Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 43 min 57 sec ago

Report: Medicaid Expansion Tied To Lower Costs for States

Thu, 10/16/2014 - 15:40

States that did not expand their Medicaid programs under the Affordable Care Act (PL 111-148) will increase state Medicaid spending this year by 2.4 percentage points more than expansion states, according to a new Kaiser Family Foundation analysis, CQ HealthBeat reports.

Report: Medicaid Expansion Tied To Lower Costs for States

October 16, 2014 — States that did not expand their Medicaid programs under the Affordable Care Act (PL 111-148) will increase state Medicaid spending this year by 2.4 percentage points more than expansion states, according to a new Kaiser Family Foundation analysis, CQ HealthBeat reports.

Specifically, state Medicaid spending in non-expansion states is expected to grow by 6.8%, compared with 4.4% in expansion states. Overall, total spending in expansion states will increase by 18.3%, compared with 6.5% in non-expansion states.

According to the analysis, Medicaid enrollment in non-expansion states during FY 2015 is expected to increase by only 5.2%, compared with an estimated 18% enrollment growth in expansion states.

The slower state spending increase in expansion states can partially be attributed to higher federal funding matching rates, CQ HealthBeat reports. According to CQ HealthBeat, CMS through 2016 is covering the cost for all newly eligible individuals under the ACA's Medicaid expansion before gradually decreasing the matching rate to 90% by 2020 and beyond. However, CMS pays a lower amount for individuals who qualify for Medicaid under the old eligibility rules.

Eligibility Changes

The analysis also found that four states -- Arkansas, Indiana, Louisiana and Maine -- limited Medicaid eligibility during fiscal year 2014, while none plan to do so in FY 2015.

Meanwhile, 31 states said they expanded eligibility during FY 2014, in some cases even beyond the ACA, while nine states said they plan to expand eligibility in FY 2015 (Adams, CQ HealthBeat, 10/14).

Survey: Many States Increasing Medicaid Benefits in FY 2015

In related news, 22 states are increasing benefits for Medicaid beneficiaries in fiscal year 2015, while two states are reducing benefits, according to a separate survey released Tuesday by KFF and the National Association of Medicaid Directors, Kaiser Health News' "Capsules" reports.

The survey included an analysis of 50 state Medicaid programs. The two states cutting Medicaid benefits mark the fewest states to do so in the last nine years, according to the survey.

Among the states adding benefits, the most common new benefits include dental coverage, mental health care and services related to substance use disorders (Galewitz, "Capsules," Kaiser Health News, 10/14).


Untested Rape Kits Represent 'Colossal Law Enforcement Failure,' NYT Editorial Argues

Thu, 10/16/2014 - 15:39

Each one of the thousands of untested rape kits in the U.S. "represents a botched chance to solve a case and identify other crimes perpetrated by an assailant," a New York Times editorial states.

Untested Rape Kits Represent 'Colossal Law Enforcement Failure,' NYT Editorial Argues

October 16, 2014 — Each one of the thousands of untested rape kits in the U.S. "represents a botched chance to solve a case and identify other crimes perpetrated by an assailant," a New York Times editorial states.

The editorial notes that Joyful Heart Foundation earlier this month "announced dismaying figures" showing that four major U.S. cities have thousands of untested rape kits stored in police facilities. According to the announcement, "'few states and no federal agencies require that law enforcement track or count the untested rape kits in their storage facilities,'" the Times adds.

This lack of oversight "represents a colossal law enforcement failure to seek justice for rape victims and to protect the public's safety," the editorial states.

The Times urges Congress "to finish work on an appropriations bill for the Justice Department and other agencies containing $41 million for a new federal grant program ... dedicated solely to processing untested rape kits, investigating leads and conducting prosecutions." Although "a much larger federal investment" would be needed to end the backlog of untested rape kits, "the $41 million would be a meaningful start," the Times concludes (New York Times, 10/14).


Report Card: Many States Fail To Meet Women's Health Needs, Disparities Persist

Thu, 10/16/2014 - 15:37

Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

Report Card: Many States Fail To Meet Women's Health Needs, Disparities Persist

October 15, 2014 — Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

The Alliance for a Just Society -- a coalition of 14 racial and economic justice organizations -- compiled the report card based on data from CDC, the U.S. Census Bureau, the Gallup-Healthways Well-Being Index and the Kaiser Family Foundation. The researchers took three factors into account to determine states' grades: the proportion of women in the state who lack health coverage; women's access to timely and quality medical care; and women's health outcomes, including rates of asthma, diabetes, hypertension, mental disabilities, sexually transmitted infections and other conditions.

Key Findings

According to the report, Massachusetts and Connecticut were the only two states to receive "A" grades for all three categories. Meanwhile, 12 states received "D" or "F" grades in all three areas: Arkansas, Georgia, Idaho, Indiana, Louisiana, Mississippi, Missouri, Oklahoma, South Carolina, Texas, West Virginia and Wyoming (Stevens, Chicago Tribune, 10/14).

Further, the report found that the states with the best health coverage for women are Connecticut, Delaware, Hawaii, Massachusetts and Vermont, while those with the worst coverage are Florida, Georgia, Montana, Nevada and Texas (Zak, Puget Sound Business Journal, 10/14).

The report also looked at racial and economic health disparities and the impact they have on women's health in the states. In those areas, the report found that infant mortality rates among black women in 38 states were at least 20% higher than for all women. In 33 states, the rates were at least 50% higher among black women.

In addition, the report found that diabetes rates for Latinas were at least 20% higher than for all women in 28 states, while the rates were at least 50% higher in 19 states. Similarly, asthma rates for Native American women were at least 20% higher than for all women in 13 states and at least 50% higher in 10 states.

Comments

The researchers said they hope the report card will serve as a catalyst for state lawmakers to take action, particularly in states that received low grades.

The report noted, "These states have a middling, poor or failing record when it comes to meeting women's health needs," adding that they have not provided women with "fair opportunities to lead healthy, prosperous and productive lives." It said, "This harms not only women but also their families, their communities and their states" (Chicago Tribune, 10/14).


Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

Thu, 10/16/2014 - 15:35

The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports.

Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

October 15, 2014 — The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports (Barnes, Washington Post, 10/14).

The high court's order reverses rulings by the 5th U.S. Circuit Court of Appeals. Specifically, the justices placed a hold on a provision that requires abortion clinics in Texas to meet the same standards as ambulatory surgical centers and exempted abortion facilities in El Paso and McAllen from a provision that requires abortion providers to have admitting privileges at nearby hospitals (Bravin, Wall Street Journal, 10/14).

Background

The Supreme Court order is the latest step in a string of rulings on HB 2 that have placed the availability of abortion services in flux throughout much of Texas (Rosenthal, Texas Tribune, 10/14).

In March, a three-judge panel from the 5th Circuit said that the admitting privileges provision -- as well as a separate provision restricting medication abortion --- could take effect statewide. The full 5th Circuit earlier this month rejected a request from abortion clinic lawyers for an en banc review of the panel's decision (Women's Health Policy Report, 10/10).

Meanwhile, in August, U.S. District Court Judge Lee Yeakel barred enforcement of the ambulatory surgical centers provision statewide and the admitting privileges provision as it applies to the El Paso and McAllen clinics (Women's Health Policy Report, 9/2).

However, the 5th Circuit earlier this month lifted the hold on the ambulatory surgical centers provision, which was originally scheduled to take effect on Sept. 1. Thirteen clinics were forced to close immediately to comply with the ruling. The Center for Reproductive Rights then filed an emergency appeal to the Supreme Court on the clinics' behalf.

The 5th Circuit's ruling also meant that about 750,000 women of reproductive age, most of whom live in West Texas and near the Texas-Mexico border, were more than 200 miles away from the nearest abortion facility, according to abortion clinic lawyers (Women's Health Policy Report, 10/14).

Details on Tuesday's Decision

The Supreme Court order was unsigned and did not include an explanation for the justices' decision. The ruling noted that Justices Samuel Alito, Antonin Scalia and Clarence Thomas opposed the stay, which implies that Chief Justice John Roberts and Justices Ruth Bader Ginsburg, Stephen Breyer, Elena Kagan, Anthony Kennedy and Sonia Sotomayor likely were in favor of the decision, according to the Post (Washington Post, 10/14).

The ruling will allow the 13 clinics to reopen as soon as Wednesday, according to CRR, which is leading the challenge to the law. Although the Supreme Court blocked enforcement for now, the justices did not rule on the merits of the case.

Next Steps

The 5th Circuit is now expected to rule on the merits of the ambulatory surgical centers provision, according to Politico.

Meanwhile, the plaintiffs could appeal the 5th Circuit's admitting privileges ruling to the Supreme Court (Haberkorn, Politico, 10/14). Last fall, the high court declined an emergency request to intervene in that case, but comments by Breyer in a dissent suggested he believes the court's eventual review of the provision is likely, according to the New York Times.

Reaction

CRR President and CEO Nancy Northup said in a statement that although "clinics across the state will be allowed to reopen and provide women with safe and legal abortion care in their own communities," the "fight against Texas' sham abortion law is not over" (Liptak, New York Times, 10/14).

Planned Parenthood Federation of America President Cecile Richards said, "We're seeing the terrible impact these restrictions have on thousands of Texas women who effectively no longer have access to safe and legal abortion. We're relieved that the court stepped in to stop this, and we hope this dangerous law is ultimately overturned completely" (Politico, 10/14).

A spokesperson for the state attorney general's office said it "will continue to defend the law, just as we defend all state laws when they are challenged in court" (New York Times, 10/14). Greg Abbott, the current state attorney general, is also the Republican candidate for governor, facing state Sen. Wendy Davis (D), who drew national attention last year for her filibuster that helped stall HB 2 from becoming law (Women's Health Policy Report, 10/3).

LA Times: Supreme Court Must Stop State Abortion Restrictions

In a related editorial, the Los Angeles Times argues that laws like Texas' HB 2 often "arrive cloaked in encomiums about protecting women's health, when in fact they are intended to do one thing only: to make it more difficult, and in some cases almost impossible, to get an abortion."

The Times adds, "These relentless attacks on abortion are destined to continue until the Supreme Court steps in and rules definitively. It should take up these challenges to its authority and put a stop to this growing patchwork of bad, restrictive laws" (Los Angeles Times, 10/14).


Report: Medicaid Expansion Tied To Lower Costs for States

Thu, 10/16/2014 - 15:33

States that did not expand their Medicaid programs under the Affordable Care Act (PL 111-148) will increase state Medicaid spending this year by 2.4 percentage points more than expansion states, according to a new Kaiser Family Foundation analysis, CQ HealthBeat reports.

Report: Medicaid Expansion Tied To Lower Costs for States

October 16, 2014 — States that did not expand their Medicaid programs under the Affordable Care Act (PL 111-148) will increase state Medicaid spending this year by 2.4 percentage points more than expansion states, according to a new Kaiser Family Foundation analysis, CQ HealthBeat reports.

Specifically, state Medicaid spending in non-expansion states is expected to grow by 6.8%, compared with 4.4% in expansion states. Overall, total spending in expansion states will increase by 18.3%, compared with 6.5% in non-expansion states.

According to the analysis, Medicaid enrollment in non-expansion states during FY 2015 is expected to increase by only 5.2%, compared with an estimated 18% enrollment growth in expansion states.

The slower state spending increase in expansion states can partially be attributed to higher federal funding matching rates, CQ HealthBeat reports. According to CQ HealthBeat, CMS through 2016 is covering the cost for all newly eligible individuals under the ACA's Medicaid expansion before gradually decreasing the matching rate to 90% by 2020 and beyond. However, CMS pays a lower amount for individuals who qualify for Medicaid under the old eligibility rules.

Eligibility Changes

The analysis also found that four states -- Arkansas, Indiana, Louisiana and Maine -- limited Medicaid eligibility during fiscal year 2014, while none plan to do so in FY 2015.

