Previous research from the Guttmacher Institute found large variations in rates of unintended pregnancy across states. Nationally, rates of unintended pregnancy are higher among black and Hispanic women than they are among white women, and poor women have much higher rates of unintended pregnancy than those with incomes of at least 200% of the poverty line. Young women and unmarried women also experience relatively high unintended pregnancy rates. Given these disparities, Kost and her colleagues sought to examine whether a state’s demographic and socioeconomic composition was related to variations in rates across states.

The authors did not find a relationship between the proportion of women at risk of unintended pregnancy in the state who are contraceptive users and levels of unintended pregnancy after controlling for demographic or socioeconomic characteristics within each state. They explain that this finding is not surprising. “It does not mean that contraceptive use has no relationship to unintended pregnancy,” says Dr. Kost. “It means that the relationship between contraceptive use and unintended pregnancy does not differ across states.” The authors speculate that what does differ among states is “the extent to which vulnerable populations have access to insurance and Medicaid, and hence to contraception and other family planning services.”

These findings, according to the authors, suggest that efforts to expand insurance and Medicaid coverage among groups with high levels of unintended pregnancy merit examination as ways to lower rates. Understanding variations in unintended pregnancy by state is crucial to helping policymakers and program planners design interventions that most effectively reduce unintended pregnancy.

“Variation in State Unintended Pregnancy Rates in the United States” is currently available online and will appear in the March 2012 issue of Perspectives on Sexual and Reproductive Health.

For more information on this topic, click here for Facts on Unintended Pregnancy in the United States.

On Tuesday we told you about the bishops’ campaign to contest the decision to make no-copay contraceptive coverage available to employees, including those working for Catholic institutions. This Department of Health and Human Services ruling was an important victory for the many women and men who need this coverage, especially during these tough economic times. With your help, this victory will actually reach the pocketbooks of American workers.

Right now, the Catholic voice reaching the White House is almost exclusively coming from conservative Catholics, including the US bishops and their allies. The media is continuing this misconception by running these reactions as a reflection of a monolithic Catholic outrage. These protests are not on behalf of employees’ conscience rights, and do not reflect most Catholics’ convictions or practice related to contraception. We need to speak up now and let the administration know that US Catholics support the right to choose contraception, just as they support no-copay coverage for employees’ contraception.

We need you to call and e-mail the White House today with a simple message: the bishops do not speak for me on contraceptive coverage.

Use our action center here to contact the White House today.

Remember to include a personal story in your e-mail to the White House. Your voice is needed now more than ever to preserve this great advance for the well-being of US workers.

We are also looking to share your stories as part of a campaign bring a different vision of Catholics into the spotlight: the experiences of Catholics like you who believe this contraception coverage supports employees’ freedom of conscience and should be available to all Americans, regardless of their employer.

Share your story to help combat the myth that contraceptive coverage is anti-Catholic.

Share your story online and send this link to others you know. There is no more effective way to educate policymakers and the media about the widespread Catholic support for equitable access to contraception.

If you would like more information, please contact Marissa Valeri at activists@catholicsforchoice.org or by phone at (202) 986-6093.

Thank you for taking action with Catholics for Choice. Please forward this alert to your friends, family, colleagues or any others who may be interested in getting active on this important issue.

Thanks for the fact check on the South Carolina Gingrich-versus-Romney ad ["Gingrich’s ‘Baloney’-filled Attacks on Romney," Jan. 11]. Confusing the public about emergency contraception pills (ECP) is deliberate, pervasive, and routinely served by opponents of contraception.

Although fact-checking the fact-checking seems tedious sometimes, it is important to explain that available research on Plan B One-Step (“the morning after pill”) shows that it prevents pregnancy by preventing ovulation and/or fertilization.

Ron Hamel, a Catholic ethicist publishing the conclusions of five years of scientific review in the January-February 2010 issue of Health Progress, said: ” … virtually all of the evidence in the scientific literature indicates Plan B has little or no post-fertilization effect, that is, it has little or no effect on the endometrium that would make it inhospitable to implantation. Its mechanism of action is to disrupt ovulation.”

One objection frequently repeated by Plan B opponents is that there is language in the pill package that the drug may prevent implantation. However, Nicanor Pier Giorgio Austriaco, a priest, theologian, and scientist also studied the active drug’s effects and determined that it has no post-fertilization effect. On the argument of labeling, he stated that: “ … labels mean nothing without the scientific data to back up their claims.”

These conclusions are reinforced in the 2010 World Health Organization’s fact-sheet on levonogestrel (LNG) which states: “… LNG ECP use does not prevent a fertilized egg from attaching to the uterine lining.”

The important answer to the question on emergency contraception is that there cannot be an abortion before there is a pregnancy; therefore, preventing unwanted pregnancies prevents abortions. But even if you believe pregnancy is the same as fertilization, you no longer have to put up with the warmed-over baloney that Plan B is an “abortion pill.”

Thanks, again, for your excellent work.

Lon Newman
Executive director, Family Planning Health Services
Wausau, Wisc.

President Obama listened to all of the women and men who called, e-mailed and wrote to the White House to express their support for family planning decisions staying in the hands of women. In so doing, he remained true to the original vision of the Affordable Care Act (ACA) and refused to bend the knee to intense lobbying from the United States Conference of Catholic Bishops, the Catholic healthcare industry and other special interests who wanted him to expand a refusal clause that would have denied millions of women access to affordable family planning.

The president of Catholics for Choice, Jon O’Brien, said, “The bishops pulled out all the stops in their campaign against women’s access to contraception. The Obama administration stood with those who support religious liberty and believe in giving women the freedom of conscience to make their own reproductive health decisions.

“While the refusal clause that is contained in the legislation is still too expansive, denying many women, as it does, affordable access to contraception, we are relieved by this announcement. Catholics for Choice and our colleagues in the reproductive rights movement expended a huge amount of energy and resources mobilizing the public to take action on this pivotal issue. In the final analysis, this was a victory for common sense and scientific advice in the interests of the common good.

“The battle over this issue is a warning about what is to come, especially as the bishops are playing the victim card in their pleas for special treatment and their false assertions about alleged attacks on religious freedom. The president and Congress will need to get real about what is going on, and remember that this coming November the electorate will not be listening to the bishops, so neither should they.”

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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.

Dear Laura,

Thank you for contacting me regarding right to life and the issue of abortion.

I fully understand the controversy and diverse opinions surrounding this issue. My own views have been forged over a lifetime of raising a family and following the national debate. In all sincerity, and with due respect to the beliefs of others, I believe that life begins at conception.

Our founding documents establish that we have an unalienable right to life endowed by our creator. Because the abortion debate concerns more than one life, there is not a national consensus as to when life begins or when the life of an unborn child should be protected.

Unfortunately, the Supreme Court in Roe v Wade imposed a judicial dictate that did not end a debate that would be better resolved through the legislative process. As a result, the controversy over abortion has raged for over 3 decades, and there will continue to be attempts to come to a better resolution of the issue legislatively.

I have cosponsored two current bills in the Senate that help define and resolve the issue. I support S. 91 that defines life as beginning at conception, and S. 906 that prohibits the use of taxpayer funds for procedures that so many Americans strongly believe are morally wrong.

Thank you again for taking the time to share your thoughts. It is important for me to hear the views and concerns of the people I serve. Since taking office, I have received over 300,000 pieces of correspondence and have had over 150,000 people participate in live forums and telephone town hall meetings. Please feel free to contact me in the future if I can further assist you or your family. It is an honor representing you and the good people of Wisconsin in the U.S. Senate.

Sincerely,

Ron Johnson
United States Senator

________________________________

I received the above email this morning. I immediately posted it on Facebook and the comments keep coming.

I’m not sure which email Sen. Johnson is replying to here, but I am so appalled by his use of religious language in official correspondence that I have to share it.

I’m referring specifically to Sen. Johnson’s candid mention of “our creator.” As if everyone believes whatever Sen. Johnson believes. As if imposing his religious beliefs on his constituents is part of his job as a U.S. senator.

Regardless of “our founding documents,” I am a strong proponent of separation of church and state. Everyone is entitled to their own religious beliefs or having no religious beliefs, but religion should have no place in government- in theory and practice.

Unfortunately, that’s not the reality. After all, organizations like NARAL wouldn’t have to exist if it weren’t for the religion-politics crossover.

