Articles about Policy
The trial over a Wisconsin law that requires abortion providers to obtain admitting privileges at a nearby hospital or face prosecution came to a close last week, with federal District Court Judge William Conley expressing both frustration at the law and the inability of those challenging it to explain why area hospitals were not responding to admitting privileges requests.
Like admitting privileges requirements passed in states like Texas, Alabama, North Dakota, Mississippi, and Louisiana, supporters of the requirement in SB 206, which has been on hold since July, insist the law is necessary to protect patient safety.In support of that claim attorneys for the state offered the testimony of Lena Wood, an Oshkosh woman who claimed she was hospitalized after becoming ill following an abortion nearly 20 years ago and that her provider never followed up with her. Wood, an anti-choice activist, admitted under cross-examination that she did not understand her medical records, and there were no facts to back up her assertion that it was the abortion that had caused her hospitalization.
The state’s second witness in support of the law was James Linn, an obstetrician and gynecologist at Columbia St. Mary’s and advisor to Wisconsin Right to Life, the main group supporting the law. During his testimony, Linn said he hoped Affiliated Medical Services in Milwaukee—one the providers challenging the law—would close so that fewer legal abortions would be performed in the state. The clinic, the only one in the state that performs abortions beyond 19 weeks, faces closure under the law because its doctors have so far been unable to obtain the required admitting privileges. Judge Conley said he was “bewildered” by the fact that local hospitals had not yet stated whether they would grant privileges to Affiliated Medical Services providers and ordered the parties to continue to pursue privileges, indicating he would order the hospital to respond if they continued to evade the request. One of those providers, Dr. Dennis Christensen, testified he had been pursuing admitting privileges at two Milwaukee hospitals for months but had not had any response from the hospitals. Christensen testified he believed the lack of response from the hospitals is connected to the hospital credentialing officials’ demand for information on patients he has treated in a hospital. Christensen testified he has no such data to provide in response to their demand because he hasn’t treated an abortion patient in a hospital for at least a decade.
“The fact that we’ve managed to keep our patients out of the hospital appears to be a detriment to getting hospital privileges,” he said.
A ruling on whether or not the law will go into effect is not expected from Judge Conley for at least a month, and in the meantime he ordered the parties to continue to pursue obtaining hospital privileges. Should providers be able to obtain those privileges, it could resolve, at least temporarily, the legal challenge. That was the case in North Dakota, where the state’s only abortion clinic faced closure under the state’s admitting privileges requirement. But just as a trial over the constitutionality of North Dakota’s law was about to begin, Sanford Health, a Dakotas-based health-care system, granted admitting privileges to the providers, prompting attorneys for the state and those challenging the law to reach a settlement and end the legal challenge. At the close of last week’s trial, Judge Conley suggested a similar possibility for Wisconsin, noting he was troubled by the inflexibility of the law.
“I’m being asked to strike down a law,” said Conley. “I take no pleasure in that. If there’s a way to get privileges short of that you should do that.”
The stately Lady Justice sits beneath the Supreme Court inscription: “EQUAL JUSTICE UNDER LAW.”
Advocates at the national family planning conference visited our elected officials this week. As I passed Lady Justice, I thought about the pending case on contraceptive insurance coverage under the Affordable Care Act (ACA). Much of the public is weary of this seeming tedious and endless debate on women’s health and women’s rights. But if the court’s motto is not to become an epitaph for equality for women, individual constitutional rights in these most intimate and personal decisions must be upheld.
Several private for-profit corporations argue that bosses opposed to birth control methods for personal religious reasons, should be permitted to deny all contraceptive coverage to their employees.
“Equal justice under law” promises that each person before the court will have impartial and evidence-based judgment. The scales of justice declare that evidence will be weighed.
First the court must decide whether a for-profit corporation is even able to exercise religious liberty. An employee can claim religious rights, but it seems overreach to say that corporations with no religious purpose are able to deny equality of health care access to their employees to impose the religious beliefs of their owners.
Even if the court determines that for-profit corporations are able to exercise religious liberty rights, then it must say whether the requirement of the ACA is asubstantial burden. Actuarial studies have shown that the cost of providing contraceptive coverage is less than $2.00 per employee per month. With many exceptions and alternatives available for providing contraceptive coverage, the cost of the benefit is not substantial.
The burden, even if substantial, can nonetheless be justified. In this situation, the compelling argument is that preventing unintended pregnancies and their outcomes, including impacts on women’s health, children in poverty and even abortions, represent a national public health goal. These very corporations benefit from women participating fully in the work force including by reducing the substitution, replacement and productivity costs of family medical leave.
Contraceptive care is primarily used by women and has been shown to advance equality of opportunity – a national goal. Enabling a few employers to deny health care that others are guaranteed is contrary to foundational American separation of church and state.
