Most of us know what it feels like to be frustrated with the US health care system, but much needed change is happening as the industry is working hard to move away from outdated payment models to a system that pays providers for the quality of health care, not the quantity.

Called Accountable Care, this new approach prioritizes better patient outcomes and expanded access to care.

Accountable for Health is a non-partisan organization working with policymakers to accelerate this movement.

To learn more, visit accountableforhealth. Org. I'm Dr. Laura Santos, host of The Happiness Lab podcast. As the US elections approach, it can feel like we're angrier and more divided than ever. Please stick to policy.

Don't get personal.

But in a new hopeful season of my podcast, I'll share what the science really shows, that we're surprisingly more united than most people think. We all know something is wrong in our culture, in our politics, and that we need to do better and that we can do better.

Listen on the iHeartRadio app, Apple podcasts, or wherever you listen to podcasts. Lemonada. Major ruling in Florida on abortion rights. Florida Supreme Court saying the state's six-week abortion ban can take effect in 30 days. The ruling allows a trigger law to go into effect, banning the procedure before most women even know they're pregnant. If I saw a patient at six weeks and three days on Monday, I could provide the care for her. If I saw that same patient today, I would have to tell I am so sorry. I cannot provide your abortion care. All these regulations are trying to put on women.

I mean, they're making us second-class citizens.

If you've been following Florida news this year, you know that it has an extreme near total ban on abortion. Since May first, 2024, Floridians can't get an abortion after six weeks of pregnancy, which you might remember from season one, is actually closer to just four weeks of pregnancy. Add on a 24-hour mandatory waiting period, and getting an abortion in Florida is nearly impossible before that cutoff. But while Floridians are living with this new reality, they're also gearing up to change it at the polls. This is The Defenders, a show about the fight for freedom in a post-Roe America. I'm your host, Gloria Rivera. This week, we're zeroing in on Florida, the third largest state in the country by regulation and a battleground for abortion access this November. Like Arizona, Florida has abortion on the ballot. If passed, their ballot measure, Amendment 4, would protect abortion access in the state Constitution and reverse the six-week ban. It's a massive opportunity for protecting rights in Florida and improving abortion access across the South. Pre-dobbs, Florida was one of the last states in the Southeast with abortion access, up to 24 weeks. Every year, some 40 to 60,000 Floridians had an abortion.

Plus, patients from states like Louisiana, Georgia, Arkansas, Mississippi, and Alabama all traveled there for care. That all changed when Roe fell in 2022. Shortly after, a 15-week ban went into effect, and it was devastating. But the state was still a last resort for women coming from surrounding states with total or near total bans. In the last five years, the number of people traveling to Florida for abortions tripled. Then came the six-week ban in May of this year. Let me just point out that all of this is happening, even though the majority of Floridians oppose abortion restrictions. Not surprising because, like we've talked about before on this show, abortion rights are popular and a winning political issue. Organizers in Florida know that, and they are working harder than ever to ensure another win come November.

I think we have a lot of work to do, and it's our to keep giving it our all to this campaign. But I believe that we will win because I don't think Floridians want politicians making medical decisions for them. They don't want politicians in their doctor's office with them. I think they are perfectly capable of making health care decisions for themselves.

That's Lauren Brinzel, the campaign director for Floridians Protecting Freedom. They are one of the organizers behind the ballot measure, Yes on Four, and are working around the clock to mobilize voters. With the election Right around the corner, I had the chance to talk to Lauren about what it will take to pass and what's at stake if it doesn't. Lauren's path into repros started early. When they were a 21-year-old college student, they started volunteering at the Planned Parenthood at their campus.

It was just this totally transformative experience where I was talking to patients every day. You would talk to patients who are 18-year-olds who are getting birth control and are super excited to come into the office. Then you talk to somebody who just found out that their partner was having an affair and they're having an STD scare. Then you would talk to somebody who was planning to have an abortion who needed finance funding. Then you'd be back to somebody who was super excited to get birth control or was just scheduling their path. I really got to experience through that the full range of what reproductive health care means to people. I also got such insight in scheduling abortion appointments into how vital that service was. After that, I moved into a front desk position at the Planned Parenthood, where I got to see patients both before as they were checking in and after as they were coming out of their abortions. I was struck by how supportive the women, predominantly women, working in the Planned Parenthood were. I was struck by how kind and generous the doctors providing care were. It was so evident how impactful in a positive way this care was to people.

From there on, I started organizing, and I haven't loved rebro since.

When you think about your experience at that first job or the front desk, what did it show you about a patient's own experience accessing abortion?

