By MARK SHERMAN, Associated Press

WASHINGTON (AP) — The Supreme Court on Wednesday seemed likely to preserve the $8 billion a year the government spends to subsidize phone and internet services in schools, libraries and rural areas.

The justices heard nearly three hours of arguments in a new test of federal regulatory power, reviewing an appellate ruling that struck down as unconstitutional the Universal Service Fund, the tax that has been added to phone bills for nearly 30 years.

Liberal and conservative justices alike said they were concerned about the potentially devastating consequences of eliminating the fund that has benefited tens of millions of Americans.

The Federal Communications Commission collects the money from telecommunications providers, which pass the cost on to their customers.

A conservative advocacy group, Consumer Research, challenged the practice. The justices had previously denied two appeals from Consumer Research after federal appeals courts upheld the program. But the full 5th U.S. Circuit Court of Appeals, among the nation’s most conservative, ruled 9-7 that the method of funding is unconstitutional.

The 5th Circuit held that Congress has given too much authority to the FCC and the agency in turn has ceded too much power to a private entity, or administrator.

Justice Sonia Sotomayor said the FCC subsidies cover only phone and internet services. “It a very real constraint. They are the only two services that have been identified,” Sotomayor said.

Justice Neil Gorsuch seemed most supportive of the challengers, calling the fund “a tax that’s unlike any other tax this court has ever approved.”

The last time the Supreme Court invoked what is known as the nondelegation doctrine to strike down a federal law was in 1935. But several conservative justices have suggested they are open to breathing new life into the legal doctrine.

The conservative-led court also has reined in federal agencies in high-profile rulings in recent years. Last year, the court reversed a 40-year-old case that had been used thousands of times to uphold federal regulations. In 2022, the court ruled Congress has to act with specificity before agencies can address “major questions,” in a ruling that limited the Environmental Protection Agency’s ability to combat climate change.

“This is simply not the right case for the court to revamp the nondelegation doctrine,” lawyer Paul Clement told the justices on behalf associations of telecommunications companies.

The Trump administration, which has moved aggressively to curtail administrative agencies in other areas, is defending the FCC program. The appeal was initially filed by the Biden administration.

“Neither Congress’s conferral of authority on the FCC, the FCC’s reliance on advice from the administrator, nor the combination of the two violates the Constitution,” acting Solicitor General Sarah Harris wrote in a Supreme Court brief.

Consumer Research calls the situation a “nightmare scenario” in which Congress has set no limits on how much the FCC can raise to fund the program. “Predictably, the USF tax rate has skyrocketed. It was under 4% in 1998 but now approaches 37%,” lawyers for the group wrote.

They said there is an easy fix: Congress can appropriate money for the program, or at least set a limit on how much can be spent, even in the trillions of dollars.

But several justices said that Congress could satisfy objections by setting an astronomically high figure that provides no real limit. “That sounds like a meaningless exercise,” Justice Amy Coney Barrett said.

But last year, Congress let funding lapse for an internet subsidy program, the Affordable Connectivity Program, and the FCC moved to fill the gap by providing money from the E-rate program, one of several funded by the Universal Service Fund.

Congress created the Universal Service Fund as part of its overhaul of the telecommunications industry in 1996, aimed at promoting competition and eliminating monopolies. The subsidies for rural and low-income areas were meant to ensure that phone and internet services would remain affordable.

A decision is expected by late June.

Dr. Damla Karsan lives in fear for her patients—and for all pregnant Texans. 

The Houston OB-GYN has spent the last four years painfully navigating the state’s draconian abortion bans, oftentimes for patients who face severe complications. With vaguely defined exceptions for medical emergencies, the law has forced doctors to either delay or deny life-saving care out of worry they could face lawsuits or prison time for performing pregnancy termination. 

Karsan knows the risks well: When she promised to perform abortion care in 2023 for Kate Cox, a Dallas mother who saw her health steadily deteriorate after doctors failed to terminate her fatal pregnancy, she was met with direct threats of prosecution from Attorney General Ken Paxton. Cox eventually fled the state. Paxton’s attacks on reproductive healthcare workers have only escalated since then, most recently with the arrest of a Houston-area midwife for allegedly giving abortion pills to a patient—the first criminal charges under the state’s ban that took effect after the 2022 fall of Roe.

Karsan has had other patients who were hemorrhaging during a miscarriage—just a few steps away from death—and still faced delayed care at the ER. Some of her patients are too scared to even get pregnant, while others have fled Texas in order to start their families safely. Her experiences mirror the flood of traumatic stories from other Texans and providers. 

