Choice News

Friday Femorandum: A Grim Example

While all right-thinking people in the United States were horrified by President Donald Trump’s equivocal statements about the violent white supremacists who killed Heather Heyer and injured at least 19 other counterprotesters in Charlottesville last weekend, Trump was quietly working to sign away one of the most fundamental components of the Affordable Care Act: The contraceptive mandate, which requires insurance companies to provide all forms of birth control to women without a copay. (Pro-choice groups such as NARAL Pro-Choice America condemned Trump’s “both sides are to blame” remarks; anti-choice/”pro-life” groups? Not so much.)

 30 rock tina fey liz lemon shut it down GIFMother Jones reports on the administration’s plans to eliminate the benefit, by changing rules associated with the ACA so that virtually any company could deny coverage for birth control. The rule change would expand the ACA’s “moral objection” clause, which has been interpreted as applying only to explicitly religious organizations, so that most companies that do not want to pay for birth control could opt out of doing so. Essentially, the new rule would be Hobby Lobby on steroids, and its effect would be that more women who need access to contraception would be forced to pay out of pocket, choose cheaper, less effective methods, or face an unplanned pregnancy.

Two states passed laws this week that illustrate the power state governments have to counteract or worsen Trump-era abortion policy. The first is a familiar battleground for abortion rights advocates: Texas, where Gov. Greg Abbott just signed a bill this week requiring women who anticipate that they may have an unplanned pregnancy (which is basically the definition of an oxymoron) to pay extra for special “abortion insurance.” From now on, private insurance companies will be barred from covering abortion as part of their regular insurance plans, and allowed (but not required) to offer extra abortion insurance to women.

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Opponents, the Texas Tribune notes, have dubbed the legislation the “rape insurance bill,” because it doesn’t include any exceptions for rape and incest—that is, in effect, it requires women to anticipate that they will be raped. (Or, even more perversely, that their teenage daughters will be raped or become pregnant through incest.) That’s an  effective (and accurate) description, but the fact is, the definition of insurance is that it ensures coverage for unanticipated events. If pregnancy is put in a different category than, say, a broken leg due to a car accident, or a rare and expensive form of cancer, then there’s a strong case to be made that this law discriminates against all Texas women, not just those who may be the victims of rape or incest.

Oregon, very much in contrast to Texas,  just passed a law this week that will require all insurance companies to cover abortion and birth control for all women in the state, including undocumented immigrants; it also includes state funding for abortions and brith control for women who are uninsured. According to Broadly, the bill also requires coverage for “STI and pregnancy testing, voluntary sterilization, postpartum care, and a long list of other reproductive health care–related drugs, devices, and services,” including vasectomies.

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Pro-choice groups, including NARAL Pro-Choice Oregon, consider the bill a bulwark against future Trump administration crackdowns on access to birth control and abortion, including the possibility that Roe v. Wade is overturned, sending abortion rights back to the states. Washington State has its own law ensuring that abortion will remain legal even if Roe v. Wade is overturned, but efforts to pass legislation requiring abortion and male contraception coverage have failed, thanks to a state legislature narrowly split between pro-choice and anti-choice factions.

Finally, here’s a grim example of what happens when a federal government places draconian restrictions on abortion access—from India, where the laws regulating abortion are not much different than what many Republicans, including Vice President Mike Pence, want to institute in the United States. The New York Times reports that a ten-year-old girl who was denied an abortion after being raped by her uncle—because India’s ban on abortions after 20 weeks has no exceptions for rape, incest, or to save the life of the pregnant person—just gave birth. She was never told she was pregnant; instead, her family told her she was having a kidney stone removed. The pregnancy was especially dangerous because 10-year-old children are not physically equipped for pregnancy and childbirth, and the procedure required the girl to spend a week in the hospital monitored by three gynecologists, two pediatricians, two psychologists, a dietitian and a cardiologist. In service to a law designed to punish women, India’s government forced a 10-year-old who had already endured the trauma of rape to undergo a dangerous pregnancy and an invasive medical procedure. It’s inexcusable. But the US shouldn’t labor under the delusion that it couldn’t happen here.


