the rules that allow them to advance a bill under the process known as reconciliation — a tactic that helps them avert a GOP filibuster. That gave the Republicans an opening to jettison it.

“Republicans have just gone on the record in favor of expensive insulin,” said Sen. Ron Wyden (D-Ore.). “After years of tough talk about taking on insulin makers, Republicans have once against wilted in the face of heat from Big Pharma.”

Some Republicans did support the price cap in the 57-43 vote for the measure, but not enough joined Democrats in support of it to meet the threshold for passage.

More than 1 in 5 insulin users on private medical insurance pay more than $35 per month for the medicine, according to a recent analysis from the Kaiser Family Foundation.

Some 7 million Americans require insulin daily. A Yale University study found that 14 percent of those insulin users are spending more than 40 percent of their income after food and housing costs on the medicine.

The seven Republicans who voted with the Democrats were: Senators Susan Collins of Maine, Josh Hawley of Missouri, Cindy Hyde-Smith of Mississippi, Lisa Murkowski and Dan Sullivan of Alaska, and John Kennedy and Bill Cassidy of Louisiana.

Mary Trump tweeted that Josh Hawley, a fierce partisan, must have a relative with diabetes. Or maybe the Republicans drew straws to see who would cast a futile vote against a popular measure.

Tweet by @toylsome

Question: Will Republican voters remember in November?

Senators Joe Manchin and Kyrsten Sinema were the two Democrats whose support for the Inflation Reduction Act was in doubt until the very end. Manchin won protection for the fossil fuel industry. Sinema killed taxes that would hit the hedge fund industry. The Washington Post explains here:

Senate Democrats agreed Sunday to protect firms owned by the private equity industry from a new minimum tax on billion-dollar corporations, bowing to pressure from Sen. Kyrsten Sinema (D-Ariz.), who insisted on making the change to the Democrats’ sprawling climate, health-care and tax package.

The decision came as Democrats tried to hold their caucus together through nearly 19 hours of debate over the Inflation Reduction Act of 2022, which the 50-50 Senate approved Sunday with the help of a tiebreaking vote from Vice President Harris.

The package proposes hundreds of billions of dollars in fresh spending, financed in part through new taxes, including a corporate minimum tax that would require firms with more than $1 billion in annual profits to pay a tax rate of at least 15 percent. As originally written, the provision would have required private equity firms to tally profits from their various holdings and pay the tax if the total exceeded the $1 billion threshold.

Sinema, who for over a year has blocked Democratic ambitions to raise taxes, raised objections on Saturday, according to two people with knowledge of the matter, who spoke on the condition of anonymity to discuss private talks.

The senator argued that, without changes to the bill, small and medium-sized businesses that happen to be owned by private equity firms would be exposed to the tax, violating a Democratic pledge to hike taxes only on the largest firms. A Sinema spokeswoman said several Arizona small businesses, including a plant nursery, had raised concerns.

The senator’s objections came days after she persuaded Democrats to abandon a different effort to raise taxes on private equity managers by closing the so-called “carried interest loophole,” which permits investment managers to pay lower rates on certain portions of their income.
In a statement, Sinema’s office said her goal is to “target tax avoidance, make the tax code more efficient, and support Arizona’s economic growth and competitiveness.”

“At a time of record inflation, rising interest rates, and slowing economic growth, Senator Sinema knows that disincentivizing investments in Arizona businesses would hurt Arizona’s economy’s ability to create jobs, and she ensured the Inflation Reduction Act helps Arizona’s economy grow,” the statement said.

The last-minute changes mark a significant victory for the private equity industry and an estimated savings of $35 billion over the next decade. Private equity represents a roughly $4 trillion industry in the United States, and as the sector has grown markedly over the past decade, it has flexed its considerable political muscle repeatedly in Washington.

From the start, the unusual way private equity businesses are structured posed a challenge for Democrats crafting the new minimum tax. Typically, large conglomerates are formed as “C corporations” under the tax code and pay corporate taxes. The new minimum tax would clearly apply to them. But private equity firms are legally formed as partnerships, which typically pay taxes on the individual returns of their owners. Senate Democrats say they crafted the legislation to ensure that wealthy investment managers who own numerous C corporations and other business entities collectively worth more than $1 billion would be subject to the tax.

