Defendants In Diapers? Immigrant Toddlers Ordered To Appear In Court Alone

As the White House faces court orders to reunite families separated at the border, immigrant children as young as 3 are being ordered into court for their own deportation proceedings, according to attorneys in Texas, California and Washington, D.C.

Requiring unaccompanied minors to go through deportation alone is not a new practice. But in the wake of the Trump administration’s controversial family separation policy, more young children — including toddlers — are being affected than in the past.

The 2,000-plus children will likely need to deal with court proceedings even as they grapple with the ongoing trauma of being taken from their parents.

“We were representing a 3-year-old in court recently who had been separated from the parents. And the child — in the middle of the hearing — started climbing up on the table,” said Lindsay Toczylowski, executive director of Immigrant Defenders Law Center in Los Angeles. “It really highlighted the absurdity of what we’re doing with these kids.”

The Immigration and Customs Enforcement, which oversees the deportations of unauthorized immigrants, did not respond to a request for comment.

Toczylowski said parents typically have been tried along with young children and have explained the often-violent circumstances that led them to seek asylum in the U.S.

The children being detained under the new “zero tolerance” policy, though, are facing immigration proceedings without mom or dad by their side.

“The parent might be the only one who knows why they fled from the home country, and the child is in a disadvantageous position to defend themselves,” Toczylowski said.

Meanwhile, the broader legal situation is in flux. A federal judge Tuesday night commanded the White House to reunify families within 14 days if the child is under 5 and 30 days if the child is older. The Justice Department has not indicated whether it will appeal. Attorneys who are involved in the cases said it’s unclear how the judge’s order will work in practice, and when and how it could take effect.

“We don’t know how the judge’s order is going to play out with reunification of children. What if parents have already been deported?” said Cynthia Milian, a Texas-based attorney at the Powers Law Group.

In the interim, she added, the implications for kids remain an urgent concern.

Given the trauma the children faced in their home country that spurred their families to flee and the pain of being separated from a parent, the expectation that children can mount a legal defense is “unconscionable,” said Dr. Benard Dreyer, director of the division of developmental-behavioral pediatrics at New York University School of Medicine.

“It’s certainly grossly inappropriate,” said Dreyer, who is a member of the American Academy of Pediatrics advocacy committee. “I’m ashamed that we’re doing this.”

Leaders at three legal services organizations and a private firm confirmed that the children are being served with notices to appear in court. They are not entitled to an attorney but rather are given a list of legal services organizations that might help them.

Steve Lee, a UCLA child psychology professor, said expecting the children to advocate for themselves in court is an “incredibly misaligned expectation.”

“That couldn’t be any less developmentally appropriate,” he said, adding that some children may not be mature enough to verbalize a response.

More than 2,000 children who were separated from their parents at the border have been dispatched to the far corners of the nation to care facilities and foster homes.

Officials with the Department of Health and Human Services emphasized Tuesday that the agency is working to unify children with either a parent or a sponsor. But it did not provide a timeline for how long that would take.

“We are working across agencies for reunification of each child with [a] parent or family as soon as that is practical,” Jonathan White, HHS’ assistant secretary for preparedness and response, said in a media call.

HHS representatives said children in facilities run by the Office of Refugee Resettlement receive adequate care, including medical and mental health services, and at least two phone calls per week with family.

Yet children who are just arriving at care facilities are still not connected with their families, said Megan McKenna, a spokeswoman for Kids in Need of Defense. She said the children arrive at care facilities without a parent’s tracking number, and parents don’t tend to have their kids’ numbers.

After kids arrive in care facilities, HHS officials work on finding a “sponsor” to care for the child, such as a parent, guardian, family member or family friend. Historically, unaccompanied minors — who tended to be teens — found a sponsor in about a month and a half.

However, Rachel Prandini, a staff attorney with the Immigrant Legal Resource Center, said finding a sponsor is more difficult now given recent fears that stepping forward to accept a child could trigger a sponsor’s deportation.

In April, HHS entered into an agreement with law enforcement officials that requires sponsors and adult family members to submit fingerprints and be subject to a thorough immigration and criminal background check.

HHS officials said the process is meant to protect the child.

Immigration lawyers from around the country have been flying into Texas to help represent children and families, said George Tzamaras, a spokesman for the American Immigration Lawyers Association.