Friday Femorandum: Outside the “Big Tent”

As you’re probably aware, the Democrats are currently weighing whether abortion rights are important enough to fight for. Specifically, the man who heads up the Democratic Congressional Campaign Committee, which provides funding and support to congressional candidates, said recently that the Party will throw its support behind candidates who oppose women’s right to choose when, whether, and how to start a family. Nothing could be more fundamental, yet the leaders of the only major party that has vowed in the past to protect that right consider it nonessential. At a time when both parties of Congress, the White House, and the judiciary are controlled by the party that is explicitly anti-choice, the failure of the Democratic Party to say they will fight for women on this most basic level is inexcusable. Moreover, it tells women—the absolute bedrock of the Democratic Party—that their rights and humanity don’t matter. If the Democrats abandon women, then women may well abandon the Democrats.

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Another prominent male Democrat who has picked up his party’s “abortion rights don’t matter” banner is California Governor Jerry Brown, who said this week that making the right to choose a nonnegotiable value would make the Democrats no different than “the Marxist Party in 1910. Hasn’t this guy been governor long enough?

Fortunately, there are a lot of people who’ve been willing to stand up to this appalling abdication of responsibility by the nominally “pro-choice” party, starting with NARAL Pro-Choice America President Ilyse Hogue. Hogue told the AP this week that “Every time the Democrats lose an election, they start casting about in ways that are deeply damaging to the base. If they go out and start recruiting anti-choice candidates under the Democratic brand, the message is, ‘We’re willing to sell out women to win,’ and politically that’s just suicide.” Elaborating on NPR, Hogue said, “If there was ever a stronger signal sent that women are looking for leadership who has our backs because equality and justice is more important in the Trump administration than it’s ever been, that moment is now.”

 fun celebrate unbreakable kimmy schmidt kimmy schmidt ellie kemper GIFMany progressive groups, thankfully, are fighting back, by signing a joint statement pledging not to support candidates who don’t support a woman’s right to choose. Alternet has the full statement, and Glamour reports:

The right to decide how and when to have a family has a huge impact on other vital party issues, like the economy, education, and gender equality. But more important, the statement says, women cannot be free in a society that forces them to have children against their will. “As progressives, we stand united in the belief that a woman’s autonomy over her own body is not a secondary issue or a ‘social issue,’ but rather a human right and a necessity in order to attain and preserve economic security in her life,” it reads. 

The consequences of deeming abortion rights inessential are far from theoretical. In Texas, Republican legislators—emboldened by Trump’s election and undeterred, as Rewire reports, by last year’s Supreme Court ruling striking down laws designed to force abortion providers out of business—are moving ahead with several new proposals to limit or eliminate women’s right to choose. The first and furthest-reaching would bar private insurance companies from providing abortion coverage except as a separate, “abortion-only” policy, forcing women to anticipate in advance whether they will have an unintended pregnancy (kind of an oxymoron) or become pregnant as the result of rape—one reason pro-choice activists are calling the proposal the “rape insurance” bill. (Insurance, as a reminder, is supposed to insure against unanticipated medical events, making the supplemental abortion-only “insurance” policy anything but.)

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Three other bills, the Houston Chronicle reports, would require doctors to report more detailed personal information about abortion patients to state authorities, including specific details about women under 18 who seek judicial bypasses to the state’s parental-consent law, and would prohibit the state from contracting with Planned Parenthood clinics for non-abortion-related services.

What will happen if Democrats capitulate to Republicans by declaring that women’s rights don’t matter? Most likely, we’ll see a proliferation of Texas-style laws across the country, including states run by anti-choice Democrats. When the Democrats’ “big tent” expands so much that encompasses anti-choice Republican values, is there any good reason for women to stay inside?




Friday Femorandum: Fake Clinics, Real Consequences

Women in Seattle and the rest of King County, Washington, had reason to celebrate this week, when the King County Board of Health voted to adopt a new rule requiring “crisis pregnancy centers”—fake “clinics” run by anti-choice nonprofits that bait pregnant women with promises of medical care and counseling, then try to talk them out of having abortions—to disclose the fact that they do not actually provide any health-care services. Starting in one month, CPCs will have to display a large sign declaring “This is not a health-care facility” in 10 different languages, and include the same information on all their promotional materials.

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CPCs generally provide pregnancy tests and ultrasounds, and may offer samples of formula and diapers. Their main purpose, however, is to frighten women out of terminating even risky pregnancies by providing misinformation about abortion and birth control, including claims that abortion leads to cancer, suicide, and “post-abortion syndrome.”

