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The justices say they are nonpartisan. Cameron v. EMW Women’s Surgical Center puts that to the test.

The justices are feeling insecure.

Four members of the Supreme Court — Justices Clarence Thomas, Stephen Breyer, Samuel Alito, and Amy Coney Barrett — all gave speeches in the last several months complaining that they are often perceived, as Barrett put it, as “a bunch of partisan hacks.”

Justice Thomas summarized these justices’ complaints at a mid-September speech at the University of Notre Dame: “The media makes it sound as though you are just always going right to your personal preference. So if they think you are anti-abortion or something personally, they think that’s the way you always will come out.”

As it turns out, the Court will hear a case on Tuesday, Cameron v. EMW Women’s Surgical Center, which tests the hypothesis that the justices are “always going right to [their] personal preference” in abortion cases.

On the one hand, Cameron involves a Kentucky state law that restricts certain kinds of abortions — and it also involves an effort by Kentucky’s Republican attorney general, Daniel Cameron, to undo the pro-abortion work of his Democratic predecessor-turned-current-governor Andy Beshear. It is a classic partisan dispute over reproductive rights, with high officials from both parties maneuvering to get the policy outcome they prefer.

On the other hand, the specific legal issue before the justices has little to do with abortion. It’s a hyper-technical procedural case asking whether Cameron may appeal a particular court order directly, or whether he must instead file a motion seeking “relief from a judgment or order” in a federal trial court. (The Cameron case should not be confused with another case being heard in December, Dobbs v. Jackson Women’s Health Organization, which is an existential threat to Roe v. Wade.)

Viewed through a partisan lens, in other words, one would expect Cameron to end in a 6-3 decision with all six Republican appointees siding with Cameron and all three Democratic appointees voting against him. This is, after all, an abortion case. We know where each party stands on abortion.

But seen through the eyes of a nonpartisan judge, Cameron is exactly the sort of case where the justices’ votes are difficult to predict and where the final vote could break down on unconventional lines. Even in an era of extreme polarization, it’s not like the national leadership of either party has strong feelings about whether the proper vehicle for Cameron to seek relief is a petition for rehearing en banc, or a motion filed under Federal Rule of Civil Procedure 60(b)(5).

Each justice will need to make a decision about how they approach this case. Will they analyze the procedural question presented by Cameron with the same objective neutrality that most justices would apply to a similar case that did not involve a politically charged issue like abortion? Or will their personal preferences overcome their legal analysis?

There’s good reason to fear that at least five of the justices will fail this test. Just last month, in Whole Woman’s Health v. Jackson, the Supreme Court considered a Texas ban on abortions after six weeks of pregnancy, which was drafted specifically to evade judicial review.

It’s hard to imagine that the Court would have tolerated a similar effort to undermine the judiciary’s own authority if a different right were at stake, such as the right to own a gun or the right to criticize President Joe Biden. And yet, five members of the Court allowed this Texas law to take effect. Now, a Texas statute that unquestionably violates decisions such as Roe v. Wade prohibits the overwhelming majority of abortions in that state.

In Cameron, the stakes are much lower. No one questions that Attorney General Cameron is allowed to press his anti-abortion arguments in court, even though the parties in Cameron disagree about which court should hear those arguments.

But the case is worth watching nonetheless, not because it is likely to end in a landmark decision fundamentally reshaping abortion rights, but because it could tell us a great deal about whether the justices are capable of thinking in a nonpartisan way whenever they are confronted with an abortion case.

What’s the actual legal issue in Cameron?

The plaintiffs in Cameron challenge a Kentucky law that prohibits doctors from using the standard method to perform “dilation and evacuation” abortions. A left-leaning panel of the United States Court of Appeals for the Sixth Circuit struck this law down. They held that it violates the Supreme Court’s decision in Whole Woman’s Health v. Hellerstedt (2016), which required courts to balance “the burdens a law imposes on abortion access together with the benefits those laws confer” in determining whether a restriction on abortion is unconstitutional.

According to the Sixth Circuit, the Kentucky law effectively required many abortion patients to undergo a medical procedure that exposes them to “additional risks and burdens” without there being any evidence that the procedure is “necessary or provide any medical benefit to the patient.” (Disclosure: The Sixth Circuit’s opinion was authored by Judge Eric Clay, whom I clerked for in 2007-2008.)

