On Monday, illegal abortion provider Kermit Gosnell was convicted of first-degree murder for the barbaric crimes he committed in his unsanitary Philadelphia-area clinic. Throughout his high-profile murder trial, anti-choice activists claimed that Gosnell’s case proved that abortion is always an inherently dangerous procedure — attempting to conflate incredibly late-term abortion services with first-trimester medication abortions. Even though their claims often fly in the face of scientific fact, abortion opponents have been largely successful at obscuring the medical realities of different types of abortion procedures.

That’s partly why restrictions on the abortion pill, which is medically known as mifepristone, are advancing across the country. Despite the fact that mifepristone is perfectly safe for women to take outside of the doctor’s office — an option that many women prefer, since it allows them the added privacy of taking the medication in their own home — anti-choice Republicans claim that more restrictions are necessary to protect women’s health. But these kind of restrictive state laws actually drive up the cost of the abortion pill, and don’t do anything to improve reproductive health care.

Here are five states where anti-abortion lawmakers are advancing medically unnecessary restrictions on the abortion pill, ultimately inserting themselves between a woman and her doctor:

1. MISSOURI: On Monday, Missouri lawmakers gave final legislative approval to HB 400, a measure that requires doctors to be physically present to administer the first dose of mifepristone and schedule an in-person follow-up appointment two weeks later. Critics of the legislation say it will interfere with women’s relationships with their doctors, as well as impose a serious burden on the women who must travel from different parts of the state to terminate a pregnancy. According to Paula Gianino, the CEO of Planned Parenthood for the St. Louis region and southwest Missouri, about 1 in 5 patients seeking an abortion at her clinic travel at least 100 miles.

2. NORTH CAROLINA: Anti-choice Republicans in North Carolina are currently pushing a package of anti-abortion bills intended to limit reproductive rights from several different angles. The most far-reaching measure is SB 308, which would require the clinics that administer medication abortions to adhere to the same standards as surgical facilities, including making costly updates to the building and requiring physicians to obtain admitting privileges from local hospitals. That’s a common method of attacking abortion clinics, and it often forces them to either stop providing the abortion pill or shut down altogether.

3. INDIANA: Earlier this month, Indiana lawmakers successfully pushed through SEA 371, a measure that is solely intended to prevent a Planned Parenthood clinic in the state from providing the abortion pill to its patients. Just like North Carolina’s proposed bill, the new law in Indiana requires clinic that administer medication abortions to make costly and unnecessary updates to their facilities under the guide of “protecting women’s safety.” When Gov. Mike Pence (R) signed the bill into law at the beginning of May, he repeated the popular anti-choice myth that the abortion pill is “dangerous” — despite all scientific evidence to the contrary.

4. MISSISSIPPI: At the end of April, Gov. Phil Bryant (R) approved SB 2795, which will require women to take the abortion pill in the presence of a physician as well as come in for a follow-up physical examination two weeks later. The measure takes effect on July 1 of this year — and it could represent a significant burden for women in the state. There’s only one abortion clinic left in all of Mississippi, and it’s fighting to remain open as anti-choice Republicans keep trying to shut it down.

5. LOUISIANA: Last month, the Louisiana Senate approved SB 90, a measure that would require a doctor who has completed a residency in obstetrics or gynecology to be physically present when administering medication abortions. If the bill becomes law, doctors who violate the new rule could be fined $1,000, imprisoned for two years, or both.

Requiring doctors to be physically present to administer the pill, even though most clinics don’t currently use that protocol, is a thinly-veiled attempt to ban abortion procedures conducted with the help of internet technology. Allowing doctors to prescribe mifepristone over a video conference helps improve low-income and rural women’s access to abortion services, since they may not be able to make a long trip to the nearest abortion clinic. Studies have shown that this type of abortion procedure is safe and effective. Nonetheless, anti-choice lawmakers continue to launch attacks at so-called “webcam abortions.”

The Jackson Women’s Health Organization, the last remaining abortion clinic in the entire state of Mississippi, has been fighting to stay open for more than a year — ever since Republican lawmakers enacted burdensome regulations solely intended to force the clinic to close its doors. Fortunately, thanks to a decision handed down from a federal judge on Monday evening, Mississippi’s only abortion clinic will be able to remain open.

U.S. District Judge Daniel P. Jordan III’s ruling is not final. But it does effectively block part of the new state law, HB 1390, that posed an imminent threat to the Jackson Women’s Health Organization. HB 1390 requires the clinic’s doctors to obtain admitting privileges from a local hospital, an arbitrary and medically unnecessary rule that doesn’t actually have anything to do with ensuring women’s safety. All seven of the area’s hospitals have denied those privileges, and the abortion clinic faced penalties for failing to comply with the state law. In fact, a hearing was scheduled for later this week so the state’s Department of Health could consider revoking the clinic’s license.