When I started in this work, there was solid access in the state of Florida to care. Until 2021 and 2022, that's really when we started to see the rise of anti-abortion legislation in this state, we had a parental notification process, which is in the Florida Constitution that's been set since the early 2000s. We had mandatory consent requirement with some state guidance that provides information on vague clinics. But it was predominantly about the relationship between a patient and their doctor. That also meant that in Florida, we used to be able to provide later in pregnancy abortion. There is such a limited access to abortion later in pregnancy, and it's so stigmatized. And now we have almost nothing in state. We have a six-week ban, and it is a six-week and zero-day ban. And we have a 24-hour waiting period, which means that it's actually five weeks and six days. The average time someone finds out they're pregnant is five weeks and five days. So if you aren't on top of tracking your menstrual cycle, if you're the average patient, you have 24 hours to find an appointment.

Oh, my God. Hearing it put like that, it gives me chills, right? You have 24, which is impossible, which is an impossible path for It used to be...

We used to have over 50 providers in state. Again, we used to be able to offer specialized care in state. We had more comprehensive access in more rural counties. That has all been decimated by this law.

What does a Floridian have to do right now just to get an abortion after six weeks? People have to travel. What are the wait times? What are the nearest realistic options?

If you are in a dangerous medical circumstance, you allegedly can have one provider sign off on care for you. But there have been multiple circumstances where providers have been too afraid to sign off on care and have had to wait until patients are nearly dying. If you have a fatal fetal abnormality, you have to have two physicians sign off on an exemption for you. If you are a survivor of rape or incest, and you're trying to get an exemption, it's pretty unclear right now how you can go about doing that. And after 15 weeks, you can't seek any exemption for rape or incest. And then if you are the vast majority of abortion patients, if you're after five weeks and six days, you have to travel out of state. Right now, the average cost to travel out of state and obtain care is between $3,000 and $4,000, which is make or break money for a lot of people. So you have to compile thousands of dollars of money. And then your closest state is North Carolina. Abortion is banned at 12 weeks there. So if your past 12 weeks, your closest state is Virginia. And Virginia only sees 16 to 20,000 patients a year, so they can't fit all of Florida's patients.

So you probably have to travel to DC, New York, or Illinois in order to obtain an appointment.

Which is just... I mean, not only is it not possible for a lot of Floridians, but it's nowhere near sustainable. It's not providing care, period.

Correct.

Let's just talk about where Florida is geographically, for our listeners, because we're not all super geography nerds. But let's talk about what Florida looks like and what is required to access care in Florida.

In Florida, the vast majority of our state is surrounded by water, so there's nowhere to go but up and out. Then when you get to our northern border, every state that's around us has entirely banned abortion or has a six-week ban in place. So no different than Florida's law. So if you're over time in Florida, you're over time in those states as well. You think about I'm in Miami Dade right now. You think about somebody from Miami Dade having to go out of care for a state. The closest state is North Carolina. That's an over 10-hour drive. It's not accessible. The real story of Florida is that nobody can intake our patients. There is an influx of tens of thousands of patients with nowhere to go, and you can't just stand up new health centers automatically, take new doctors.

I remember reading over 80,000 abortions of performance in a year, right? Okay, what are the numbers that we're asking abortion providers in other states that still have access to absorb?

We know that it is over half. The provider is actually We don't know how bad it is yet.

Wow.

It is more than 40,000, but we don't know how many more than 40,000 yet.

We don't know how bad the problem is going to be right now.

Oh, we are not prepared for how bad the problem is going to be. It's not even that we don't know. I'm hearing stories from two different providers in the past week that are not in contact with each other. Totally different geographic areas. Stories of private OB-guinds who are unwilling to provide miscarriage management. To pregnancies that have no cardiac activity because of the risk of going to prison. So it goes beyond just the influx of patients getting out. The crises that we're seeing in state, there's been almost every provider I've talked to has told me that they have women that come in to find out about the ban and are immediately threatening suicide, that they're having to have crisis psych response teams. What is on the horizon because of Florida's abortion ban has devastating national consequences.