Although the majority of Americans identify as Christians, 3.9-5.5% identify as non-Christian, and 15% don’t identify with any religion at all.

Furthermore…

• A recent Gallup poll shows that those who believe that abortion should be illegal in all cases are the minority;
• A Guttmacher report shows 78% of women who have abortions have a religious affiliation;
• And the Religious Coalition for Reproductive Choice, for example, is made up of about 40 national religious and religiously affiliated organizations from 15 denominations and faith traditions

Clearly, religion and anti-choice sentiments don’t always go hand in hand.

I expected Sen. Johnson’s response to be anti-choice, but I did not expect such a blatant disregard for religious freedom and separation of church and state. Like many politicians, he is using “the issue of abortion” as a platform to promote his personal religious beliefs rather than to simply state his position.

Sen. Johnson’s response illustrates that he is both out of touch and out of line.

By Leila Abolfazli

Here’s to a new year.

Arriving at the National Women’s Law Center three months ago, I never anticipated just how sustained and systemic the efforts to dismantle women’s health and reproductive rights had become.  Sure, I had paid attention to the Planned Parenthood defunding fight (which included the “trade” for a ban on DC funding of abortion services and the “this is not meant to be a factual statement” debacle) and had heard about HR 3and the disgusting “forcible rape” debate. Indeed, it was those events that informed my decision to work on reproductive rights issues full time. But even though I was aware of what was going on, it was only when I became involved with the issues on a daily basis where I gained a whole new perspective on just how far those who oppose reproductive rights are going in order to completely unravel women’s rights. And it got me thinking, if so many bad things can happen in just my three months here, what will 2012 look like?

So in order to be prepared for this year, I decided to give a quick review of my first three months – a recap of the numerous anti-choice measures that cropped up in just the final months of 2011. Because when you lay it all out, you can’t ignore how serious these efforts really are.

In my very first week, the House of Representatives voted on HR 358, which literally would allow women to die at hospitals instead of getting the emergency care they need if it included abortion care. Seriously? Ok, next? How about the Rehberg Draft, the House’s version of the Labor, Health and Human Services Appropriations bill, which was never reviewed, debated, or marked up in subcommittee before the subcommittee chair posted it online (meaning circumventing the typical process for getting bills through). The draft included defunding Title X (the family planning program), ensuring Planned Parenthood gets no federal funds whatsoever (once again), expanding refusal rights, and taking away funding for implementing the Affordable Care Act. So basically everything that would hurt women’s and their families’ health. Thankfully, these provisions did not make it into the final appropriations bill (although there was a cut in Title X funding), so take a momentary sigh of relief. But with this sigh of relief there is also one of frustration when considering the 2012 appropriations didn’t include provisions providing coverage of abortion in case of rape, incest, or life endangerment for Peace Corps volunteers or permanently banning the global gag rule. Oh, and don’t forget, the bill prevents DC from using its own funds to cover abortion services. Sigh.

Ok, next up we have the debate of the National Defense Authorization Act, where Senator Shaheen was trying to include an amendment in the bill that would correct a very serious gap in coverage for women who rely on the military for insurance. Does it make sense that military women who fight and sacrifice for our country are left without any health insurance coverage for abortion services when they find themselves pregnant after surviving sexual violence? Does it make any more sense that civilian federal employees and those on Medicaid get such coverage and women in the military do not? Despite it making no sense for not providing this coverage to military women, the amendment was blocked from coming to a vote.

Now back to the House again, where there was a hearing in the Subcommittee on Health of the Energy & Commerce Committee on whether the groundbreaking HHS rule guaranteeing no cost sharing coverage of contraception should have an even bigger exemption for more religious entities, like hospitals and universities. Even though the rule in no way forces someone to take contraception, several witnesses at the hearing said that the rule still impinges on hospitals’ and universities’ consciences. Contraception is widely accepted, widely used, and used to be non-controversial. So it makes you think, are we really debating this? Is this where we are now, that even contraception is now up for negotiation? Ugh.

Just weeks after the HHS rule hearing, there was another House hearing, “HHS and the Catholic Church: Examining the Politicization of Grants” where HHS officials were questioned why a grant to help survivors of trafficking (including sex trafficking) wasn’t given to the U.S. Conference of Catholic Bishops. Although claims were made of an administration bias against the Catholic Church, the issue boiled down to the fact that the Bishops would not provide or refer for all services that were required to get the grant. This includes providing or referring for the full range of gynecological care (remember what we are talking about here – providing care to sex trafficking survivors). The Bishops weren’t going to provide what the grant required, so they didn’t get the grant. Simple enough.

Next, we move on to a real roller coaster of a week. First, the House held a hearing on the Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act of 2011, a bill that would criminalize race and sex selective abortions. The hearing was unbelievably depressing as members of the House advanced the extremely anti-choice, anti-woman bill in the name of civil rights, even quoting famous civil rights leaders, all the while ignoring the very big elephant in the room – i.e. the fact that those touting this “civil rights” law voted against every other civil rights legislation in the past several years. This one requires a big sigh…

Ok, but no time to dwell on a bill that would basically require doctors to racial profile patients, because now we are at one of the most stunning decisions of the year – i.e. Secretary Sebelius’s alarming decision to overrule the FDA’s conclusion that Plan B should be given over the counter status. Ouch, this one really hurt. And just to add salt to the wound, the next day President Obama said he agreed with the decision,because he didn’t want his daughters to be able to get Plan B between the bubble gum and batteries.Thud, my head has officially hit the table. There are so many problems with this decision (including ignoring the difficulty women can face in obtaining Plan B at a pharmacy) and the subsequent commentary, but, at its core, the decision to deny women over the counter access to contraception is a huge loss for this country.The decision has done great damage to the message about the benefits of access to contraception, women’s ownership of their reproductive health decisions, and elevating science over an incorrect political calculation (yeah sometimes I really want to think global warming isn’t happening, but then I look at the science…).  Oh, and did you know that Obama’s daughters could get a lot more dangerous medicines at the pharmacy next to the bubble gum that is a lot cheaper than the $50 needed to buy Plan B… But that’s beside the point, right?

And so, with that great disappointment, 2011 is over, and with it the end of my first three months at the Law Center. Oh, and just as an fyi, this is just what happened on the national level, I did not even step into theNINETY-TWO anti-abortion restrictions passed in the states, which would make this blog even more depressing than it is and, not to mention, as long as the dictionary. But just as a reference - this total is almost THREE times higher the last highest number of state anti-abortion restrictions, which was 34 in 2005.

All of these attacks on women’s reproductive health, what is it about? Is it about controlling women’s decisions? Is it about nervousness about people having sex? Or is it just about scoring political points, and getting reelected?

Whatever it is or isn’t, it is madly saddening. Not only because women’s bodies are being used as political points, but because the conversation that happens in Washington about women’s bodies is completely ignorant of the conversation that is happening in the rest of America. That conversation is that there is an America that is struggling to make it. That there is a stubborn high unemployment rate (which, if the proponents of sex and race selection abortion were really concerned about discrimination and civil rights issues, they would work on legislation to help with the fact that black women in America have been particularly hit by job loss during the recovery). That the income gap is growing, people’s houses are underwater, extreme poverty is rising. These are all serious issues that are affecting Americans. But instead of dealing with these real issues, Washington is focused on women’s reproductive organs and figuring out new and unique ways to restrict, deny, and control them.

It is all very maddening, but if you think of a silver lining, think that the public gets it even if Washington doesn’t. Think about the Personhood Amendment failing in Mississippi by a large margin (yes, Mississippi).

And be ready for 2012.

Today (Friday, January 6th), the President’s Council on Science and
Technology will hold its bi-monthly meeting, and 5 representatives from
different sectors of the reproductive health community will address the
Council during the public comment period at 1:30. The speakers will be:

* Dr. Francesca Grifo, Program Director of the Union of
Concerned Scientists Scientific Integrity Program

* Dr. Susan Wood, Associate Professor at the Jacobs Institute of
Women’s Health, George Washington University School of Public Health and
Health Service

* Mr. Wayne Shields, President and CEO of the Association of
Reproductive Health Professionals

* Dr. Doug Laube, MD, Obstetrician and Gynecologist; Board Chair
of the Physicians for Reproductive Choice and Health

* Ms. Kelly Cleland, MPA, MPH, Executive Director of the
American Society for Emergency Contraception; Research Staff at the
Office of Population Research at Princeton University

If you’re interested in watching a webcast of the meeting tomorrow,
click here. Each
speaker only has 2 minutes, so hopefully we will succeed in getting the
attention of the Council (and the President) in that brief amount of
time.