About a month after the Sixth Circuit ruled, however, the Supreme Court handed down a new decision in June Medical Services v. Russo (2020). Chief Justice John Roberts’s controlling opinion in June Medical rejects Hellerstedt’s balancing test, and thus casts a cloud of doubt over the Sixth Circuit’s decision.

Cameron, in other words, has a strong argument that the Sixth Circuit’s decision striking down Kentucky’s law should be revisited because it is at odds with the new rule announced by Roberts in June Medical.

Which brings us to the specific, extraordinarily technical procedural question before the Supreme Court in Cameron. Ordinarily, if the attorney general of a state disagrees with a lower court’s decision striking down a state law, they would simply file an appeal in a higher court (or, perhaps, ask the same court that struck down the law to rehear the case). But it is unclear whether Cameron can appeal the Sixth Circuit’s decision because of an action taken by Cameron’s Democratic predecessor.

The anti-abortion law at issue in Cameron was signed in 2018 by then-Gov. Matt Bevin, a Republican. The next year, Bevin lost his reelection bid to current Kentucky Gov. Andy Beshear, a Democrat who served as the state’s attorney general for most of Bevin’s term as governor. Yet, while the 2019 election flipped the Kentucky governorship from red to blue, that same election made Cameron attorney general — meaning that the attorney general’s office flipped from blue to red.

All of this matters because the plaintiffs in the Cameron suit initially sued four state officials in their effort to block the Kentucky law, including then-Attorney General Beshear and then-interim health secretary Scott Brinkman. (Indeed, when the case was originally filed in a federal district court, it was known as EMW Women’s Surgical Center v. Beshear.)

Shortly after the lawsuit began, Beshear successfully sought to be removed from the lawsuit as a defendant — and he agreed that “any final judgment in this action . . . will be binding on the Office of the Attorney General, subject to any modification, reversal or vacation of the judgment on appeal.” This agreement initially had little practical impact because a Republican health secretary remained a defendant, and his office continued to defend the state law in court after Beshear was taken off the case.

But Beshear’s agreement to step away from the case took on new significance after the 2019 election. Shortly after becoming governor, Beshear appointed current health secretary Eric Friedlander, and Friedlander — who by this point was the only defendant who remained a party to the case — decided not to appeal the Sixth Circuit’s decision striking down the anti-abortion law.

Cameron, meanwhile, asked the Sixth Circuit to grant him “intervenor” status — which would enable him to appeal the Sixth Circuit’s decision without having to get permission from Friedlander first. The issue now before the Supreme Court is whether the Sixth Circuit acted properly when it denied Cameron’s request to intervene. Cameron is opposed by the original plaintiffs in the case, an abortion clinic and two abortion providers.

It should be noted that, even if Cameron cannot appeal the Sixth Circuit’s decision directly, that decision is unlikely to be the final word on whether Kentucky’s law is constitutional. Under the Supreme Court’s decision in Horne v. Flores (2009), Kentucky may ask a trial court to lift the previous order blocking the anti-abortion law if “‘a significant change either in factual conditions or in law’” renders continued enforcement ‘detrimental to the public interest.’”

Thus, Cameron could file a motion in the appropriate federal trial court at any time, claiming that the Supreme Court’s decision in June Medical made “a significant change” to the law governing abortion rights — and therefore that the court order blocking the Kentucky law should be lifted.

Yet, rather than taking this step, which even the plaintiffs in the Cameron case concede that Cameron could do, the attorney general decided to take the case to the Supreme Court to fight for his ability to intervene.

There are good arguments on both sides of the narrow procedural question presented by the Cameron case

The Sixth Circuit’s order denying intervenor status to Cameron is persuasive, but not completely airtight under existing law. It faults Cameron for waiting until the last possible moment to file his motion to intervene — nine days after the Sixth Circuit had already issued its decision striking down the Kentucky law.

As the Sixth Circuit explains, if nonparties to a lawsuit are allowed to intervene this late in the process — after a trial court and an appeals court have both ruled on the case — such nonparties could game the system. “Potential intervenors,” the Sixth Circuit warns, would have “every incentive to sit out litigation until we issue a decision contrary to their preferences, whereupon they can spring to action.”

Just as importantly, while the Supreme Court has not yet weighed in on whether a nonparty to a lawsuit may intervene this late in the process — Cameron concedes in his brief that the Supreme Court “has said very little about how to judge the timeliness of a post-judgment motion to intervene, especially one filed in a court of appeals” — the overwhelming weight of lower court decisions indicate that very late motions to intervene are disfavored.

