Overnight Healthcare: Supreme Court appears split in crucial abortion case

The Supreme Court's potential swing vote on its pivotal abortion case gave few hints on Wednesday whether he would be willing to strike down Texas's law, which is considered among the strictest in the country.

Anthony Kennedy, a conservative justice who once ruled in favor of abortion access, revealed little throughout 90 minutes of arguments on whether Texas had created an "undue burden" on women by imposing restrictions on abortion providers that opponents say have closed at least 11 clinics statewide.

The eight-member court appeared deeply divided on the case, making it more likely that it will end in a deadlock 4-4 tie and prevent a ruling from establishing national precedent.

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Kennedy suggested that the case may be sent back to the lower courts, extending the uncertainty around the 2013 law, which has been under legal challenge since its passage.

Much of the debate Wednesday centered on the safety of the abortion procedure and whether the state's restrictions on clinics were necessary. While liberal justices compared the procedure to a colonoscopy, Texas's solicitor general said it was more like brain surgery.

Opponents of the Texas law said they felt hopeful after Kennedy noted the number of medical abortions in Texas has increased relative to surgical abortions -- the opposite of the national trend.

It was an acknowledgement that the law seemed to be affecting the types of abortions women were having in Texas, even as his conservative counterparts, particularly Justice Samuel Alito, argued that the plaintiffs lacked evidence in their argument.

"This may not be medically wise," Kennedy said of the increase in medical abortions, though he added that "you might say" it is a state's decision to control those factors. Read more here: http://bit.ly/1L6bRr7

VULNERABLE SENATORS SUPPORT MORE OPIOID $$: The Senate GOP on Wednesday blocked a Democratic push to add $600 million in emergency funding to an otherwise bipartisan opioid abuse bill.

But that proposal earned the support of several Republicans facing tough reelection bids this fall: Sens. Kelly AyotteKelly AyotteRyan optimistic about GOP majorities in House and Senate Dems gain upper hand on budget GOP senators hit FBI on early probe of NY bombing suspect MORE (N.H.), Mark KirkMark KirkSenate rivals gear up for debates The Trail 2016: Trump seizes on Charlotte violence Iran president hints at future prisoner swaps, cash settlements with US MORE (Ill.) and Rob PortmanRob PortmanRyan optimistic about GOP majorities in House and Senate Dems kill more ads in Ohio Senate rivals gear up for debates MORE (Ohio).

The final vote was 48 to 47 against the funding, which had been backed by the White House. Sens. Susan CollinsSusan CollinsSwing-state Republicans play up efforts for gun control laws Reid knocks GOP on gun 'terror loophole' after attacks GOP pressures Kerry on Russia's use of Iranian airbase MORE (Maine) and Lindsey GrahamLindsey GrahamObama nominates ambassador to Cuba Funding bill rejected as shutdown nears Shutdown risk grows over Flint MORE (S.C.) also broke ranks to support it.

Final passage of the bill could take place later this week. Read more here: http://bit.ly/1QsuzWJ

FIREWORKS AT PLANNED PARENTHOOD HEARING: The House committee investigating Planned Parenthood held its first hearing Wednesday, and it got intense, before settling in to a discussion of the ethics of fetal tissue research.

Democrats on the panel argued that Republicans are on a "witch hunt" akin to former Sen. Joe McCarthy's (R-Wis.) investigation of communists in the 1950s and are endangering researchers by requesting their names in the subpoenas.

Rep. Jerrold Nadler (D-N.Y.) said the committee could be "complicit" in the murders of those researchers if their names became public and they are then killed. Democrats pointed to the shooting at a Planned Parenthood clinic in Colorado to illustrate the danger. Read more here. http://bit.ly/1LW8MEW

STUDY: MEDICARE ADVANTAGE CUTS TO COST $870M: A coalition of groups opposing the Obama administration's proposed cuts to the Medicare Advantage retiree program are arguing that the policy would carry a nearly $900 million price tag and hurt more than 3 million enrollees.

The report was commissioned by the U.S. Chamber of Commerce and prepared by the firm Milliman. Read it here: http://bit.ly/1TRntRm

COMMITTEE UPDATES:

The Government Accountability Office raised concerns about the still-unknown Zika virus in a hearing with the House Energy and Commerce Committee on Wednesday. "Unanswered questions remain regarding the epidemiology and transmission of the disease," the GAO wrote in its testimony, underscoring the major challenges in tackling the epidemic.

ON TAP TOMORROW:

President Obama travels to Milwaukee to celebrate the winner of the administration's ObamaCare sign-up contest in an effort to tout the health law.

HHS Secretary Sylvia BurwellSylvia Mathews BurwellOvernight Healthcare: McConnell unveils new Zika package | Manchin defends daughter on EpiPens | Bill includes M for opioid crisis Insurance executives ask for changes to ObamaCare Obama meets with insurance CEOs on health law MORE heads back to Capitol Hill for a Senate Appropriations committee hearing.

WHAT WE'RE READING:

Unintended pregnancy rates are falling (CNN)

Supreme Court conservatives dodge and weave on abortion case (National Journal)

Valeant CEO races to repair drugmaker's reputation (Wall Street Journal)

Feds forgoing $13.9 billion from ACA insurance tax (Modern Healthcare)

IN THE STATES:

Oklahoma House passes bill cutting 100,000 from Medicaid (KOCO News)

Arkansas governor wades into GOP primaries with eye on Medicaid (Arkansas Times)

California governor approves plan to restructure health insurer tax (Orange County Register)

ICYMI FROM THE HILL:

Senate panel advances bill blocking state GMO labeling rules

Send tips and comments to Sarah Ferris, sferris@thehill.com, and Peter Sullivan, psullivan@thehill.com. Follow us on Twitter: @thehill@sarahnferris@PeterSullivan4