It’s impossible to know how many children have begun deportation proceedings, Tzamaras said. “There have been reports of kids younger than 3 years old and others as old as 17.”

Ashley Tabaddor, president of the National Association of Immigration Judges and a jurist in Los Angeles, said that unaccompanied minor cases are heard on a special docket there. She said the judges who take the cases were trained during the last administration on children’s developmental stages, impulse control and making sure the proceedings are understandable to children.

She said in a statement that the court’s work is vital: “This is not traffic court. A mistake on an asylum case can result in jail, torture or a death sentence,” Tabaddor said. “We are a nation of laws. We value fairness, justice and transparency.”

She said children seeking asylum tend to make their case in a non-adversarial office setting with a hearing officer.

But that isn’t always the case, Prandini said. Lawyers might choose a strategy that requires more time in the courtroom.

“It’s difficult for adults at times. They go to court and they get nervous before a judge,” Milian said. “Now can you imagine a child having to go before a judge and just explain to them why they’re having to flee their country?”

Toczylowski said her organization is trying to help reunify the families so the children can be tried alongside the parents.

“The kids don’t understand the intricacies that are involved with deportation and immigration court,” she said. “They do understand that they have been separated from their parents, and the primary goal is to get back with people they love.”


KHN’s coverage of children’s health care issues is supported in part by the Heising-Simons Foundation.

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ACA Protections For Sick Patients Still Popular Despite GOP’s Efforts To End Them

Even as many Republicans continue to back a repeal of the Affordable Care Act, a majority of GOP voters want to retain a core consumer protection of the law that prohibits insurers from denying care or charging more to people with histories of health problems, according to a poll released Wednesday.

The requirement that insurers treat people with preexisting conditions the same as those with pristine health histories allowed the law to expand coverage to millions of previously uninsurable people starting in 2014.

But the Trump administration has refused to defend it in a legal challenge against the law brought by 20 Republican state attorneys general. The administration called for the protections guaranteeing coverage to be nullified.

The poll from the Kaiser Family Foundation showed 7 in 10 people think insurance companies should not be permitted to deny coverage because of a person’s medical history or charge them higher rates. Support for the preexisting conditions provision included 58 percent of Republicans. (Kaiser Health News is an editorially independent program of the foundation.)

As the 2018 congressional elections near, Democratic and independent voters identify health care as “the most important issue” for candidates to discuss. Support for the provision is especially strong among households where someone has a preexisting condition. But it remains a second-tier priority for Republican voters, according to the poll, nearly tied with immigration and behind the economy and jobs. Nearly 6 in 10 Republican voters place a priority on a candidate’s support for repealing the health law.

There is more partisan agreement on President Donald Trump’s proposal to require that drugmakers publish list prices for their drugs in television commercials. Three-fourths of the public support the idea.

Those drug ads are ubiquitous on TV, and 14 percent of people who said they saw an ad said they had talked with a doctor about the specific medicine, the poll found. More than half said the physician gave them the drug and 48 percent said they discussed the cost of the medicine with the doctor.

The poll was conducted June 11-20 among 1,492 adults. The margin of error is +/-3 percentage points for the full sample.

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AstraZeneca, Merck eye $1 billion boost from cancer drug success

LONDON (Reuters) – AstraZeneca’s (AZN.L) oncology business received a boost on Wednesday as results of a clinical trial showed its drug Lynparza helped women with ovarian cancer live longer without their disease worsening when given as a first-line treatment.

FILE PHOTO: A man walks past a sign at an AstraZeneca site in Macclesfield, central England May 19, 2014. REUTERS/Phil Noble/File Photo

The result should pave the way for expanded use of the medicine, which is being developed and marketed with Merck & Co (MRK.N) under a deal struck last year.

Analysts said first-line use could boost Lynparza sales by more than $1 billion a year, although experts will first want to see the scale of the clinical benefit when full results are presented at a medical meeting.

The two companies did not say where they planned to present the data but one obvious venue would be the ESMO cancer congress in Munich in October.

Lynparza is already approved for later use in patients with so-called BRCA genetic mutations. Its latest success could expand the number of women with newly diagnosed ovarian cancer who are suitable for the drug by 30-50 percent, AstraZeneca believes.

Lynparza – abandoned at one stage by AstraZeneca but revived by CEO Pascal Soriot when he took over in 2012 – became the first drug in a class known as PARP inhibitors to reach the market when it won U.S. approval at the end of 2014.

