Ruling on Abortion Medication, Recovery in Maui, Elections in Guatemala

A new ruling sets up a legal showdown over abortion pills.

A federal appeals court decision would restrict access to the common drug mifepristone. What happens if the case makes it to the Supreme Court?

I'm Leila Faldun, that's Michelle Martin, and this is up first from NPR News.

It's difficult because these are our people we're trying to take care of.

And rescue teams are still combing the area for human remains.

Elections are set for this weekend in Guatemala. A few years ago, the country was battling corruption, but that battle has stalled. Will voters decide to pick up the fight again? Stay with us, we've got the news.

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A federal appeals court issued a ruling on the abortion medication Mifepristone yesterday.

The F.D.A. approved Mifepristone 23 years ago, and today it's widely used medication. Abortions account for about half of all abortions in the U.S, and for now, Mifepristone is still available any place abortion is legal. But Wednesday's ruling sets the stage for the Supreme Court to weigh in on that.

NPR's Selena Simmons-Duffin is covering this story and she's with us now to tell us more. Good morning.

Good morning Michelle.

So tell us what this ruling does broadly.

So, a panel of judges at the Fifth Circuit Court of Appeals in New Orleans decided that Mifepristone should still have F.D.A. approval. But it should be much harder to access. So, as a reminder, this case came out of Texas from several medical groups and doctors that oppose abortion. They challenged the Food and Drug Administration's approval of Mifepristone and the changes it made later to how the medicine is prescribed. So, on Wednesday, this appeals court agreed with those challengers in part, and said the F.D.A. should never have made it easier to prescribe Mifepristone. Nothing changes yet, though, because the Supreme Court ruled in April that access to Mifepristone must remain the same until it gets a chance to weigh in.

So when could that happen and what could change at that point?

The Supreme Court could hear oral arguments in this case as soon as this fall. Its decision could be different than this appeals court ruling. But if it's the same, access to this drug would change dramatically. So, under yesterday's ruling, access would essentially be rolled back to before 2016, when doctors needed to prescribe this medication in person and there were other restrictions. Here's how Greer Donnelly put it She is a health law professor at the University of Pittsburgh.

It would cause pretty significant changes to the status quo in terms of how pills are accessed in this country.

Changes like no more telehealth appointments for Mifepristone and no access after those very first few weeks of pregnancy. And this would be nationwide. So the ruling would reach out into states that have been working to protect access to abortion and change things for patients and doctors in those states, too.

Was this ruling expected, or is it a surprise?

It was definitely not a surprise. This was a panel of three judges, they were all appointed by Republican presidents, two were appointed by former President Trump. In the hearing, they really hammered attorneys for the F.DA and Danco, which is the pharmaceutical company behind Mifepristone.

And, of course, this is the same court, the same Supreme Court that overturned Roe v. Wade last year. What is our expectation about how they're going to respond to this ruling?

I mean, we will have to wait and see what happens. But many legal experts say this case has some weaknesses, especially when it comes to the plaintiff's argument that they have standing to sue. So, Mary Ziegler is a law professor at U.C. Davis who's written books about the history of abortion.

My impression is that this is the fifth circuit trying to resurrect what had been a pretty flawed case. In the hope that this Supreme Court is conservative enough, that there's no case too weak or extreme, really, for this court on abortion.

I think many people will remember there was a separate federal case on Mifepristone, which was led by Democratic states. Where is that now?

Yeah, so. A federal judge in Washington state agreed with the challengers, who said that F.D.A. was being too restrictive when it came to Mifepristone. And Ziegler says these conflicting lower court rulings makes it more likely the Supreme Court will take this up. So that's what will likely happen next.

That's NPR's Selina Simmons-Duffin, Selina, thank you.

Thank you.

Residents of West Maui are starting to head back to their homes or what is left of them, as recovery from last week's wildfires continues.

Disaster responders have loosened restrictions on parts of the island. But with the death toll still climbing and thousands of people now homeless, some residents are frustrated by what they perceive to be a slow recovery.

NPR's Gabriel Spitzer has been reporting from Lahaina, Hawaii, and he's with us now to tell us what he's seeing. Gabriel, thanks so much for joining us.

Sure thing, Michelle.

Gabriel Just to start us off, what are you able to see?

