Daily Women's Health Policy Report

  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
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Syndicate content
Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 1 hour 53 min ago

House Passes 20-Week Abortion Ban

Thu, 05/14/2015 - 17:45

The House on Wednesday voted 242-184 to pass a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, the New York Times reports.

House Passes 20-Week Abortion Ban

May 14, 2015 — The House on Wednesday voted 242-184 to pass a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, the New York Times reports (Huetteman, New York Times, 5/13).

According to the Washington Post, the measure faces opposition among abortion-rights supporters in the Senate, and President Obama has said he will veto the bill should it gain congressional approval (Somashekhar, Washington Post, 5/13). Nonetheless, Sen. Lindsey Graham (R-S.C.) on Wednesday said he soon would introduce a similar measure in the Senate (Schoof, McClatchy/Sacramento Bee, 5/13).

Background

House leaders originally planned to vote on a version of the bill on Jan. 22 -- the 42nd anniversary of the Supreme Court's Roe v. Wade decision -- but changed course after some conservative lawmakers raised concerns about a requirement that a rape survivor would have to formally report the rape to police to obtain an abortion after 20 weeks of pregnancy.

Bill Details

Though lawmakers tweaked the original language permitting limited exceptions in cases of rape, adult rape survivors would still be required to meet strict restrictions, before obtaining abortions after 20 weeks of pregnancy under the revised bill. Specifically, abortion care would only be permitted if the woman receives counseling or medical care at least 48 hours prior to the procedure.

Meanwhile, the revised bill maintains reporting requirements for rape or incest survivors who are minors, allowing them to obtain abortion care after 20 weeks of pregnancy only if the incident has been reported to a law enforcement agency or a government agency that deals with child abuse. The bill would not provide exemptions in cases of incest for adults.

The revised measure also includes provisions that would require women seeking abortion later in pregnancy to sign an "informed consent" form and make physicians who violate the bill liable for civil action (Women's Health Policy Report, 5/13). Criminal penalties, including up to five years’ imprisonment, are also permitted for certain violations (Bill text, 5/7).

Comments

Rep. Renee Ellmers (R-N.C.) said that the revised legislation is "a better bill" (McClatchy/Sacramento Bee, 5/13).

Debra Ness, president of the National Partnership for Women & Families, condemned the "dangerous, unconstitutional, national 20-week abortion ban." She said, "It would insert politicians into the relationship between women and their health care providers, depriving women of the ability to make extremely personal medical decisions with the people they trust" (NPWF statement, 5/13).

Similarly, Gretchen Borchelt, the National Women's Law Center's vice president for health and reproductive rights, said the vote shows that conservative lawmakers believe that "politics -- not medical expertise or a woman's health -- should drive important health care decisions." She added, "Passing an unconstitutional nationwide ban on later abortions does nothing to help women -- instead, it threatens their health and lives and interferes in their personal medical decisions" (Walsh, CNN, 5/14).

Planned Parenthood Federation of America President Cecile Richards on Wednesday added that the legislation is "dangerous and misguided" (Washington Post, 5/13).

Meanwhile, White House press secretary Josh Earnest on Wednesday before the vote said the legislation "would ... impose ... additional harsh burdens on survivors of sexual assault, rape and incest" (Cooney, Reuters, 5/13).


Texas House Advances Bill Adding Additional Restrictions to Parental Involvement Law

Thu, 05/14/2015 - 16:10

The Texas House on Wednesday in a 98-47 vote gave preliminary approval to a measure (HB 3994) that would tighten a state law that allows pregnant minors to obtain a court's permission to have an abortion instead of obtaining parental consent for the procedure, the Texas Tribune reports.

Texas House Advances Bill Adding Additional Restrictions to Parental Involvement Law

May 14, 2015 — The Texas House on Wednesday in a 98-47 vote gave preliminary approval to a measure (HB 3994) that would tighten a state law that allows pregnant minors to obtain a court's permission to have an abortion instead of obtaining parental consent for the procedure, the Texas Tribune reports.

According to the Tribune, the bill requires final approval from the state House before it can advance to the state Senate for consideration (Ura, Texas Tribune, 5/13).

Background

Currently, minors can apply for a judicial bypass in any Texas county. The proceedings remain confidential to protect minors. The state does not track how many cases there are annually or which judges have ruled on the cases.

Minors seeking judicial bypass must prove at least one of three reasons: that they are well-informed and mature enough to obtain an abortion without parental notification; that it is not in their best interests to notify their parents of the procedure; or that notifying their parents would cause emotional, physical or sexual abuse.

