We’d like to thank all the colleagues, advocates, friends and supporters who cared about and worked for a positive outcome for women and families. Our friends at Raising Women’s Voices for the Health Care We Need put out two fact sheets this week detailing the pros and cons of the new health insurance reform. We like their fact sheets and include them here for our visitors to access.

The Raising Women’s Voices for the Health Care We Need bulletin stated, “After the hard fought debates about health reform, there’s a lot of misinformation about the legislation out there. “ We want to do our part in promoting the facts about health insurance reform.

Family Planning Health Services Administration and Staff

You can download this fact sheet here.

And a second one here.

Health Reform and Reproductive Health: Positive and Negative Effects March 30, 2010

1.            Of the 12.4 million uninsured women of reproductive health age (15 to 44) in the United States, 94% would qualify for either Medicaid or federal subsidies to help them buy health insurance.1 They will receive, among other things, contraceptive counseling and services, STI prevention, Pap smears, mammograms and complete maternity coverage. Effective in 2014.

a.            Slightly more than half of these women (55% or 6.7 million) would qualify for Medicaid coverage. Medicaid eligibility is expanded up to 133% of poverty (29,327 annual income for a family of four). Most reproductive health care is included, but not abortion coverage, except in case of rape, incest or life endangerment, unless the state pays for it. (See “negative effects” for further discussion.)

b.            Another 4.8 million women of reproductive health age will qualify for federal subsidies to help them purchase private health coverage. Individuals and families with incomes up to 400% of poverty ($88,400 for a family of four) will be eligible for federal subsidies. Women living in some states will be able to buy abortion coverage. (See “negative effects” for further discussion.)

2.            Young adults will be able to stay on family health insurance policies until their 26th birthdays, thus providing them access to reproductive health care. Effective 2010.

3.            Almost $75 million per year will go to states over five years for a “personal responsibility education program” that will largely focus on preventing pregnancy and STIs through a combination of abstinence and contraceptive education. (2)

4.            States will be more easily able to expand Medicaid coverage to both men and women solely for family planning services up to almost the same eligibility level as for pregnancy-related care (200% of poverty). Some 21 states have done this already. The rest will be able to do so without having to go through a time-consuming and costly federal waiver process. (3)

5.            Community health centers, where many low-income women and undocumented immigrant women receive primary and reproductive health care, will receive $11 billion in new funding. In addition, insurance plans will be required to contract with 2 community health centers and other essential community providers such as family planning centers, public hospitals and HIV/AIDS clinics. Effective beginning in 2010.

6.            Insurance companies will not be able to cancel our policies if we get sick, including with ovarian cancer, cervical cancer, breast cancer or HIV. Effective in 2010.

7.            Insurance companies will not be able to deny us coverage for such “pre-existing conditions” as pregnancy or having had a c-section delivery in the past. Effective 2014, except for 2010 for children.

8.            All private insurance plans will be required to offer a package of women’s preventive and screening services, such as such as pap smears and mammograms, without requiring co-pays. Effective January 1, 2011.

9.            Licensed practitioners serving women using free-standing birthing centers will be eligible for Medicaid reimbursement. Effective within 90 days of enactment. Some states may have to adopt new laws or policy to implement this provision.

10. New funds ($1.5 billion over five years) are appropriated for maternal, infant and early childhood home visiting programs.

11. New funds ($50 million a year) are appropriated for school-based health programs, which often provide STI and birth control counseling and services.

12. Medicaid reimbursements for primary care doctors will be increased, making it easier for Medicaid recipients (including women of reproductive health age) to get preventive office visits with more physicians. Effective 2013.

13. Insurance companies will no longer be able to set lifetime or unreasonable annual limits on the amount of medical care they will cover. This is especially important for women who have expensive maternity care or abortion services, or treatment for such illnesses as breast cancer, ovarian cancer or cervical cancer, which can costs thousands of dollars. Effective 2010.

