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ROB SCHMITZ, HOST:

Today, the rules for using an abortion pill in the United States are exactly the same as they were the day before.

STEVE INSKEEP, HOST:

That lack of a change is news because the Supreme Court turned aside a request to change them. The court unanimously rejected a challenge to the abortion pill mifepristone. Some doctors had sued the Food and Drug Administration, saying its approval of the drug was improper, but because the doctors opposed the drug and didn't actually prescribe it, the court said they did not have the standing to sue. In other words, they had no direct stake in the case.

SCHMITZ: NPR's Elissa Nadworny covers reproductive rights and joins us now. Good morning, Elissa.

ELISSA NADWORNY, BYLINE: Good morning.

SCHMITZ: So you've been talking to medical providers who actually do provide mifepristone. What are they telling you?

NADWORNY: That's right. I talked with many doctors and nurses. Dr. Kristyn Brandi is an OB-GYN in New Jersey. And when the decision came down, she and her staff were actually in a meeting where they were making a plan for if access to mifepristone was changed.

KRISTYN BRANDI: We were all in shock and just so thrilled and relieved that this was not something that we had to worry about anymore. It's something that's kind of been looming in the background for weeks now.

NADWORNY: Others were a bit more cautious in their optimism. Here is Dr. Louise King, director of reproductive ethics at the Harvard Medical School Center for Bioethics.

LOUISE KING: It's a pause and panic (laughter).

NADWORNY: A pause and panic, one that allows providers to keep prescribing mifepristone during the first 10 weeks of pregnancy and via telehealth appointments.

SCHMITZ: A pause and panic. You know, by rejecting the case on standing, the court basically sidestepped the original question about FDA approval. So what does abortion access look like now?

NADWORNY: Well, it's a patchwork. Fourteen states have a near-total ban on abortion. Many more have restrictions after the first trimester. But the landscape since the Supreme Court struck down Roe v. Wade has changed a lot, in big part because of expanded access to telehealth, which now makes up 1 in 5 abortions in the U.S. And several states have enacted shield laws, which allow providers to send abortion medication by mail to states with bans and restrictions. Lauren Jacobson is a nurse practitioner in Massachusetts who does this.

LAUREN JACOBSON: We continue business as usual. The Supreme Court has not made it more difficult than it already is for people to get access to abortion pills.

NADWORNY: Jacobson works for Aid Access, one of the largest abortion-by-mail organizations that sends pills to all 50 states. And yesterday, she wrote about 30 prescriptions for mifepristone.

SCHMITZ: So, Elissa, what is next for anti-abortion groups now that this challenge has failed?

NADWORNY: Well, you first look for clues in the opinion. And in Brett Kavanaugh's opinion, he essentially writes, go through Congress, not the courts, if you want to challenge regulations. However, the lawyers who brought the case are confident they can still continue in the courts, perhaps with state attorneys general making a more compelling argument than the group of doctors. Erin Hawley is senior counsel at Alliance Defending Freedom. She argued the case before the court, and here she is in a briefing for reporters.

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ERIN HAWLEY: We still have work to do. ADF is encouraged and hopeful that the FDA will be held to accounts.

NADWORNY: You know, Rob, even the providers I talk to expect more challenges. I talked to Melissa Grant, who leads Carafem, which runs abortion clinics and telehealth services in several states.

MELISSA GRANT: Ultimately, it's a tepid happiness here because we know that there are other shoes to drop. And we look for this case to come forward with gusto again in the next several months.

NADWORNY: So providers are kind of bracing for more challenges. Melissa says the main thing she can do now is tell people her medical care will remain the same as it's been for the last two years.

SCHMITZ: That's NPR's Elissa Nadworny. Elissa, thanks so much.

NADWORNY: You bet.

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SCHMITZ: Tesla shareholders voted again to pay Elon Musk tens of billions of dollars.

INSKEEP: The vote showed the majority's confidence in the CEO, and at a shareholder meeting, Musk responded.

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ELON MUSK: Hot damn, I love you guys.

INSKEEP: This is the second time Tesla investors have voted on Musk's pay package, the same one that a judge threw out earlier this year.

SCHMITZ: NPR's Camila Domonoske covers the car industry. She's here to break this down for us. Good morning, Camila.

CAMILA DOMONOSKE, BYLINE: Hi, Rob.

SCHMITZ: So tell us about the pay package at the heart of this vote. How much are we talking about?

DOMONOSKE: You know, it's somewhere in the neighborhood of $50 billion. It's all stocks, so the exact value varies, but it's a lot. If you go back in time to 2018, which is when shareholders first approved this pay package, it was a deal where Musk would get no salary at all. But if Tesla got really, really big, so big the benchmark that was set to most people seemed completely impossible, he would get a mind-boggling amount of stock. And then that's exactly what happened. Tesla grew phenomenally, and he received this huge compensation package that was entirely Tesla stock. And that means not just a phenomenal amount of money - it also means a huge amount of control expanding his influence over this company.

SCHMITZ: Wow, so we've got an eye-popping figure for Mr. Musk, a lot of control. But is there something wrong with that?