We're going to take a short break, but when we come back, we'll get into the day that changed everything for Lauren, the day the Florida Supreme Court issued two major rulings on abortion, setting the ballot initiative into motion. This year in November, voters showed up for critical elections in states like Ohio, Pennsylvania, and Virginia, where big issues from abortion access to Supreme Court seats to fair voting districts We're on the ballot. Next year, there will be thousands of races happening, from new ballot initiatives to primaries and the general election, and every one of these races will have an impact on reproductive justice. We're talking everything from autonomy over our bodies to freedom and democracy. To learn about the issues in candidates in every race and on every ticket, visit www. Vote411. Org. To learn more about how to register and cast your ballot, go to www. Vote411. Org. That's www. Vote411. Org. Make sure you vote in every race on your ballot, because if you vote and you get your friends and family to vote, you're a defender, too. The Levi Strauss Foundation outfits the movements and leaders pushing us towards a more just and abundant world through investments in worker rights and well-being, democracy, reproductive justice, and immigrant rights.

For For more information, visit levi StraussFoundation. Org. That's levi-s-t-r-a-u-s-s-foundation. Org. Okay, let's time travel back to April first, 2024. That was the day the Florida Supreme Court issued two monumental decisions around abortion.

Florida's Supreme Court ruled Monday, a law triggering a six-week abortion ban can go into effect, but it may not stay that way for long. In a separate decision, the court cleared the way for an abortion protection ballot initiative.

The court will leave it to Florida voters to decide whether to restore abortion rights when they go to the polls in November. The first ruling was a big blow. No abortions after six weeks. That's extreme. Plus, Lauren told us it's really five weeks and six days because of the mandatory 24-hour waiting period. They were shocked.

Immediately was just rage. I don't think that I've been that angry in my life before. It's just a total disconnect from the reality of everyday Floridians' lives.

The second Supreme Court decision offered a glimmer of hope. This November, Floridians could pass a ballot initiative that would protect abortion rights up to fetal viability for 24 weeks.

Floridians will be able to vote on that measure that reads, No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient's health as determined by the patient's health care provider. The measure will need 60% support to pass and override the six-week ban set to take effect in one month.

This was a life-changing day for Lauren. Along with other organizers, with Floridians Protecting Freedom, they had already been hard at work for months petitioning to get abortion on the ballot. First, they had to go through the petition process, and boy, Florida law does not make that easy. Lauren told me they had to get about a million signatures, a million, for the initiative to qualify. That was just step one. After that, the state had to actually validate the petition, which Lauren says came with a huge price tag of $1.5 million. All this just to get a Citizens initiative on the ballot in November.

So it's just egregiously expensive, which means that everybody who contributed to this campaign, whether it be by collecting petitions or by providing funds to this campaign, had to take a huge gamble on what the Supreme Court would do.

Well, let's talk about the ballot Initiative a little bit more specifically. So if this is passed, what will the Ballet Initiative do?

The Ballet Initiative will remove our near total abortion ban It will reestablish the laws that we had in Florida before 2022. It'll bring us back to the legal framework that we previously were in that everybody was fine with. Our major hope is that we'll also be able to reverse the 24-hour waiting period here in Florida.

And is that included in this initiative, the 24-hour? Yes. Yes. Okay. Because when I read it, it was very simple, and I was grateful because some of the other ballot initiatives that I've read took me a few reads. This one, I was like, I think this just reverses everything.

That was our goal. We tried to write it so that Florida voters could absolutely understand what it was trying to do. One of the things with the initiative process is that it could be really confusing for people to understand what's going on. I think of all the times that I voted on an initiative here in the state of Florida, and it's been about things like property taxes or homestead exemptions that I really have to look up what the initiative is actually doing. And with an issue like abortion, we wanted to make sure that voters knew exactly what we were trying to do.

Like Lauren said, ballot initiatives can be confusing for voters. That's why I was so struck when I read this one. It's clear and direct. It states, no law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient's health, as determined by the patient's health care provider. This amendment does not change the legislature's constitutional authority to require notification to a parent or guardian before a minor has an abortion. Let's talk about what it's going to take to pass this amendment. We have seen, thankfully, Every time abortion is on the ballot since Dobbs, abortion rights have prevailed. Thank the good Lord. We're hoping that's what happens in Florida, but the bar is set a little bit higher. Let's talk about a super-majority. That is what is required here. What does it mean?

We have to get to 60% in the state of Florida. The things that make me feel solid about that threshold are that Floridians have passed numerous policies under a 60% threshold that folks outside of the state would be surprised about. We have medical cannabis because of a Citizens Referred Initiative. We have a $15 minimum wage. We have We have a ban on indoor smoking. We have the rights for formerly incarcerated individuals to vote. Floridians are capable of making really good decisions. It's really important that we don't politicize this issue. That's one of the reasons why I'm really proud to work in a team that's full of providers and full of people with repro experience, because they don't think of this as a hyper-political issue. They think of it as an issue that has been politicized, which is a very large distinction. We don't want to turn off voters who are supporting one candidate or another. It is not the mission of this campaign to dictate who you vote for in the 2024 election. It's the mission of this campaign to say, You need to vote yes on Amendment 4.