The never-ending efforts of the United States Conference of Catholic Bishops (USCCB) to force US law to comply with the bishops’ interpretation of Catholic teachings continue. The USCCB has rounded up its colleagues in the Catholic healthcare industry and allies in Catholic education, social services, NGOs and religious orders and placed a full-page ad in today’s Washington Post calling for an expansive refusal clause that will ensure that millions of women and men are denied no-cost family planning coverage.

Jon O’Brien, president of Catholics for Choice, issued the following statement today about the bishops’ lobbying efforts.

“The United States Conference of Catholic Bishops isn’t satisfied with its privileged status in US policymaking. Having held healthcare reform hostage over insurance coverage for family planning and abortion services, it is now demanding that Catholic institutions be given unprecedented conscience rights over the people to whom they provide health insurance coverage. This is unacceptable.

“The bishops’ conference is focused like a laser on politics. It wants to increase its role in policymaking so that the bishops can impose their own narrow religious views about sexuality—views that are only shared by a tiny minority of Catholics—on the entire nation, all the while keeping the billions of dollars they receive from state and federal budgets.

“Just weeks ago, the USCCB launched its Ad Hoc Committee for Religious Liberty. The committee isn’t designed to focus on religious beliefs, or worship, or catechesis, as one might expect a committee of Catholic bishops would. The committee’s mandate is to work in six areas, with five of those related to sex issues and the other seeking allowances to discriminate in the employment arena.

“The committee is a major lobbying initiative that seeks to give the bishops a free pass—allowing them to get taxpayer dollars for their social service charities without having to adhere to the standards that apply to others working in the same field or competing for the same contracts. Just look at what the bishops have spent the last few months working on: an all-out assault on the Obama administration and allies in Congress demanding the right to block workers at Catholic institutions from gaining access to contraception through their insurance without a copayment.

“The USCCB wants to take taxpayer money while refusing to provide condoms as part of HIV outreach; to ban employees and their dependents from getting the benefit of contraceptive coverage that other Americans enjoy; and to opt out of providing emergency contraception to victims of sexual violence who come to Catholic hospitals.

“Catholic teachings tell us that we each have a responsibility to listen to our own consciences in matters of moral decision making and to respect other people’s right to do the same. Our tradition also tells us to care for the most vulnerable. The bishops need to remember this when they are making decisions about where to expend their political energies.

“Rather than playing politics to impose their beliefs on people in need, the bishops should focus on their own flock, the people they have yet to convince to follow their lead on key issues related to conscience and religious freedom. I trust that President Obama will listen to the electorate and not the US bishops and their allies when making decisions about healthcare delivery.”

      Family Planning Health Services (FPHS) administers a statewide emergency contraception (EC) hotline which provides Plan B One Step ™ to women in need. Lon Newman, FPHS executive director, commented on the decision: “I am surprised by this administration’s willingness to divorce drug policy from medical evidence, but my response, is grim determination. I am not angry and I am not discouraged.”

     Newman explained that the statewide hotline (866-EC-FIRST or 866-323-4778) makes Plan B One Step ™ easily accessible by giving women access to prescribing clinicians and helping them find the fastest and the best no-cost or low-cost delivery in their area.  “It is important that people are aware of access to Plan B One Step ™ provided in Wisconsin with the Hotline,” explained Newman. “We want people to have swift access to this medication to help prevent unintended pregnancies. Mistakes can happen. We want people to know they have safe and sound options to help prevent an unintended pregnancy.”  National publicity has focused on the policy and controversy, and that may leave women ill-informed or misinformed. Newman gave examples of important points that Wisconsin women of reproductive age should know:

• Plan B – One Step ™ is available and accessible to all women at risk of unintended pregnancy through the statewide network of family planning providers, all of which

provide EC at low or no cost. The EC Hotline 866-EC-FIRST is able to connect people quickly to medication and resources in their area. Plan B One Step ™ remains available to women ages 17 and older over-the-counter.

• There is no medical evidence to support the claim that Plan B One Step ™ prevents implantation of a fertilized egg and it does not disrupt an existing pregnancy.(Source:  Contraception Volume 84, Issue 5 , Pages 486-492, November 2011)

There is a great deal of misinformation about this – often from otherwise reliable sources – and this mistaken belief is the reason many women of religious faith are uncertain about whether they should take Plan B One Step ™.

     Newman said that there has been a reduction in the unintended pregnancy rate among FPHS patients over the past six years. “Birth control methods have improved over the past few years and our ability to provide them has improved, but the major difference in our protocols has been the provision of EC in advance of need to our patients.  I believe that EC has prevented almost 200 unintended pregnancies and more than 75 abortions every year since 2006.”

     Newman, when asked about the broader repercussions of Secretary Sebelius’ decision, said that he fears it may foreshadow a separation between the Women’s Health preventive services recommendations of the Institute of Medicine and the Obama administration’s policy for the Affordable Care Act (which makes contraception available through insurance without co-pays or deductibles). “This administration has pledged to base policy on best medical evidence. The public must tell them that it’s time to prove it.”

“I regret that HHS has stepped in and overridden the FDA’s long-overdue decision to remove the unnecessary age restriction on Plan B One-Step emergency contraception,” said Rep. Gwen Moore. “The FDA’s proposal would have meant that emergency contraception would be brought out from behind the pharmacy counter, onto the shelves with other similar contraceptive methods. Medical experts, including the American Academy of Pediatrics, agree that Plan B is perfectly safe for over-the-counter use for anyone at risk of an unintended pregnancy, including younger women. I fervently hope that HHS is not putting politics or ideology over science in their decision.” 

Plan B One-Step is a safe and effective emergency contraceptive that is meant to be taken within 72 hours after contraceptive failure or unprotected intercourse. Plan B prevents fertilization from happening, and does not work if the woman is already pregnant.

“I thought we could all agree on the importance preventing unintended pregnancy, especially among teenagers,” said Rep. Moore. For the past few years, my home city of Milwaukee has worked very hard to reduce our epidemic teen birth rate. We’ve seen a 15% drop since 2005, when our teen birth rate was second in the nation only to Baltimore. But we still have a long way to go. A recent study released by United Way of Greater Milwaukee showed that statutory rape is among our biggest challenges to reducing teen pregnancy. Seventy-one percent of babies born to Milwaukee’s teenage girls were fathered by men at least 20 years of age. These pregnancies have serious consequences not only for these young women—who often experience tremendous isolation and vulnerability—but for their communities at large. Decisions like the one made today by HHS will only exacerbate the problem in places like Milwaukee.”

Plan B One-Step is a single-dose pill (1.5 mg levonorgestrel tablet) which is effective in decreasing the chance of pregnancy if taken within 3 days after unprotected sexual intercourse.  The product contains higher levels of a hormone found in some types of daily use oral hormonal contraceptive pills and works in a similar way to birth control pills.

Plan B One-Step was originally approved in July 2009 for use without a prescription for females age 17 and older and as a prescription-only option for females younger than age 17.  In February 2011, Teva Women’s Health Inc. submitted a supplemental application seeking to remove the prescription-only status for females younger than age 17 and to make Plan B One-Step nonprescription for all females of child-bearing potential.

The Center for Drug Evaluation and Research (CDER) completed its review of the Plan B One-Step application and laid out its scientific determination. CDER carefully considered whether younger females were able to understand how to use Plan B One-Step.  Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider.

It is our responsibility at FDA to approve drugs that are safe and effective for their intended use based on the scientific evidence.  The review process used by CDER to analyze the data applied a risk/benefit assessment consistent with its standard drug review process.  Our decision-making reflects a body of scientific findings, input from external scientific advisory committees, and data contained in the application that included studies designed specifically to address the regulatory standards for nonprescription drugs.  CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.