Contraceptives prevent pregnancy. Some corporate owners may believe that contraception is equivalent to abortion, but under accepted medical, legal, and scientific standards it is not. Almost everyone understands that a woman cannot have an abortion prior to pregnancy. An employee whose employer offers health insurance cannot simply go to the ACA marketplace and get coverage. If the employer denies contraceptive coverage, the employee may not be able to afford themost effective or medically necessary method.
Regardless of what the court decides, family planning clinics in Wisconsin and throughout the country will continue to provide all approved methods of birth control confidentially to men and women. Insured or uninsured, rich or poor, in the face of persistent political and legal attacks, family planning programs will support equal justice and equal access under law.
Women’s health services shouldn’t (and now don’t) come with a co-pay! Happy one-year anniversary, ACA’s preventive services benefit for women. Essential preventive services at no additional cost for women and their families. Share widely!
Members and supporters of the local American Association of University Women met with Congressman Sean Duffy’s staff to ask for his leadership to pass the Violence Against Women Act (VAWA). The group expressed its concern about delays in reauthorization.
AAUW supporters asked congressional staffers to request that Representative Duffy add his name to a February 11th letter authored by John Runyon (R-NJ) and co-signed by seventeen Republican House members to Speaker John Boehner and Majority Leader Eric Cantor urging them to reauthorize VAWA. The leader of the local delegation, Marian Seagren Hall, said that Representative Duffy should “add his name to the list of courageous and principled House members who signed this letter.”
Barbara Munson, a member of the Oneida Tribe, discussed the objections by House Republicans to prosecution and trial of non-native people accused of sexual assault and domestic violence in tribal courts. She emphasized that there are not adequate protections for Native American women against violence and assault now, and that is the reason that VAWA should be passed immediately. It was passed by a 78-22 margin in the U.S. Senate. “It is past time to act,” she said. “Congressman Duffy, as a prosecutor and as a representative of Wisconsin’s native people, is able to lead and to help get this done.”
Lon Newman, an AAUW member and president of the Women’s Health Network of Wisconsin, asked Congressman Duffy to support a compromise being proposed by Darrell Issa (R-CA) if the Senate version does not pass. The Issa compromise would permit non-native people charged with sexual assault to have their trials transferred to federal courts if they believe their constitutional rights are in jeopardy in the tribal court system. “People in the 7th District are frustrated with Congressional inaction,” Newman said. “It’s time to get this done.” This compromise holds great promise for the resolution of issues that seemed a barrier to passage of VAWA and AAUW members asked Representative Duffy to support the Issa compromise if the Senate version, with Duffy’s help, fails to pass the House.
The delegation and the congressional staffers agreed that all women and men deserve to be protected from violence and assault. The AAUW members emphasized that Representative Duffy understands the needs of the people of the 11 tribes in Wisconsin, understands the difficulties of prosecuting these crimes, and therefore they encourage him to take the lead in showing respect and fairness to everyone in all communities. They asked him to support and pass the Senate version of VAWA promptly.
“What is the matter with the bishops? Last week the Obama administration conceded the health and welfare of women to placate the bishops, and yet they’re still railing that they’re somehow offended. The new, expanded designation of employers who can claim a full exemption to contraceptive coverage—that means no ‘accommodation’—will, for example, affect employees (and their dependents) at more than 6,000 Catholic schools. One million employees and their dependents at thousands of Catholic-related institutions will have to hope that the alternative ways to access contraception work as well as those in the administration claim they will. But the bishops got what they wanted: they and their friends don’t have to provide coverage for birth control, religious liberty of their employees be damned.
“The bishops’ hyperbolic reaction to the provision of basic healthcare reveals how far they have strayed from the social justice tradition that most Catholics embrace. Having failed to convince Catholics to avoid using modern methods of family planning, the hierarchy is reduced to demanding that the federal government enforce their prohibition, or at least make contraception more expensive for the bishops’ employees than it is for the rest of the population. This is an unconscionable attack on the healthcare available to employees at Catholic-related institutions who forsake higher salaries and better benefits because of their own commitment to social justice.
“The bottom line, which the bishops don’t want to acknowledge, is that Catholics use contraception at the same rate as do all Americans. Some 98 percent of sexually experienced Catholic women have used a method that the bishops prohibit. Perhaps we shouldn’t be surprised that the bishops are still complaining about contraception—but the administration should stop listening. Catholics already have.”
Catholics for Choice shapes and advances sexual and reproductive ethics that are based on justice, reflect a commitment to women’s well-being and respect and affirm the capacity of women and men to make moral decisions about their lives.