Negative

1.            There still will be no use of federal funds for abortion services (except in cases of rape, incest or threat to the life of the woman). This provision was included in the health reform bill and restated in an Executive Order issued by President Obama on March 24, 2010.

a.            Women on Medicaid and those who will become eligible for Medicaid in 2014 will not be able to use their coverage for abortion services in most cases, except in the circumstances stated above, or if they live in one of the 17 states that use state-only dollars to provide abortion coverage under Medicaid.

b.            Low-income women receiving care at Community Health Centers still will not be able to receive federally-subsidized abortion services, making it more difficult for CHCs to provide this care. The health centers will have to continue to scrupulously segregate federal funds from any other funds that are used to provide abortion services. Women may be asked to use their own money to pay for abortion services if no non-federal subsidies are available.

c.            No federal subsidies can be used toward abortion coverage in any private health insurance plans purchased through insurance exchanges.

2.            States could prohibit abortion coverage in health insurance plans offered in new insurance “exchanges” that will become available in 2014. While states already are able to prohibit abortion coverage in private health insurance (5 states have done so to date), the advent of the state insurance exchanges may present new opportunities for anti- choice forces to advocate for abortion bans. Reproductive justice advocates will be forced to fight these proposed prohibitions state by state.

3.            In states where abortion coverage is allowed in the exchanges, women will have to send in two checks – one for abortion coverage and one for everything else. This requirement (the “Nelson language”) is burdensome and unnecessary, since insurers will be required to segregate federal funds from private payments going to abortion coverage. Moreover, experts predict it could lead insurance companies to simply drop abortion coverage, rather than comply with the requirements.(4)

4.            There is a one-sided “conscience clause” that requires health insurers to protect providers that refuse to provide or refer for abortions, but does not protect those who do.

5.            New funding for ineffective abstinence-only sex education. Title V, the federal abstinence-only-until-marriage program is resuscitated and given $50 million a year for five years.

6.            Undocumented immigrants, including women of reproductive health age, are excluded from health reform. They are not eligible for Medicaid or federal subsidies to help them buy insurance and are even prohibited from using their own money to buy health insurance through the exchanges.

7.            Legal immigrants, including women of reproductive health age, still must wait five years to become eligible for Medicaid. Some states already provide Medicaid coverage to legal immigrants, especially pregnant women and children, within their first five years, and may continue to do so.(5)

1 Kaiser Family Foundation, Abortion and Health Reform, January 2010.

2 Guttmacher Institute analysis, March 29,2010, http://www.guttmacher.org/media/inthenews/2010/03/29/index.html

3 Guttmacher Institute analysis, March 29,2010, http://www.guttmacher.org/media/inthenews/2010/03/29/index.html

4 Analysis by Sara Rosenbaum of the George Washington University School of Public Health. 5 New York Immigration Coalition, March 2010

This fact sheet was developed using resources and guidance from The Guttmacher Institute, the ACLU Reproductive Freedom Project, Legal Voices, the Kaiser Family Foundation, Community Catalyst, the New York Immigration Coalition, the National Physicians Alliance, the National Institute for Reproductive Health, the Southwest Women’s Law Center and the American Association of Birth Centers. Thanks for all their generous assistance.

This morning, the Kentucky Supreme Court heard oral argument in the case of Cochran v. Commonwealth, a case that could have enormous consequences for healthy moms and babies in that state.

Ms. Cochran’s road to Kentucky’s Supreme Court has been a long one. Almost four years ago, Ms. Cochran gave birth to a baby girl. Her daughter allegedly tested positive for cocaine, and for that alone, Ms. Cochran was charged with felony child abuse. However, before her case could go to trial, the court dismissed the prosecution. The court was right: Ms. Cochran never should have been charged. In 1993, in Commonwealth v. Welch (the ACLU represented Ms. Welch in that case), the Kentucky Supreme Court ruled that Kentucky’s criminal laws could not be used to punish women who become and choose to remain pregnant despite a substance abuse problem.

You might think that the court’s dismissal of her case would have been the end of Ms. Cochran’s ordeal; unfortunately it was not. The state appealed, arguing that in later cases the Kentucky Supreme Court had actually reversed itself, even though it could point to no explicit language where the court had done so. Surprisingly, the appeals court agreed (though not one of the three judges on that court agreed for the same reason). With the law now totally in flux, the state Supreme Court accepted the case to settle the issue — again — of whether becoming and remaining pregnant is ever a crime in the state of Kentucky.