The Sixth Circuit is not the only court to weigh in on this issue. A few other appeals courts agree with the Sixth, including the Tenth Circuit, which held that “‘only in an exceptional case for imperative reasons,’ may a court of appeals ‘permit intervention where none was sought in the district court’” — in an opinion by now-Supreme Court Justice Neil Gorsuch.

These decisions are not particularly surprising. Judges of all political persuasions understand that judicial economy is an important value. At some point, litigation needs to come to an end. And that may not happen if nonparties can inject themselves into a case at a very late stage and insist that a new panel of judges should hear the case.

The best argument for Cameron’s position, meanwhile, was articulated by the Ninth Circuit in Day v. Apoliona (2007), a case where the state of Hawaii waited until after that circuit court had ruled on a case before it filed a motion to intervene. Although Day faulted Hawaii for waiting so long when it could have intervened “in this matter at any time during these proceedings, both before the district court and before this Court on appeal,” it ultimately decided to excuse Hawaii’s delay because of the court’s “discomfort with what will occur at this stage of the proceedings if its motion is not granted.”

If Hawaii was not granted intervenor status in Day, the Ninth Circuit explained, “no petition for rehearing can be filed in this Court, and there will be no opportunity for the Supreme Court to consider whether to” hear the case. Thus, Day granted intervenor status to Hawaii so that it would “not foreclose further consideration of an important issue.”

Day also captures an important judicial value which is shared by many judges across the political divide. When possible, litigation should be resolved based on the best reading of the law. And states shouldn’t have their laws permanently enjoined by a federal court because of technical procedural errors by the state’s lawyers.

At this point I will pause to note that, if I were a justice, I would vote to affirm the Sixth Circuit’s decision denying intervenor status to Cameron. While I agree with Day that state laws should not be subject to unappealable permanent injunctions because their lawyers filed a motion too late, that problem does not exist in the Cameron case. Under Horne, Cameron may still challenge the court order blocking Kentucky’s law by filing the appropriate motion in a federal district court.

But a reasonable judge could also conclude that the state’s interest in being able to directly appeal an adverse court order overcomes the ordinary rule that motions to intervene should be denied if they are filed too late.

All of which is a long way of saying that, if you ignore the fact that Cameron happens to involve an anti-abortion statute, the specific legal question presented by the case is both fairly difficult and not especially political. A truly nonpartisan Supreme Court could come down either way in the case, with liberal justices potentially siding with Cameron and conservative justices siding against him.

Cameron, in other words, is a kind of lie detector test for the Supreme Court. The justices tell us that they are capable of deciding politically charged cases in a nonpartisan way. But if this case ends with all six of the conservatives voting for the anti-abortion attorney general, and all three of the liberals voting against him, we will know that they aren’t telling the truth.

A chart of Covid-19 cases that led to deaths, by age. German Lopez/Vox

“We’ve known from the beginning that Covid is relatively mild in children compared to adults — and especially older adults,” Shamez Ladhani, a pediatric infectious diseases specialist at St.  George’s Hospital in London, told me.

The risk is even lower for children under 10, experts told me. Infants under 1 year old might be at higher risk than slightly older children due to their immature immune systems, but the data is way too thin to draw any conclusions for infants.

Another way to gauge risk is to compare Covid-19 to other significant causes of death. Covid-19 has killed 280 children under 18 from January through September 2021, the time span in which the alpha and delta variants were active. Flu and pneumonia, heart disease, drowning, guns, and motor vehicles were all deadlier to children during the same time periods annually from 2015 to 2019 (the latest years with available data).

A chart comparing 
Covid-19 deaths to other causes of deaths.

German Lopez/Vox

As one example: The number of children under 18 who died in vehicle crashes from January through September in recent years was nearly six times higher than the number of children who died of Covid-19 from January through September of this year.

These numbers can help contextualize risk. “One of the best ways to communicate risk — and for me, personally, to even think about risk — is to compare the risk of something I don’t understand to the risk of something I do,” Stephen Kissler, an infectious disease researcher at Harvard, told me.