Meanwhile, 31 states said they expanded eligibility during FY 2014, in some cases even beyond the ACA, while nine states said they plan to expand eligibility in FY 2015 (Adams, CQ HealthBeat, 10/14).

Survey: Many States Increasing Medicaid Benefits in FY 2015

In related news, 22 states are increasing benefits for Medicaid beneficiaries in fiscal year 2015, while two states are reducing benefits, according to a separate survey released Tuesday by KFF and the National Association of Medicaid Directors, Kaiser Health News' "Capsules" reports.

The survey included an analysis of 50 state Medicaid programs. The two states cutting Medicaid benefits mark the fewest states to do so in the last nine years, according to the survey.

Among the states adding benefits, the most common new benefits include dental coverage, mental health care and services related to substance use disorders (Galewitz, "Capsules," Kaiser Health News, 10/14).


Untested Rape Kits Represent 'Colossal Law Enforcement Failure,' NYT Editorial Argues

Thu, 10/16/2014 - 14:06

Each one of the thousands of untested rape kits in the U.S. "represents a botched chance to solve a case and identify other crimes perpetrated by an assailant," a New York Times editorial states.

Untested Rape Kits Represent 'Colossal Law Enforcement Failure,' NYT Editorial Argues

October 16, 2014 — Each one of the thousands of untested rape kits in the U.S. "represents a botched chance to solve a case and identify other crimes perpetrated by an assailant," a New York Times editorial states.

The editorial notes that Joyful Heart Foundation earlier this month "announced dismaying figures" showing that four major U.S. cities have thousands of untested rape kits stored in police facilities. According to the announcement, "'few states and no federal agencies require that law enforcement track or count the untested rape kits in their storage facilities,'" the Times adds.

This lack of oversight "represents a colossal law enforcement failure to seek justice for rape victims and to protect the public's safety," the editorial states.

The Times urges Congress "to finish work on an appropriations bill for the Justice Department and other agencies containing $41 million for a new federal grant program ... dedicated solely to processing untested rape kits, investigating leads and conducting prosecutions." Although "a much larger federal investment" would be needed to end the backlog of untested rape kits, "the $41 million would be a meaningful start," the Times concludes (New York Times, 10/14).


L.A. Times Profiles Abortion Provider at S.D.'s Only Clinic

Thu, 10/16/2014 - 14:04

In a Los Angeles Times profile, physician Carol Ball -- medical director for Planned Parenthood of Minnesota, North Dakota, South Dakota -- discusses the difficulties she faces in providing abortion care at South Dakota's lone abortion clinic amid increasing restrictions on the procedure in the state and across the U.S.

L.A. Times Profiles Abortion Provider at S.D.'s Only Clinic

October 16, 2014 — In a Los Angeles Times profile, physician Carol Ball -- medical director for Planned Parenthood of Minnesota, North Dakota, South Dakota -- discusses the difficulties she faces in providing abortion care at South Dakota's lone abortion clinic amid increasing restrictions on the procedure in the state and across the U.S.

According to the Times, the Planned Parenthood facility in South Dakota has been unable to find in-state physicians to perform abortions, likely because of several antiabortion-rights measures that have been passed by the state legislature. The Times notes that PPMNDSD has sued state officials to block some of the measures and that the clinic has considered closing if the disputed requirements are enforceable.

Ball is one of six physicians who fly into South Dakota to work at the Planned Parenthood facility several times per month, sometimes making multiple visits per week. She also provides abortions at two clinics outside the state.

Ball said that because of the state's 72-hour mandatory delay on the procedure, many of her patients have to travel four or five hours each way to the clinic twice, in some cases accounting for more than 20 hours of travel. Ball also noted that she is required to ensure her patients are not being coerced into having an abortion and to tell them information about abortion that she considers to be "pseudo-science of the anti-choice people."

Ball said that abortion "is basic healthcare for women," adding, "One in three women have an abortion in their lifetime. How much more basic is that?" Still, she noted that recent Supreme Court decisions, like one striking down a "buffer zone" around abortion clinics in Massachusetts, make her "fee[l] very discouraged" about the future of abortion care (La Ganga, Los Angeles Times, 10/14).


Reproductive Health Services v. Strange

Wed, 10/15/2014 - 22:41

Federal court challenge to an Alabama law that expands the state's judicial bypass provisions of the existing parental notification law.

Reproductive Health Services v. Strange

Federal court challenge to an Alabama law that expands the state’s judicial bypass provisions of the existing parental notification law. Specifically, the challenged law authorizes the court to appoint an attorney for the fetus and allows the state and the teen’s parents to call witnesses to testify against the teen during the bypass proceeding. The challenged law also allows the state, the fetus’s attorney, or the teen’s parents to appeal the case if judicial bypass is granted. (See the law here. See the complaint here. Read more about the case here.)

Whole Woman's Health, et al., v. Lakey, et al.

Wed, 10/15/2014 - 22:26

Federal court challenge to a Texas law that requires all clinics providing abortions, even non-surgical medication abortions, to meet building standards required for ambulatory surgical centers.

Whole Woman’s Health, et al., v. Lakey, et al.

Federal court challenge to a Texas law that requires all clinics providing abortions, even non-surgical medication abortions, to meet building standards required for ambulatory surgical centers. The law also mandates that physicians who provide abortion care must have admitting privileges at a hospital within 30 miles of where the procedure is performed. All plaintiffs are challenging the ambulatory surgical center standards. Additionally, the suit brings as-applied challenges to the admitting privileges requirement of the law on behalf of two clinics that have ceased, or are about to cease, providing abortion care as a result of the law. The U.S. District Court for the Western District of Texas found the ambulatory surgical center requirement unconstitutional and enjoined enforcement of this provision. Additionally, the court declared the admitting privileges requirement to be unconstitutional as applied to the two clinics challenging that portion of the law. The state announced immediate plans to appeal and asked the 5th Circuit Court of Appeals to intervene by allowing the law to take effect pending the outcome of the state’s appeal. A three-judge panel of the 5th Circuit granted the state’s request for a stay of the district court’s injunction and allowed the law to take effect pending the state’s appeal. Current Status: The U.S. Supreme Court vacated the 5th Circuit’s stay of the district court’s order. This reinstates the district court’s order and enjoins the ASC requirement for all providers and the admitting privileges requirement for the two clinics challenging the law. The case returns to the 5th Circuit for further proceedings on the state’s appeal. (See the law here. See the complaint here. See the district court's order here. See the 5th Circuit’s order granting the stay here. See the U.S. Supreme Court’s order vacating the stay here. Read more about the case here.)