Up next, Lauren shares what is happening on the ground right now to make Amendment 4 a reality and why they are convinced it will pass in Florida. The William and Flora Hewlett Foundation believes everyone should have a meaningful opportunity to thrive, no matter who they are or where they come from. But right now, people in the US and across the world are confronted by enormous challenges changes, from catastrophic climate change and pervasive inequities to attacks on democracy itself. Institutions at every level are struggling to provide solutions that work for all people. And there's a growing lack of faith in each other and even in the possibility that progress is possible. That's why the Hewlett Foundation supports a diverse set of creative thinkers and problem solvers who engage across differences, advance constructive dialog, and address institutional failures. Whether through its work in gender equity, democracy, environment, education, or the arts, the Hewlett Foundation seeks to harness our collective capacity to build a world where all people have the an opportunity to thrive. Learn more at hewlett. Org. Women's Bodies are at the center of today's cultural conversations. We face overt regulations that dominate the headlines, but we also face quiet regulations.

They are so entrenched in our everyday lives that decisions around our bodies and how we feel about them are no longer ours alone to make. Because so much of what women experience is shrouded in secrecy, treated as an afterthought, or just blatantly ruled by societal expectations and norms, the simple act of exchanging stories becomes the most powerful tool we can use to stay informed. Introducing Unruly, an eight-part podcast from Flamingo, highlighting the not often discussed ways women's bodies are subjected to needless oversight. Hosted by writer, curator, and activist Kimberly Drew, Unruly tackles conversations around body neutrality, wellness capitalism, menopause, and more. Because information is power, and your body is your business. Unruly is available wherever you get your podcast. Learn more at shopflamingo. Com/unruly. What I want to know right now is for you, let's see, heading into the election, what is your day-to-day look like? What does every day look like for you?

Everyone on this campaign is waking up every morning and going to bed every night, trying to do everything we can ahead of November. We have a really phenomenal team of organizers who have already started their door-knocking process. They've already started phone banking. When we did phase one of this campaign, we set up hubs all across the state. We had over 50 hubs in the state of Florida where people could come get petitions so that they could gather signatures in their community and then drop them off to be submitted to us. We're trying to rebuild that model right now for this canvassing I want to circle back for a moment and just get specifically to speaking to not the opposition, but the people that you have to convince, right?

How do you go about that? What's the thought process? What's the in speaking to conservative and independent voters on this issue?

It's another area where I feel stories are so incredibly instrumental to the work that we're doing. I also think that it's uplifting how ridiculous it is to trust politician with your health care over a doctor. That's something that is resonant with a wide variety of Floridians because they don't want politicians making medical decisions for them. They don't want politicians in their doctor's office with them. So for swing voters, it's incredibly important for us that we talk about the realities of what it means to allow politicians to control your health care. And it's important that we share the stories of everyday Floridians who have experienced the harms of these abortions of bands.

What are the stories that you've heard that have stayed with you that come to your mind quickly when you're thinking about talking to not only Republican and independent voters, but just... I don't know that you just can't let go of.

I got a chance about a year ago now to meet a man named Derek Cook. And Derek's wife, Anya, was pregnant, and she was hemorrhaging and lost half of the blood in her before she was offered a medically necessary abortion. She had come in for care two days before that happened. I was on a call with him, and he talked about the loss of his child and the devastation and the trauma that caused him. And then he talked about that moment calling him into action. And he's been volunteering with an organization called Men For Choice consistently over a year since his family experienced this. I come back to it regularly if I'm feeling tired or sad or unmotivated. And it's like, who am I to not show up every day in the same way that he shows up? Who am I not to advocate for others in the same way that he is advocating for his wife? And so that is a moment that I constantly come back to. Seeing somebody translate a devastating trauma into a desire to change his state for the better is one of the most impactful things that I've seen on this campaign.

I love that. That's really beautiful. Who am I? When you first started telling that story, I was thinking, Oh, I want to hear a story about a person who's pregnant. But I like this idea of someone intimately adjacent being so invested, so therefore, why can't you? Yeah.

Not everybody in the state of Florida should have to experience trauma at the level that the Cooke family did. But everybody in this state better care about them and what they experienced because we have a responsive... We are the only ones who are going to protect us from what's going on here.