But the tax was never intended to hit the smaller subsidiaries that make up private equity portfolios, said Ashley Schapitl, a spokeswoman for Senate Finance Committee Chairman Ron Wyden (D-Ore.), who called industry claims to that effect “nonsense.”

Independent analysts largely agreed with that reading of the provision. “The language in the bill was intended to make sure they are treated the same way,” said Steve Wamhoff, a tax expert at the Institute on Taxation and Economic Policy, a left-leaning think tank. “The idea that billion-dollar private equity funds must be protected to save small businesses is absolutely absurd.”

President Biden proposed a $2.2 trillion investment in stopping climate change, expanding health care, and other ambitious goals. But Democrats hold only 50 seats in the Senate, and the defection of only one vote would kill any bill. As it happened, the Democrats had two Senators who blocked Biden’s plans: Joe Manchin of West Virginia and Kyrsten Sinema of Arizona. Both demanded and won concessions. The bill that passed over the weekend is still a dramatic improvement over doing nothing, but the holdouts watered it down.

Except for Manchin and Sinema, every Democrat supported the bill; the two holdouts required concessions. Every single Republican opposed every part of the bill, except for the part lowering the monthly cost of insulin, supported by 7 Republicans, not enough to save the proposal.

As a general proposition, the vote on the bill shows that Republicans are staunchly opposed to any legislation to slow the devastating effects of climate change and overwhelmingly opposed to lowering the cost of prescription drugs. The seven Republicans who voted with the Democrats were probably given permission by Leader McConnell to break ranks, since their seven votes were insufficient to pass the provision.

WASHINGTON — After months of painstaking negotiations, Democrats are set to push through a climate, tax and health care package that would salvage key elements of President Biden’s domestic agenda.

The legislation, while falling far short of the ambitious $2.2 trillion Build Back Better Act that the House passed in November, fulfills multiple longstanding Democratic goals, including countering the toll of climate change on a rapidly warming planet, taking steps to lower the cost of prescription drugs and to revamping portions of the tax code in a bid to make it more equitable.

Here’s what’s in the final package:

It is the largest single American investment to slow global warming.

The bill includes the largest expenditures ever made by the federal government to slow global warming and to reduce demand for the fossil fuels that are primarily responsible for causing climate change.

Energy experts said the measure would help the United States to cut greenhouse gas emissions about 40 percent below 2005 levels by the end of this decade. That puts the Biden administration in striking distance of meeting its goal of cutting emissions roughly in half by 2030. Far more will be needed to help keep the planet from warming to dangerously high global temperatures, scientists said, but Democrats considered it a momentous first step after decades of inaction.

It would invest nearly $400 billion over 10 years in tax credits aimed at steering consumers to electric vehicles and prodding electric utilities toward renewable energy sources like wind or solar power.

A number of fossil fuel and drilling provisions as concessions to Senator Joe Manchin III of West Virginia, a holdout from a conservative state that is heavily dependent on coal and gas.

The measure would assure new oil drilling leases in the Gulf of Mexico and Alaska’s Cook Inlet. It would expand tax credits for carbon capture technology that could allow coal or gas-burning power plants to keep operating with lower emissions. And it would mandate that the Interior Department continue to hold auctions for fossil fuel leases if it plans to approve new wind or solar projects on federal lands.

The tax credits include $30 billion to speed the production of solar panels, wind turbines, batteries and critical minerals processing; $10 billion to build facilities to manufacture things like electric vehicles and solar panels; and $500 million through the Defense Production Act for heat pumps and critical minerals processing.

There is $60 billion to help disadvantaged areas that are disproportionately affected by climate change, including $27 billion for the creation of what would be the first national “green bank” to help drive investments in clean energy projects — particularly in poor communities. The bill would also force oil and gas companies to pay fees as high as $1,500 a ton to address excess leaks of methane, a powerful greenhouse gas, and it would undo a 10-year moratorium on offshore wind leasing established by President Donald J. Trump.