Rewire, The Stranger, Q13, and MyNorthwest covered the Thursday vote. (KIRO, typically the most conservative of Seattle’s local news outlets, did a one-sided story that repeated false talking points from opponents and did not include any interviews or perspective from the proponents of the new rule, which passed on Thursday with just one dissenting vote).

Senate Republicans’ noxious health care bill is dead, so you may be tempted to breathe a sigh of relief. Not so fast, though—not only do Republicans who supported the bill, and President Donald Trump, hope to revive it as “repeal and delay”—that is, eliminate Obamacare and replace it with nothing, ending health care coverage for 32 million Americans—the GOP has found other ways of cutting women’s health care without repealing the Affordable Care Act altogether. Rewire reports that the US House Appropriations Committee approved budgets for the Departments of Labor, Health and Human Services, and education that include deep cuts to family planning programs. Notably, the bill eliminates $286 million in funding for family planning through the Title X program, which provides health care to low-income people.
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Additionally, the committee cut $6.4 million in funding for the Office of Women’s Health and $11.4 million for the Office of Minority Health.

Six months after Trump sat in the Oval Office surrounded by white men and signed off on the reinstatement and expansion of the global gag rule–a law that bans US funding for organizations that provide or even discuss abortion anywhere in in the world—the Guardian takes a look at how the rule is playing out worldwide.

As much as $10bn (£7.7bn) of global health funding hangs in the balance. Among those who will lose money if they refuse to sign up to the anti-abortion orthodoxy are the two big international family planning organisations, Marie Stopes International (MSI) and the IPPF. But for the first time, global NGOs such as Save the Children, WaterAid and the International HIV/Aids Alliance are also targeted.

The effects will be felt most keenly in the tiny, frontline clinics run by small NGOs struggling to help women and children in crowded townships, refugee camps and remote rural villages. There are no abortion doctors in such places (in most African countries, abortion is banned unless the woman’s life is in danger). These clinics instead offer contraceptive injections and condoms for those who would struggle to feed numerous children. But they also treat children for malaria and malnutrition and their mothers for HIV. This integrated care is now under threat.

The Trump administration’s antipathy toward women’s rights is so great that organizations like Save the Children (and, the piece goes on to note, the UN Population Fund) will suffer if they refuse to comply with administration policies. And if they do comply, they can no longer provide potentially life-saving services and information to women. No matter what organizations do, as long as the global gag rule is in place, women and their families around the world will suffer.

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But what’s behind Trump’s assault on women’s physical autonomy? Michele Goldberg, writing at the New York Times, has a theory: He wants to “accomplish legislatively” what he has bragged about doing to women physically—manhandling their bodies.  In a piece aptly titled “The Playboy President,” Goldberg notes the “deeply insulting irony” that an “erotically incontinent libertine”—a President whose resume includes a cameo in a softcore porn video, and who gleefully bragged about being able to grab women “by the pussy”—is spearheading what could be the most significant rollback of women’s rights since the days before Roe v. Wade. “Mr. Trump doesn’t care about women’s health or rights, and it’s easy to outsource policy to the activists of the religious right who helped elect him,” Goldberg concludes. “When you’re the president, they let you do it.”

Oh—and lest you think the judicial branch will be an effective check on the Trump Administration’s worst excesses, consider this: John Bush, the latest youthful judge to receive a Trump nomination to a lifetime seat on the federal bench, is an unqualified anti-choice blogger who has compared abortion to slavery. His nomination to the 6th Circuit Court of Appeals sailed through the Senate on Thursday.


Friday Femorandum: Zeroing Out Title X

As readers of the Femorandum are undoubtedly aware, the US Senate is currently working frantically to dismantle the Affordable Care Act and eliminate insurance coverage for 22 million Americans. (If you haven’t called your senators yet, there’s still time! Find out their contact information here). Repealing the ACA would particularly impact vulnerable women who need family planning services or rely on Planned Parenthood for health care, along with their families.

Lady Gaga music video beyonce lady gaga mv GIFBut regardless of what happens with the health care bill, Republicans in the House are moving forward with a proposal to zero out Title X funding for family planning services, eliminating $300 million in funding for family planning for low-income women, including $60 million in funding for Planned Parenthood. The cuts, according to Rewire, will disproportionately impact “a diverse population of people with low incomes.”

Of 4 million patients who benefit from Title X funding, “30 percent self-identified as Black or African American, Asian, Native Hawaiian or Pacific Islander, or American Indian or Alaska Native; 32 percent self-identified as Hispanic or Latino; and 13 percent had limited English proficiency.”