On the 40th anniversary of Roe v. Wade, we reaffirm its historic commitment to protect the health and reproductive freedom of women across this country and stand by its guiding principle: that government should not intrude on our most private family matters, and women should be able to make their own choices about their bodies and their health care. Today and every day, my Administration continues our efforts to reduce unintended pregnancies, support maternal and child health, and minimize the need for abortion. On this anniversary, we recommit ourselves to supporting women and families in the choices they make and redouble our efforts to promote safe and healthy communities.
[From our friend Carey Pope]
An important fact that is often missing in the debate around abortion is that, for many women, the decision to have an abortion is informed by an already existing family unit. Six out of every ten American women having an abortion already have a child, and more than three out of ten have two or more children. At the same time, more than 40% of American women who have an abortion are living below the federal poverty level ($18,530 for a family of three). For poor women with children, abortion can be a critical financial issue for their families.
Yet, our policies on abortion in the United States don’t reflect this reality. Federal funding—and public funding in general—for abortion is nearly nonexistent. This became headline news again in 2011 when Congress imposed a ban prohibiting the District of Columbia from using its own locally raised revenues to provide abortion services to its residents, thereby obstructing a local government’s autonomy.
The debate around public funding for abortion isn’t a new one. In 1973, before funding for abortion in the U.S. was cut off, the Helms Amendment to the Foreign Assistance Act passed, prohibiting the use of U.S. funds for the performance of abortion as a method of family planning, or to motivate or coerce any person to practice abortions. In 1976, we were given the Hyde Amendment, which forbids federal funding for abortion except in cases of rape, incest, or danger to the life of the woman.
Millions of women in the United States and around the world benefit from U.S.-funded programs that improve maternal health. Yet the Helms and Hyde Amendments undermine that important work, harming women, particularly low-income women and women of color. The Helms Amendment has effectively been applied as a total ban on speech and services for safe abortion and on any activity that might enable a health worker to know what to do or to have the means to help when a woman has an unwanted pregnancy. In fact, the United States is the largest single donor for family planning—which of course is a way of preventing abortion—and a huge supporter of postabortion care programs designed to treat complications from unsafe abortion.
In our work at Ipas, we see the impact of unsafe abortion—something that is entirely preventable—all the time. Take, for instance, the story of Meena, a 23-year-old woman with two children in Nepal, where abortion is legally permitted. Meena went to a local health clinic in the remote Kailali District with an unwanted pregnancy. Because the facility was U.S.-funded, the nurse there did not help Meena with a safe abortion and instead referred her to a hospital 60 miles away—too far for Meena to travel on foot or ox cart. So Meena tried to self-induce with sticks. She went back to the clinic two weeks later with a severe infection and was given (more traumatic and expensive) emergency treatment, considered postabortion care and thus available in a U.S.-funded program.
The Hyde Amendment functions in the U.S. in much the same way as the Helms Amendment does abroad, restricting access to abortion care for U.S. women. I haven’t read anything quite as compelling as the testimony from Toni Bond Leonard, former president of the board of directors of the National Network of Abortion Funds and former CEO of Black Women for Reproductive Justice, who shared her story at a 2010 Congressional briefing. Toni was pregnant at age 12. Her mother, who was unable to work and relied on welfare, realized that if Toni carried the pregnancy to term, she’d essentially be raising another child, spreading the family resources even thinner. “She wanted better for me,” said Toni. So the light bill and the rent went unpaid and they didn’t have enough food—all so Toni could get an abortion. “Hyde set off a life-changing course of events for me and my family, which could have been prevented with public funding,” Toni said. “Hyde punishes women for being poor.”
The most striking part of Meena and Toni’s stories is that they aren’t unusual. Every day, everywhere, women make these choices for their families—both the ones they have, and the ones they hope to have. But U.S. abortion funding bans don’t reflect the complexity of women’s reproductive lives and the challenges of low-income women with children. After 40 years, isn’t it time that our policies reflect real women and real families?
Carey Pope is the Senior Associate for Advocacy Communications at Ipas, a global organization dedicated to ending preventable deaths and disabilities from unsafe abortion. Follow her and Ipas on Twitter @IpasOrg.
This post is part of Still Wading: Forty years of resistance, resilience and reclamation in communities of color, a blog series by Strong Families commemorating the 40th anniversary of Roe v Wade.
Justice Sonia Sotomayor of the Supreme Court refused to block enforcement next week of a requirement in the health care overhaul that some companies provide insurance coverage for contraceptive drugs and devices. In an order Wednesday, Justice Sotomayor, who hears emergency appeals from the 10th Circuit, said two companies controlled by the Oklahoma City billionaire David Green and his family did not qualify for an injunction while they challenged the rule. The companies, Hobby Lobby Stores, with more than 500 stores, and Mardel, with 35 Christian bookstores, said it violated their religious beliefs to require their health plans to cover contraception. Justice Sotomayor did not rule on the merits of the claims, and said that even without an injunction, the companies could continue their challenge in the lower courts.