Medicare could directly negotiate the price of prescription drugs, pushing down costs.

For the first time, Medicare would be allowed to negotiate with drugmakers on the price of prescription medicines, a proposal projected to save the federal government billions of dollars. That would apply to 10 drugs initially, beginning in 2026, and then expand to include more drugs in the following years.

Opponents argue that the plan would stifle innovation and the development of new treatments by cutting into the profits that drug companies can plow into their business, while some liberals expressed frustration that the policy would be too slow to take hold. Should the package become law, as expected, it would be the largest expansion of federal health policy since passage of the Affordable Care Act.

The package would cap the out-of-pocket costs that seniors pay annually for prescription drugs at $2,000, and would ensure that seniors have access to free vaccines. Lawmakers also included a rebate should price increases outpace the rate of inflation. (Top Senate rules officials, however, said that penalty could apply only to Medicare, not private insurers.)

Republicans successfully challenged the inclusion of a $35 price cap on insulin for patients on private insurance during a rapid-fire series of amendment votes early Sunday morning, forcing its removal. But a separate proposal that caps the price of insulin at $35 per month for Medicare patients remained intact….

The tax proposals were shaped by Senator Kyrsten Sinema, Democrat of Arizona, who resisted her party’s push to increase tax rates on the country’s wealthiest corporations and individuals.

To avoid the rate increase Ms. Sinema opposed, Democrats instead settled on a far more complex change to the tax code: a new 15 percent corporate minimum tax on the profits companies report to shareholders. It would apply to companies that report more than $1 billion in annual income on their financial statements but that are also able to use credits, deductions and other tax treatments to lower their effective tax rates.

Ms. Sinema did protect a deduction that would benefit manufacturers, a change she successfully demanded before committing on Thursday to moving forward with the legislation. And she joined six other Democrats and all Republicans in narrowing the scope of that corporate minimum tax by backing an amendment in the final hours of the vote-a-rama Sunday afternoon.

Democrats, to make up for the loss of revenue forced by that amendment, extended a limit on tax deductions for business losses that was enacted as part of the Trump tax cuts in 2017.

She also forced the removal of a proposalsupported by Democrats and Republicans that would have narrowed a tax break used by both hedge fund and private equity industries to secure lower tax rates than their entry-level employees. And she committed to pursuing separate legislation outside of the budget package, but that would require at least 10 Republicans to support it.

The Washington Post reports that Arizona Senator Kyrsten Sinema signed on to the “Inflation Reduction Act”—which provides funding for climate change/health care. Her demand? She blocked taxes on the wealthiest and on corporations that pay nothing. Why is she a Democrat?

Sen. Kyrsten Sinema (D-Ariz.) said she would “move forward” on a revised version of Senate Democrats’ health care, climate and deficit-reduction package, after party leaders agreed to scale back some of their original tax proposals.
The new approach — along with other changes to the proposal known as the Inflation Reduction Act of 2022 — satisfied Sinema’s chief concerns and helped set in motion a plan to approve it as soon as this weekend.

In a statement, Sinema said Democrats had “agreed to remove” a key tax targeting wealthy investors and had made changes to a second provision that aims to impose a new minimum tax on corporations that currently pay nothing to the U.S. government. From here, Sinema said she would await a final review from the chamber’s parliamentarian — a critical step in the process that allows Democrats to move their spending bill — at which point she would “move forward.”

The Miami-Dade School Board met today and reversed its decision on the adoption of a sex-education textbook for middle school and high school.

The Miami-Dade School Board last week rejected a recommendation to adopt a comprehensive health and sexual health education textbook for middle and high school students. On Thursday, the board reversed that decision — again.

The decision came about four hours into a special meeting Thursday that the chairwoman called to discuss the implications of the board’s decision last week, which left the district without a comprehensive health education curriculum and out of compliance with state statute. Chairwoman Perla Tabares Hantman flipped her vote from last week, this time voting in favor of adopting the textbook, attributing the change to her realization that the district could be penalized for not following state statute and requirements. (The Department of Education did not respond to the Herald’s request for comment regarding possible ramifications of violating state requirements.)

The majority of people attending the meeting favored adoption of the text. The sex-ed course also covers health and nutrition.