Thanks to Jordan’s ruling, however, that hearing will be canceled — and state officials won’t be able to halt operations at the Jackson clinic just because its doctors can’t get admitting privileges. According to the Mississippi judge, requiring abortion doctors to obtain those privileges from a local hospital represents a direct threat to women’s reproductive rights, since it may “result in a patchwork system where constitutional rights are available in some states but not others.”

The Jackson Women’s Health Organization has been the sole abortion provider for Mississippi women since 2002, and it has served the Jackson community for the past 17 years. Nancy Northrup, the president of the Center for Reproductive Rights — the group representing the clinic in its lawsuit against the state — said in a statement that the judge’s decision will allow “the women of Mississippi to breathe a collective sigh of relief.”

But Northrup also cautioned that the fight over these types of abortion restrictions is far from over. “The battle doesn’t stop at the defeat of this one law,” she pointed out.

The over-regulation of abortion providers is an incredibly effective attack on women’s reproductive freedom — rather than banning the procedure itself, abortion opponents hope to make it virtually inaccessible by forcing clinics to close their doors — and it’s advancing in states across the country. At least six other states are currently pushing legislation specifically intended to target abortion clinics. Just earlier this month, Alabama approved new restrictions that are directly modeled on Mississippi’s.

Last Friday, the U.S. Department of Health and Human Services (HHS) announced that it would allow states to pursue waivers letting them privatize their Medicaid expansions under Obamacare — an idea that took root with a deal worked out by Arkansas Gov. Mike Beebe (D) and the Obama HHS last month. Commentators and policy-makers heralded it as a “game-changer” for the reform law, as it could influence red states — many of which have high poverty levels and massive uninsurance rates — to extend coverage to poor people and help facilitate a major Obamacare provision.

But as Medicaid policy expert and George Washington University professor Sarah Rosenbaum smartly pointed out to the Washington Post’s Sarah Kliff in March, using federal dollars to put Medicaid-eligible populations into privately-contracted plans isn’t a novel concept at all — to the contrary, states have actually been doing it for decades through their increasing use of Medicaid managed care (MMC) arrangements. These arrangements contract beneficiaries’ care out to private insurers and providers, and a full “two-thirds of Medicaid enrollees now receive most or all of their benefits in managed care.”

Republicans have historically been strong proponents of MMC, touting its potential to cut costs while protecting poor Americans’ benefits. But with HHS’s new offer to institute a wide-scale version of this program now on the table, several notable Republicans are balking at the idea — including some who have pushed for similar measures themselves in the recent past:

1. TEXAS GOV. RICK PERRY. The 2012 presidential aspirant has been on an anti-Medicaid bender of sorts lately, declaring that “Texas will not be held hostage by the Obama administration’s attempt to force us into the fool’s errand of adding more than a million Texans to a broken system.” Yet, during his presidential run in late 2011, Perry struck a massive deal with federal officials allowing him to move close to a million Medicaid beneficiaries into managed care. Perry heralded the move in a press release, saying, “By approving Texas’ Healthcare Transformation and Quality Improvement Program Waiver, state and local officials can provide more efficient and effective care, and implement locally-tailored health solutions.” Apparently, Perry doesn’t view the Obama Administration’s offer on privatized Medicaid to be a similar opportunity for implementing “locally-tailored” solutions.

2. LOUISIANA GOV. BOBBY JINDAL. One of Obamacare’s most ardent critics, Jindal has steadfastly refused to expand Medicaid in his low-income state, saying that “Medicaid still operates under a 1960s model of medicine with inflexible, one-size-fits-all benefits and little consumer engagement and responsibility.” So far, he has stuck by that decision despite the urging of local lawmakers and his own state’s hospital chains. But back in 2011, Jindal aggressively — and successfully — pushed through an expansion of Louisiana’s MMC program, shifting 900,000 Medicaid and CHIP beneficiaries onto private, managed care. The measure was actually Jindal’s number one health care-related priority for 2012, and his administration publicly sold it “as a way to save taxpayer money and provide better care through coordination among doctors, hospitals and other medical professionals.”

3. MISSISSIPPI GOV. PHIL BRYANT. In an interview with Kaiser Health News, the Mississippi governor said, “I would rather pay extra to Blue Cross [to help cover uncompensated costs for the uninsured], rather than have to raise taxes to pay for additional Medicaid recipients” — a tacit endorsement of a managed care scheme. In fact, in 2012, Bryant signed a bill allowing Mississippi’s Medicaid division to increase the proportion of beneficiaries who could be placed onto managed care programs from 15 percent to 45 percent of the aggregate pool. Bryant has attributed his opposition to Medicaid expansion to his view that the program disincentivizes people “to find a better job, or to go back to school, or to get [into] a workforce training program.”