The ACLU filed a friend-of-the-court brief in support of Ms. Cochran, not only because we believe Welch is still good law, but, more fundamentally, because using criminal laws to punish pregnant women who are struggling with addiction makes for bad law and even worse public policy. If a pregnant woman can be charged with a crime for potentially harming her fetus, then literally everything she does or does not do — including choosing to continue her pregnancy to term despite an underlying health condition — could land her in jail. What if a pregnant woman has a glass of wine with dinner now and then, or lives with a smoker; what if she drives over the speed limit, fails to get regular pre-natal care, or works in a coal mine, as many women in Kentucky do?

Allowing the government to exercise such unlimited control over women’s bodies, and every aspect of their lives, would essentially reduce pregnant women to second-class citizens, denying them the basic constitutional rights enjoyed by the rest of us.

Moreover, from a public health perspective, these prosecutions are simply counterproductive. Fifty-nine organizations and experts, including the American College of Obstetricians and Gynecologists and the Kentucky Psychiatric Medical Association, joined friend-of-the-court briefs in this case, explaining that punitive approaches to improving fetal health just don’t work. Seems obvious, right? By forcing doctors to turn in their own patients, these prosecutions only drive women away from the health care and treatment they need. If the state of Kentucky was truly interested in supporting healthy moms and babies, these groups point out, it would not be violating its own laws to throw the pregnant women who need health care the most in jail.

We are hopeful that the Kentucky Supreme Court will agree and uphold nearly two decades of sound law and policy in the state of Kentucky. Indeed, the court’s decision will have ramifications beyond Ms. Cochran’s case. At least two other women have been charged with similar “crimes” since Ms. Cochran’s arrest. Our efforts should be focused on ensuring that pregnant women with underlying health conditions can get the care they need. Hopefully, this case will set us squarely on that path.

If  you or someone you know has been prosecuted or threatened with prosecution for allegedly harming their fetus, please contact us.  Any information you provide will be treated as confidential.  You can email rfp@aclu.org or send a letter to the Reproductive Freedom Project at 125 Broad Street, 18^th floor, NY, NY 10004.  For more information about the ACLU’s work on pregnancy prosecutions and other reproductive freedom issues, please visit http://www.aclu.org/.

To follow the State Supreme Court of Kentucky regarding this case, please go here.

You can also follow the case at the ACLU Reproductive Freedom Website.

If anyone listening has been prosecuted or threatened with prosecution, or knows anyone who has been prosecuted or threatened with prosecution, for allegedly harming their fetus, they should definitely get in contact with Alexa and the folks at the ACLU.  You can email rfp@aclu.org or send a letter to the Reproductive Freedom Project at 125 Broad Street, 18^th floor, NY, NY 10004.  For more information about the ACLU’s work on pregnancy prosecutions and other reproductive freedom issues, please visit www.aclu.org.

In an act of keeping it fresh, we once again look to you.  Over the last several months, many of you came together to change the course of our nation.  We ask now, that you bring that change of yours to us.  We are calling for submissions to Below The Waist.  Now, more than ever, we need you to be involved in this discussion.

More and more as the winter comes, and goes (or as in the case of those of us in Wisconsin, winter comes and stays, and stays, and stays); we will look to you as our partners and valuable resources.  Share your voice with us.  Whether you have a voice for change, for action on reproductive rights, a voice for reproductive justice or everything above, share your call with us.

Over the next week or so we will to expand our footprint with things like facebook, twitter, etc.  We hope to offer you something interesting and engaging.  We hope to offer you a space for change.  A space where you can learn and contribute; a space where you can listen and be heard.

In this same time, you can look forward to a few posts about out seeking to create online audio libraries about some specific issues.  We have a chance with the tools of the internet, like our podcast, to collect and offer these stories up as tools to create and to inform CHANGE.

So, as you can see, it all comes down to change, creating change, embracing change, being the change you seek, all of these things are part of change, and we hope you get involved with Below The Waist.

“Based on all of the information we have today, CDC and FDA have determined that the HPV vaccine is safe to use and effective in preventing 4 types of HPV,” the CDC said.

This is in direct opposition to the claims made by opponents of the vaccine.