Read more at:

It would seem obvious that students, like adults, have a physical need to use a bathroom during the school day. But in Massachusetts, many schools are closing bathrooms to avoid student misbehavior and vaping.

The condition of bathrooms in Boston Public Schools, and in other urban districts, has fueled public outrage for years, with broken taps and empty towel dispensers seen as sorry symbols of a failure to meet even basic needs.

But across the state and country, an even more fundamental problem is gaining attention: increasing restrictions on students’ access to bathrooms, as administrators keep more restrooms locked and off limits for more of the school day.

Driven by efforts to curtail teen vaping, and to prevent outbreaks of vandalism sparked by the TikTok trend known as “Devious Licks”, the widespread crackdowns on bathroom access have left students in some schools searching urgently for unlocked stalls — and pining for any open restroom, no matter how broken or dirty. As teenagers learn to hold their urine for hours – or stop eating and drinking at school to avoid discomfort — the outcry against the closures from students and parents has grown louder.

“I understand that there are safety concerns, but the whole school shouldn’t have basic human rights taken away,” said Nevaeh Lopez, 16, a student at Holyoke High School who started an online petition to push back against bathroom closures at her school this spring.

The issue has provoked fiery debate at school committee meetings and in online forums around the region in recent months, as well as calls and e-mails to principals and school nurses. A post about bathroom restrictions at New Bedford High School, on the New Bedford Live Facebook page in October, garnered nearly 200 comments, from students who described missing class time while waiting in long bathroom lines, and from adults who placed blame squarely on the teenagers. (“If they would act like civilized human beings they would be able to be trusted,” wrote one.)

There is no doubt uncivilized — and sometimes violent — acts have taken place in school bathrooms. Several students were suspended at Wilmington High School in March after they picked up another student and tried to force his head into a toilet in a boys’ bathroom. “What is equally disturbing is the fact that other students were present and did nothing to stop the incident, and in fact recorded the altercation,” Superintendent Glenn Brand said later.

School leaders nationwide have reported a general uptick in discipline and behavior issues, including fighting and bullying, since students returned to full-time, in-person school following two years of disruption. The troubling trend has been linked to the mental health toll of the pandemic, and to social development delays possibly caused by students’ recent isolation.

Student use of electronic cigarettes has alsorisen at “epidemic” rates in recent years, health officials have warned. As countless school bathrooms have become de facto vaping lounges, desperate school leaders have grasped at any possible solution, including removing doors from restroom stalls and installing vape-detection sensors.

Yet even Donna Mazyck — head of the National School Nurses Association and a leader in the fight to curb teen vaping — said rampant restroom shutdowns are not the answer…

Staffing shortages, exacerbated by pandemic burnout, have reduced the number of hall and restroom monitors available in many districts, forcing more closures of unsupervised bathrooms. But staffing is a problem that can be solved, said Worcester School Committee member Tracy O’Connell Novick, who spoke forcefully against the locking of bathrooms at the committee meeting in January.

“I taught high school, I know why we lock bathrooms, and I don’t think it should be against a policy — I think it should be against the law,” O’Connell Novick told the School Committee. “There are things that are right and things that are wrong, and denying students access to bathrooms is wrong.”

Blogger Robert Hubbell brings clarity and reason to the abortion debate. The Court’s decision overturns a precedent that had been in place for 49 years. Both Justices Gorsuch and Kavanaugh pledged to Senators that they would not overturn roe. They lied. What now?

Hubbell writes:

There is much to discuss after the Supreme Court’s brutal ruling in Dobbs v Jackson Women’s Health, but the most important question is, “What are we going to do about it?” We have several effective paths forward and must pursue all simultaneously.

First, Alito claims he is returning the decision of reproductive freedom “to the people and their state representatives.” Let’s ignore (for the moment) Alito’s smoldering bad faith and thinly veiled contempt for the rights of women. We need to flip state legislatures to repeal antiabortion legislation and capture statewide executive offices that can veto legislation abortion bans. While this path is not an answer in every state, it can make a difference in states where the GOP margin of control is thin.