The proposed measure would require minors to apply for bypass in their county of residence, an adjacent county if their home has fewer than 10,000 residents or in the county in which they plan to have the procedure (Women's Health Policy Report, 4/16). In addition, the bill would require physicians to assume pregnant women are minors until they show a "valid government record of identification" showing they are not. Further, the bill would increase the burden of proof that minors face when claiming that obtaining parental consent for abortion would lead to emotional, physical or sexual abuse. The bill would also publicize the names of judges who decide on judicial bypass cases.

Debate on the Measure

During about four hours of debate on the measure, state Rep. Geanie Morrison (R), who proposed the bill, said it is intended "to improve the protection of the minor girl and ensure that parental rights are protected."

Meanwhile, abortion-rights supporters in the state House voiced opposition to the bill, with some lawmakers calling several points of order against the measure in an effort to delay or kill the chances of the bill's passage. Other state lawmakers who support abortion rights also offered various amendments to try to weaken the measure, but none of the amendments were adopted.

Among the proposed amendments were measures to remove the "abortion ID" requirement or broaden the types of ID that would be accepted under the proposed rule. State Rep. Eddie Rodriguez (D), who offered one such amendment, asked whether the requirement was meant to be "a defacto ban on abortion for people who don't have IDs."

Separately, state Rep. Rafael Anchia (D) asked Morrison why student or college IDs would not be accepted under the proposed requirements or whether she thought that victims of human trafficking would have the necessary identification to comply with the potential rule. Morrison replied that such victims "should be going to a police department" to receive help.

Meanwhile, state Rep. Roland Gutierrez (D) spoke in support of a proposed amendment that would have retained the law's current burden-of-proof standards. He said he was concerned that altering the "long-standing" burden of proof could spur changes in other laws.

An amendment offered by state Rep. Mary González (D) would have removed the measures' judicial reporting requirements, which she said would "put a target on the backs of judges who rule on these cases." González also proposed an amendment that would have changed the filing location requirement to include population limits of 50,000.

Further, some state lawmakers who support abortion rights also offered amendments that would have broadened the parental involvement law to allow for family members other than parents to give consent, to define minors as individuals who are younger than age 17 and to allow for exceptions for minors who are survivors of rape or incest (Texas Tribune, 5/13).


House Passes 20-Week Abortion Ban

Thu, 05/14/2015 - 15:52

The House on Wednesday voted 242-184 to pass a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, the New York Times reports.

House Passes 20-Week Abortion Ban

May 14, 2015 — The House on Wednesday voted 242-184 to pass a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, the New York Times reports (Huetteman, New York Times, 5/13).

According to the Washington Post, the measure faces opposition among abortion-rights supporters in the Senate, and President Obama has said he will veto the bill should it gain congressional approval (Somashekhar, Washington Post, 5/13). Nonetheless, Sen. Lindsey Graham (R-S.C.) on Wednesday said he soon would introduce a similar measure in the Senate (Schoof, McClatchy/Sacramento Bee, 5/13).

Background

House leaders originally planned to vote on a version of the bill on Jan. 22 -- the 42nd anniversary of the Supreme Court's Roe v. Wade decision -- but changed course after some conservative lawmakers raised concerns about a requirement that a rape survivor would have to formally report the rape to police to obtain an abortion after 20 weeks of pregnancy.

Bill Details

Though lawmakers tweaked the original language permitting limited exceptions in cases of rape, adult rape survivors would still be required to meet strict restrictions, before obtaining abortions after 20 weeks of pregnancy under the revised bill. Specifically, abortion care would only be permitted if the woman receives counseling or medical care at least 48 hours prior to the procedure.

Meanwhile, the revised bill maintains reporting requirements for rape or incest survivors who are minors, allowing them to obtain abortion care after 20 weeks of pregnancy only if the incident has been reported to a law enforcement agency or a government agency that deals with child abuse. The bill would not provide exemptions in cases of incest for adults.

The revised measure also includes provisions that would require women seeking abortion later in pregnancy to sign an "informed consent" form and make physicians who violate the bill liable for civil action (Women's Health Policy Report, 5/13). Criminal penalties, including up to five years’ imprisonment, are also permitted for certain violations (Bill text, 5/7).

Comments

Rep. Renee Ellmers (R-N.C.) said that the revised legislation is "a better bill" (McClatchy/Sacramento Bee, 5/13).

Debra Ness, president of the National Partnership for Women & Families, condemned the "dangerous, unconstitutional, national 20-week abortion ban." She said, "It would insert politicians into the relationship between women and their health care providers, depriving women of the ability to make extremely personal medical decisions with the people they trust" (NPWF statement, 5/13).

Similarly, Gretchen Borchelt, the National Women's Law Center's vice president for health and reproductive rights, said the vote shows that conservative lawmakers believe that "politics -- not medical expertise or a woman's health -- should drive important health care decisions." She added, "Passing an unconstitutional nationwide ban on later abortions does nothing to help women -- instead, it threatens their health and lives and interferes in their personal medical decisions" (Walsh, CNN, 5/14).