States Restrict Telemedicine Abortion Services, Despite Safety, Other Benefits

Wed, 10/15/2014 - 16:52

While medication abortion can be administered safely and cost effectively via telemedicine, the method is "widely unavailable" in most of the U.S., according to The Atlantic.

States Restrict Telemedicine Abortion Services, Despite Safety, Other Benefits

October 15, 2014 — While medication abortion can be administered safely and cost effectively via telemedicine, the method is "widely unavailable" in most of the U.S., according to The Atlantic.

Since 2010 fifteen states have implemented telemedicine abortion bans, and it was only ever offered in three states: Iowa, Minnesota and Texas. However, Texas has since banned the practice.

By contrast, the use of telemedicine in other areas of health care has expanded rapidly in recent years. Elizabeth Nash, a senior state-issues associate with the Guttmacher Institute, said, "Everyone is trying to figure out how to incorporate telemedicine and how can they use it, but in this one area, we're seeing it be restricted."

Telemedicine Abortion in Iowa, Minnesota

Telemedicine abortion remains available in Iowa and Minnesota. In Iowa, the state has attempted to prohibit it, but that ban has been challenged in court, and in Minnesota, the governor vetoed a ban that was passed by the Legislature, according to The Atlantic.

In Minnesota, patients who have used the service through Planned Parenthood of Minnesota, North Dakota and South Dakota have reported that it enabled them to obtain an abortion at earlier stages of pregnancy and avoid a surgical abortion.

Meanwhile, Planned Parenthood of the Heartland in Iowa has used telemedicine services to administer medication abortion for 6,400 women since June 2008, according to PPH spokesperson Angie Remington.

Daniel Grossman, a doctor and researcher at Ibis Reproductive Health, said, "From a public-health perspective, [telemedicine] does improve access to early abortion [and] decreases later abortion, and that would result in improved health outcomes" (Semuels, The Atlantic, 10/10).


Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

Wed, 10/15/2014 - 16:51

The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports.

Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

October 15, 2014 — The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports (Barnes, Washington Post, 10/14).

The high court's order reverses rulings by the 5th U.S. Circuit Court of Appeals. Specifically, the justices placed a hold on a provision that requires abortion clinics in Texas to meet the same standards as ambulatory surgical centers and exempted abortion facilities in El Paso and McAllen from a provision that requires abortion providers to have admitting privileges at nearby hospitals (Bravin, Wall Street Journal, 10/14).

Background

The Supreme Court order is the latest step in a string of rulings on HB 2 that have placed the availability of abortion services in flux throughout much of Texas (Rosenthal, Texas Tribune, 10/14).

In March, a three-judge panel from the 5th Circuit said that the admitting privileges provision -- as well as a separate provision restricting medication abortion --- could take effect statewide. The full 5th Circuit earlier this month rejected a request from abortion clinic lawyers for an en banc review of the panel's decision (Women's Health Policy Report, 10/10).

Meanwhile, in August, U.S. District Court Judge Lee Yeakel barred enforcement of the ambulatory surgical centers provision statewide and the admitting privileges provision as it applies to the El Paso and McAllen clinics (Women's Health Policy Report, 9/2).

However, the 5th Circuit earlier this month lifted the hold on the ambulatory surgical centers provision, which was originally scheduled to take effect on Sept. 1. Thirteen clinics were forced to close immediately to comply with the ruling. The Center for Reproductive Rights then filed an emergency appeal to the Supreme Court on the clinics' behalf.

The 5th Circuit's ruling also meant that about 750,000 women of reproductive age, most of whom live in West Texas and near the Texas-Mexico border, were more than 200 miles away from the nearest abortion facility, according to abortion clinic lawyers (Women's Health Policy Report, 10/14).

Details on Tuesday's Decision

The Supreme Court order was unsigned and did not include an explanation for the justices' decision. The ruling noted that Justices Samuel Alito, Antonin Scalia and Clarence Thomas opposed the stay, which implies that Chief Justice John Roberts and Justices Ruth Bader Ginsburg, Stephen Breyer, Elena Kagan, Anthony Kennedy and Sonia Sotomayor likely were in favor of the decision, according to the Post (Washington Post, 10/14).

The ruling will allow the 13 clinics to reopen as soon as Wednesday, according to CRR, which is leading the challenge to the law. Although the Supreme Court blocked enforcement for now, the justices did not rule on the merits of the case.

Next Steps

The 5th Circuit is now expected to rule on the merits of the ambulatory surgical centers provision, according to Politico.

Meanwhile, the plaintiffs could appeal the 5th Circuit's admitting privileges ruling to the Supreme Court (Haberkorn, Politico, 10/14). Last fall, the high court declined an emergency request to intervene in that case, but comments by Breyer in a dissent suggested he believes the court's eventual review of the provision is likely, according to the New York Times.

Reaction

CRR President and CEO Nancy Northup said in a statement that although "clinics across the state will be allowed to reopen and provide women with safe and legal abortion care in their own communities," the "fight against Texas' sham abortion law is not over" (Liptak, New York Times, 10/14).

Planned Parenthood Federation of America President Cecile Richards said, "We're seeing the terrible impact these restrictions have on thousands of Texas women who effectively no longer have access to safe and legal abortion. We're relieved that the court stepped in to stop this, and we hope this dangerous law is ultimately overturned completely" (Politico, 10/14).

A spokesperson for the state attorney general's office said it "will continue to defend the law, just as we defend all state laws when they are challenged in court" (New York Times, 10/14). Greg Abbott, the current state attorney general, is also the Republican candidate for governor, facing state Sen. Wendy Davis (D), who drew national attention last year for her filibuster that helped stall HB 2 from becoming law (Women's Health Policy Report, 10/3).