Well, they fully opened the main road into West Maui for the first time since the fire struck more than a week ago. The actual burn area is still off limits. But we were able to visit an aid hub in a beachside park just a few miles north of central Lahaina. And many people there still had really basic needs, things like pet food and underwear. And honestly, there's no real end in sight for now, as this is likely to be a really long recovery effort.

Well, just from what we've all been able to see, the destruction was just enormous in Lahaina. Why do you think people say that the recovery is moving slowly?

Well, there's a lot to be cautious about as they go through the burn area. For one thing, it's extraordinarily difficult to identify and even to find human remains. I talked with a forensic anthropologist and she said it really takes a trained, expert eye to spot, say, bone fragments in the rubble. And then there's a huge concern about toxics. This fire burned so many buildings and vehicles that it unleashed just a whole stew of hazardous chemicals.

We've been hearing from local residents who say they're filling in the gaps that they feel have been left by their federal response. Are you hearing that?

Yeah, very much so. And this aid hub that we visited actually is a really good example, it's almost completely run by locals. And talking to folks there, you get a sense of the tension between these grassroots aid efforts and the government response. Jeff Gracia lives just across the street from the aid station, and he's been volunteering every day at the infotent.

It makes me kind of frustrated that like police telling us to start to move people towards the federally organized shelters. Just because we're more grassroots and not centralized, which is what they want, which is a valid concern. But also it's difficult because these are our people we're trying to take care of.

You know, speaking of that, I'm just trying to think about how this is all going to take place when so many people in the community are also victims themselves.

Exactly, I mean, I talked to so many people who went through hell themselves and then just put their heads down to go help their neighbors. I met a guy named Adam Perry, who's a former Wildland firefighter himself and who lives in Lahaina. He wound up sheltering with a few dozen other people in a concrete parking structure as the fire passed. His own house was leveled, but Adam says his firefighting training just kicked in.

Wow, well, Gabriel, before we let you go as we are speaking now. Just a small fraction of the victims have been identified, and an even smaller percentage of them have been named so far. Do you have any sense, or do people there have any sense of what people are going to expect to learn in the coming days?

Well, people have been told again and again that those numbers are going to rise. The search and rescue teams have only combed through about 40 percent of the burn area so far. And so this is all still what officials call phase zero, which is the recovery of human remains and the cleanup and eventually rebuilding. Seem a long way off, still.

That's NPR's Gabriel Spitzer from Lahaina in Maui. Gabriel, thank you so much.

You're welcome.

Thank you.

Now we're going to look ahead at the presidential election set for this weekend in Guatemala.

The first round in June was met with apathy, but it produced a surprise candidate and a real choice about where the country is headed to step back. A second, Guatemala had been a place of hope. A few years ago, a brave movement backed by the U.S and U.N was fighting corruption and impunity.

NPR's Ada Peralta is with us now from Mexico City to talk about how this vote could determine which way Guatemala goes next. Ada, welcome, thanks for joining us.

Hey Michelle.

So the country is down to a runoff vote between two candidates for president. As briefly as you can tell us about who they are and who's backing them.

So the establishment is backing Sandra Torres from 2008 to 2012.

Guatemala was once a focus of the U.

It's dead. There was a U..N..-backed task force that conducted hundreds of investigations, but they were kicked out of the country. Many judges and prosecutors have fled, or they've been bought off, and we've seen some of the effects of that. During the presidential campaign. The candidate who was leading in the polls during the first round was an outsider.

So you've been telling us about lots of problems with these elections. Given all that, what are the chances that this vote, however, it turns out, will be disputed?

Well, there's already a lot of uncertainty. The offices of Bernardo Revalo, the surprise candidate, have been raided, and the court actually ruled that he should be disqualified from the race. Electoral authorities said that they didn't know if that decision was legal. So the elections and the campaigns have continued.

And the elections are this Sunday, and when are we going to have preliminary results?

Overnight we should get them.

All right, that's NPR's Adar Peralta in Mexico, Adar, thank you.

Thank you, Michelle.

And that's up first for Thursday, August 17th. I'm Michelle Martin.

And I'm Leila Fawzid Up First is produced by Monsey Karana and Claire Marashima. Our editors are Kevin Drew, Larry Kaplow, Ali Schweitzer, Alice Wolfley and Diane Weber. Our director is Lily Quiroz, our technical director is Zach Coleman, with engineering help from Hannah Glovna.

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