Second, we must demand that Congress pass legislation codifying Roe. That means gaining a 54-seat majority in the Senate, carving out an exception to the filibuster, and retaining control of the House. Will national legislation be challenged? Sure! Will the Supreme Court invalidate it? Possibly, but it is worth the effort.

Will national legislation be challenged? Sure! Will the Supreme Court invalidate it? Possibly, but it is worth the effort.

Third, we must break the Supreme Court. Democrats should expand the Court to thirteen justices. This path also requires holding the House, gaining a 54-seat majority in the Senate, and carving out an exception to the filibuster. Expanding the Court requires only a majority vote in both chambers of Congress and signing of the bill by the president. Will Republicans expand the Court to nineteen? Maybe. But what Republicans might do in the future shouldn’t deter us now. Will tit-for-tat expansions of the Court undermine its legitimacy? It is far too late for that.

Fourth, reproductive choice must be on the ballot in every race. Republicans have finally achieved what they wanted—no right to abortion and no exceptions for rape or incest. We must make every Republican running for every office in the land own the GOP position on abortion in its ugliest manifestation. The outcome in Dobbs is opposed by a strong majority of Americans and should provide a basis for a sweeping Democratic victory in 2022.

Finally, the right to same-sex marriage, same-sex relations, contraception, and other privacy-based rights must be on the ballot in every race. Justice Clarence Thomas’s concurrence declared war on those rights and invited reactionary legislatures to pass laws to serve as test cases. We would be foolish to assume that the other members of the reactionary majority will not follow his lead, given a chance.

None of these approaches will be easy or provide a complete answer. Readers have already sent emails that preemptively identify the problems with some of these approaches and dismiss their chances of success. But these are the paths available to us. We can choose to pursue them or do nothing. We must pursue them relentlessly until we have regained control of every branch of government, including the Supreme Court. Only then can we reverse the ruling in Dobbs and preserve other liberties grounded in the same right to privacy that supported reproductive rights for a half-century.

We are the majority, and American democracy presumes majority rule while protecting the rights of the minority. Republicans are attempting to reverse that presumption by seeking to impose permanent minority rule with no protection for the rights of the majority. That cannot stand. It will not stand. But it is up to us to restore the natural balance to democracy. It is not enough that we vote with greater passion or conviction. We must motivate those who did not believe this day would not come or who were not paying attention. We can do that—if we act with greater passion, conviction, and urgency.

The ruling.

Alito’s final decision is a judicial insult. In a single blow, he has demoted American women to second-class citizens. It is filled with venom and contempt in addressing a contentious issue on which people of good faith can disagree. He refers to physicians as abortionists when they seek to save a woman’s life or terminate a pregnancy forced on a teenager by a rapist. He misrepresents, minimizes, and dismisses the burdens and risks of pregnancy. He substitutes his Catholic dogma for judicial analysis.

Alito’s final version of his opinion changed little from the draft leaked last month. As such, it retains the dishonesty and intellectual sophistry of the “deeply rooted tradition” analysis contained in the draft—an analysis that deliberately misrepresents the American tradition relating to abortion. See Aaron Tang in The Los Angeles Times, Op-Ed: The Supreme Court flunks abortion history.

But most ominously, Alito’s “deeply rooted” analysis signals Alito’s intent to attack other privacy-based rights, such as same-sex marriage. Alito dissented in the Court’s decision recognizing same-sex marriage, Obergefell v. Hodges. Alito wrote in Obergefell, as follows:

          To prevent five unelected Justices from imposing their personal vision of liberty upon the American people, the Court has held that “liberty” under the Due Process Clause should be understood to protect only those rights that are ‘deeply rooted in this Nation’ s history and tradition.’ And it is beyond dispute that the right to same-sex marriage is not among those rights.

There it is: Alito’s analysis in overruling Roe v. Wade does not stop with reproductive rights. It reaches to same-sex marriage. He said so in his dissent in Obergefell. And Justice Thomas made that explicit in his concurrence in Dobbs:

          In future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell.