“These laws are torturing women, there’s no other way to put it,” Karsan told the Texas Observer in between deliveries from her practice just south of the Houston Medical Center. “It is absolutely horrible having to try to help patients get care when the state has barred us from using our best medical judgement.” 

May 2022 abortion rights protest at Texas Capitol in Austin (Gus Bova/Texas Observer)

A 2021 near-total abortion ban, known as Senate Bill 8, encourages private civil suits against anyone who “aids or abets” care, and the 2022 post-Roe criminal ban threatens doctors who perform abortion with $100,000 in fines, loss of their medical license, and up to 99 years in prison. The criminal law holds an exception for patients who are at “risk of death” or “substantial impairment of a major bodily function.” For years, doctors and advocates have said the carve-out is ambiguous and unworkable in reality, resulting in confusion and trepidation when treating high-risk patients. 

Following a long—and largely unsuccessful—road to clarify the laws, including a 2023 lawsuit filed by 20 women denied abortion care despite pregnancy complications and a flurry of proposals from Democrats last legislative session, a new bill filed by Senate Republican Bryan Hughes now seeks to add clarity. 

Introduced just before the Legislature’s bill filing deadline, Senate Bill 31—now scheduled for a committee hearing Thursday—would strike the term “life-threatening condition” from the criminal law, as the language has caused confusion among doctors. It includes guidance from a previous Texas Supreme Court ruling that found the law does not require a medical emergency to necessarily be imminent or irreversible before a doctor can take action. It would also clarify that physicians are not required to “delay or withhold” life-saving medical care in order to preserve the life of the fetus, and it would ostensibly offer stronger protections for doctors when treating ectopic pregnancy and premature water breaks. 

Dubbed the “Life of the Mother Act,” the bill also clarifies that a doctor or lawyer can discuss a medically necessary abortion with a patient without the risk of “aiding and abetting” charges. Representative Charlie Geren, a Fort Worth Republican, has filed an identical companion bill in the House.

The legislative proposals mark the most significant effort by Republicans to allay concerns from patients and providers about Texas abortion law thus far. 

Hughes’ office did not return calls for comment; however, he recently told local newspapers in Texas that the law is meant to “remove any excuse” for doctors not to treat pregnant patients whose lives are in jeopardy. “I’ve said for some time that the law is clear, but if we can make it clearer, if we can remove any doubt and hesitation we want to do that,” Hughes told the Houston Chronicle. At a Capitol press conference this month, Geren said he considers the legislation “the most important bill” he’s carried in his more than two decades at the Legislature. “Too many women have suffered. Too many have died. If one has died, it’s too many,” said Geren. “I have friends whose wives can no longer conceive because of the problems they went through with their first pregnancy and the delay their doctors faced in addressing the problems.”

In January, the staunchly anti-abortion Lieutenant Governor Dan Patrick called on the Legislature to clarify language in the law so that doctors are “not in fear of being penalized if they think the life of the mother is at risk,” becoming the first statewide official to do so this session. And he included the bill on his list of top 40 legislative priorities. Meanwhile, Republican Governor Greg Abbott—who holds veto power over bills—has said the law doesn’t need to be changed but that he may be accepting of the GOP-backed legislation. Geren has pleaded with Abbott to “Veto everything else, but [leave this bill] alone.”

It remains to be seen if either proposal will win the approval of enough fellow Republicans to pass, or if the GOP will get sidetracked by a slew of bills aimed at further restricting the flow of abortion pills—the most aggressive of which is backed by Hughes himself. The sweeping 43-page Senate Bill 2880 would allow Texans to file civil suit against groups that mail abortion-inducing drugs into Texas; make it a felony to pay for a person’s abortion care, including travel costs; and empower the “biological father of the unborn child” to file “wrongful death” lawsuits against abortion patients, among other extreme provisions. 

Democrats like Representative Donna Howard, an Austin Democrat, have spent years championing wider exceptions to the state’s abortion laws, including filing a broader bill to do so this session as well as a measure to allow abortion care for survivors of sexual assault. Howard is supportive of Hughes and Geren’s bill and will urge her Democratic colleagues to support it, saying it “would save the lives of Texas moms.” She considers the new Republican-backed measure a reflection of the dissatisfaction among GOP constituents.

“Many of the communities my Republican colleagues represent aren’t happy. They feel like the law went too far,” she told the Observer. “They are pressuring for a change so they can safely grow their families. And I think [the new GOP] bill is a direct response to that. … To let the law stand as-is would be the total opposite of what Republicans supposedly say they want: Women will continue to lose their pregnancies, lose their babies, and even lose their lives.”