Planned Parenthood Federation of America President Cecile Richards on Wednesday added that the legislation is "dangerous and misguided" (Washington Post, 5/13).

Meanwhile, White House press secretary Josh Earnest on Wednesday before the vote said the legislation "would ... impose ... additional harsh burdens on survivors of sexual assault, rape and incest" (Cooney, Reuters, 5/13).


Iowa House Committee Advances Budget Blocking Abortion Providers From Family Planning Program

Thu, 05/14/2015 - 15:04

An Iowa House committee on Tuesday advanced a state health and human services budget (SF 505) that would prevent abortion providers from participating in a family planning program, the AP/Omaha World-Herald reports.

Iowa House Committee Advances Budget Blocking Abortion Providers From Family Planning Program

May 14, 2015 — An Iowa House committee on Tuesday advanced a state health and human services budget (SF 505) that would prevent abortion providers from participating in a family planning program, the AP/Omaha World-Herald reports.

Background on Current Program

According to the AP/World-Herald, the program provides family planning services to nearly 17,000 low-income individuals between ages 12 and 54. The program is projected to spend $3.4 million in federal funding and $532,000 in state funding during the current fiscal year.

All family planning clinics that participate in Medicaid are eligible to participate in the program, including Planned Parenthood of the Heartland.

Proposed Changes

Under the proposed budget, Iowa would no longer accept matching funds from the federal government to operate the program. Instead, it would create a new program funded by federal grant money, which would provide the state with more leeway in how the funds are spent.

The budget proposal would not allow "any entity that performs abortions or that maintains or operates a facility where abortions are performed" to provide services under the new program. It would include exemptions for miscarriages and life-threatening medical conditions.

Reaction

State Sen. Amanda Ragan (D) said the state Senate in its budget would keep the current program and funding system in place. According to the AP/World-Herald, any potential differences between the two budgets will need to be resolved in negotiations.

PPH Director of Public Affairs Erin Davison-Rippey said if the state House's proposed changes were to go into effect, "Iowans [would] have a harder time finding a provider who is eligible to participate" (AP/Omaha World-Herald, 5/13).


Maine Parental Involvement Bill 'Could Put a Girl's Health and Safety at Risk,' Editorial Contends

Thu, 05/14/2015 - 14:19

A proposal (LD 83) before the Maine Legislature that would require a minor to involve her parent before obtaining an abortion "could put a girl's health and safety at risk," according to a Portland Press Herald editorial.

Maine Parental Involvement Bill 'Could Put a Girl's Health and Safety at Risk,' Editorial Contends

May 14, 2015 — A proposal (LD 83) before the Maine Legislature that would require a minor to involve her parent before obtaining an abortion "could put a girl's health and safety at risk," according to a Portland Press Herald editorial.

According to the editorial, the measure, if approved, "would repeal a 1989 state law [Title 22] that lets a physician determine whether a minor is competent enough to make her own decision on abortion" and instead require any girl under age 18 to obtain "the signed consent of someone who can provide written proof that they are the girl's parent" before obtaining an abortion.

The editorial states that while "[m]ost teens who have abortions do, in fact, tell their families beforehand," those "who decide not to tell their parents that they're pregnant often have good reason: Twenty-two percent are afraid of being kicked out of the house, and 8 percent fear being beaten." In addition, the editorial argues that "[b]y making it harder for teens to get abortions ... parental consent laws have been shown to boost the likelihood that minors will undergo later, more risky, procedures."

Further, the proposal's exceptions to the requirement "could have unintended consequences," according to the editorial. "For example, a teen who has the consent of a sibling (age 21 or older), stepparent or grandparent could get an abortion," but only if she provides "a written statement alleging that she has been abused by a parent." This requirement would force the girl to allege the abuse "regardless [of] whether she feels safe telling her story" and "expose the teen and her family to a child protective services investigation." Meanwhile, the editorial notes that the proposal's provisions allowing minors to seek judicial bypass have proven "difficult" in other states.

The editorial urges state lawmakers not to advance "a proposal that could put young Maine women in harm's way" (Portland Press Herald, 5/13).


'Oklahoma Governor Signs 72-Hour Waiting Period Bill'

Wed, 05/13/2015 - 17:19

"Oklahoma Governor Signs 72-Hour Waiting Period Bill," (Wilson, RH Reality Check, 5/6)

May 8, 2015

"Oklahoma Governor Signs 72-Hour Waiting Period Bill," Teddy Wilson, RH Reality Check: "Oklahoma Gov. Mary Fallin (R) signed a bill [HB 1409] into law Wednesday mandating that a person seeking an abortion must wait 72 hours for the procedure," making it "the fourth state in the country -- joining Missouri, South Dakota, and Utah -- with a 72-hour" mandatory delay, Wilson writes. Further, Wilson notes that the law, which takes effect on Nov. 1, also requires physicians to share "so-called informed consent materials" with patients. Wilson cites concerns of several reproductive rights advocates, including Amanda Allen, state legislative counsel at the Center for Reproductive Rights, who said, "'The message that this [law] really sends is that the [Oklahoma] Legislature and the government are second-guessing a woman's ability to decide for herself." Wilson adds that similar bills "have been introduced in state legislatures nationwide to create or increase [delays] before a woman can seek abortion care" (Wilson, RH Reality Check, 5/6).

