USAID Takedown May Be Illegal; Should Ambulances Carry Blood? State’s Abortion Fight

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

USAID Takedown May Be Illegal

The Trump administration’s recent gutting of the U.S. Agency for International Development (USAID) likely violated multiple laws and the Constitution, according to a ProPublica investigation.

No president, or their friends and donors, has completely shuttered an entire agency like this before — especially not one independently enshrined into law like USAID, the article stated. But the Trump administration began breaking laws from the start, ProPublica reported.

The former USAID chief of staff allegedly told employees that the administration did not have plans to reinstate most projects. He told staffers that the administration had a high tolerance for legal risk and was “willing to bend or even break laws to get what it wanted, and then take the fight to court.”

“It’s very hard not to see what’s going on as a Constitutional crisis,” said Peter Shane, JD, a law professor and Constitutional scholar. “It’s very scary and tragic.”

When Elon Musk and his IT team were given access to USAID’s digital network, they were able to see organizational financial systems and all information on all computers — including personal material from background checks, like employees’ credit histories and Social Security numbers.

Experts told ProPublica that giving Musk such access may have violated the Privacy Act of 1974, passed in the aftermath of Watergate, which requires individual consent before the government gives private information to anyone. It may have violated other laws and the Constitution itself too, ProPublica reported. Federal worker groups sued the administration for violating the Constitution, which so far is the only major challenge the White House has encountered in its USAID takedown.

“For all intents and purposes you are dismantling an agency created by Congress, and that’s a violation of the law,” said Lawrence Gostin, JD, of Georgetown University. “It can’t stand unchallenged, in my view.”

Should Ambulances Carry Blood?

Few ambulances are equipped to do blood transfusions even though it could save thousands of lives, according to reporting in KFF Health News.

Take for instance one 74-year-old woman who was mauled by dogs. She was on the blood thinner apixaban (Eliquis), which can lead to critical blood loss.

“The whole situation would have been different if they hadn’t given her blood right away,” said the woman’s niece, who is a nurse. “She very well might have died.”

Dying from blood loss is all too common in the U.S., with 60,000 people bleeding to death annually. Yet only 1% of ambulances carry blood, which requires specialized equipment to cool, warm, and deliver. Plus reimbursements are low, though changes are happening to increase payments to make carrying blood more feasible.

And with blood, every minute counts — especially if blood volume gets too low and the body can no longer perform essential functions.

In combat situations, the military relies on medics who carry blood in their backpacks to do emergency transfusions. Military research has shown that soldiers who get blood quickly are much more likely to survive.

Rural areas far from acute care centers and urban areas with heavy traffic may be considered “blood deserts.” Some emergency services agencies have programs to get these patients blood before they arrive at the hospital since they may not otherwise survive.

Missouri’s Battle Over Abortion

Abortion up through fetal viability was recently enshrined in Missouri’s constitution, yet Missourians can’t access it months later because of legal red tape, ProPublica reported.

In response to a reproductive rights amendment that passed in November, abortion opponents have filed bills to make it difficult to implement while they further strategize to prevent abortion rights, according to ProPublica.

One such attempt is a proposed amendment that would block most abortions, with exceptions for rape and incest, as well as gender care for youth, which is already illegal in the state. Republican lawmakers said that when Missourians voted to enshrine abortion, they may not have understood what they were voting for — a claim that has received pushback.

Missouri had a trigger law in effect, so when Roe v. Wade was overturned in 2022, an abortion ban took effect. Planned Parenthood, the primary abortion provider in the state, stopped performing abortions and since then, thousands of Missourians have gone to other states for abortions.

Even after the reproductive rights amendment passed, Planned Parenthood said it was limited by regulations targeting abortion providers and sued. In response, a state judge blocked some rules, like a 72-hour waiting period. But the judge left others in place, like specific dimensions for hallways, rooms, and doors and requiring providers to perform an invasive pelvic exam on patients seeking abortion. Abortion advocates say these requirements “are medically unnecessary and create barriers to care.”

The trial for this case is set to begin in January of next year.

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