It now faces competition from rival products made by Tesaro (TSRO.O) and Clovis Oncology (CLVS.O).

Based on the strong results seen in the latest Phase III study, known as SOLO-1, AstraZeneca and Merck said they would talk to regulators about approving the earlier use of the medicine in women with BRCA mutations, which can drive tumor growth.

“It is the first time that we see a significant and clinically impactful improvement in progression-free survival in the first-line maintenance setting for women with BRCA-mutated ovarian cancer treated with a PARP inhibitor,” said Sean Bohen, chief medical officer at AstraZeneca.

Deutsche Bank analysts said this could represent around a $1 billion incremental sales opportunity for the drug, on top of its existing approved second- and third-line use, while Jefferies put it at $1.6 billion.

A spokeswoman said AstraZeneca viewed competitors as 18 months behind in generating similar clinical data. The closest rival is Tesaro, which is expected to report first-line ovarian cancer results next year.

Reporting by Ben Hirschler, editing by Louise Heavens

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FDA approves Array BioPharma’s melanoma combo treatment

(Reuters) – The U.S. Food and Drug Administration (FDA) said on Wednesday it had approved Array BioPharma Inc’s oral combination treatment for use in patients with the deadliest form of skin cancer.

A view shows the U.S. Food and Drug Administration (FDA) headquarters in Silver Spring, Maryland August 14, 2012. REUTERS/Jason Reed/File Photo

The combination therapy, which consists of encorafenib and binimetinib, is approved bit.ly/2tNoOQW to treat patients with advanced melanoma associated with a common gene mutation called a BRAF mutation, the FDA said.

Shares of Array BioPharma were halted in afternoon trading.

The company released data from a key trial in February that showed the combination led to median overall survival of 33.6 months, meaning half the patients were still alive nearly three years after the treatment.

This was in comparison to a median overall survival of 16.9 months observed in patients in the control arm of the study, who were administered Roche Holding AG’s Zelboraf, a drug that is commonly part of standard-of-care regimens.

The combination, dosed as 450 milligrams of encorafenib once daily and 45 mg of binimetinib twice a day, gives Array its first marketable regimen.

About 91,270 new melanomas will be diagnosed and about 9,320 people are expected to die of melanoma in the United States in 2018, according to the American Cancer Society.

(The story was refiled to correct the third paragraph to clarify that shares were halted and not up 2.2 percent)

Reporting by Tamara Mathias and Anuron Kumar Mitra in Bengaluru; Editing by Anil D’Silva

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Take charge, get tested for HIV

Did you know that 1 in 7 of the more than 1.1 million Americans living with Human Immunodeficiency Virus (HIV) don’t know they have it?

Getting medical care, support, and maintaining safe behaviors can help improve the health and lives of people living with HIV. Medicare can help.

Medicare covers HIV screenings for people with Medicare of any age who ask for the test, pregnant women, and people at increased risk for the infection (such as gay and bisexual men, injection drug users, or people with multiple sexual partners).

HIV is the virus that can lead to Acquired Immunodeficiency Syndrome, or AIDS. There have been many advances in treatment, but early testing and diagnosis play key roles in reducing the spread of the disease, extending life expectancy, and cutting costs of care.

Get tested. Take charge. Visit Health & Human Services’ HIV.gov website to learn more about National HIV Testing Day, June 27, and watch our video.

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New study finds way to help treat alcohol addiction and ease withdrawal symptoms

June 27, 2018

According to a new study by Scripps Research scientists, activating a receptor found in brain cells may help treat alcohol addiction and ease some withdrawal symptoms. The researchers studied the effects of activating the receptor in alcohol-addicted rats and reported the results today in the journal eNeuro.

“The big takeaway here is that we have a new molecular target linked to alcohol addiction,” says Olivier George, PhD, associate professor at Scripps Research. “This is something that will trigger a lot more research and hopefully eventually lead to the discovery of new medicines not only for alcohol addiction but drug addiction in general.”

An estimated 15 million adults in the United States have alcohol use disorder- compulsive alcohol drinking and a loss of control over alcohol intake. Today, there are three medications approved by the Food and Drug Administration to treat alcohol addiction, but each has weaknesses and limitations.