However, this morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency’s decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential.   Because of her disagreement with FDA’s determination, the Secretary has directed me to issue a complete response letter, which means that the supplement for nonprescription use in females under the age of 17 is not approved.  Following Secretary Sebelius’s direction, FDA sent the complete response letter to Teva today.  Plan B One-Step will remain on the market and will remain available for all ages, but a prescription will continue to be required for females under the age of 17.

The Catholic Church says new federalregulations requiring employers to provide no-cost prescription birth control as part of their health insurance plans infringe on their religious liberty.

“If we comply, as the law requires, we will be helping our students do things that we teach them, in our classes and in our sacraments, are sinful — sometimes gravely so,” Catholic University President John Garvey wrote in The Washington Post. “It seems to us that a proper respect for religious liberty would warrant an exemption for our university and other institutions like it.”

But while some insist that the rules, which spring from last year’s health law, break new ground, many states as well as federal civil rights law already require most religious employers to cover prescription contraceptives if they provide coverage of other prescription drugs.

While some religious employers take advantage of loopholes or religious exemptions, the fact remains that dozens of Catholic hospitals and universities currently offer contraceptive coverage as part of their health insurance packages.

“We’ve always had contraceptive birth control included in our health care benefits,” said Michelle Michaud, a labor and delivery nurse at Dominican Hospital in Santa Cruz, Calif. “It’s something that we’ve come to expect for ourselves and our family.”

Dominican is part of the Catholic Healthcare West System. A spokeswoman for the 40-hospital chain confirmed that it has offered the benefits since 1997.

Michaud, who was raised Catholic but doesn’t practice now, says she doesn’t see any problem for a Catholic hospital to provide a benefit that conflicts with the religion’s teachings.

“Oh no, because they don’t just employ Catholics,” she said. “They may be Catholic, but who they employ are not necessarily Catholic.” At the same time, said Michaud, “even practicing Catholics would want to have birth control options.”

Indeed, studies have shown that the vast majority of Catholic women in the U.S. use artificial birth control.

But while Catholic Healthcare West began offering coverage before it was legally required, today the landscape is quite different. According to the National Women’s Law Center, 28 states currently require contraceptives to be offered in health plans that also cover other prescription drugs; eight of those laws include no exemption for religious organizations.

Georgetown University in Washington, D.C., also offers contraceptive coverage to its employees – though not to its students.

That’s a relief for Andrea Waters, who works at the university’s law school. She’s 26, Presbyterian and lives with her boyfriend.

Without the coverage, she says, “I think I’d have to reevaluate what I spend monthly” in order to afford birth control pills.

Now some religious employers have been able to skirt state requirements by becoming “self-insured,” rather than buying insurance from a company. That makes them subject to federal, rather than state regulation. But they are wrong if they think that gets them out of having to offer contraceptive coverage, says Sarah Lipton-Lubet of the American Civil Liberties Union.

“Institutions like hospitals and universities … you’re required to include contraception coverage in your insurance plan where you include coverage for other prescription drugs, as a matter of basic gender equality,” she says.

That’s the result of a ruling in 2000 by the federal Equal Employment Opportunity Commission. It found that employers whose health plans offer prescription drugs and other preventive services but not contraceptives violated the Pregnancy Discrimination Act, 1978 civil rights law that amended the 1964 Civil Rights Act.

And what does contraception have to do with pregnancy discrimination? “Prescription contraception is a form of health care that is unique to women, and the consequences of the inability to be able to access contraception, those fall primarily on women,” Lipton-Lubet says.

The EEOC ruling isn’t technically binding unless people who are being discriminated against take action. That happened recently when some faculty members at a small Catholic college in North Carolina filed a complaint. The EEOC ruled in their favor.

What the Catholic Church’s leaders are now seeking from President Obama is a broader exemption from the new rules, which would let them not offer — or stop offering — contraceptive coverage. They have the strong backing of Catholic members of Congress like Pennsylvania Republican Tim Murphy.

“The foundation of our country is not to impose laws that restrict the ability of persons to practice their faith,” he said.

But Lipton-Lubet of the ACLU says this isn’t a fight about religious liberty.

“What the bishops and their allies are asking for is the ability to impose their religious beliefs on people who don’t share them,” she said.

A decision by the administration on the rules is expected soon.

Personhood  (and all anti-choice efforts) emerge from politically entrenched religious zealots and political opportunists, quite often these operatives are men; men who generate a willing group of women followers to cast their efforts as somehow pro-woman.  Men like Tony Perkins of the Family Research Council, Bryan Fischer of the American Family Association, Chris Slattery of Expectant Mother Care, Troy Newman of Operation Rescue and of course, Les Riley, the man behind Prop 26 in Mississippi.

Religious zealots form a symbiotic relationship with politicians to pass draconian legislation sacrificing the rights of women.  The zealots get to walk away having successfully implemented a cog in their overall attempt to implement a Christian worldview system of governing on the US securely placing men in the headship roll and subjugating women.  The politicians in return get tons of fundraising cash and a committed group of one-issue voters that can propel them into office.

As Mississippi votes on a woman’s right to her own body, Herman Cain is promising to set the record straight regarding the numerous allegations of sexual harassment coming up from his past.  While the Cain campaign tweets about Gloria Allred in a condescending male voice, the right wing media blames the victim, and a liberal media is busy determining whether Cain remains electable or not, we are all missing the point.

Our public discourse, by and large, discuses women and issues impacting women as if women themselves are removed from the equation.  That we are somehow having a high-level think-off on the rationality of a bill that establishes the contents of a woman’s body as not her own, that the GOP front runner can run his hand up a woman’s leg and pull her head toward his crotch and make a killing in fundraising – and keep is position in the polls – as a result.  Instead of focusing on women taking a beating in this country, the discussion deteriorates into who said what, political polls and Howard Stern’s producer commanding audience at various press conferences.

Cain is, by some accounts, being accused by up to seven women of sexual harassment and now with the public statement of Sharon Bailek, Cain is being accused of possible sexual assault.  Instead of the Cain scandal being called what it is – a possible criminal situation and a case study in the abuse of male power – pundits busy themselves arguing whether or not, Cain will be able to weather this political storm. Can he make it through to Iowa?  As the anti-Romney are the Republicans willing to overlook Cain’s unfortunate sex business (my guess is yes)?

The media needs to seize this moment to connect the dots.  The Mississippi personhood amendment, the ultrasound bills, waiting period laws and the myriad others ravaging women’s rights across the country and Herman Cain’s sex scandal fall under a neat umbrella: men seeking to encroach on the rights of women for personal and/or political gain.  Whether it is Herman Cain’s apparent need to quench his sexual desires by making unwanted advances on subordinates or Les Riley’s need to create a Christian utopia starting with egg citizenship – we need to talk about them as connected.

It looks like the race to watch in Mississippi on Tuesday night will be the state’s proposed ‘Personhood Amendment,’ which would make the state’s laws regarding abortion and birth control the strictest of any state in the country. Right now it looks like it could go either way, with 45% of voters supporting the amendment and 44% opposed.

Men (48-42), whites (54-37), and Republicans (65-28) support the proposal. But women (42-46), African Americans (26-59), Democrats (23-61), and independents (35-51) oppose it. The good news for those opposed to the amendment is that 11% of voters are undecided and their demographics are 58% women, 54% Democratic, and 42% black- those still on the fence disproportionately belong to voter groups that oppose the amendment. That suggests when those folks make up their minds the proposal could be narrowly defeated.

There should be less suspense in the Gubernatorial race. Republican Phil Bryant leads his Democratic opponent Johnny DuPree by 14 points, 54-40. The race is incredibly polarized along racial lines with Bryant up 74-20 with whites, while DuPree has an 80-11 advantage with African Americans. It’s an unusual contest for this highly negative political climate in that voters have a positive opinion of both candidates: Bryant’s favorability is 54/25 and DuPree’s is 46/27. We don’t see that very often.

The decisive factor in this race may be Haley Barbour. His 60/29 approval rating represents the best numbers we’ve found for any Governor in the country this year. When you have an incumbent leaving office that popular, you’re usually not going to see voters eager to switch the party in power.

One finding on the poll that could be particularly bad news for Democrats is that they trail 49-38 on the generic legislative ballot. It’s always hard to say how generic ballot results will translate to seats gained and lost, but with Democrats holding a narrow majority right now in the House of Representatives these numbers suggest that the GOP could gain control on Tuesday.