Republicans who advocate cutting Planned Parenthood’s funding have argued, consistently and inaccurately, that women who need family planning services can simply go to community clinics. Pro-choice advocates have pointed out that community clinics that provide family planning services are already badly overburdened, and that many of the “clinics” Planned Parenthood opponents suggest women use aren’t clinics at all.

It’s easy to laugh at the suggestion that women seeking birth control go to a dentist or a school nurse. But a real-world experiment on the results of cutting funds for Planned Parenthood has been going on in Texas, and the results have been devastating. The Huffington Post reports that according to a study by researchers at Texas A&M University, in the first three years after Texas lawmakers slashed the state’s family planning budget—forcing the closure of more than 80 women’s health clinics—the abortion rate among teenagers has actually increased. The cuts, in other words, are accomplishing exactly the opposite of their stated goal—and doing so at a time when the teen pregnancy and abortion rate nationwide is actually going down.

 judge duh judge judy GIFAccording to HuffPo, “The greatest rises in abortion rates occurred in rural areas, where access to affordable family planning care was already scarce. In Gregg County, where the local health center lost 60 percent of its family planning funding, the abortion rate increased by 191 percent between 2012 and 2014.” What prevents abortion? Medically accurate sex education (also in short supply in Texas) combined with access to birth control and other family planning services. People who need abortions will find ways to access them, even in states like Texas that try to make it as difficult and financially draining as possible.

Another state that’s engaged in an incredibly misguided attempt to stop women from accessing a legal medical procedure is Arkansas, where lawmakers just passed a bill that will require women seeking abortions to inform and potentially get permission from the men who impregnated them, even in pregnancies that result from rape or incest. The bill accomplishes this by including fetuses in a rule that requires family members to agree on how to dispose of human remains—a change that also, conveniently, opens the door to “personhood” for embryonic tissue. The legislation also requires women under 18 to get permission from their parents for abortions. NARAL Pro-Choice America and the American Civil Liberties Union are among many groups opposing this outrageous violation of women’s rights, the Independent reports.

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Women who choose abortion in Arkansas must also undergo mandatory “counseling” and wait 48 hours before getting the procedure, requirements designed to scare women out of having abortions and make the procedure, which often requires women to travel and take days off work, prohibitively expensive.

One state that’s working to fight back against restrictions on abortion access is Oregon, where lawmakers passed a bill this week that will require insurance companies to cover abortion at no cost to patients. The Huffington Post reports that the bill, which aims to both preempt ACA repeal and expand access to coverage beyond what all other states, including Washington, require, would also extend abortion coverage to undocumented immigrants and keep abortion legal in Oregon, even if Roe v. Wade is overturned. Thanks to Initiative 120, which Washington State voters passed in 1991, abortion rights are protected at the state level; however, Washington legislators have consistently failed to pass a reproductive parity bill that would ensure women women have access to abortion coverage through their insurance companies.


Friday Femorandum: Meet the New Trumpcare, Same As the Old Trumpcare

The big news this week was the US Senate’s latest tax cuts for the wealthy health care “reform” bill, which in addition to eliminating coverage for millions of poor Americans who get their health care through Medicaid and setting up a death spiral for the individual market will once again make being a woman a preexisting condition, effectively end private coverage for abortion care, and defund Planned Parenthood. Here are some details from the “Better Care Reconciliation Act”—drafted in secret by 13 Republican men—that are especially concerning for women and for anyone who benefits from access to reproductive health care (that is, everyone).

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Vox focuses on the BCRA’s elimination of the “essential health benefits” mandate, which required insurance companies to cover ten basic health care services, including mental health and maternity care. (Under the bill, governors in conservative states will be able to opt out of the essential health benefits requirement by virtual fiat, with no consultation with their legislatures). “f the Better Care Act passes, it could mean we could turn back to a time before the Affordable Care Act, when some 88 percent of plans on the individual market did not provide maternity coverage,” Vox reports.

The bill would also defund Planned Parenthood for one year by barring Medicaid recipients from using Planned Parenthood clinics. Given that half of Planned Parenthood’s patients use Medicaid, the one-year cut would represent a devastating blow both to the clinic network and to women on Medicaid who use the clinics for basic health care, including birth control and cancer screenings.