What others are saying about abortion restrictions:

~ "Colorado Democrats Defeat Fetal 'Personhood' Legislation," Jason Salzman, RH Reality Check.

~ "California Lawmakers Won't Allow Insurers To Opt Out of Abortion Coverage," Nina Liss-Schultz, RH Reality Check.

Federal Judge Dismisses Some Claims in Suit Challenging La. Admitting Privileges Law

Wed, 05/13/2015 - 16:23

A federal judge on Tuesday dismissed portions of a lawsuit challenging a Louisiana admitting privileges law (Act 620), while allowing other parts of the case to proceed, AP/ABC News reports.

Federal Judge Dismisses Some Claims in Suit Challenging La. Admitting Privileges Law

May 13, 2015 — A federal judge on Tuesday dismissed portions of a lawsuit challenging a Louisiana admitting privileges law (Act 620), while allowing other parts of the case to proceed, AP/ABC News reports.

A trial for the parts of the lawsuit that were not dismissed is scheduled to take place from June 22 to June 29 (McConnaughey, AP/ABC News, 5/12).

Background

The law requires abortion providers in the state to have admitting privileges at hospitals within 30 miles of the facility where they practice.

Abortion clinics in Shreveport, Bossier City and Metairie filed suit against the law in August 2014. Delta Clinic of Baton Rouge and Women's Health Center in New Orleans filed a separate suit against the law the following month.

In August 2014, U.S. District Court Judge John deGravelles said the law could take effect as scheduled on Sept. 1, 2014, but he granted a temporary restraining order that blocks the state from enforcing the law. Meanwhile, in December 2014, the Baton Rouge and New Orleans clinics requested their suit be dismissed, citing cost concerns. DeGravelles had been considering the clinics' suit together with the other three clinics' suit, which remained intact.

On March 19, Louisiana Gov. Bobby Jindal's (R) administration asked deGravelles to dismiss parts of the suit, arguing that the court should throw out the clinics' claims that the law constitutes a "medically unreasonable" requirement and that lawmakers intended for the law to reduce abortion access. Attorney Kyle Duncan, representing the Louisiana Department of Health and Hospitals, argued that a federal appeals court had denied similar claims in cases regarding Mississippi and Texas laws.

Meanwhile, Ilene Jaroslaw, an attorney with the Center for Reproductive Rights, which is representing the abortion clinics, argued that case law is not settled on such issues and that the claims should be considered during the trial. In addition, she said dismissing those claims would reduce the ability of the facilities to provide the court with medical evidence that could show that the admitting privileges measure restricts abortion access "with no obvious benefits to women's health" (Women's Health Policy Report, 3/23).

Judge Dismisses Some Claims

DeGravelles on Tuesday dismissed some claims, ruling that while the law could have a rational basis, it could put too great a burden on women trying to access abortion in the state.

Specifically, deGravelles said he was bound by the 5th U.S. Circuit Court of Appeals' ruling to uphold a similar Texas law (HB 2), but he noted that the Texas ruling is "only one part of the test for constitutionality." He added that the 5th Circuit also overturned Mississippi's admitting privileges law (HB 1390) because it would have made it too difficult for women in the state to access abortion.

According to Duncan, deGravelles in the upcoming trial will consider whether the Louisiana Legislature intended to close abortion clinics in the state when it passed the law last year and how the law will affect abortion access in the state.

Reaction

Duncan said the state is "pleased that the judge's ruling recognizes that an admitting [privileges] requirement like Louisiana's is medically reasonable and we look forward to the trial."

Meanwhile, Jaroslaw also voiced support for the decision, saying, "What the judge was saying is: evidence matters, facts matter, and the state can't hide behind a technicality to obscure the fact that the point of this law is just to shut down abortion clinics."

She continued, "If the state says that their purpose is to help women and [the law] has a net effect of harming women -- which in fact it does -- it will shed a lot of light on the true purpose." According to Jaroslaw, four of the state's six abortion providers do not have the necessary privileges. Meanwhile, one of the physicians who does have the privileges only performs abortions part-time, while the other -- who performs abortions in both New Orleans and Baton Rouge -- has privileges only in New Orleans (AP/ABC News, 5/12).