After a string of horrifying near-death experiences under the laws, an investigation last fall from ProPublica found that three pregnant women in Texas—Josseli Barnica, 28, Nevaeh Crain, 18, and Porsha Ngumezi, 35—died after doctors waited to treat their miscarriages. Medical experts interviewed concluded that their deaths were preventable. The news spurred Karsan and 110 other OB-GYNs to sign on to a letter in November urging lawmakers to reform Texas abortion law, writing: “Anti-abortion groups and others are saying the blame does not fall on Texas law. That is simply not true. As OB-GYNs in Texas we know firsthand how much these laws restrict our ability to provide our patients with quality, evidence-based care. Texas needs a change in laws.”

Karsan points out that the groundswell of opposition is significant for Texas doctors, who have been hesitant to express their frustration publicly out of fear of retaliation. Self-employed in private practice and unbound by the systems that rely on state coffers, Karsan said she is more able to speak her mind and has even helped challenge the laws in court. 

“A lot of my colleagues have been muzzled by the healthcare institutions they are employed by. They do not want to upset the powers that be because these institutions get some of their funding from the state.”

Until now, efforts to help clarify the law have been minimal. After years of staying noticeably silent on the issue, The Texas Medical Board—prompted by a petition from healthcare lobbyists—adopted guidance last June on how doctors should interpret the abortion bans. However, those like Karsan say the guidelines didn’t help give physicians like her any “meaningful leeway.” Additionally, the board failed to provide a comprehensive list of cases in which abortion care would be legal, and TMB Board Chair Dr. Sherif Zaafran himself acknowledged the guidance is limited and could not prevent criminal prosecution. (All TMB members are appointed by Governor Abbott, and many have donated generously to his campaign.)

While the 2023 legislative session saw a successful bipartisan effort to cover two specific conditions under the law, ectopic pregnancies and premature water breaks, the measure still left many other potentially life-threatening conditions in gray area. 

Until Patrick’s recent call, Texas Republicans have largely reiterated—in the media as well as in the courtroom—that the law is clear as-is and the onus rests with individual physicians. In fact, in a November op-ed for the Houston Chronicle, Hughes himself not only wrote that the law is “plenty clear” but ascribed blame for doctors’ fear to articles like the ones “published in ProPublica,” writing that, “Pro-abortion groups and their allies in the left-wing media have been relentless in their attempts to scare doctors.”

Elisabeth Smith, director of state policy at the Center for Reproductive Rights, said Texas is “sadly not alone” in its slow efforts to widen medical exceptions, as the 11 other states that enforce criminal abortion bans have largely not done so. (Recently, lawmakers in Kentucky added exceptions to their state’s near-total abortion ban; however, pro-abortion groups have criticized the additions as insignificant.)

“Up until now, the state of Texas—like most other banned states—has made it very clear they are not interested in providing clarity for providers and patients,” said Smith. “And Texas doctors face some of the most draconian penalties in the country. They feel like hospital lawyers are sitting on their shoulders, and [are] afraid of making the wrong choice.”

Reproductive health advocates like Smith note that the only real solution to preventing deaths and physical trauma as a result of abortion bans is to strike the law altogether. “More clarity is a good thing,” she said. “But the problem with any abortion ban is that they are trying to squeeze medical decision-making into narrow exceptions that cannot possibly cover every case. Exceptions give a veneer or gloss to make bans appear more [palatable] for people who have never really worked in the medical field. But in practice, they rarely work.”

Dr. Ghazaleh Moayedi, a Dallas-area OB-GYN and complex family planning specialist, echoed the skepticism. Glaringly, Hughes himself was the author of the state’s 2021 lawsuit-based ban. His new bill proposes “continuing education” for doctors to better understand how to interpret the law, which Moayedi considers a subtle reaffirmation of the state’s motive to push responsibility on anyone but lawmakers. (“Who is going to run the seminar? It could be an anti-abortion activist perpetuating state propaganda; we don’t know yet,” she points out.) She also believes much of the “clarifying” language remains vague or confusing. Moreover, the new bill fails to add exceptions for rape, incest, or fatal fetal diagnoses, forcing vulnerable pregnant people into more trauma.

“It feels like they are playing a semantics game that is ultimately not going to help people,” Moayedi said. “The GOP is looking for a deflection from the crisis they’ve caused. I urge Democrats not to settle for crumbs this session—we really deserve better, our state deserves better.”

Some reproductive rights advocates worry that the bill could end up actually causing more damage than good. In addition to amending the current criminal ban, the bill also amends a 1925 pre-Roe-era ban still on the books, which prohibits abortion and targets anyone who “furnishes the means” to do so with a potential prison sentence of up to five years. (Paxton sought to enforce the ban to target abortion funds after the fall of Roe, but a federal court blocked those efforts in 2023.) They caution that by tacitly implying the law is still relevant, the bill could be used as a backdoor attempt to revive the 100-year-old ban to again try to prosecute abortion funds or others down the road.