Mississippi — where about one in three adults is at least 30 pounds heavier than a healthy weight — isn’t on board with New York City Mayor Michael Bloomberg’s attempt to combat obesity rates by regulating large sugary drinks. In fact, lawmakers in Mississippi want to be absolutely certain their own local officials won’t implement the same kind of public health initiatives. A bill awaiting Gov. Phil Bryant’s (R) signature would prevent any Mississippi county from taking steps to address the obesity epidemic by regulating the food and beverage industries:

A bill now on the governor’s desk would bar counties and towns from enacting rules that require calorie counts to be posted, that cap portion sizes, or that keep toys out of kids’ meals. “The Anti-Bloomberg Bill” garnered wide bipartisan support in both chambers of the legislature in a state where one in three adults is obese, the highest rate in the nation.

The bill is expected to be signed by Gov. Phil Bryant, a Republican. It was the subject of intense lobbying by groups including the restaurant association, the small business and beverage group, and the chicken farmers’ lobby.

Mike Cashion, executive director the Mississippi Hospitality and Restaurant Association, says the bill is a direct reaction to Bloomberg-style government intervention in public health.

Despite the fact that a judge recently struck down Bloomberg’s soda initiative, preventing it from taking effect this week, public health experts still agree it was a good policy. Unlike other foods that can have some benefits if they’re consumed in moderation, sugary drinks have absolutely no nutritional value — and portion sizes have continued to spiral out of control anyway.

“There is really very clear evidence now that soft drinks are related to weight gain and obesity and, most certainly, diabetes,” Dr. Walter Willett, a nutrition expert at the Harvard School of Public Health, told NBC News. “We are in the midst of an epidemic of diabetes and obesity. The evidence is very clear that soda consumption has a role in the epidemic.”

Some proponents of Mississippi’s measure claim it’s simply an attempt to standardize nutrition policy across the state. Still, passing reactionary legislation to New York City’s attempt to address the obesity epidemic — which already accounts for 21 percent of national health care spending, a figure that’s likely to continue to rise since roughly 42 percent of Americans are projected to be obese by 2030 — is a step in the wrong direction.

Mississippi, one of the poorest states in the nation, is grappling with what to do about its Medicaid program. A deeply red state where the GOP controls both state houses and the governor’s mansion, Mississippi lawmakers are highly skeptical of Obamacare’s optional Medicaid expansion. So, in a last-ditch effort to protect the state’s low-income residents — as well as the fiscal security of the safety net hospitals that serve them — Democrats in the state senate sent Gov. Phil Bryant (R) a letter expressing their wish to introduce legislation that would automatically trigger a Medicaid expansion if Mississippi’s disproportionate share hospitals (DSHs) buckle under the weight of the payment cuts contained in Obamacare. Unfortunately, Bryant’s initial response to the proposal suggests he doesn’t fully understand the dire consequences awaiting his state’s safety net hospitals without an expansion of Medicaid.

For some context: as part of Obamacare’s efforts to make a dent in government health expenditures, the law contained some pretty deep cuts to so-called “DSH payments” — federal reimbursements to safety net hospitals that cater mostly to the poor and uninsured. Such hospitals need these reimbursements since their patients usually can’t afford the full cost of their care, and the DSH payments help make up for their resulting high uncompensated care costs. But Obamacare cuts these payments in half by the year 2019. The reason? When lawmakers first passed the reform law, they were working under the assumption that its Medicaid expansion would be mandatory, and that an influx of newly-insured Americans on Medicaid would reduce the federal government’s need to dole out DSH payments.

Of course, the Supreme Court ultimately rendered the Medicaid expansion optional and left it to states’ individual discretion. That threw a pretty big wrench into the Obama Administration’s plans, and is a large part of the reason the Administration has been begging states to grow their Medicaid pools; it’s also a large part of the reason that GOP governors in highly uninsured states like Arizona and Florida have embraced expansion, giving into pressure from hospital associations warning that they can’t afford to keep treating poor and uninsured Americans in the face of DSH payment cuts. But Bryant is betting that the federal government won’t actually follow through on the DSH cuts because they would violate the Supreme Court’s ruling that states cannot be “punished” for not expanding Medicaid:

“Without disproportionate share payments, many rural hospitals and hospitals that treat a disproportionate share of uninsured Mississippians will close,” Sen. David Blount, D-Jackson, said during a news conference that two dozen Democrats had in the Capitol rotunda. “People will lose jobs and people will lose access to health care, particularly in our rural communities.”

Bryant said in an interview a short time later he doesn’t believe the federal government will eliminate disproportionate share payments.

“We believe that they would be in violation of the United States Supreme Court decision, which said you can’t punish a state for not expanding Medicaid. And they certainly would be punishing us by doing that. So, I don’t think that ought to be a trigger,” Bryant told reporters in an office next to the House chamber, where he’d been having closed-door meetings with Republican lawmakers.

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