In 2005, researchers sifting through the human genome for new receptors- looking for genetic sequences that resembled known receptors- uncovered a G-protein coupled receptor (GPCR) dubbed GPR139. GPCRs play a large role in brain signaling, and some have been linked to mental disorders. Since discovering GPR139, scientists have shown that the receptor is primarily found in an area of the brain called the habenula. Since the habenula is activated during drug and alcohol withdrawal, George and his colleagues wondered whether GPR139 might play a role in addiction.

“We’re been very interested in the habenula because this is the area of the brain that produces withdrawal symptoms, which an animal or human then tries to avoid by taking another drink or another dose of a drug,” says George, who also serves as co-director of the institute’s Alcohol Research Center Animal Core.

In the new work, George’s group took advantage of an experimental compound, known as JNJ-63533054, that activates GPR139. They gave the compound orally to 12 non-alcohol-dependent male rats and 17 alcohol-dependent rats. The compound had no effect on the alcohol intake of animals that weren’t already dependent on alcohol or on the water intake of alcohol-addicted animals. But it did significantly decrease the alcohol intake of alcohol-addicted rats.

When Jenni Kononoff, PhD, a postdoctoral researcher in the George lab, looked more closely at the rats, she discovered that JNJ-63533054 was particularly effective at decreasing drinking in one subgroup of animals: those that had the highest alcohol intake and showed compulsive drinking behavior. These rats were so addicted to alcohol, that they would normally continue to drink even when their alcohol was adulterated with a bitter taste.

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“What this tells us is that this receptor is activated when you’re drinking a lot and going through withdrawal,” says George.

The pain threshold of rats- or humans- undergoing alcohol withdrawal is generally lower than normal, so to make a further connection between GPR139 and withdrawal, the scientists tracked the pain threshold of 17 rats going through alcohol withdrawal. When the rats were treated with JNJ-63533054, they found, the animals had a higher threshold for pain. Similar to the first experiment, the effect was strongest in rats that had the highest levels of compulsive drinking behavior.

This suggests that, once again, GPR139 is activated during withdrawal only in severe cases of alcohol addiction, George says, and the drug helps mediate the physical pain associated with withdrawal in these cases.

Finally, the team used thin tubes to deliver JNJ-63533054 to small areas of the brain. The drug decreased alcohol intake when it was infused into the habenula, they found, but not other brain areas, confirming the importance of the brain region in addiction and withdrawal.


While the research was only performed in male rats, and only alcohol addiction was studied, George suspects the results will hold true both for females and for other drug addiction, since the habenula has been shown to be critical in drug withdrawal more broadly.

“The good thing about this type of target is that is almost exclusively expressed in the brain, which limits side effects, and it seems to have no effect on individuals who are not dependent,” says George. “Those are both positive indications of the receptor being druggable.”

His group is already planning more studies on GPR139’s link to addiction and withdrawal, and the researchers are looking for additional compounds that activate or block the receptor.

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https://www.scripps.edu/news/press/2018/20180626-alcohol-addiction-brain.html

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Researchers discover immune cells that create and sustain chronic inflammatory bowel disease

June 27, 2018

In preclinical experiments, Laurie Harrington, Ph.D., and colleagues at the University of Alabama at Birmingham have discovered a subset of immune cells that create and sustain chronic inflammatory bowel disease. These cells could become potential therapeutic targets to ameliorate or cure Crohn’s disease and ulcerative colitis.

Furthermore, if this subset of CD4 T cells plays a similar role in other autoimmune diseases, such as Type 1 diabetes or rheumatoid arthritis, they could also be targets for therapy.

“We think these cells could be in a number of auto-inflammatory diseases,” said Harrington, an associate professor in the UAB Department of Cell, Developmental and Integrative Biology. “Our hope is, if we could treat these cells, it could be curative.”

Inflammatory bowel disease, or IBD, has two forms: Crohn’s disease, which can affect any part of the gastrointestinal tract but most often occurs in the lower small intestine; and ulcerative colitis, found in the large intestine and rectum. In both, prolonged inflammation damages the GI tract, accompanied by symptoms that include persistent diarrhea and abdominal pain.

IBD is an autoimmune disease caused by a dysfunctional immune response, yet the mechanisms of how the immune cells cause chronic inflammation and pathology are unknown. In IBD, the cytokine interferon-gamma is abundantly produced by a type of immune cells called CD4 T cells, yet there is conflicting information about the role of interferon-gamma in the disease.