LA Times: Supreme Court Must Stop State Abortion Restrictions

In a related editorial, the Los Angeles Times argues that laws like Texas' HB 2 often "arrive cloaked in encomiums about protecting women's health, when in fact they are intended to do one thing only: to make it more difficult, and in some cases almost impossible, to get an abortion."

The Times adds, "These relentless attacks on abortion are destined to continue until the Supreme Court steps in and rules definitively. It should take up these challenges to its authority and put a stop to this growing patchwork of bad, restrictive laws" (Los Angeles Times, 10/14).


Many States Fail To Meet Women's Health Needs, Disparities Persist

Wed, 10/15/2014 - 16:47

Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

Report Card: Many States Fail To Meet Women's Health Needs, Disparities Persist

October 15, 2014 — Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

The Alliance for a Just Society -- a coalition of 14 racial and economic justice organizations -- compiled the report card based on data from CDC, the U.S. Census Bureau, the Gallup-Healthways Well-Being Index and the Kaiser Family Foundation. The researchers took three factors into account to determine states' grades: the proportion of women in the state who lack health coverage; women's access to timely and quality medical care; and women's health outcomes, including rates of asthma, diabetes, hypertension, mental disabilities, sexually transmitted infections and other conditions.

Key Findings

According to the report, Massachusetts and Connecticut were the only two states to receive "A" grades for all three categories. Meanwhile, 12 states received "D" or "F" grades in all three areas: Arkansas, Georgia, Idaho, Indiana, Louisiana, Mississippi, Missouri, Oklahoma, South Carolina, Texas, West Virginia and Wyoming (Stevens, Chicago Tribune, 10/14).

Further, the report found that the states with the best health coverage for women are Connecticut, Delaware, Hawaii, Massachusetts and Vermont, while those with the worst coverage are Florida, Georgia, Montana, Nevada and Texas (Zak, Puget Sound Business Journal, 10/14).

The report also looked at racial and economic health disparities and the impact they have on women's health in the states. In those areas, the report found that infant mortality rates among black women in 38 states were at least 20% higher than for all women. In 33 states, the rates were at least 50% higher among black women.

In addition, the report found that diabetes rates for Latinas were at least 20% higher than for all women in 28 states, while the rates were at least 50% higher in 19 states. Similarly, asthma rates for Native American women were at least 20% higher than for all women in 13 states and at least 50% higher in 10 states.

Comments

The researchers said they hope the report card will serve as a catalyst for state lawmakers to take action, particularly in states that received low grades.

The report noted, "These states have a middling, poor or failing record when it comes to meeting women's health needs," adding that they have not provided women with "fair opportunities to lead healthy, prosperous and productive lives." It said, "This harms not only women but also their families, their communities and their states" (Chicago Tribune, 10/14).


Report Card: Many States Fail To Meet Women's Health Needs, Disparities Persist

Wed, 10/15/2014 - 15:31

Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

Report Card: Many States Fail To Meet Women's Health Needs, Disparities Persist

October 15, 2014 — Massachusetts ranks as the best state in the U.S. for meeting women's health needs, while Mississippi is the worst state, according to the Alliance for a Just Society's 2014 Women's Health Report Card, the Chicago Tribune reports.

The Alliance for a Just Society -- a coalition of 14 racial and economic justice organizations -- compiled the report card based on data from CDC, the U.S. Census Bureau, the Gallup-Healthways Well-Being Index and the Kaiser Family Foundation. The researchers took three factors into account to determine states' grades: the proportion of women in the state who lack health coverage; women's access to timely and quality medical care; and women's health outcomes, including rates of asthma, diabetes, hypertension, mental disabilities, sexually transmitted infections and other conditions.

Key Findings

According to the report, Massachusetts and Connecticut were the only two states to receive "A" grades for all three categories. Meanwhile, 12 states received "D" or "F" grades in all three areas: Arkansas, Georgia, Idaho, Indiana, Louisiana, Mississippi, Missouri, Oklahoma, South Carolina, Texas, West Virginia and Wyoming (Stevens, Chicago Tribune, 10/14).

Further, the report found that the states with the best health coverage for women are Connecticut, Delaware, Hawaii, Massachusetts and Vermont, while those with the worst coverage are Florida, Georgia, Montana, Nevada and Texas (Zak, Puget Sound Business Journal, 10/14).

The report also looked at racial and economic health disparities and the impact they have on women's health in the states. In those areas, the report found that infant mortality rates among black women in 38 states were at least 20% higher than for all women. In 33 states, the rates were at least 50% higher among black women.

In addition, the report found that diabetes rates for Latinas were at least 20% higher than for all women in 28 states, while the rates were at least 50% higher in 19 states. Similarly, asthma rates for Native American women were at least 20% higher than for all women in 13 states and at least 50% higher in 10 states.

Comments

The researchers said they hope the report card will serve as a catalyst for state lawmakers to take action, particularly in states that received low grades.

The report noted, "These states have a middling, poor or failing record when it comes to meeting women's health needs," adding that they have not provided women with "fair opportunities to lead healthy, prosperous and productive lives." It said, "This harms not only women but also their families, their communities and their states" (Chicago Tribune, 10/14).


Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

Wed, 10/15/2014 - 15:29

The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports.

Supreme Court Halts Parts of Texas Antiabortion-Rights Law, Allowing Clinics To Resume Services

October 15, 2014 — The Supreme Court on Tuesday issued a stay on parts of a Texas antiabortion-rights law (HB 2), allowing more than a dozen abortion facilities in the state to reopen while court challenges continue, the Washington Post reports (Barnes, Washington Post, 10/14).

The high court's order reverses rulings by the 5th U.S. Circuit Court of Appeals. Specifically, the justices placed a hold on a provision that requires abortion clinics in Texas to meet the same standards as ambulatory surgical centers and exempted abortion facilities in El Paso and McAllen from a provision that requires abortion providers to have admitting privileges at nearby hospitals (Bravin, Wall Street Journal, 10/14).