Judge: Calif. Law Does Not Permit Teaching Abstinence as the Only Safe Way To Prevent Pregnancy

Wed, 05/13/2015 - 16:19

A Fresno County, Calif., judge has ruled that the state's law (SB 71) on sexuality education does not allow school districts to teach students that abstinence is the only safe way to protect against sexually transmitted infections and prevent pregnancy, the San Francisco Chronicle reports.

Judge: Calif. Law Does Not Permit Teaching Abstinence as the Only Safe Way To Prevent Pregnancy

May 13, 2015 — A Fresno County, Calif., judge has ruled that the state's law (SB 71) on sexuality education does not allow school districts to teach students that abstinence is the only safe way to protect against sexually transmitted infections and prevent pregnancy, the San Francisco Chronicle reports.

According to the Chronicle, the decision applies only to the Clovis Unified School District, but it is the first ruling that interprets the state's sexuality education law.

Background


In California, school districts are required to teach age-appropriate sexuality education programs. Districts must teach students, beginning in seventh grade, that abstinence is the only certain way an individual can prevent pregnancy and avoid contracting STIs. However, districts must also teach medically accurate information about other methods of contraception, including all FDA-approved contraceptives.

In November 2012, a group of parents sued the Clovis school district, alleging that sexuality education courses used videos and texts that had minimal discussion of contraceptives, no mention of contraceptives or claimed contraceptives were ineffective. Further, the parents said the materials focused on abstinence.

The district revised its policies, and the parents dismissed their suit in February 2014.

Ruling Details

In the ruling, Fresno County Superior Court Judge Donald Black held that the district should pay the parents' attorneys' fees, saying that their suit had led the school district to revise its ninth grade courses so they were compliant with the law.

He ruled that the law prohibits districts from indoctrinating students about having to abstain from sex until marriage. Black said, "Access to medically and socially appropriate sexual education is an important public right."

Black in the ruling noted that one video in the course had compared a woman who had had sex to a dirty shoe, while other videos "perpetuated sexual orientation bias" and promoted the stance of "one man, one woman, one life."

Comments

Phyllida Burlingame, an attorney with the American Civil Liberties Union, which took part in the suit, said that as the ruling was the first to interpret the state sexuality education law, it should make schools aware that "young people need complete, accurate health information required by law." She noted a 2011 University of California-San Francisco study that found compliance with the law varied among districts.

According to Burlingame, the ruling marks the first time "abstinence-only-until-marriage curricula have been found to be medically inaccurate" (Egelko, San Francisco Chronicle, 5/12).


House Expected To Pass 20-Week Ban on Wednesday

Wed, 05/13/2015 - 15:00

The House on Wednesday is expected to vote on a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, although the measure has "little chance of becoming law," the Wall Street Journal reports.

House Expected To Pass 20-Week Ban on Wednesday

May 13, 2015 — The House on Wednesday is expected to vote on a revised version of a bill (HR 36) that would ban abortions at 20 weeks of pregnancy, although the measure has "little chance of becoming law," the Wall Street Journal reports (Peterson/Radnofsky, Wall Street Journal, 5/12).

According to the New York Times, the bill likely would be blocked in the Senate. Don Stewart, chief of staff for Senate Majority Leader Mitch McConnell (R-Ky.), added that while McConnell supports the bill, it is unlikely the measure will be immediately considered by the Senate (Huetteman, New York Times, 5/13).

In addition, the bill would likely be vetoed by President Obama if it were to pass Congress.

Background

House leaders originally planned to vote on a version of the bill on Jan. 22 -- the 42nd anniversary of the Supreme Court's Roe v. Wade decision -- but changed course after some conservative lawmakers raised concerns about a requirement that a rape survivor would have to formally report the rape to police to obtain an abortion after 20 weeks of pregnancy.

The Wednesday vote on the revised measure is scheduled to coincide with the anniversary of the conviction of illegal abortion provider Kermit Gosnell (Women's Health Policy Report, 5/11).

Bill Details

In the updated bill, lawmakers revised language regarding the original measure's rape provision. Under the revised bill, adult rape survivors only would be able to receive abortions after 20 weeks of pregnancy if they receive counseling or medical care at least 48 hours prior to the procedure (New York Times, 5/13).

Meanwhile, the revised bill would only allow rape or incest survivors who are minors to receive abortions after 20 weeks of pregnancy if the incident has been reported to a law enforcement agency or a government agency that deals with child abuse (Theobald, USA Today, 5/12). The bill would not provide exemptions in cases of incest for adults (Wall Street Journal, 5/12).

The revised measure also includes provisions that would require women seeking abortion later in pregnancy to sign an "informed consent" form and make physicians who violate the bill liable for civil action (Women's Health Policy Report, 5/11). In addition, the bill imposes several reporting requirements on physicians who provide abortions after 20 weeks' gestation (Bill text, 5/7).