You said that story is one that you reflect on when you're feeling sad or unmotivated. When somebody literally knocks on my door or the phone rings, what am I going to hear? How do I get to hear that story?

Right now in the organizing realm, we're honestly doing just a ton of public education about what the laws are here in Florida. People know that they don't like extreme abortion bans, but they don't know that we have one in effect. Very oftentimes, people don't find out about the ban until they're trying to actively seek care. It's incredibly common story that we're hearing right now. We are trying to let everybody know that there is almost all care banned in the state of Florida already.

But there's also the other subsect of people that they don't need to be convinced on this issue, but they do need to be convinced that they should go to the polls and vote this November.

That is a ton of the work that our organizers are doing at this stage in the game, is not trying to persuade people to vote yes on this, but trying to persuade people to out to the polls and vote in November on this issue.

Okay, so let's talk about an ideal world in which this initiative passes. What happens?

We have a fabulous network of abortion funds in the state of Florida, and I can't wait for them to go back to getting to do community activism instead of having to focus on getting folks out of the state. I would love for us to figure out more local solutions to making sure people have access to care and working on mutual aid within communities. So I We have to shout out the phenomenal Abortion Funds across the state of Florida who will be helping to lead that work. And then we have to start building towards a long-term vision of what change is possible in the future. I have not gotten that far yet. I am a singular thinker right now.

Having been in this work for so long, Lauren, do you think Floridians have it in them to pass this initiative? I do.

I think that they know what's at stake. I think we are resourced, and if we do our job correctly over the four months, that we will win because I don't think Floridians are stupid. I think they are empathetic, and I think they care about this issue.

What can they do? What can Floridians do from now until November. Yeah.

Everybody should go to our website, floridiansprotectingfreedom. Com, and you can learn all about the stories of Floridians and how they've been impacted by these abortion bans. You can sign up for events in your community or online online, and you should talk to everybody you know about what's going on in the state of Florida right now with regards to a lack of access to abortion, and that there is a solution this November, and it's to vote yes on for and end Florida's abortion ban.

You heard Lauren, folks. If, like me, you're in another state, you can support the effort by donating your money or your time via phone banking. As we close out this episode, episode, I want to linger on something else Lauren said. Floridians are empathetic. They care about this issue, and they can make their own health care decisions. Thank you very much. I think that's what it comes down to, right? We know that across this country, abortion bans do not reflect the will of the people. The vast majority of Americans oppose restrictions, whether they see it as an imposition on their freedom, their health care, their fundamental rights, or all of the above. Florida is no exception. So this November, thanks to the work of organizers like Lauren, we have an opportunity, an opportunity to chart a new course in Florida, one that protects the rights of Floridians and reflects what they truly believe. There's more of the Defenders with Lemonada Premium. Subscribers get exclusive access to bonus content like extended interviews news with organizers, abortion providers, and experts. Subscribe now in Apple Podcasts. The Defenders is a production of Lemonada Media. I'm your host, Gloria Rivera.

Muna Danish is our supervising producer. Hannah Boomershine and Lisa Fou are our producers. Isara Aceves is our associate producer. Bobby Woody is our audio engineer. Music by Hannah Brown, with additional music by Natasha Jacobs. Story editing by Jackie Danzinger, our VP of Narrative Content. Executive producers are Jessica Cordova-Kramer and Stephanie Wittelswax. This series is supported by Charles and Lynn Schusterman Family Philanthropies, the William and Flora Hewlett Foundation, and Levi Strauss Foundation. Follow The Defenders wherever you get your podcast or listen ad-free on Amazon Music with your prime membership. Hi, everyone. Gloria Rivera here, and we are back for another season of No One is Coming Save Us, a podcast about America's Childcare Crisis. This season, we're delving deep into five critical issues facing our country through the lens of childcare: poverty, mental health, housing, climate change, and the public school system. By exploring these connections, we aim to highlight that childcare is not an isolated issue, but one that influences all facets of American life. Season 4 of No One is Coming to Save Us is out now wherever you get your podcast. Why hello there. It's your old pal, Sarah Silverman, and I'm back with a brand new season of the Sarah Silverman podcast.

On my podcast, I am talking about everything, politics. Yeah, we get into it. Favorite sandwich shop in LA? I know a few spots, and I'm going to tell you about them.

I'm also going to be talking to you.

I will be reacting and responding to listener voicemails in real time.

Let me tell you, things can get weird, and I love every second of it. Weird is my comfort zone.

The newest newest season of the Sarah Silverman podcast is out now wherever you get your podcasts.