Covid-19 deaths are likely lower than they would be if people had not engaged in social distancing and other precautions, meaning they could increase as the country shifts back to a pre- pandemic normal. But many parts of the country already have undergone that shift with only a relatively small increase in Covid-19 deaths among children, with surges concentrated among older adults, even as the delta variant spread.

What about other risks of Covid-19 among children?

One concern is multisystem inflammatory syndrome in children, or MIS-C, which appears in some children after a Covid-19 infection. But the risk of MIS-C is also very low: Around 4,700 MIS-C cases and 41 deaths were confirmed in the US as of August 27, 2021, according to the Centers for Disease Control and Prevention. At that point, there were 3.7 million total Covid-19 cases among children 17 and under in the US.

Long Covid is also a concern. A huge problem is that the research on long Covid in kids is very thin — so thin that some experts didn’t feel comfortable talking about the issue much, if at all.

Still, the research we do have, experts said, suggests long Covid is not a big threat to kids. Looking at a sample of 1,700 children ages 5 to 17 in the UK, a study in The Lancet Child & Adolescent Health found that less than 2 percent experienced symptoms for at least eight weeks, and symptom severity appeared to decrease over time.

One possible explanation: Long Covid seems to happen more often after severe illness, which is less common for children. A study analyzing private health care claims, by the nonprofit FAIR Health, found hospitalized Covid-19 patients were almost twice as likely to develop “post-Covid conditions” as patients who were symptomatic but not hospitalized.

Finally, there’s the risk children’s transmission may pose to others. “If kids continue to get infected, others will continue to get infected who are unvaccinated — and the virus will continue to mutate,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “It’s not just that we need to protect the kids. It’s this larger question.”

Children do appear to transmit the coronavirus less than adults do, Ladhani said. One possible explanation: Kids are less likely to develop symptoms than older groups, and have those symptoms for shorter periods. And the coronavirus is less likely to spread if it’s not being coughed or sneezed out into the world.

Children’s defenses against Covid-19 have held up, even against delta

The coronavirus, thankfully, remains a small threat to children overall. What’s less clear is why kids haven’t been hit harder by Covid-19.

The explanations so far are largely speculative.

One possibility is children’s immune systems are better built to deal with novel viruses. After all, to young immune systems, most viruses are novel. Outside of some defenses passed down by parents and the protection from childhood vaccines, kids adapt to the pathogens around them through repeated exposure. So when a new coronavirus began to spread, the theory goes, children were better able to deal with the threat. But for adults, especially older ones, encountering a new pathogen is rarer, and so their immune systems perhaps haven’t been able to deal with a novel threat to the same degree as their younger counterparts.

Two studies, by Herold, point in that direction, finding that the adaptive part of the immune system appears to be more active in adults than children. Herold suggested that’s because kids’ “innate response is better at dealing with Covid and perhaps other novel pathogens in general.” (For more on this research, I recommend Smriti Mallapaty’s recent article in Nature.)

Another possibility is that children, generally, have fewer health problems that put them at risk of severe illness from Covid-19. A range of comorbidities are known to make the virus a much bigger threat, including asthma, obesity, cancer, and heart disease. Some of these are more or as likely during childhood, but many, like cancer and heart disease, are more likely to happen with older age. As a result, kids “will cope better when they are infected,” Ladhani said.

There are other theories, from social and biological differences in coronavirus exposure to potential side effects of non-Covid vaccines. But, again, this field of research is just starting, and no one has a sure explanation — the ultimate contributor could be something we don’t even know about yet.

Given the uncertainty, experts also can’t say that kids’ protection against Covid-19 will hold true forever. It’s possible a future variant will end up more dangerous for children, even if that hasn’t been the case with delta. It’s yet another reason to mitigate the spread of the virus as much as possible: to deny it more chances to replicate and mutate into something that children’s defenses might not so easily conquer.

Different people will have different risk tolerances

The data isn’t going to lead every parent to the same conclusions. Some people want to wait to return to normal until Covid-19 cases decline, after the current wave of delta fully eases (as is already starting to happen), or until everyone can get vaccinated, including kids. Others see higher vaccination rates in their community or nationwide as a prerequisite to easing up on precautions. Many are already moving on, at least to some degree, ready to put the virus and its impacts on day-to-day life behind.

Among the experts I’ve spoken to over the past several months, there are still divisions on when the time is right to ease up. “These are really hard, personal decisions,” Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, told me. “There’s not a one-size-fits- all.”