Griswold recognized the right to use contraceptives of choice; Lawrence recognized the right to enter into a same-sex relationships; and Obergefell recognized the right of same-sex couples to marry. Justice Thomas notably omitted a right based on “substantive due process precedents”—the right of members of different “races” to marry, a right first granted in Loving v. Virginia in 1967. If the Court reverses Loving v. Virginia, Thomas’s marriage to Ginny Thomas would be illegal in some states.

For a longer discussion of the threat to other rights, see Mark Joseph Stern in Slate, The Supreme Court decision overruling Roe v. Wade puts marriage equality in immediate jeopardy.

It will take weeks to understand the implications of Justice Alito’s decision, but a good place to start is with Ian Millhiser’s analysis in Vox, The Roe v. Wade abortion decision, explained.

Finally, for a discussion of self-inflicted damage to the Court’s legitimacy, see Dahlia Lithwick, in Slate, Roe v. Wade overturned: The Supreme Court will pay for abortion decision.

The corruption and illegitimacy of the Supreme Court.

As currently constituted, the Supreme Court is illegitimate and corrupt. It is illegitimate because two justices appointed by Trump resulted from norm-busting “rules” made up by Mitch McConnell on the fly. Gorsuch sits in a seat stolen from an Obama appointee, and Barrett sits in a seat that belonged to the incoming president.

The Court is corrupt because Gorsuch, Kavanaugh, and Barrett lied to the Senate about their pre-determined intent to overrule Roe v. Wade. And it is corrupt because Justice Thomas has refused to recuse himself from cases in which his wife assisted in an attempted coup.

The trust of the American public in the Court has plummeted to an all-time low of 25%. It will decline further if the January 6th Committee proves that Ginny Thomas funneled information about Court deliberations to John Eastman. It will fall further if the Committee demonstrates that Justice Thomas knew of and condoned his wife’s insurrectionist activities.

Jennifer Rubin succinctly summarizes the death blow to the Court’s legitimacy in her column in WaPo, The Supreme Court eviscerates abortion rights and its own legitimacy. Per Rubin,

The hypocrisy and intellectual dishonesty of the court’s right-wing justices lead to the conclusion that they have simply appointed themselves super-legislators free to impose a view of the United States as a White, Christian and male-dominated society despite the values, beliefs and choices of a majority of 330 million modern Americans.

The court’s decision may result in women’s deaths. But it has certainly killed off what is left of the court’s credibility. And for that, there is no solution in sight.

Concluding Thoughts.

On a day like today, it does not feel right to end on an optimistic note. Rather, we should acknowledge the anger, frustration, fear, and grief that tens of millions of women in America are feeling after the ruling. There will be a time to rally and rejoin the fight for the dignity and equality of women—a fight we will win.

But today, we should acknowledge what women have lost and give them the time and space to absorb and recover from a once-in-a-generation shock. As they do, everyone in their lives should let them know we are at their side every step of the way. Walk along in silence and listen. Nothing can be “fixed” today, but we can begin the long journey back in the coming days.

Now that conservative justices have a solid five votes on the Supreme Court (assuming that Chief Justice John Roberts will not join them on the most divisive issues), no prior decision is safe. American women had abortion rights for 49 years, and that right is on the verge of being nullified by Justices Alito, Thomas, Gorsuch, Kavanaugh, and Barrett.

Milton J. Valencia of The Boston Globe warns that the anti-abortion movement will not be satisfied until all abortions are ended, in every state.

The strongly worded legal language used in the draft Supreme Court opinion that appears to overturn nearly 50-year-old abortion-rights protections could provoke conservative efforts to enact a universal, nationwide abortion ban, according to legal and policy analysts on both sides of the political debate. They say the case has already galvanized advocates who want a federal law criminalizing abortion.

The Supreme Court, based on the draft opinion, appears set to not only uphold a controversial Mississippi law banning abortions after 15 weeks of pregnancy but also overturn the landmark 1973 Roe v. Wade decision that protected a person’s right to abortion. The court opinion suggests the question over abortion restrictions should be legislated at the state level.

The draft opinion was written by conservative Justice Samuel Alito and leaked to Politico, and legal analysts say it remains unclear whether the language will survive in a final court opinion. Even if it does, the ruling itself would not necessarily affect liberal states such as Massachusetts, which have built what are known as Roe protections of abortion rights into state law.