The immune system in mammals functions via an exquisite series of interactions among a large cast of different immune cells. The goal is to trigger a response that will identify and eliminate infecting bacteria or viruses, and then turn off that response when the infection is gone. At the same time, the immune response is not supposed to attack a person’s own cells, a harmful attack that is called autoimmunity.

This tightly controlled immunity starts with blood-line stem cells in the bone marrow that have the capacity to differentiate into a large number of different immune cells. The stem cells themselves can divide indefinitely. The stem cells produce intermediate cells known as progenitor cells. Progenitor cells can divide for a while, but not indefinitely, and they have the ability to further differentiate into one or several types of fully differentiated immune cells.

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As an example, effector CD4 T cells are progenitors that can differentiate into various types of T-helper cells that are found in IBD.

In a mouse model of colitis, Harrington, first author Boyoung Shin and colleagues found that effector CD4 T cells exist in a spectrum of differentiation states, and the pathogenic potential of the cells was directly linked to the differentiation status.

They were able to separate the CD4 T cells into two groups: interferon-gamma-producing CD4 T cells and CD4 T cells that did not produce interferon-gamma. The interferon-gamma-positive CD4 T cells were not able to confer colitis when transferred to healthy mice, and those cells were not required to sustain disease.

In contrast, it was the interferon-gamma-negative CD4 T cells that were pathogenic. Those cells were capable of eliciting and maintaining intestinal inflammation. That group showed a stem cell-like transcriptional signature, which supports the capacity to self-renew and resist the programmed cell death, called apoptosis. They also continually seeded terminally differentiated, interferon-gamma-producing cells in the inflamed intestine.

The researchers also identified a glycosyltransferase enzyme in the interferon-gamma-negative CD4 T cells that positively regulated a transcription factor involved in stemness.

Similar to the Harrington study, a different group of researchers recently found there is a distinct subset of CD8 T cells that sustains the control of chronic viral infections, and this unique cell population is distinguished by its stem-like qualities.

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Gawande’s Goal Is Providing The ‘Right’ Health Care In New Venture By 3 Firms

Dr. Atul Gawande, the famed surgeon-writer-researcher chosen to lead a joint health venture by three prominent employers to bring down health costs, said his biggest goal is to help professionals “make it simpler to do the right thing” in delivering care to patients.

His comments at the Aspen Ideas Festival came just days after being named chief executive of a health care partnership unveiled earlier this year by Amazon, Berkshire Hathaway and JP Morgan Chase & Co. The new enterprise will oversee health coverage for about 1.2 million employees of the companies and their families. Gawande said he will focus on the same behaviors by doctors and hospitals that he studies at his Boston-based think tank Ariadne Labs.

One of the biggest problems in health care is that “doing the right thing is incredibly complicated” and that one of the biggest sources of waste in the system is that patients are given “the wrong care in the wrong way at the wrong time,” he said

He said he hopes to find specific ways to make health care more efficient and the solutions exportable.

“The opportunities are as long as my arm,” he said. “So all we have to do in this new venture is pick a few of them and try to bat them out of the park.”

For example, he said, even in countries where everyone is covered by insurance only about half of those with high blood pressure have it controlled. In the U.S. that percentage is closer to 40 percent. And while Americans spend “tons more money” to treat low back pain, he said, “the level of disability and pain has changed not at all.”

Gawande, 52, was purposely vague about his new job — which he will add to his long list of activities, including teaching at Harvard and operating on patients at a university-affiliated hospital in Boston, writing for The New Yorker and serving as chairman of Ariadne Labs.

“We are going to come up with a name, it’s one of my first jobs,” he joked to interviewer Judy Woodruff of “PBS NewsHour” during a session at Aspen on Saturday. On Monday, at another session, he told The New York Times’ David Leonhardt that he “had no idea” how many employees would eventually come to work for the organization, although it will be a stand-alone, not-for-profit entity. He declined a separate interview.

But Gawande did talk at length in both appearances about his approach to the new initiative.

“The largest concept here is I get to have a million patients that I as a doctor get to add to my responsibility,” he said Saturday. “And my job to them is to figure out ways that we are going to drive better outcomes, better satisfaction with care and better cost efficiency with new models that can be incubated for all.”

That is essentially what Ariadne already does — tests ways to make care more effective and efficient and spreading those practices in the U.S. and abroad.