Comments

Rep. Diane Black (R-Tenn.) said the revised legislation is "a stronger bill."

However, Rep. Charlie Dent (R-Pa.) criticized conservative lawmakers for spending "a lot of time and energy ... on a bill that really has no chance of becoming law" (Wall Street Journal, 5/12).

Meanwhile, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), chairs of the House Pro-Choice Caucus, in a statement said the legislation would violate the "constitutional right" of "[e]very woman ... to make health care choices in the manner she sees fit" (New York Times, 5/13).

NARAL President Ilyse Hogue added that conservatives opposed to abortion rights "clearly missed the message the first time around: Americans don't want these politicians inserting themselves into our personal health care decisions" (Howell, Washington Times, 5/12).


Federal Judge Dismisses Some Claims in Suit Challenging La. Admitting Privileges Law

Wed, 05/13/2015 - 14:39

A federal judge on Tuesday dismissed portions of a lawsuit challenging a Louisiana admitting privileges law (Act 620), while allowing other parts of the case to proceed, AP/ABC News reports.

Federal Judge Dismisses Some Claims in Suit Challenging La. Admitting Privileges Law

May 13, 2015 — A federal judge on Tuesday dismissed portions of a lawsuit challenging a Louisiana admitting privileges law (Act 620), while allowing other parts of the case to proceed, AP/ABC News reports.

A trial for the parts of the lawsuit that were not dismissed is scheduled to take place from June 22 to June 29 (McConnaughey, AP/ABC News, 5/12).

Background

The law requires abortion providers in the state to have admitting privileges at hospitals within 30 miles of the facility where they practice.

Abortion clinics in Shreveport, Bossier City and Metairie filed suit against the law in August 2014. Delta Clinic of Baton Rouge and Women's Health Center in New Orleans filed a separate suit against the law the following month.

In August 2014, U.S. District Court Judge John deGravelles said the law could take effect as scheduled on Sept. 1, 2014, but he granted a temporary restraining order that blocks the state from enforcing the law. Meanwhile, in December 2014, the Baton Rouge and New Orleans clinics requested their suit be dismissed, citing cost concerns. DeGravelles had been considering the clinics' suit together with the other three clinics' suit, which remained intact.

On March 19, Louisiana Gov. Bobby Jindal's (R) administration asked deGravelles to dismiss parts of the suit, arguing that the court should throw out the clinics' claims that the law constitutes a "medically unreasonable" requirement and that lawmakers intended for the law to reduce abortion access. Attorney Kyle Duncan, representing the Louisiana Department of Health and Hospitals, argued that a federal appeals court had denied similar claims in cases regarding Mississippi and Texas laws.

Meanwhile, Ilene Jaroslaw, an attorney with the Center for Reproductive Rights, which is representing the abortion clinics, argued that case law is not settled on such issues and that the claims should be considered during the trial. In addition, she said dismissing those claims would reduce the ability of the facilities to provide the court with medical evidence that could show that the admitting privileges measure restricts abortion access "with no obvious benefits to women's health" (Women's Health Policy Report, 3/23).

Judge Dismisses Some Claims

DeGravelles on Tuesday dismissed some claims, ruling that while the law could have a rational basis, it could put too great a burden on women trying to access abortion in the state.

Specifically, deGravelles said he was bound by the 5th U.S. Circuit Court of Appeals' ruling to uphold a similar Texas law (HB 2), but he noted that the Texas ruling is "only one part of the test for constitutionality." He added that the 5th Circuit also overturned Mississippi's admitting privileges law (HB 1390) because it would have made it too difficult for women in the state to access abortion.

According to Duncan, deGravelles in the upcoming trial will consider whether the Louisiana Legislature intended to close abortion clinics in the state when it passed the law last year and how the law will affect abortion access in the state.

Reaction

Duncan said the state is "pleased that the judge's ruling recognizes that an admitting [privileges] requirement like Louisiana's is medically reasonable and we look forward to the trial."

Meanwhile, Jaroslaw also voiced support for the decision, saying, "What the judge was saying is: evidence matters, facts matter, and the state can't hide behind a technicality to obscure the fact that the point of this law is just to shut down abortion clinics."

She continued, "If the state says that their purpose is to help women and [the law] has a net effect of harming women -- which in fact it does -- it will shed a lot of light on the true purpose." According to Jaroslaw, four of the state's six abortion providers do not have the necessary privileges. Meanwhile, one of the physicians who does have the privileges only performs abortions part-time, while the other -- who performs abortions in both New Orleans and Baton Rouge -- has privileges only in New Orleans (AP/ABC News, 5/12).


Judge: Calif. Law Does Not Permit Teaching Abstinence as the Only Safe Way To Prevent Pregnancy

Wed, 05/13/2015 - 14:04

A Fresno County, Calif., judge has ruled that the state's law (SB 71) on sexuality education does not allow school districts to teach students that abstinence is the only safe way to protect against sexually transmitted infections and prevent pregnancy, the San Francisco Chronicle reports.