There’s some better news for Democrats down ballot. Attorney General Jim Hood looks to be headed for reelection, leading his Republican opponent Steve Simpson by a 52-39 margin. In addition to having his party unified behind him Hood leads with independents and is taking an impressive 26% of the GOP vote. If Democrats are ever going to win a Gubernatorial or Senate race in Mississippi Hood is probably their guy. Things don’t look as promising for the party in the Treasurer’s contest. There Republican Lynn Fitch is leading with 54% to 35% for Democrat Connie Moran and 4% for Reform Party candidate Shawn O’Hara.

We also polled two other proposed constitutional amendments. A photo id requirement vote looks like it will pass easily, currently leading 64-29. An eminent domain amendment looks like it will pass as well, although by a narrower margin. It currently leads 51-39.

Full results here.

Will the Obama Administration Stand up for Workers or Cave into the Demands of the Catholic Bishops?

Today the public comment period for the Department of Health and Human Service’s regulations on coverage for preventive health services comes to a close. Catholics for Choice has spearheaded advocacy from a broad spectrum of voices for those people who may be denied coverage—a refusal or conscience clause is included which will permit religious organizations to deny coverage for family planning to their employees. The proposed refusal clause leaves too many women without affordable access to the family planning coverage they need. We know that each and every woman—her health and her conscience—matters. Jon O’Brien, president of Catholics for Choice, said, “It is simply unjust to leave even one woman without access in order to gain coverage for a few. Restricting access for select groups is in fact counter to the ultimate goal of the Affordable Care Act, which is to expand access to quality, affordable healthcare for all Americans.”

The majority of Catholics support family planning, and they are not afraid to speak up about it. Hundreds of Catholics have sent comments to Secretary Sebelius calling on her to ensure that all women are covered. In addition, groups of Catholic theologians, political leaders and Catholic organizations have signed onto collective statements. These appeared as open letters in the National Catholic Reporter, Politico, and The Hill earlier this week.

The United States Conference of Catholic Bishops launched an unprecedented campaign seeking to pressure the Obama administration to impose even further limits on who will be covered under the new regulations. Having failed to convince Catholics in the pews to follow their hard-line ban on all contraception, the bishops are seeking to bypass the consciences of employees of religious organizations by imposing their extremist beliefs on all women, Catholic and non-Catholic alike. As they assure commentators and policymakers that they have the right to determine what healthcare is best for others, the bishops and other conservative Catholics have struggled to conceal their disdain for the choices others make about family planning—including those who work in diocesan offices, teach in Catholic schools and otherwise serve the Catholic community. We should remember that it was not that long ago that a majority of the pope’s hand-picked advisors agreed that there was no moral, theological or pastoral reason to ban Catholics from using contraception. The bishops would like us to forget that moment in history.

Catholics for Choice has also submitted comments to Secretary Sebelius in support of comprehensive reproductive health coverage, arguing that “the proposed refusal clause is an affront to religious freedom [that] constitutes state-sponsored discrimination.” It continued, “Granting entire institutions the rights of conscience that should be left to individuals is an affront to the Catholic ideals of conscience, workers’ rights, social justice and religious freedom.” In addition, secular groups and interfaith groups also sent open letters to Secretary Sebelius.

In a letter sent earlier this week, a dozen of the nation’s leading Catholic theologians revealed the fact that the inclusion of coverage for family planning in the Affordable Care Act aligns very closely with Catholic teachings on social justice. They stated that they saw “no medical or religious justification for exempting employers from paying for some necessary aspects of women’s healthcare,” because “there is no Catholic teaching to support selective fairness.”

In another letter to Secretary Sebelius, Catholic policymakers emphasized the needs of their constituents by asserting that during these difficult times everyone should be covered, “especially those who face economic hardships.” Catholic groups stated in their letter that they “cannot and do not presume to tell others how best to listen to their own consciences as they make important decisions about whether or when to have children. We do not support any effort to deny and disrespect the conscience of individuals who seek comprehensive family planning services, and encourage you to reject all policies that do so.”

Catholics for Choice president Jon O’Brien said, “We organized this campaign because the bishops do not represent the views of Catholics. They have a very narrow worldview that they pretend is indicative of the views of all Catholics. That is simply not true. It’s time for the Obama administration to stop facilitating discriminatory practices, and start promoting a society where all people have access to comprehensive and affordable healthcare, including family planning services.”

The Obama administration has announced that starting as early as August of next year, many women will have coverage for contraception with no out-of-pocket costs. At the same time, many other women will be denied this coverage.

Understandably, the focus of the debate has been on the coverage, not the denial of coverage. But in the midst of the maelstrom surrounding the announcement by the Department of Health and Human Services (HHS) about new regulations for coverage of women’s preventive services, it is easy to forget that these are the facts as they currently stand. Sadly, the many women left behind by these regulations, those working for religious employers, have had their voices drowned out both by extremists opposed to all birth control and those ordering them to remain seated silently at the back of the bus—unseen and unheard as the limelight shines on the positive step for those women who will benefit.

Not surprisingly, the Catholic bishops have a hand in this debacle. Once again, the bishops and their allies seek to impose a refusal clause exempting some employers from having to follow the new and needed increase in coverage. Having failed to convince Catholics in the pews to follow their hard-line ban on all contraception, the bishops are ignoring the consciences of those who work for them by seeking to impose their extremist beliefs on all women, Catholic or otherwise.

As they assure pundits and policymakers that they have the right to determine what healthcare is best for others, the bishops and other conservative Catholics have hardly concealed their outright disdain for their own employees—those who work in diocesan offices, teach in Catholic schools and otherwise serve the Catholic community. Indeed, the head of the Catholic Health Association (CHA), Sr. Carol Keehan, went so far as to imply that the effect of these refusal clauses is somehow minimal by (erroneously) calling it “only” the “parish housekeeper exemption.”

It is disgraceful that the spokespeople for a faith that prioritizes the primacy of individual conscience would be so willing to trample the consciences of others, no matter the cost. It is disgraceful that the head of an organization supposedly committed to social justice would unabashedly look down her nose at a fellow human being simply because of that woman’s occupation. It is disgraceful that some reproductive justice advocates have thrown “the parish housekeepers” and other women affected by these exemptions under the bus. Simply put, they have all accepted a second-class citizenship designation for parish housekeepers and other employees of the church.

Downright discriminatory, however, is the fact that the Obama administration is willing to write all of this extremism into public policy.

In the summer of 2009, we outlined our hopes for what healthcare reform would look like. We believed then, as we believe now, that all women and men, regardless of income, should be able to access contraception that is not only affordable, but free. At the core of this belief is a sincere adherence to our faith’s respect for the primacy of every person’s conscience. Given the Obama administration’s professed commitment to healthcare reform that would be both cost-effective and that would guarantee equitable access, we hoped that those in power would share this belief.

The refusal clauses included in HHS’s regulations for contraception mean that the plan is fundamentally flawed. No person should be left behind in these steps forward, but the proposed regulations will do just that.

One woman who would be left behind is “Sandra,” a science teacher at a Catholic school in the Midwest whose story shows the reality of what many women can see in their future—and is an example of the many who will fall under the type of employer refusal clause that the bishops hope to extend to all.

As with almost all Catholic schools, her employers follow diocesan rules regarding employees’ insurance—meaning no contraceptive coverage, regardless of medical necessity. When she first learned of HHS’s regulations she was outraged. They added, as she explained, “insult to injury” by ignoring the healthcare needs of women like her and allowing her employers to continue denying her coverage.

“I just never assumed that in 2011 I would be denied birth control,” she said. “I’m in my mid-twenties. I have no intention of having kids at the moment. I like teaching kids, but it’s a whole other thing having them.”

“Sandra” lost coverage when she began working under the jurisdiction of her local diocese. “I went to fill my birth control prescription like I always do. I say ‘here’s my new insurance card,’ and they say I’m not covered,” she said. “They thought that it was weird and asked where I worked, and as soon as I said I worked in a Catholic school, they said, ‘Oh, 99 percent of Catholic schools will not cover it. We’ve never had it covered before.’ I had no clue.”

For “Sandra,” this posed a significant hardship. She had taken a salary reduction in order “to go to work everyday saying that it’s what I love” to do. She and her husband had carefully considered their insurance plans and determined that it was more economical for them to remain on separate policies, but once she had to pay out of pocket for the birth control that was best for her, a non-generic brand prescription, their careful financial planning went down the tubes.