But the legal arguments cited in Alito’s opinion could give political momentum to efforts to enact a federal abortion ban similar to what Mississippi enacted — or, potentially, even more restrictive — on the grounds the fetus is an unborn human being with its own rights. Attempts to pass a federal ban have been proposed before but always failed under the protections of Roe v. Wade.

In his ruling, Alito argues a woman has no constitutional rights to an abortion and suggests that fetuses deserve protection. A federal ban based on the ruling could set up legal challenges of state laws that protect an individual’s right to decide. Massachusetts’ Constitution grants far broader legal rights than the federal Constitution allows, say legal observers, who point out the state was the first to legalize same-sex marriage. But federal law trumps state law.

“The court ruling signals to those in Congress that it’s providing a blueprint for those who want to take away the reproductive rights of all people,” said Carol Rose, legal director of the American Civil Liberties Union chapter in Massachusetts. “It suggests Justice Alito is providing something of a legal road map for people trying to criminalize abortion.”

Priscilla Smith, a former litigator in reproductive rights issues who now runs Yale Law School’s Reproductive Rights and Justice Project, said Alito appears to be “putting all the bread crumbs on the trail,” for what she called the decades-long conservative effort to ban abortion.

“This opinion is as outrageously conservative and extreme as it could get,” she said.

Here, according to Rose and Smith and other analysts, are the key concerns among abortion rights advocates with Alito’s draft opinion:

— The justice, and others who appear to be joining in on a majority decision, argue that there is no right to abortion spelled out in the Constitution, rejecting the argument — granted in Roe v. Wade — that a woman’s right to choose is an inherent, fundamental right built into broad due process rights to liberty. Alito’s determination, legal analysts say, undercuts the same legal principles that have affirmed other rights, such as the rights of people to choose whom they marry, or have sex with. Smith accused the court and antiabortion advocates of “cherry-picking” which fundamental rights they want to challenge, arguing that many rights are widely accepted even though they are not built into the Constitution.

Harvard legal scholar Laurence Tribe wrote on Twitter: “If the Alito opinion savaging [the Roe decision and similar cases] ends up being the opinion of the court, it will unravel many basic rights beyond abortion and will go further than returning the issue to the states: It will enable a GOP Congress to enact a nationwide ban on abortion and contraception.” Tribe added, “Predictable next steps after the Alito opinion becomes law: a nationwide abortion ban, followed by a push to roll back rights to contraception, same-sex marriage, sexual privacy, and the full array of textually un-enumerated rights long taken for granted.”

— Alito appears to refer to fetuses as human beings as a matter of traditional and common law and refers to a fetus as an “unborn human being,” which could give constitutional rights and protections to the fetus and set up legal challenges of state laws that do protect abortions. He refers to a fetus as being destroyed by abortion rights. Rose said the opinion fails to discuss the viability of a fetus. “They don’t distinguish whether you’re pregnant for one day or 24 weeks,” she said.

— The judge also appears to follow the originalist legal theory that matters not involving federal constitutional law should be decided by the states, writing, “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.” But legal analysts say that reference to elected representatives, rather than state officials, opens the door for a Republican-controlled Congress to get involved. “This is not an originalist document, it’s an ideological document,” Rose said.

— The opinion would effectively call for what is legally known as a “rational basis for review” of future abortion restrictions, which is considered the lowest level of legal scrutiny, and it allows for little consideration of a person’s reproductive rights and factors an individual must consider in choosing whether to have an abortion. “It never talks about pregnant people’s bodily integrity, or autonomy, or forcing somebody to go to term. That’s really the huge shift,” Rose said.

Elizabeth Smith, director of state policy and advocacy of the Center for Reproductive Rights, an advocacy organization, said in a statement that, “Any scenario in which Roe v. Wade is overturned would open the door to a national ban — and we know that is the ultimate goal of the anti-abortion movement. For them, overturning Roe is just the beginning. They are determined to ban abortion in every state in the US.”

Brown University released a study showing that hundreds of thousands of lives might have been saved if everyone had gotten vaccinated.