“By trying to sneak in a revival of this pre-Roe ban, lawmakers could criminalize practical support organizations like us,” said Kamyon Conner, executive director of the Texas Equal Access Fund, which provides financial support to Texans traveling out-of-state for care. “It would be harmful to one of the last pathways for Texans to access abortion care outside the state. We hope Democrats pressure their colleagues to remove this part.”

Studies show the already-strained OB-GYN workforce in Texas has suffered under the laws. Of nearly 500 Texas OB-GYNs surveyed, 60 percent said they fear legal repercussions for practicing evidence-based medicine, according to research from Manatt Health. And nearly 80 percent feel that they cannot provide the best treatment for their patients under the bans. One in five doctors has considered leaving Texas, and 13 percent are planning to retire early due to the restrictions. Already tenuous abortion training for medical students is also vanishing. A women’s healthcare provider for more than two decades, Karsan stressed the intense fear is felt not just among frontline physicians but everyone in the chain of medical care. 

“All medical staff are so scared and so confused. They are reluctant to get involved in a patient’s care … because they don’t even want their name on the chart,” said Karsan, which compromises the team effort required for all complex medical care.

“Something needs to change soon, or we are going to keep living in fear and we are, without a doubt, going to see more women die.”

The post Republican Abortion Laws Are ‘Torturing Women.’ Can the GOP Fix Its Own Crisis? appeared first on The Texas Observer.

By MATTHEW LEE, Associated Press Diplomatic Writer

KINGSTON, Jamaica (AP) — Weaning Caribbean countries from their dependence on Venezuelan oil and combating illegal immigration will top U.S. Secretary of State Marco Rubio’s tour of three Caribbean nations this week as the Trump administration increasingly focuses its attention on the Western Hemisphere.

The State Department said Rubio, who arrived in Jamaica on Wednesday, will push for the region to diversify its energy supplies. Rubio also will visit Guyana and Suriname, his visit coming just days after U.S. President Donald Trump announced new sanctions on Venezuelan oil exports and threatened tariffs on all goods imported into the United States by other countries that buy oil from Venezuela.

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Another main issue for Rubio will be the situation in Haiti, where a multinational peacekeeping force has been in place for months struggling to prevent gangs from taking over the country. Rubio spoke Tuesday with the president of Kenya, which is leading that force, although the State Department account of the call made no reference to Haiti.

“The challenge, obviously, is Haiti,” said Mauricio Claver-Caron, Trump’s special envoy for the Western Hemisphere. “And, obviously, we all know and we share the deep commitment to tackling this challenge in Haiti.”

But in a conference call with reporters Tuesday, he did not offer details on what the Republican former Florida senator would suggest on Haiti policy. Rubio has extended waivers on an overall U.S. foreign aid freeze to continue to fund the security force in Haiti, but it remains unclear how long they will last.

“This trip is going to add in the urgency of the moment and in the urgency of the situation to the development and implementation of a very targeted strategy in regards to Haiti to try to ensure that these gangs do not take over, obviously, Port-au-Prince but then expand beyond that,” Claver-Caron said without elaborating.

Energy, he said, will be the top topic of conversation while Rubio is in the Caribbean.

“We are in a historic moment in the Caribbean for energy security, which has been the Achilles’ heel of the Caribbean for so long and its economic development with disproportionately high electricity and energy prices,” Claver-Caron said.

He said Rubio’s visit comes at a time of a “historic opportunity for energy security in the Caribbean, which will improve people’s lives, will improve also the opportunities and the relationship with the United States and what that means, and obviously, will strengthen our neighbors, which we seek.”

On Monday, Trump announced he was tightening U.S. sanctions on Venezuelan oil exports and would slap a 25% tariff on all goods sent to the U.S. by countries that import Venezuelan oil on April 2. But just hours later, the Treasury Department said it would extend a sanctions waiver for the U.S. company Chevron to continue to send Venezuelan oil to the United States until the end of May.

“The fact that now their own countries — Guyana, Suriname — are able to have and really surpass Venezuela in its oil production and be able to work with its neighbors there in the region is a huge opportunity for the Caribbean,” Claver-Caron said.

He also suggested the U.S. was prepared to field questions from regional leaders about U.S. sanctions on Cuba that target programs that send doctors and nurses to the region and elsewhere. American officials have said the programs resemble organized human trafficking because the medical professionals are not paid directly.