“Birth control is a lot of extra money on top of the salary reduction, but the principle of it is really what gets me,” she told us. “I don’t like being told by some guy that I’ve never met that I can’t use it. The bishops are not even having sex in the first place. How are they supposed to know how to tell me what to do in that situation?”

Her story, as she recognized, is all too common and reflects the repeated marginalization of many women by the Catholic hierarchy—the same women whose voices have been deemed unimportant by those on both sides of the contraceptive coverage debate. She first noticed this silencing in her own Catholic home, where her devout grandmother and aunts all used birth control but were “quiet about it, because we didn’t want to anger the boys in the big house.”

With the bishops failing to convince Catholics in her own family, like the majority of Catholics, of their extremist views on birth control, “Sandra” saw the consequences of this extremism on her colleagues, Catholic and non-Catholic alike.

“Most of the girls, the first thing they complain about is the lack of birth control coverage. It’s one of those unspoken things that no one talks about, because no one wants to risk their job—it’s hard enough to find a job right now, anyway,” she said. “You also don’t have to be Catholic to work at a Catholic school. I respect the beliefs of some of the parents in our school and others, but for those who don’t believe that or who aren’t Catholic, I think that as your own person, you should be able to do what you believe.”

As she explained, the majority of Catholic school teachers are female, but their access to contraception is determined by those most out of touch with their healthcare needs. The cost, however—and the emotional toll of an unspoken vow of silence—extend far beyond this direct impact on teachers. In “Sandra’s” experience, for the spouses of male teachers, some of whom share their husbands’ insurance policies, and for all teachers’ dependents, some of whom need birth control to regulate medical conditions, the complete lack of access poses a serious hardship.

In the course of telling her story, this one teacher outlined in chilling detail the ways in which the bishops’ own failure to convince Catholics in the pews has translated into their forceful imposition of extremist beliefs on everybody. It is the same story that the bishops hope all women will share, and Obama’s Department of Health and Human Services seems quite willing to let this happen. These refusal clauses do not represent the vision for the Affordable Care Act that we were promised, and we hope that it is not one that the Obama administration is willing to accept.

There is still time for Secretary Sebelius and the Department of Health and Human Services to do the right thing for “Sandra,” her family, her colleagues, their families and the many others who are relying on healthcare reform to ensure contraceptive coverage for all women. While some are busy claiming that this woman and others like her are unimportant, we know better.

We believe that each woman—her conscience, and her health—matters, and we know that if we do not stand in solidarity with every one, we will not only compromise our morality, but we will eventually lose coverage for all. We also know that there are many others, Catholic and otherwise, men and women, who share this conviction. HHS must hear from these people who need to argue strongly and consistently that leaving any person behind is unacceptable.

“Sandra,” whose anonymity was required because speaking up about birth control coverage could mean the loss of her job, may have said it best: “I was told by everybody, ‘What can you do about it? The church is never going to change.’ If it’s just me whining about it, that’s true, but if every woman said something, they’d have to take us into account.”

We are certainly taking her into account. It is high time for others to speak up and tell the Department of Health and Human Services to do the same.

[From Guttmacher]

In a move that could significantly improve access to contraceptives for millions of women, the U.S. Department of Health and Human Services (DHHS) on Monday announced that it is adopting in full the recommendations for women’s preventive health care the Institute of Medicine (IOM) issued in July. The services recommended by the IOM, including contraceptive counseling and provision of all methods approved by the Food and Drug Administration, will be covered without out-of-pocket costs to patients by new private health plans written on or after August 1, 2012.

Making contraceptive counseling, services and supplies—including long-acting, reversible methods (the IUD and the implant), which have high up-front costs—more affordable addresses the fact that cost can be a daunting barrier to effective contraceptive use. Removing that barrier for women covered by private health plans not only makes it easier for them to use contraception generally, but will also allow them to use the most effective methods, which they might not previously have been able to afford.

The evidence strongly suggests that insurance coverage of contraceptive services and supplies without cost-sharing is a low-cost—or even cost-saving—means of helping women overcome barriers to effective contraceptive use. The IOM recommendations fill important gaps in three existing sets of services that are already covered without cost-sharing under a provision of the 2010 health reform legislation. Developed after an exhaustive review of the scientific evidence, the recommendations also include coverage for an annual well-woman preventive care visit, specific services for pregnant women and nursing mothers, and counseling and screening services related to HIV and other STIs, cervical cancer and domestic violence.

Government bodies and private-sector experts have long recognized contraceptive services as a vital and effective component of preventive and public health care. A strong body of research shows that contraceptive use helps women avoid unintended pregnancy and improve birth spacing, resulting in substantial benefits for the health and well-being of women, infants, families and society.

However, while endorsing the IOM recommendations in full, DHHS also included an exemption that makes it possible for religious employers to opt out of the contraceptive coverage provision. Such an exemption was not required by the health care reform law and could potentially inhibit some women’s access to the contraceptive services and supplies on which they rely to prevent unintended pregnancy. Special care must be taken in implementing this exemption to mitigate any harmful impact on women who are affected.

Moreover, not all plans would be affected by the preventive services requirement—at least, not in the short run. Existing plans are “grandfathered”—meaning they are exempt from the requirement—so long as no significant negative changes, such as cutting benefits or raising cost-sharing, are made to them. DHHS has said that most plans will likely lose grandfathered status within a few years.

For more information:

The case for insurance coverage of contraceptive services and supplies without cost-sharing

Contraceptive use is the norm among religious women

Contraception is highly effective when used consistently and correctly

Facts on contraceptive use in the United States

Is there nothing in last year’s Affordable Care Act that people won’t fight over?

The latest battle is set to come to a head Wednesday, when the independentInstitute of Medicine is expected to make recommendations about preventive health care services for women. And one service that’s drawing a lot of the attentions is contraception.

Depending on the group’s recommendation, contraception could become part of a package of preventive benefits that every health plan would have to cover without patient cost-sharing. In other words, it would become effectively free.

That would have made a big difference for Andrea Leyva, of Tucson, Ariz. A few years ago, following the cancer death of one of her three children, she and her husband — both employed and with health insurance — were nonetheless struggling to pay the bills for them and their remaining two children.

The $25 copay for her monthly birth control prescription “began to fall into the category of a luxury for us,” she said, and they stopped filling the prescriptions regularly. At age 36, Leyva found herself pregnant with what she calls her “blessed surprise,” daughter Alexandria. “So while we’re happy that she’s here, it was not planned, and had we had some better finances, we probably could have made some better decisions,” Leyva says now.

Deborah Nucatola, senior director for medical services for Planned Parenthood Federation of America, says Leyva’s story isn’t unique. “Half of all pregnancies that happen in the U.S. every year are unintended,” she says. “And if we could prevent an epidemic of this proportion, that should be justification enough that contraception is preventive care.”

But at the same time, says Nucatola, who’s also an OB-GYN, birth control is about more than just preventing pregnancy. “We can also use it as essential preventive medicine for the 4 million women who have babies every year in the U.S.,” she says. “Babies born at least 18 months apart are going to be healthier than those born closer together, and closely timed births are risky for their mothers, too.”

Earlier this year, NPR and Thomson Reuters polled people for their views on whether private insurance plans should cover contraceptives. About three-quarters of Americans believe private insurance, including employer-based policies, should cover all or some of the cost of oral contraceptives. Support was just about the same when people were asked if government assistance was used to make the purchase of insurance more affordable.

But not everyone agrees that contraception should be available to the same extent as mammograms or childhood immunizations.

“There are two reasons we oppose the inclusion of contraceptives as a preventive service,” says Jeanne Monahan. She’s director of the Center for Human Dignity at the conservative Family Research Council.

One big problem, she says, is that requiring insurers to cover contraceptives violates the conscience rights of people who belong to religions that don’t believe in artificial contraception. “Say for example that I had a problem with it; I would be paying into a plan that would be covering them,” she says. “So in a way I would be forced to pay for it myself.”

The other problem, says Monahan, is abortion. Specifically, abortion opponents argue that some emergency contraceptives — so called morning-after pills — can cause very early abortions by preventing the implantation of fertilized eggs into a woman’s uterus.