Judge: Calif. Law Does Not Permit Teaching Abstinence as the Only Safe Way To Prevent Pregnancy

May 13, 2015 — A Fresno County, Calif., judge has ruled that the state's law (SB 71) on sexuality education does not allow school districts to teach students that abstinence is the only safe way to protect against sexually transmitted infections and prevent pregnancy, the San Francisco Chronicle reports.

According to the Chronicle, the decision applies only to the Clovis Unified School District, but it is the first ruling that interprets the state's sexuality education law.

Background


In California, school districts are required to teach age-appropriate sexuality education programs. Districts must teach students, beginning in seventh grade, that abstinence is the only certain way an individual can prevent pregnancy and avoid contracting STIs. However, districts must also teach medically accurate information about other methods of contraception, including all FDA-approved contraceptives.

In November 2012, a group of parents sued the Clovis school district, alleging that sexuality education courses used videos and texts that had minimal discussion of contraceptives, no mention of contraceptives or claimed contraceptives were ineffective. Further, the parents said the materials focused on abstinence.

The district revised its policies, and the parents dismissed their suit in February 2014.

Ruling Details

In the ruling, Fresno County Superior Court Judge Donald Black held that the district should pay the parents' attorneys' fees, saying that their suit had led the school district to revise its ninth grade courses so they were compliant with the law.

He ruled that the law prohibits districts from indoctrinating students about having to abstain from sex until marriage. Black said, "Access to medically and socially appropriate sexual education is an important public right."

Black in the ruling noted that one video in the course had compared a woman who had had sex to a dirty shoe, while other videos "perpetuated sexual orientation bias" and promoted the stance of "one man, one woman, one life."

Comments

Phyllida Burlingame, an attorney with the American Civil Liberties Union, which took part in the suit, said that as the ruling was the first to interpret the state sexuality education law, it should make schools aware that "young people need complete, accurate health information required by law." She noted a 2011 University of California-San Francisco study that found compliance with the law varied among districts.

According to Burlingame, the ruling marks the first time "abstinence-only-until-marriage curricula have been found to be medically inaccurate" (Egelko, San Francisco Chronicle, 5/12).


Physicians Group Backs LGBT-Inclusive Health Policies

Wed, 05/13/2015 - 13:47

The American College of Physicians has expressed support for policies that the group said will improve health among lesbian, gay, bisexual and transgender individuals, according to a policy paper published Monday in the Annals of Internal Medicine, Reuters reports.

Physicians Group Backs LGBT-Inclusive Health Policies

May 13, 2015 — The American College of Physicians has expressed support for policies that the group said will improve health among lesbian, gay, bisexual and transgender individuals, according to a policy paper published Monday in the Annals of Internal Medicine, Reuters reports.

According to Reuters, ACP is the largest group representing internal medicine doctors in the U.S.

Announcement Details

In the policy position paper, the organization outlined nine LGBT-inclusive policies that it favors. The policies include support for insurance plans that cover comprehensive transgender health care services, opposition to so-called conversion or reparative therapy and support for same-sex marriage rights, among others.

According to the paper, the LGBT community experiences the same health concerns as the rest of the population, but certain disparities might be greater among LGBT individuals. For example, ACP wrote that women who have sex with women, as well as women who have sex with men and women, are less likely than heterosexual women to be screened for cervical cancer or breast cancer. Meanwhile, men who have sex with men, as well as men who have sex with men and women, represent about 4% of the male population but about two-thirds of new HIV infections in the U.S., according to CDC estimates.

ACP President Wayne Riley said the paper "speaks to the fact that the nation's largest specialty society comes down on the side of health equity for all."

Specifically, he said the support for transgender health coverage helps ensure "transgender individuals can access the appropriate level of healthcare services to provide them with opportunities that ... anybody else has with health and wellness." Conversely, he said that ACP "agree[s] conversation therapy is not a wise use of healthcare resources" (Seaman, Reuters, 5/11).


Featured Blogs

Wed, 05/13/2015 - 11:41

"Tennessee's New Abortion Law Could Leave the State With Just Four Abortion Clinics" (Barbato, Bustle, 5/9); "Oregon Bans 'Conversion Therapy' of LGBTQ Youth" (Liss-Schultz, RH Reality Check, 5/11).