The New York Times reports that despite a tidal wave of individual contributions in the wake of the Trump election, Planned Parenthood’s funding falls far short of what it would need to serve the millions of Medicaid clients who come through its doors every year. “those new funds do not come close to compensating for the money that the bill would strip away. The national office and affiliates of Planned Parenthood together rely on reimbursements and grants from the government for more than 41 percent of their total $1.35 billion in revenue, according to the group’s latest annual report.

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Dame Magazine points out another way in which the Republican health-care repeal bill is particularly cruel to women. By allowing states to seek waivers from the requirement that insurers can’t deny access to health care because of preexisting conditions, the bill could make it impossible for women who report their rapes to get health care coverage. Or, conversely, it could create a perverse incentive for women not to report their rapes, for fear of losing coverage in the future:

When women report an assault, people often ask, “Why didn’t she report it?” and inquire what the victim was wearing or why she was in that place at that time. Those questions are just one aspect of blaming victims of sexual assault that frequently discourages people from reporting attacks.

The consequences of sexual assault qualifying as a preexisting condition will be widespread:

According to Rape, Abuse & Incest National Network, an American is raped every 98 seconds. One out of every six American women has been the victim of an attempted or completed rape in her lifetime. And those are the assaults on the record; many go unreported.

“People ask, ‘Why didn’t she report it sooner? Why was she doing this? Why did this happen?’” Jessica [who reported her rape] said. “So she gets punished for doing that. And then I’d be punished for doing what they ask people to do. The fact that I saw a therapist to try and get better shouldn’t penalize me if I have to go see a therapist again.”

Vox explains how allowing insurance companies to discriminate against people with preexisting conditions will mean financial ruin for many Americans, by creating a “death spiral in the health care system. Basically, by allowing states to opt out of requiring coverage for preexisting conditions, and by allowing insurers to offer bare-bones coverage that doesn’t include essential health benefits, the Senate bill sets up a two-tiered system in which healthy people with no preexisting conditions buy the cheaper, minimal insurance and everybody else is stuck buying the more expensive, more comprehensive kind. As more and more healthy people leave the comprehensive insurance market, that market will fill up with older, sicker people, driving up costs so far that none but the wealthiest can afford decent insurance.

Consider, for example, a family with a spouse or parent with cancer whose drug treatment costs thousands of dollars for their drugs. They think they have a victory in that under the Senate plan, their insurance company can’t explicitly charge them more because of their family member with a pre-existing condition. But, unfortunately for them, they find that they live in a state that allows insurers to offer plans that don’t cover prescription-drug costs. This family will face nothing but bad choices.

Because the skinny, incomplete plans are a non-starter for them, they can’t take the cheap option. But everyone who’s young or healthy does. The only people choosing the alternative, signing up for a plan that actually meets their needs, are those with serious conditions. This will further drive up the costs of these plans—the only plans that actually cover the treatment that seriously sick people need—and will further drive the young and the healthy away.

And of course, the bill takes direct aim at abortion services, by effectively “prohibit[ing] any health insurance plan, private or public, from covering abortion care,” Rewire reports.

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“The abortion restrictions in the House-passed AHCA mirror the ACA’s failed Stupak-Pitts Amendment, according to Guttmacher Institute Senior Policy Manager Adam Sonfield, who spoke with Rewire in the lead-up to Thursday’s reveal in the Senate. Senate Republicans also appear to rely on the Stupak-Pitts model,” Rewire reports.

“For the uninitiated, then-Reps. Bart Stupak (D-MI) and Joe Pitts (R-PA) in 2009 played into the GOP myth that taxpayer money is fungible. Their amendment sought to bar the ACA’s tax credits from subsidizing any health insurance plan that covers abortion, not just abortion care itself in compliance with longstanding federal policy. The amendment passed the House with the help of 64 Democrats,” but failed in the Senate, which passed the slightly less-restrictive [Ben] Nelson Amendment instead.

Bottom line: Republicans are going beyond banning direct federal funding for abortion, and are trying to stop all health insurers from covering abortions—a lack of coverage that will disproportionately impact low-income women.

The expanded abortion funding ban originated with the far-right Republican Study Committee in the House, which wrote that they would not support any health care bill that did not include cuts to Planned Parenthood and restrictions on federal support for plans that cover abortion. “The bill, they wrote, fulfills ‘an important conservative commitment to promote life and protect the unborn,'” the New York Times reports.