Latin American leaders have denounced the U.S. sanctions, saying they deprive their people of much needed medical assistance, but Claver-Caron dismissed those complaints and said if the leaders Rubio meets with focus on that, it will be a waste of time.

“If they choose to overshadow this trip with the issue of Cuban doctors, it’ll be a lost opportunity, because again, the huge opportunity here is energy security, economic development that has plagued this region, and the biggest challenge that we have is Haiti,” he said.

“In this year’s budget, Gov. Kathy Hochul has proposed an expansion of mental health forced hospitalization, which would direct law enforcement to approach people who they deem mentally ill—leaving the discretion entirely in policing even in the absence of present threat.”

Gov. Kathy Hochul delivering the 2025 State of the State Address in Albany. (Mike Groll/Office of Governor Kathy Hochul)

We all deserve safety and wellness, and it’s clear to New Yorkers that our government is too often failing to provide this. As elected officials come to realize that New Yorkers will not accept the status quo where thousands of people living with mental illness suffer in our communities without adequate housing or treatment, we’ve seen them rush to share their “plans” to respond.

We need to do something different, but we need to invest in the solutions that actually work. Those solutions must be rooted in treating public health challenges with public health responses, not the same reflexive reliance on law enforcement that has already failed us.

In this year’s budget, Gov. Kathy Hochul has proposed an expansion of mental health forced hospitalization, which would direct law enforcement to approach people who they deem mentally ill—leaving the discretion entirely in policing even in the absence of present threat. This is the wrong approach on many levels, and the state legislature must reject it.

The current standard for involuntary transport to a hospital—which directs police to intervene when they deem a person poses a danger to themselves or others—already creates a problem of relying on law enforcement to determine who fits this standard, and is too often abused to justify harassment of people experiencing homelessness and mental health challenges.

This proposal would create an even more disastrous outcome for people experiencing an emotional crisis by permitting law enforcement personnel to make subjective determinations about who is a threat, and forcibly remove them to a hospital. I commend the governor in understanding that our mental health system has been deprioritized and defunded, but this is not the solution. We need real investments in true public health responses.

As a person who has experienced forced hospitalization, nothing in the plan will lead to de-escalation, and will only bring about a sense of fear and anxiety among people who have, in many cases, already had traumatizing interactions with law enforcement.

In 2014 when I was living in the New York City shelter system, I was victimized by both NYPD and Department of Homeless Services Police, reported as an “Emotionally Disturbed Person,” held against my will unlawfully in numerous city and privately owned hospitals, and forcefully medicated without examination or evaluation.

This impacted my employment and my mental health, contributing to numerous PTSD episodes that leave me in utter fear and isolated. Even after exposing the treatment in a lawsuit, I was again subjected to abuse by the NYPD over a pretext traffic stop (no consent to search vehicle) in August 2023, and subjected to forced medication. If the governor’s plan is permitted, it will lead to confrontation between law enforcement and people in crisis, which NYPD tends to escalate. We will see more New Yorkers subjected to the abuses that I was by the NYPD, DHS and Health & Hospital Corporation. 

Following Mayor Eric Adams’ previous push to expand forced hospitalization, more people are already being involuntarily transported to hospitals by police. The city’s most recent data shows that officers involuntarily transported people to hospitals 7,060 times in 2024. That’s almost 20 people per day. It’s no mystery why all of that police intervention has not produced the safety or wellness the Mayor promised us. Forced hospitalization, initiated by police officers, is not treatment, but rather criminalizing people for a public health concern. 

Beyond being ineffective, the governor’s proposal could bring deadly results. It will not work to improve safety or public health—but we know what will. We need investments in the resources that keep people well in their communities, like supportive and affordable housing, community based mental health treatment teams, crisis respite centers, mental health clubhouses, and more.

With these resources in place, far fewer people will reach the point of crisis. But when they do, we need to have a fully-funded system to respond with mental health professionals, including peers, rather than police. When people with mental health needs do come into contact with law enforcement, we need off-ramps throughout the system—from pre-arraignment diversion to mental health courts and alternatives to incarceration—to connect people with the treatment they need, rather than languishing on Rikers. Finally, for people coming home from incarceration who have mental health needs, we need strong services and connections in place to help them quickly secure housing, treatment and any other support they need to rejoin their communities.

We clearly need to do something differently around mental health, and this is the time for our governor and state lawmakers to make sure that we’re investing in what works.

Victor M. Herrera is a member of Freedom Agenda, and a resident of Queens.

The post Opinion: Governor’s Forced Hospitalization Plan Will Criminalize Already At-Risk Communities appeared first on City Limits.