Background

The Supreme Court order is the latest step in a string of rulings on HB 2 that have placed the availability of abortion services in flux throughout much of Texas (Rosenthal, Texas Tribune, 10/14).

In March, a three-judge panel from the 5th Circuit said that the admitting privileges provision -- as well as a separate provision restricting medication abortion --- could take effect statewide. The full 5th Circuit earlier this month rejected a request from abortion clinic lawyers for an en banc review of the panel's decision (Women's Health Policy Report, 10/10).

Meanwhile, in August, U.S. District Court Judge Lee Yeakel barred enforcement of the ambulatory surgical centers provision statewide and the admitting privileges provision as it applies to the El Paso and McAllen clinics (Women's Health Policy Report, 9/2).

However, the 5th Circuit earlier this month lifted the hold on the ambulatory surgical centers provision, which was originally scheduled to take effect on Sept. 1. Thirteen clinics were forced to close immediately to comply with the ruling. The Center for Reproductive Rights then filed an emergency appeal to the Supreme Court on the clinics' behalf.

The 5th Circuit's ruling also meant that about 750,000 women of reproductive age, most of whom live in West Texas and near the Texas-Mexico border, were more than 200 miles away from the nearest abortion facility, according to abortion clinic lawyers (Women's Health Policy Report, 10/14).

Details on Tuesday's Decision

The Supreme Court order was unsigned and did not include an explanation for the justices' decision. The ruling noted that Justices Samuel Alito, Antonin Scalia and Clarence Thomas opposed the stay, which implies that Chief Justice John Roberts and Justices Ruth Bader Ginsburg, Stephen Breyer, Elena Kagan, Anthony Kennedy and Sonia Sotomayor likely were in favor of the decision, according to the Post (Washington Post, 10/14).

The ruling will allow the 13 clinics to reopen as soon as Wednesday, according to CRR, which is leading the challenge to the law. Although the Supreme Court blocked enforcement for now, the justices did not rule on the merits of the case.

Next Steps

The 5th Circuit is now expected to rule on the merits of the ambulatory surgical centers provision, according to Politico.

Meanwhile, the plaintiffs could appeal the 5th Circuit's admitting privileges ruling to the Supreme Court (Haberkorn, Politico, 10/14). Last fall, the high court declined an emergency request to intervene in that case, but comments by Breyer in a dissent suggested he believes the court's eventual review of the provision is likely, according to the New York Times.

Reaction

CRR President and CEO Nancy Northup said in a statement that although "clinics across the state will be allowed to reopen and provide women with safe and legal abortion care in their own communities," the "fight against Texas' sham abortion law is not over" (Liptak, New York Times, 10/14).

Planned Parenthood Federation of America President Cecile Richards said, "We're seeing the terrible impact these restrictions have on thousands of Texas women who effectively no longer have access to safe and legal abortion. We're relieved that the court stepped in to stop this, and we hope this dangerous law is ultimately overturned completely" (Politico, 10/14).

A spokesperson for the state attorney general's office said it "will continue to defend the law, just as we defend all state laws when they are challenged in court" (New York Times, 10/14). Greg Abbott, the current state attorney general, is also the Republican candidate for governor, facing state Sen. Wendy Davis (D), who drew national attention last year for her filibuster that helped stall HB 2 from becoming law (Women's Health Policy Report, 10/3).

LA Times: Supreme Court Must Stop State Abortion Restrictions

In a related editorial, the Los Angeles Times argues that laws like Texas' HB 2 often "arrive cloaked in encomiums about protecting women's health, when in fact they are intended to do one thing only: to make it more difficult, and in some cases almost impossible, to get an abortion."

The Times adds, "These relentless attacks on abortion are destined to continue until the Supreme Court steps in and rules definitively. It should take up these challenges to its authority and put a stop to this growing patchwork of bad, restrictive laws" (Los Angeles Times, 10/14).


States Restrict Telemedicine Abortion Services, Despite Safety, Other Benefits

Wed, 10/15/2014 - 14:33

While medication abortion can be administered safely and cost effectively via telemedicine, the method is "widely unavailable" in most of the U.S., according to The Atlantic.

States Restrict Telemedicine Abortion Services, Despite Safety, Other Benefits

October 15, 2014 — While medication abortion can be administered safely and cost effectively via telemedicine, the method is "widely unavailable" in most of the U.S., according to The Atlantic.

Since 2010 fifteen states have implemented telemedicine abortion bans, and it was only ever offered in three states: Iowa, Minnesota and Texas. However, Texas has since banned the practice.

By contrast, the use of telemedicine in other areas of health care has expanded rapidly in recent years. Elizabeth Nash, a senior state-issues associate with the Guttmacher Institute, said, "Everyone is trying to figure out how to incorporate telemedicine and how can they use it, but in this one area, we're seeing it be restricted."

Telemedicine Abortion in Iowa, Minnesota

Telemedicine abortion remains available in Iowa and Minnesota. In Iowa, the state has attempted to prohibit it, but that ban has been challenged in court, and in Minnesota, the governor vetoed a ban that was passed by the Legislature, according to The Atlantic.

In Minnesota, patients who have used the service through Planned Parenthood of Minnesota, North Dakota and South Dakota have reported that it enabled them to obtain an abortion at earlier stages of pregnancy and avoid a surgical abortion.

Meanwhile, Planned Parenthood of the Heartland in Iowa has used telemedicine services to administer medication abortion for 6,400 women since June 2008, according to PPH spokesperson Angie Remington.

Daniel Grossman, a doctor and researcher at Ibis Reproductive Health, said, "From a public-health perspective, [telemedicine] does improve access to early abortion [and] decreases later abortion, and that would result in improved health outcomes" (Semuels, The Atlantic, 10/10).


Most Irish Support Referendum To Expand Abortion Rights

Wed, 10/15/2014 - 14:30

A majority of Ireland residents support holding a referendum on whether to expand the circumstances under which abortion is legal in the country, according to a poll recently published in the Irish Times, Newsweek reports.