As an example, he talked about his mother’s recent knee replacement. A total of 66 health workers saw her in the hospital — he counted — and often provided conflicting advice about whether she should be up or in bed or exactly what she should be doing.

“And you just want to say, ‘Is anybody in charge?’” he said. “That’s the broken system.” The system is moving “from individual delivery of stuff … to team delivery of outcomes. And that’s a radically different place.” He wants to help make that transition more effective.

Gawande said his research has also shown that “the right care” can’t just be dictated. He developed a now-famous surgical checklist that was later mandated for doctors in Canada. But he pointed out in his discussion Saturday that the requirement showed no reduction in surgery-related mortality. Yet in Scotland, where the implementation was more gradual and more data-driven, he said, “in the first three years we saw a more than 25 percent reduction in deaths.”

Gawande said that although he is going to work for companies that provide insurance to their workers, “employer-based care is broken,” with the vast majority of new jobs lackinghealth insurance.

And even those workers who are offered job-based health insurance are increasingly priced out of care. Some people he grew up with in Ohio, he said Monday, “are paying half their income in taxes and health care premiums and going bankrupt because of health care costs.”

When workers have deductibles that are multiples larger than their bank accounts, they stop treating their chronic conditions. “And it has enormous harm for the future,” he said.

Still, he was optimistic about the possibilities of making health care both better and less expensive.

“It’s feasible to do these things,” he said Monday. “But it’s not sexy.”

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U.S. top court blocks California law on anti-abortion centers

WASHINGTON (Reuters) – The U.S. Supreme Court on Tuesday blocked a California law requiring clinics that counsel women against abortion to notify clients of the availability of abortions paid for by the state, finding that it violated the free speech rights of these Christian-based facilities.

Abortion rights opponents celebrate outside the U.S. Supreme Court after the Court struck down a California law requiring clinics that counsel women against abortion to notify clients of the availability of abortions paid for by the state, ruling it violated the free speech rights of these Christian-based facilities, in Washington, U.S., June 26, 2018. REUTERS/Leah Millis

The Supreme Court legalized abortion in 1973, and while the broader issue of abortion rights was not at issue in the case, the 5-4 ruling represented a significant victory for abortion opponents who operate these kinds of clinics – called crisis pregnancy centers – around the country.

The court’s five conservative justices were in the majority in the ruling authored by Justice Clarence Thomas, with the four liberals dissenting.

The justices endorsed the argument advanced by the clinics that the Democratic-backed law in the most populous U.S. state ran afoul of the Constitution’s First Amendment guarantee of free speech by forcing them to advertise for abortion in violation of their beliefs.

“California cannot co-opt the licensed facilities to deliver its message for it,” Thomas wrote.

Crisis pregnancy centers have said they offer legitimate health services but that their mission is to steer women with unplanned pregnancies away from abortion. California officials have said some of the centers mislead women by presenting themselves as full-service reproductive healthcare facilities, going so far as to resemble medical clinics, down to lab coats worn by staff.

Alliance Defending Freedom (ADF) attorneys Kristen Waggoner (C), Jeremy Tedesco and Kellie Fiedorek (L) read the decision outside the U.S. Supreme Court after the Court struck down a California law requiring clinics that counsel women against abortion to notify clients of the availability of abortions paid for by the state, ruling it violated the free speech rights of these Christian-based facilities, in Washington, U.S., June 26, 2018. REUTERS/Leah Millis

President Donald Trump’s administration hailed the decision as a victory for free speech. “Speakers should not be forced by their government to promote a message with which they disagree, and pro-life pregnancy centers in California should not be forced to advertise abortion and undermine the very reason they exist,” U.S. Attorney General Jeff Sessions said.

U.S. House of Representatives Democratic Leader Nancy Pelosi called the ruling a “grave step backwards” for women’s rights, adding that California should be able to protect people from “fake women’s health centers” that provide biased information.

Ilyse Hogue, president of abortion rights group NARAL Pro-Choice America, said that Roe v. Wade, the high court’s landmark 1973 decision establishing a woman’s constitutional right to abortion, is more at risk than ever.

“One vote made all the difference today, and it could also be the only thing between upholding Roe or outlawing legal abortion in America,” Hogue said.

The Alliance Defending Freedom conservative Christian legal group, which represented the anti-abortion centers, said the ruling dooms similar laws in other states and cities.

