Hiltzik: Are women and babies the property of the state? Red states say ‘yes!’

The arguments made by antiabortion states to sugarcoat their manifestly misogynistic policies have always borne the acrid odor of cynicism and hypocrisy.

You know what I mean: that their restrictions on reproductive medical care are all about protecting the health of women, preserving the lives of the unborn, fulfilling a moral imperative to honor the sanctity of life, etc., etc.

So we should thank the red states Missouri, Kansas and Idaho for at least being honest. As they disclosed in a federal lawsuit this month, their real goal is to farm pregnant teenagers and their unwanted babies to keep up their population numbers, in order to avoid shrinkage in their congressional delegations and lose federal dollars from programs based on population.

That may sound incredible, but it’s set forth in black and white in a joint legal filing in federal court.

“Each abortion,” they write, “represents at least one lost potential or actual birth.” Because of this “loss of potential population,” the states face “subsequent ‘diminishment of political representation’ and ‘loss of federal funds,’ such as potentially ‘losing a seat in Congress or qualifying for less federal funding if their populations are’ reduced or their increase diminished.”

The target of their legal filing is the dispensing by mail of mifepristone, the abortion drug that the Supreme Court allowed to remain on the market in a decision in June. “Remote dispensing of abortion drugs,” they assert, “is depressing expected birth rates for teenaged mothers.”

So there you have it. Missouri, Kansas and Idaho think it’s of paramount importance to keep up the rates of teen pregnancy, lest they lose a congressional seat here or there or a few bucks in federal handouts. One might ask whether this sounds humane or even sane, but to ask the question is to answer it.

Here’s the background on this ghastly argument. It started with the Supreme Court’s ruling in a lawsuit brought by a passel of antiabortion fanatics that aimed to roll back the Food and Drug Administration’s approvals of mifepristone dispensing by mail. The lawsuit persuaded federal Judge Matthew Kacsmaryk of Amarillo, Texas, one of the Trumpiest of Trump-appointed federal judges, to overturn FDA approvals dating to 2020 and throw the drug off the market.

The Supreme Court overturned his ruling and an appellate court ruling. Its grounds were that none of the plaintiffs in the case had themselves suffered an injury from the FDA policy — so none of them had “standing” to bring the suit under constitutional rules in the first place.

The three states’ amended lawsuit, filed in Kacsmaryk’s court on Oct. 11, is designed to circumvent the standing issue. That required the states to show that they’ve suffered an “injury” from the FDA policy. Their argument is that medical abortions, or “chemical abortions,” erode their population, leading to those adverse consequences for the size of their congressional delegations (Idaho has two representatives, Kansas four, Missouri eight) and their grip on federal program dollars.

To be absolutely fair, that isn’t the states’ only injury claim. They also maintain that complications experienced by women taking abortion drugs will create a burden on their Medicaid budgets.

This would be laughable if it weren’t so cynical. The states’ lawsuit discloses how much they’ve spent on women who have needed emergency room care as a result of such complications. In 2022, they report, Idaho’s estimated costs ranged from a total of $839.20 to a maximum $13,556; Missouri’s estimate ranged from $2,524 to $6,274.

The differences arose from estimates of the “severity” of the complications being treated — the more severe, the higher per-patient cost. Missouri’s estimate of the number of ER visits in 2022 by women experiencing complications and enrolled in Medicaid was about eight to twelve, pegged to a range of complication rates.

Idaho’s estimate of the number of Medicaid patients treated for medical abortion complications in 2022 ranged from a low of fewer than four to a high of fewer than six. Plainly, the states don’t even know the real figures. They were basing their estimates on estimated complication rates, not empirical data. (Kansas data weren’t disclosed in the lawsuit.)

If anyone still thinks this is all about protecting the lives of mothers and babies, consider the broader landscape of maternal and infant medical care in these three states. All three landed in the below-average category in the Commonwealth Fund’s 2024 scorecard on women’s health and reproductive care: Idaho ranked 27th, Kansas 32nd and Missouri 40th. Kansas, by the way, hasn’t expanded Medicaid under the Affordable Care Act, or its spending might have been even lower.

You might think, under the circumstances, that this legal filing is just an election-season stunt by three state attorneys general who have nominated themselves as flag carriers for Donald Trump. There’s some evidence for that: Their filing name-checks the “Biden-Harris administration” or “Biden-Harris FDA” no fewer than eight times; it reads like a Trump-Vance bumper sticker. The original lawsuit didn’t mention Vice President Kamala Harris even once, but then again it was filed in November 2022.

The rest of the three states’ legal filing is filled with claims about the safety and efficacy of medical abortion drugs, many of which have long since been debunked, and aren’t particularly relevant to this civil court case anyway; it attempts to goad a judge into discarding the years of studies consulted by the FDA in approving the drugs and replacing it with his own ideological worldview and pseudoscientific judgments.

Most experienced judges are wary of doing so. Not Kacsmaryk. It’s entirely conceivable that he’ll buy into this new attempt to outlaw a safe and effective abortion procedure, and send the three states’ threadbare case back up the judicial pipeline. So mifepristone isn’t out of the woods yet.