“So those 7 to 10 days before a baby can implant, Plan B can prevent implantation and thereby cause the demise of that baby. So we’d be opposed to those drugs being included because they act as abortifacients.”

Plan B is one of two emergency contraceptives that have been approved by the FDA. They are different from the abortion pill mifepristone. Neither can disrupt a pregnancy that has already begun. But Planned Parenthood’s Deborah Nucatola says the argument about preventing implantation has been exaggerated by abortion opponents. “If people want to postulate on the theoretical risk of prevention of implantation, they’re entitled to do that, but there is no scientific evidence that that is a mechanism of action,” she says.

Still, it was the divisive politics of birth control that prompted the Department of Health and Human Services to punt the matter to the Institute of Medicine in the first place. On Wednesday, the IoM officially tosses the decision about whether insurers should cover contraception back into the government’s lap.

The Medical Director of the SLH, Dr. Daniel Kurtcyz, M.D., Ph.D. comments; “I see at least 1-2 high grade lesions every day during cytologic evaluations. Without follow-up, there is no doubt that some of these lesions will become invasive. Because cervical cancer takes at least two years to run its course, sometime after 2015, we will have women dying of cervical cancer as a predictable consequence of the funding reduction for testing in this budget.”

“This public health program to screen women was instituted in the 1950’s when we literally had wards of women dying of invasive cervical cancer. We learned it was a preventable disease with intervention. The whole cost of our cervical cancer screening program will probably be less that the cost of the care of one hospitalized patient with advanced cervical cancer.”

Lon Newman, WFPRHA president, asked members of the committee to “. . . consider the consequences of eliminating the $266,400 that has been provided to the Wisconsin State Laboratory of Hygiene (WSLH) for laboratory tests to individuals receiving services at community based family planning clinics.”

In 1970, President Richard Nixon placed such a high priority on family planning that he approved the Title X program to make contraception available to low-income women. Another prominent Republican supporter of the policy, the future President George H.W. Bush, said at the time, “We need to take sensationalism out of this topic so that it can no longer be used by militants who have no real knowledge of the voluntary nature of the program but, rather are using it as a political steppingstone.”

Between then and now, however, a lot changed—and nothing changed. Title X funding steadily grew over the years to go some way towards meeting the comprehensive reproductive health needs of low-income women. But, as made evident by Republican efforts—with the full support of representatives from the United States Conference of Catholics Bishops—to cut off Title X funding in the 2011 budget, it appears that conservative legislators don’t seem to understand that in 2008, Title X services helped 4.7 million women access family planning services.

Millions more received HIV testing, cervical cancer screening and other health services that were, in many cases, the only healthcare they received. Did they truly believe that low-income couples should be left without any means to plan their families, or that essential services would be picked up by shrinking state Medicaid budgets? I think it is more likely that clever political maneuvering has succeeded in hanging contraception with a scarlet letter so that policymakers now fear that being associated with it will alienate part of their constituency.

The reality is that choosing how many children to have, and when to have them, is an intimate decision made by women who, as moral agents, know what is best for themselves and their families. Many have now grown up in an America where reproductive freedom and religious freedom are intimately connected and fundamentally protected. For Catholics, the injunction to respect others’ beliefs is reinforced by the Vatican Council’s Declaration on Religious Freedom, which tells us that “in spreading religious faith and in introducing religious practices everyone ought at all times to refrain from any manner of action which might seem to carry a hint of coercion.”

The Catholic tradition also promotes the primacy of conscience, and thus that every person has the right to make choices according to that conscience. The majority of Catholics also want their lawmakers serving individual constituents, not the bishops, so with 98 percent of Catholic women having used a type of birth control forbidden by the Vatican, who is being served by the three bills limiting reproductive freedom currently before Congress? (For that reason, I was delighted to see so many Catholic state legislators sign onto an open letter to Congress that opposed cuts in funding for family planning.)

By ratcheting up the ideological heat associated with family planning, conservatives have succeeded in making it politically dangerous to support funding for family planning services that, according to the Guttmacher Institute, prevented 973,000 unintended pregnancies that would have resulted in 433,000 unplanned births and 406,000 abortions in 2008. Meanwhile, what will happen to the low-income women currently served by Title X? We need look no further than the many nations in Latin America where women’s reproductive rights vary by class.

In almost all Latin American countries, contraception is not widely available and abortion is highly restricted or illegal—officially. In reality, almost any service is available for women with the money to pay for it, which creates a society where only some women are able to act as moral agents. When women are denied reproductive rights based on income, we see poor women with high rates of unplanned pregnancy, mortality from unsafe abortions, and empty promises from conservative lawmakers that don’t translate into a real commitment to poor families. Women of means can afford to purchase safe services outside the law, but poor women don’t have the same escape valve to help them as they seek to live their lives according to their consciences.

Differential access to reproductive health services doesn’t work, and is the opposite of Catholicism’s “preferential option for the poor.” By serving the uninsured, the homeless and the vulnerable, Title X clinics are already on the public health front lines. Stripping them from the landscape will turn many communities into a reproductive health frontier where abortions, legal or illegal, become the only means a woman has for controlling her reproductive destiny, resulting in more abortions every year—not a campaign promise that conservatives were open about.

What other policy items will become “scarlet”—too ideologically loaded to talk about in practical terms? Restrictive legislation has been pushed into center stage in Congress in part thanks to the rhetoric used by people like Tom Grenchik, the executive director of the Secretariat of Pro-Life Activities at the US Conference of Catholic Bishops. Grenchik recently issued a special briefing to excoriate the services Planned Parenthood offers low-income women and attack Sen. Harry Reid for saying the Senate wouldn’t go along with the attempt to totally de-fund Planned Parenthood. Such talk has little to offer the thousands of women who rely on federally-funded reproductive health services. (Not all conservatives were on the same page—the notorious funder of a plethora of right-wing causes, Richard M. Scaife, placed an op-ed in the Pittsburgh Tribune-Review—which he owns—bemoaning the short-sightedness of this latter move.)

There will always be some cooler heads in Congress who are not afraid to handle a hot topic—oftentimes they are Catholic. In a letter to leaders of the Senate Appropriations Committee, Sen. Lisa Murkowski (R-AK), a Catholic, said, “I believe Planned Parenthood provides vital services to those in need and disagree with their funding cuts in the bill.” Getting a birth control prescription filled, going for a yearly OB-GYN exam—these are the quiet acts that make up everyday life lived according to conscience. Title X is one of the successful federal programs in tune with the small, crucial decisions important to low-income families’ lives. Block access to these actions based on income, and you will see something sensational; exactly what Nixon, the Republican family planning advocate, deplored: dramatic health disparities that no lawmaker of any ideology should find acceptable.

Concealed in the jargon of the 144-page bill is an equally serious issue—a threat to silence public voice on Medicaid and Medicare coverage issues by deferring all policy decisions regarding Medicare into hands of a legislative committee’s co-chairs and the Governor—without public debate.

In Wisconsin, family planning services—including access to birth control—fall under the Medicare umbrella. I and many of my female friends use birth control and I am willing to boldly make the generalization that relying on men for birth control does not result in a 100% success rate. Like many of my female friends, I also must rely on a subsidy to help alleviate the cost of birth control.

Governor Walker proposes to take the fate of Medicaid and my access to birth control into his hands and the hands of his committee co-chairs without any public input. Three people could be deciding the future of access to family planning for the sixty-five thousand participants who rely on the program now.

Governor Walker is not only proposing to take our voices away, he is proposing to take away the control we have over our bodies too.

Eliminating the subsidy that countless numbers of women receive for birth control will prevent women from using many birth control methods. The Guttmacher Institute, a non-profit which focuses on advancing sexual as well as reproductive health, published a brief on family planning which states that “Women who had an unmet need for effective contraception account for 82% of all unintended pregnancies”. The result of having access to birth control cut off will be more unplanned pregnancies as many women would be unwilling to restructure their sex lives. Whether these pregnancies are carried to term or terminated, the costs are high. The average costs of carrying a child to term ($5,791) are much higher than the average annual cost of supplying birth control (approximately $200). Cutting the family planning services to Wisconsin women and men is fiscally irresponsible and would add to the deficit that Governor Walker is purporting to lower with his budget “repair” bill.