DOMONOSKE: So one small shareholder sued, and a judge in Delaware, where Tesla, like a lot of companies, is incorporated for the business-friendly laws - this judge said, yeah, no, this is actually no good. She found that Musk had too much influence over the board when they determined this package - CEOs aren't supposed to set their own pay, basically - and that when shareholders did vote on it, they weren't fully informed. So, in response, we've seen two votes here from Tesla. One reconfirmed the pay package, and the other moved the company's incorporation from Delaware to Texas.

SCHMITZ: So, you know, this vote yesterday went very well for Elon Musk. He said, hot damn, thank you very much to his shareholders. Did any investors have doubts about this?

DOMONOSKE: Yes. We saw some big investors, including the California teachers and public employees retirement funds, vote no. The logic here was, you know, the obvious. It's just too big. There's also been some concerns from some big investors about whether Elon Musk is paying enough attention to Tesla, which is something you do hear from some small investors, too. I've been on an EV road trip this week and chatting with people about EVs, and one Tesla shareholder in New Jersey told me that he thought it might be time for Musk to step back so, as he put it, Musk could pay more attention to Twitter. But obviously, that's a minority opinion, right? A lot of individual investors said yes to this pay package. There was actually an organized campaign to get them to come out and vote, which a lot of shareholders, individuals usually don't do. Each one's a small chunk of the voting power here, but overall - big impact. This is a vote of confidence in Musk that he himself is crucial to Tesla's future.

SCHMITZ: So is that it? Is that the end of the story here?

DOMONOSKE: There's going to be a lot more legal battles.

SCHMITZ: OK.

DOMONOSKE: A lawyer for the team that challenged this pay package called this vote coerced and, quote, "deeply flawed," said it doesn't make a difference to their case, where this judge said they won. You know, we've been in unprecedented territory for this case for a while now, and I think that's still where we are. We'll have to see where it heads.

SCHMITZ: NPR's Camila Domonoske, thank you.

DOMONOSKE: Thank you.

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SCHMITZ: Leaders of Microsoft are playing offense and defense on their security practices.

INSKEEP: Yeah, they're on the defensive because of some security lapses. Yesterday, lawmakers asked executive Brad Smith how Russian and Chinese hackers gained access to federal emails through Microsoft vulnerabilities. At the same time this week, Microsoft and Google say they're working with the White House on offense. They want to fight back against ransomware attacks at hospitals.

SCHMITZ: To talk more about this, we turn to NPR cybersecurity correspondent Jenna McLaughlin. Good morning.

JENNA MCLAUGHLIN, BYLINE: Good morning.

SCHMITZ: So, Jenna, Microsoft is under fire for security challenges, but it does have a lot of financial resources. How is this cybersecurity crisis at hospitals different?

MCLAUGHLIN: Yeah, so Microsoft does have its own problems, but, separate from those email insecurities and those potential national security concerns associated with those breaches, we've got this other problem. Cybercriminals are hoping to make money, and they're targeting the American health care system. It's really a crisis, and it's only getting worse.

SCHMITZ: So Jenna, what kind of damage are we talking about here, and how bad has it become?

MCLAUGHLIN: It's really bad, Rob. The White House says the total number of attacks between 2022 and 2023 rose a whopping 128%. So these cybercriminals don't just break into email. At hospitals, they shut everything down from imagery machines to communications. And they're demanding ransoms to unlock everything because they know that health care has to get back online as fast as possible to prevent emergencies, even deaths. And it's happening everywhere. London's hospitals are under siege as we speak. And recently, the scale of attacks has really gone up. That includes the network of 140 private Christian hospitals owned by the health care company Ascension, which is still struggling to get back online. And there was a massive attack against Change Healthcare, a company that processes payments between providers and insurance companies. That one was so bad that it's forcing clinics and pharmacies to close down because they couldn't get paid for months.

SCHMITZ: Wow, so what's being done about all this?

MCLAUGHLIN: So like you mentioned up top, the White House has announced this program with Microsoft and Google. They're going to be funneling cash and resources specifically towards rural health care facilities, because often when those places are hit by a ransomware attack, they don't have the resources to respond, and there's not a network of nearby hospitals to act as a backup. If one hospital network is down, sometimes the closest alternative is dozens of miles away. Plus the Department of Health and Human Services is putting up 50 million of its own dollars towards a research project to help develop tools to secure the health care ecosystem. What I've been hearing a lot, though, is that this approach right now might be too little too late.

SCHMITZ: So could you unpack that a little more for us? What else do experts say needs to happen here?

MCLAUGHLIN: So the experts I talked to say the White House program for rural hospitals misses some key problems. That includes vulnerabilities in third-party software and actually hiring people to monitor these systems on the ground. There's also definitely an interest within cybersecurity circles that there be mandatory minimum cybersecurity standards across the health care industry. Senator Ron Wyden of Oregon wrote a letter urging HHS to do that in light of all the major breaches. Of course, the industry's wary of moves towards regulation. It can be overly onerous and not necessarily solve the problem. But it's clear to most people I talked to that something major needs to change.

SCHMITZ: That was NPR's Jenna McLaughlin. Jenna, thank you.

MCLAUGHLIN: Thank you. Transcript provided by NPR, Copyright NPR.