There have been some points of agreement. For one, some places with lots of children, particularly schools, should do what they can to stop transmission, such as widespread testing, masking, and better ventilation. As soon as a vaccine is available, children should get the shots for an extra layer of protection, not just for themselves but also to prevent wider coronavirus spread and to block new variants.

At the same time, experts also widely agree the general risk of Covid-19 illness will likely never be zero again. The virus will be weakened over time through natural immunity and vaccination, but it will become endemic — continuing to spread in some form, perhaps in new variants, and potentially causing waves of severe illness and death on occasion. That suggests people will have to tolerate some level of risk going forward. And at least for kids, Covid-19 already isn’t too far from the risks people widely accepted before the pandemic.

Kids’ resilience against Covid-19 offers a way out of the pandemic

As the world transitions from the pandemic to endemic stage of this coronavirus, children’s natural defenses against Covid-19 could prove crucial — providing a relatively safe route to much higher levels of natural immunity across the population.

“Over time, as SARS-CoV-2 becomes an endemic virus, basically everybody is going to get exposed to it multiple times by the time they turn 5 or 10,” Kissler, the infectious disease researcher, said. The repeated exposure — and build-up of immunity it produces — could turn the virus into something more like the common cold or seasonal flu than the pathogen that’s warped our lives since the spring of 2020.

Obviously, the continued spread among children would be a big problem if kids generally got very sick with Covid-19. Since that’s not the case, the process can play out with few risks to kids themselves — especially if it’s bolstered by childhood vaccines.

 Amanda Andrade-Rhoades/Washington Post via Getty Images
Fourth grade students at Stratford Landing Elementary School in Alexandria, Virginia, on August 23. The federal government seems to be on the verge of approving vaccines for at least some younger children.

There are some lingering questions: How durable is natural and vaccine-induced immunity to Covid-19? What will be the earliest age at which someone can get vaccinated? Will a new variant overcome the effectiveness of the population’s immunity that’s been built up? The answers could shape, or completely alter, how the transition to endemic Covid-19 plays out.

But other viruses have followed this path. Earlier strains of the flu that killed up to millions of people worldwide are still present in some form today. But as humans have over time been repeatedly exposed to these viruses, they’ve built population-level immunity to what once was a more vicious threat. And a deadly pandemic in 1889, originally believed to be caused by the flu, may have actually been caused by a coronavirus that is still with us as one of the many pathogens causing a common cold.

Coupled with vaccines and potential medical breakthroughs in treatment, Covid-19 could follow a similar trajectory. The wonder of vaccines is they can speed up this process, giving people the immunity that they once had to earn through a serious — and at times deadly — bout of sickness.

In short: The world has been fortunate, throughout the pandemic, that kids aren’t hit hard by Covid-19. But that luck also may extend to the pandemic’s aftermath — to ensure we can move past the coronavirus once and for all.

“There are zero downsides to getting rid of the debt ceiling. It is utterly meaningless as a policy guide or institution; it is good only for grid-locking government. And, in the modern age, gridlock is an enormous problem, given the huge pressing needs policymakers should be addressing,” says Bivens, of the Economic Policy Institute.

Others note that it could take away an opportunity for Congress to debate fiscal policy. But many feel like that’s a moot point, given debt ceiling standoffs are rarely about any specific spending anymore, but rather about weakening the electoral advantage of the party in power.

“The debt limit was one of those stoppage points that has encouraged and allowed for conversations over how to address health care costs, tax policy, how to address fiscal reforms,” says Marc Goldwein, policy director at the Committee for a Responsible Federal Budget. “We haven’t seen that in any of the recent increases. An argument against repealing it is you lose that stoppage point.”

Rather than do away with the debt limit altogether, some experts have proposed options like giving the president the ability to propose a suspension that Congress would need to override if it disagreed, making it tougher for legislators to jam up that process. A proposal that Akabas of the Bipartisan Policy Center supports would pair this proposal with a mandatory debate on fiscal policy to force Congress to confront spending issues.

Whether there’s enough political will to make any of these changes is heavily in doubt; both parties have used this must-pass legislation to make political statements when it suits them.

“I’m not sure there’s all that much desire to take it off the table in terms of members of the minority losing this political thing they have to fight with,” University of Texas Austin government professor Alison Craig told Vox.

Instead, it seems as though lawmakers are comfortable getting right up to the brink — and running the risk of a default again and again.

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