Most Irish Support Referendum To Expand Abortion Rights

October 15, 2014 — A majority of Ireland residents support holding a referendum on whether to expand the circumstances under which abortion is legal in the country, according to a poll recently published in the Irish Times, Newsweek reports.

The poll was conducted at 120 sampling points throughout the country. It includes responses from 1,200 adults (Sharkov, Newsweek, 10/13).

Background

Last year, Ireland's Parliament legalized abortion when the procedure is needed to save a woman's life, including when there is a threat of suicide because of the pregnancy. The law, called the Protection of Life During Pregnancy Act, does not allow abortions in instances of rape, incest, fetal anomaly or when there is no prospect of the fetus surviving outside the womb (Women's Health Policy Report, 8/19).

According to Newsweek, 3,679 women who had an abortion outside of the country in 2013 listed an Irish address as their home address. However, charity organizations that work to help Irish women obtain abortions said that figures were likely under-estimates, as women tend to give the addresses of friends or family in the United Kingdom or use medication abortion purchased online.

The country's ruling coalition of political parties ruled out a referendum on abortion access shortly after passing the Protection of Life During Pregnancy Act, citing the difficultly of putting that legislation forward, Newsweek reports.

Key Survey Findings

According to the survey, 68% of Irish citizens support holding a national vote on whether abortion should be permitted in instances of rape or when a fetus cannot be born alive. Meanwhile, 23% of respondents oppose such a referendum, while 9% are unsure.

The poll found no significant difference between the responses of women and men. Overall, 77% of respondents ages 18 to 24 said they support holding such a referendum, while 40% of residents over age 65 said they would not support the vote. According to the poll, Dublin residents were the most supportive of holding such a referendum (Newsweek, 10/13).


Featured Blogs

Tue, 10/14/2014 - 18:05

"Tennessee Sentenced a Woman to Six Extra Years in Jail Simply Because She Was Pregnant," (Marcotte, "XX Factor," Slate, 10/13); "Pittsburgh Passes 'Reasonable Accommodations' for Pregnant Workers," (Murtha, Women's Law Project blog, 10/13).

October 14, 2014

FEATURED BLOG

"Tennessee Sentenced a Woman to Six Extra Years in Jail Simply Because She Was Pregnant," Amanda Marcotte, Slate 's "XX Factor": "Once you can get six extra years in prison because you made an unhealthy but not illegal choice while pregnant, it seems that the door is open to all sorts of policing of pregnant women's behavior," Marcotte writes, discussing a recent case in which a Tennessee woman was given "enhanced sentencing" for methamphetamine manufacturing because she was involved in the process while pregnant. According to a Vice report on the case, the National Advocates for Pregnant Women led a coalition of reproductive-rights organizations to urge the Department of Justice to protest the woman's sentencing, noting that drug use is not a crime under Tennessee or federal law, Marcotte writes. Marcotte adds, "[W]ith enhanced sentencing, the legal groundwork is being laid for criminalizing things that otherwise are not crimes because they are being performed while pregnant" (Marcotte, "XX Factor," Slate, 10/13).

FEATURED BLOG

"Pittsburgh Passes 'Reasonable Accommodations' for Pregnant Workers," Tara Murtha, Women's Law Project blog: The "Pittsburgh City Council passed legislation [Ordinance 2014-0809] that calls for 'reasonable accommodations' for pregnant women who work for the city or city contracts, and bans discrimination against pregnant employees," Murtha writes. She adds that the ordinance "cites examples of discrimination from around the state [of Pennsylvania], including a supermarket cashier ... who lost her job because she followed her doctor's orders to carry a water bottle and a pregnant security guard denied a request to sit down part of her shift in downtown Pittsburgh." Murtha writes that while "the Pregnancy Discrimination Act of 1978 [PL 95-555] banned discrimination against pregnant workers, it does not address reasonable accommodations under all circumstances," noting that state and federal lawmakers have proposed bills (S 942, HR 1975) to combat such discrimination (Murtha, Women's Law Project blog, 10/13).

What others are saying about supporting working families/pregnant workers' rights:

~ "Microsoft CEO Apologizes for Ridiculous Comments About Women," Sarah Gray, Salon.

NYT Weighs In on State Antiabortion-Rights Ballot Measures

Tue, 10/14/2014 - 18:01

Voters in three states next month will consider "ballot measures aimed at ending or severely limiting abortion rights," a New York Times editorial states, referencing referendums in Colorado, North Dakota and Tennessee.

NYT Weighs In on State Antiabortion-Rights Ballot Measures

October 14, 2014 — Voters in three states next month will consider "ballot measures aimed at ending or severely limiting abortion rights," a New York Times editorial states, referencing referendums in Colorado, North Dakota and Tennessee.

In Colorado, Amendment 67 "is a modified but no less unconstitutional version of the preposterous 'personhood' proposals Colorado voters overwhelmingly rejected in 2008 and 2010," the Times explains. The amendment's "wording advertises the initiative as protecting women, when, in fact, it would do the opposite," the editorial argues, noting that it would "confe[r] on fertilized eggs legal rights and protections that apply to living individuals, criminalizing abortion even in cases of rape or incest or to protect a woman's health."

Further, the Colorado measure would "curtail access to some commonly used methods of contraception and fertility treatments, while subjecting women who suffer a miscarriage and their doctors to investigation and possible prosecution because of suspicions that deliberate or negligent actions led to the miscarriage," according to the Times.

Meanwhile, North Dakota's Constitutional Measure 1 (SCR 4009), "another personhood initiative, would similarly limit abortion rights, not by invoking the criminal code, but by adding restrictive language to the State Constitution," the editorial states. "North Dakota has been so inhospitable to reproductive rights -- it has only one abortion provider -- that its initiative will be tougher to beat than Colorado's," according to the editorial.

The Tennessee measure (Amendment 1) could enable the state Legislature to enact "new obstacles to safe and legal abortions, which are already subject to serious restrictions in the state," but, "[f]ortunately, Tennessee's rules for amending the State Constitution set a high bar. In addition to requiring a majority vote, the initiative must receive more than half the number of total votes cast in the governor's race -- a bigger challenge," the Times concludes (New York Times, 10/13).