Changing the legislative administrative rule process by implementing undemocratic transactions is a gross overreach of power that could let three out-of-touch old legislators mute my voice and take away the health care that empowers me to advance my education and make responsible choices. That is unacceptable. Attacks on women’s reproductive rights in Washington, D.C.—and across the United States—are increasing in number and intensity. Now Governor Walker proposes to silence the voices of women and their representatives in the “debate”.

I urge women across Wisconsin to make their voices heard now in any and every way possible. Write letters to the editor of your local newspapers. Use social networks—Facebook and Twitter. Call your legislators. Protect your right to speak and protect your right to control your body. Just like I am not willing to rely on men for my birth control, I am not willing to rely on Governor Walker and the chairs of the joint legislative committee to control family planning decisions for women across Wisconsin.

Kirsten Crowhurst, Student at UW-Madison

In a letter to the secretary, WFPRHA president Lon Newman said that Wisconsin’s Medicaid Family Planning program has; “. . . saved taxpayers hundreds of millions of dollars by preventing unintended pregnancies and improving maternal and child health.” Newman said a face-to-face meeting is required because, “In this highly charged environment, the economic, budgetary, and workforce contributions of family planning services are often over looked.”

Newman says that a meeting of Wisconsin’s family planning health care providers with the Secretary will focus on a discussion of the positive budget impact and return on investment of Wisconsin’s family planning program and how the program:

• Maximizes federal dollars for health care.
• Provides very low-cost accountable primary preventive health care.
• Enables men and women to finish schooling, enroll in job training and retraining, and to recover from a layoff with a new job in a new community.
• Reduces family and medical leave costs to employers.
• Lowers insurance costs by reducing the number of high-risk high-cost pregnancies and births.
• Cuts retraining and rehiring costs and maintains productivity.

Secretary Smith was the director of the Centers for Medicaid and Medicare Services (CMS) under President George W. Bush.  In that position, he authorized Wisconsin’s Medicaid Family Planning Waiver for the first time in 2002.  In the first five years of the program, under the strict budget neutrality provisions that then Health and Human Services (HHS) Secretary Tommy Thompson and CMS director Dennis Smith put in place, Wisconsin’s Department of Health Services reported the program saved $487 million.

Newman said that the story of the Wisconsin’s Medicaid Family Planning expansion program is unique:  it was signed into law by Governor Tommy Thompson in 1997; approved by HHS Secretary Tommy Thompson and CMS Director Dennis Smith in 2002. It was implemented by Governor Doyle immediately on January 3^rd, 2003. It met its objectives and was renewed by HHS in 2008; it was consistently expanded over the 8 years of the Doyle administration. With the passage of the Patient Protection and Affordable Care Act in 2010, states were permitted to request a permanent State Plan Amendment rather than follow the cumbersome process of waiver renewals.  Wisconsin was the first state in the nation to receive the permanent SPA authorization to provide family planning services. “Most importantly,” Newman said, “in these difficult economic times, the program receives a 90:10 federal match because it saves money to taxpayers and improves maternal and child health. It is a win for taxpayers, a win for women and their families, a win for employers, and a win for health. We look forward to a productive discussion with Secretary Smith.”

For some who can’t afford contraception and reproductive exams, the state and federally funded programs provide coverage for these services. These programs save a phenomenal amount of taxpayer dollars by preventing unintended pregnancies. They reduce the numbers of abortions because there are less unintended pregnancies. They reduce poverty for women, children and families.

The “straight white-guys” who oppose these programs want to deny the cost-savings and health enhancing outcomes of these programs. Don’t let them do it. Call them on it each time you hear or see them attacking family planning services.

Editor’s Note: This post was originally published on RH Reality Check.

By Amanda Marcotte

When it comes to the world of feminist writer/activists, I definitely fall on the “writer” side of the line. Most of my life is researching, conducting interviews, pitching pieces, and, of course, staring at my computer, trying to think of a verb that’s dynamic but not pretentious. I love giving speeches, but they’re usually of the 20-60 minute long variety meant to educate, analyze and entertain (and there’s always a Q&A), and I’m always on a roster with journalists and academics. So how was it that Saturday afternoon, I found myself standing outside with feet growing numb in the cold amongst actors, musicians, organizers and oodles of politicians, trying to think of what I could say in 120 seconds that would be meaningful to the crowd of thousands of people waving signs and periodically erupting into chants?

Well, mostly I was there because Planned Parenthood of New York City graciously asked me to speak at a rally in support of Title X funding, which has been zeroed out by the House of Representatives in the continuing resolution to fund the government, a move that can be stopped by the Senate and President. I said yes because while drum-beating and sign-waving is really outside of my comfort zone, I consider this issue too important not to grab opportunities to speak out. For years I’ve been writing about something that most of the media tragically ignores, which is the growing radicalism of movement conservatism regarding women’s sexual health. Anti-choice is also about resisting birth control and any other health care that relates to sexual activity, on the grounds that women who have sex should face “consequences”, i.e. be punished. (As a good example, I saw my friend Katie Halper fighting some guy on Twitter over whether or not Planned Parenthood offers breast exams, something anti-choicers are trying to deny because, as Katie put it, “I guess even the most heinous distortion of punitive conservatism can’t make breast cancer a woman’s fault.” Notice that they’re not trying to deny that Planned Parenthood does a million cervical cancer screenings a year, but I guess they don’t care about those lives, since cervical cancer is usually caused by HPV, and they can convince themselves those women brought their deaths on themselves.) Even though we’ve seen evidence of the anti-choice movement pushing for abstinence-only education and fighting the HPV vaccine and emergency contraception, in most of the media, the discussion is still incorrectly framed as fetus-centric.

And now the anti-choice has scored a major victory in the war on women’s health, amongst many other programs that help people that conservatives disapprove of, such as people who want to have more energy-efficient homes and women who have to work for a living and therefore can’t play unpaid preschool teacher to their kids. So I had to speak out. Conservative activists are dropping the word “abortion” a lot, because it performs well as a conversation-stopper that allows them to continue working against women without suffering too much investigation into their real aims, but this time, people aren’t fooled. Pap smears and condoms aren’t abortion. The anti-choice resistance to them makes it clear that the concern for fetuses is actually a concern that women are having sex without facing sadistic punishments that, in the past (and sadly still today) left them traumatized, mutilated, and often dead.

That era isn’t far enough in the past that women today really can take for granted all that we have, but I thought the best way to speak out against the encroachments on women’s rights was to talk about all the ways our lives have been quietly saved by doctors, nurses, and educators who give us the tools to be, as women always have been before us, sexually active without giving up our health and dreams. For most of us, having to live without birth control would have meant drastically different, sadder lives. How better than to highlight the radical nature of this move against Title X than to instigate a speak-out about how the biggest target — Planned Parenthood — helped us, usually in ways that the vast majority of the country finds completely non-controversial?

For this purpose, I started the Twitter hashtag #thanksPPFA, where people could talk about how Planned Parenthood had improved their lives. And for this purpose, when I stood up at the rally Saturday, what I did was tell a (very short) story: I had gone to a Catholic university, and the health center didn’t offer birth control. (Boooooo!, said the crowd, surprising me and then making me laugh.) So I went to Planned Parenthood, where I could afford it, and that clinic basically was my doctor for the next five years. And I spoke briefly about the stories that came out on Twitter, 140 characters at a time: women who finished school, married the right guy, had kids when they were ready, all because of Planned Parenthood. Women who are still with us, because their cervical cancer was caught by Planned Parenthood’s routine screening. Lives are saved every day, and it’s usually not remarked on, because most of us expect it will always be there.

But if the conservative movement gets its way, it won’t be there.

While Planned Parenthood is the touchstone for this outrage, people are standing up for more than just this one large organization. We’re standing up because we believe that women, gay people, poor people, people of color, young people, and people who fall outside the gender binary are just as much people as the rich straight white guys that dominate the ranks of those trying to shut down access to sexual health care. And as people, we have the same rights as those rich straight white guys to our health, to our hopes and dreams, to our relationships, and yes, to our sexual pleasures as they do. Planned Parenthood offers substantial services that save lives every day, but they’re also a symbol in this war over who gets to decide if The Rest Of Us are people, too. In the 21st century, are we going to expand the rights of man to all of us, or are we going to slide backwards to a time when only the few got access to what we all deserve?