There are roughly 2,700 crisis pregnancy centers in the United States, including around 200 in California, according to abortion rights advocates, vastly outnumbering abortion clinics.

The law does not require abortion referral or prevent the centers from voicing their anti-abortion views, but rather helps ensure that clients are made aware of abortion and family planning services available elsewhere, California argued.

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The justices reversed a 2016 ruling by the San Francisco-based 9th U.S. Circuit Court of Appeals that refused to block the law.

WIDER IMPLICATIONS

Liberal Justice Stephen Breyer announced his dissent from the bench, saying the court previously upheld another law forcing doctors to tell women seeking abortion about adoption services.

If a state can do that, Breyer asked, “why should it not be able to require a medical counselor to tell a woman seeking prenatal care about childbirth and abortion services?”

Breyer said Tuesday’s ruling could have wider implications, calling into question all manner of government disclosure requirements including securities or consumer-protection regulations.

California’s Reproductive FACT Act, passed by a Democratic-led legislature and signed by Democratic Governor Jerry Brown in 2015, required centers licensed by the state as family planning facilities to post or distribute notices that the state has programs offering free or low-cost birth control, prenatal care and abortion services. The law also mandated unlicensed centers that may have no medical provider on staff to disclose that fact.

The National Institute of Family and Life Advocates, an umbrella group for the non-profit facilities, as well as two such facilities in San Diego County, challenged the California law, saying it was crafted to target them for their anti-abortion views.

“Pro-life centers are now free from government harassment,” Thomas Glessner, the institute’s president, said after the ruling.

There is a strong religious element to the facilities involved in the case. For example, one called itself a “front line ministry” and said on its website that once women who come to the center “have accepted Christ we begin a discipleship program with them and contact a partner church to hand them off to.”

Reporting by Andrew Chung; Editing by Will Dunham

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Exclusive: BrainStorm will not provide ALS therapy under U.S. Right to Try act

TEL AVIV (Reuters) – BrainStorm Cell Therapeutics Inc (BCLI.O) will not make its experimental stem cell treatment for neurodegenerative diseases available under the new U.S. “Right to Try” (RTT) act, citing a failure to find a way to enable all patients to afford the treatment.

FILE PHOTO: U.S. President Donald Trump shows off the signed “Right to Try Act,” which gives terminally ill patients the right to use experimental medications not yet been approved by the Food and Drug Administration (FDA), at the White House in Washington, U.S., May 30, 2018. REUTERS/Leah Millis/File Photo

The U.S.-Israeli company said on Tuesday it will focus on completing its advanced study for NurOwn in patients with amyotrophic lateral sclerosis (ALS) as quickly as possible.

U.S. Congress last month approved the RTT bill that would allow terminally ill patients to try experimental treatments not yet approved by the Food and Drug Administration. The act, which was approved by the Senate in August, was signed in to law by President Donald Trump on May 30.

The bill does not require insurance companies to pay for the experimental treatments.

BrainStorm said four elements must be satisfied in order to be able to provide NurOwn to ALS patients under the RTT pathway.

It found solutions for three of them: treating a limited number of patients at clinical trial-experienced sites for safety reasons, ensuring patients are educated on the benefits and risks, and limiting inclusion to patients who do not meet the clinical trial criteria to avoid impacting the trial.

The fourth: finding alternative funding for patients who are unable to afford the high cost of cell therapies, was unmet.

“As we are unable to identify a practical funding solution, we, unfortunately, are not in a position to initiate access to NurOwn under RTT at this time,” BrainStorm CEO Chaim Lebovits said.

Lebovits has said that the Right to Try act cannot be only for the rich.

BrainStorm could not estimate what the cost of NurOwn will be after commercialisation. Personal cell and gene therapies can cost hundreds of thousands of dollars a year.

Lebovits told Reuters that BrainStorm would provide NurOwn under RTT to one patient, Matt Bellina, a naval aviator diagnosed with ALS who helped lead the fight to get the legislation passed. Lebovits said he would personally sponsor the treatment.

BrainStorm expects to have Phase III trial results at the end of 2019 or early 2020.

According to the ALS Association, 5,600 people in the United States are diagnosed each year with the illness, also known as Lou Gehrig’s Disease.

Reporting by Tova Cohen, editing by Stephen Farrell and Louise Heavens

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