Texas Clinics Receiving More Calls, Patients Facing Longer Wait Times After HB 2 Ruling

Tue, 10/14/2014 - 18:00

Texas' remaining abortion clinics are reporting an influx of phone calls from patients and longer wait times for appointments in the wake of a federal appeals court's decision to lift a hold against a state antiabortion-rights law (HB 2), the AP/U-T San Diego reports.

Texas Clinics Receiving More Calls, Patients Facing Longer Wait Times After HB 2 Ruling

October 14, 2014 — Texas' remaining abortion clinics are reporting an influx of phone calls from patients and longer wait times for appointments in the wake of a federal appeals court's decision to lift a hold against a state antiabortion-rights law (HB 2), the AP/U-T San Diego reports (AP/U-T San Diego, 10/12).

Background

Earlier this month, the 5th U.S. Circuit Court of Appeals lifted a hold on a provision of HB 2, originally scheduled to take effect on Sept. 1, that requires abortion clinics to meet the same standards as ambulatory surgical centers. Thirteen clinics were forced to close immediately to comply with the ruling. The Center for Reproductive Rights earlier this month filed an emergency appeal on the clinics' behalf (Women's Health Policy Report, 10/9).

Only eight abortion clinics remain in the state, with two clinics each in Dallas, Houston and San Antonio, and one clinic in both Austin and Fort Worth, the AP/U-T San Diego reports (AP/U-T San Diego, 10/12). The ruling also means that about 750,000 women of reproductive age, most of whom live in West Texas and near the Texas-Mexico border, are now more than 200 miles away from the nearest abortion facility, according to state abortion clinic lawyers (Women's Health Policy Report, 10/3).

More Calls, Longer Wait Times

In the week following the ruling, Planned Parenthood of Greater Texas in Austin experienced seven times the normal rate of calls. Many calls came from women in Texas who lived far away from the facility (AP/U-T San Diego, 10/12).

Similarly, Planned Parenthood Gulf Coast spokesperson Rochelle Tafolla said its Houston location had experienced four times more calls than usual the day after the court's ruling and about 170% more calls than normal the following week.

According to the Houston Chronicle, other facilities "reported smaller but significant spikes" in call volume.

In addition, wait times at Whole Woman's Health in San Antonio have increased from three hours to seven hours, according to clinic spokesperson Fatimah Gifford.

Concerns About Meeting Demand

According to the Chronicle, even if women were able to travel to receive abortion care, state data show that "it is unlikely that the remaining facilities [in Texas] could handle the load." Six of the remaining clinics perform a total of about 15,000 abortions annually, or 22% of the 68,298 abortions performed in the state in 2012.

Planned Parenthood San Antonio spokesperson Mara Robinson said, "Any future growth [in abortion procedures performed] would have to be slow and determined by what the needs are." She added, "We just don't know. This just happened, and we're really trying to see how we can grapple with it" (Rosenthal/Collette, Houston Chronicle, 10/11).


States Continue To Limit Abortion Access, Despite Public Support for Abortion Rights

Tue, 10/14/2014 - 17:59

Although a majority of U.S. residents still support abortion rights, states across the country over the past four years have succeeded in enacting legislation that could drastically diminish abortion access for millions of women if allowed to stand, the Los Angeles Times reports.

States Continue To Limit Abortion Access, Despite Public Support for Abortion Rights

October 14, 2014 — Although a majority of U.S. residents still support abortion rights, states across the country over the past four years have succeeded in enacting legislation that could drastically diminish abortion access for millions of women if allowed to stand, the Los Angeles Times reports.

According to the Guttmacher Institute, states since 2011 have passed approximately 230 abortion restrictions. For example, several states require women to obtain ultrasounds before they can receive an abortion, while others limit insurance coverage for abortion services or restrict state funding for abortion providers. Meanwhile, a sweeping antiabortion-rights law (HB 2) in Texas has forced almost two-thirds of the state's abortion clinics to close; similar efforts in Louisiana are threatening abortion access there.

At the same time, the Pew Research Center for People and the Press reports strong support for abortion rights throughout the U.S. The center notes that last year, 63% of U.S. residents said they did not want the Supreme Court to overturn its decision on Roe v. Wade.

Still, the poll showed a geographical gap in abortion stances. For example, 75% of New England residents said they think abortion should be legal in most or all cases, an increase of 5% from 20 years ago. At the same time, 40% of residents in the South Central region of the U.S. said abortion should be legal in most or all cases, down 5% over the same time period (Semuels/La Ganga, Los Angeles Times, 10/11).

CRR President Comments on 'Shrinking' Abortion Access

In related news, Center for Reproductive Rights President Nancy Northup comments on the country's "shrinking" abortion access in a Washington Post opinion piece.

Northup writes that the number of abortion restrictions states have enacted since 2011 is more "than were enacted in the previous decade." She notes that although the laws were "[p]assed under the pretense of regulating safety standards, the true purpose of these laws is to hollow out Roe v. Wade's recognition of women's constitutional right to decide for themselves whether to end a pregnancy, as well as the legal protections afforded by that historic ruling."

Northup questions whether courts will let the restrictions stand and highlights a recent case in which the 5th U.S. Circuit Court of Appeals "lift[ed] an injunction blocking the most extreme provisions of Texas's sweeping anti-abortion law" that resulted in "not a single abortion clinic remain[ing] open in the state west or south of San Antonio." She writes, "Not since before Roe v. Wade has a law or court decision resulted in the denial of abortion care on such a sweeping scale."

Meanwhile, other states such as "Oklahoma, Alabama, Louisiana and Wisconsin have passed similarly underhanded laws designed to shutter most, if not all, clinics by requiring any physician who provides an abortion to obtain admitting privileges at a local hospital." She concludes, "The resulting sharp disparities in women's ability to obtain abortion care are becoming troublingly reminiscent of the time before Roe, when access depended entirely on where a woman lived or her ability to travel to one of the few states where abortion was safe and legal" (Northup, Washington Post, 10/10).