May 12, 2015

FEATURED BLOG

"Tennessee's New Abortion Law Could Leave the State With Just Four Abortion Clinics," Lauren Barbato, Bustle: "Following the path cleared by abortion foes in Texas, Tennessee Gov. Bill Haslam [R] signed an extreme anti-abortion measure [SB 1280] that could close a handful of the state's clinics by July 1," Barbato writes. She explains that the new law requires "all clinics and physicians' offices that perform more than 50 abortions per year to be licensed as ambulatory surgical treatment centers," meaning that they "will need to meet the same building requirements as hospital-style outpatient surgery centers," including "creating wider hallways and entrances ... and changing the size of the exam rooms." According to Barbato, only "about half of Tennessee's clinics -- just four in all -- meet the requirements of an ambulatory surgical center" and the remaining clinics, including those in more populous areas of the state, will "be forced to close unless they can upgrade their facilities by July 1." Citing figures from the Guttmacher Institute, Barbato notes that 23 states currently mandate similar requirements and that in one of those states, Texas, "the requirement has been successful at not only shutting clinics, but rendering abortion nearly obsolete for women outside metropolitan areas" (Barbato, Bustle, 5/9).

FEATURED BLOG

"Oregon Bans 'Conversion Therapy' of LGBTQ Youth," Nina Liss-Schultz, RH Reality Check: Oregon is set to become "the fourth jurisdiction, following California, New Jersey, and Washington, D.C., to ban so-called conversion therapy for minors" under a bill (HB 2307) passed Friday by the state Senate, Liss-Schultz writes. She notes that conversion therapy, "in which mental health professionals seek to change a person's sexual identity or orientation, relies on both the outdated belief that non-straight sexual orientation is a mental health disorder and the discriminatory belief that same-sex orientation is of less value than heterosexuality." Conversion therapy "has been lambasted by the medical and mental health professional communities, including the American Academy of Pediatrics, the American Psychological Association and the American Psychiatric Association," she adds, noting that bills similar to HB 2307 have been introduced in 17 states. Further, she notes that "[b]oth the California and New Jersey laws have recently held up in court" and that the Obama administration in April "threw its support behind the bans" (Liss-Schultz, RH Reality Check, 5/11).


Op-Ed Examines 'Systematic Failures' of U.S. Reproductive Health Care Behind Feticide Cases

Wed, 05/13/2015 - 11:39

The case of Purvi Patel has spurred "the expected anti-abortion and pro-choice debates," but it also can be used to evaluate women's access to reproductive health in the U.S., columnist Sharmila Rudrappa writes in an American Prospect/Public Voices Fellowship opinion piece.

Op-Ed Examines 'Systematic Failures' of U.S. Reproductive Health Care Behind Feticide Cases

May 12, 2015 — The case of Purvi Patel has spurred "the expected anti-abortion and pro-choice debates," but it also can be used to evaluate women's access to reproductive health in the U.S., columnist Sharmila Rudrappa writes in an American Prospect/Public Voices Fellowship opinion piece.

Rudrappa explains that Patel, "a 33-year old Indian immigrant from South Bend, Indiana, was charged with feticide and child neglect" based on allegations that she "attempted to terminate her second-trimester pregnancy with illegal pharmaceutical abortifacients" and disposed of the fetus before seeking medical care.

Rudrappa notes that while some have argued that Patel could have gotten an abortion during the first trimester of her pregnancy, the procedure "is not easily accessible in Indiana," which as of 2011 had "just 12 providers." Further, in Indiana, "[h]ealth plans ... and public funding cover abortions only if the woman's life is endangered, or she is a victim of rape or incest," Rudrappa writes, adding that women seeking abortion in the state also "must receive state-directed, in-person counseling including an ultrasound," be offered a choice to view the ultrasound and "wait 18 hours before any procedures can be initiated."

Further, Rudrappa questions how Patel's situation might "have been different if she had access to easily available, affordable reproductive care" beyond "simply abortion provision." She continues, "What if women and children had the right to broad sex education including contraception and not just abstinence; deeper understanding about pregnancies; comprehensive, easily accessible and high quality prenatal care; equally excellent and accessible post-natal care; and, emotional support for mother and child?"

Rudrappa cites the U.S.'s comparatively high rates of infant mortality and maternal death, adding, "What does it mean to punish women for ... their individual perceived moral failures, while remaining silent on the systemic failures that result in lack of support for women in their pregnancies, and after childbirth?" (Rudrappa, American Prospect, 5/10).


N.Y. AG Proposes Bill To Codify ACA's Contraceptive Coverage Benefits Into State Law

Wed, 05/13/2015 - 11:38

New York state Attorney General Eric Schneiderman (D) on Monday proposed a bill that would codify the Affordable Care Act's (PL 111-148) contraceptive coverage rules into state law and add additional birth control benefits and protections, the New York Daily News reports.

N.Y. AG Proposes Bill To Codify ACA's Contraceptive Coverage Benefits Into State Law

May 12, 2015 — New York state Attorney General Eric Schneiderman (D) on Monday proposed a bill that would codify the Affordable Care Act's (PL 111-148) contraceptive coverage rules into state law and add additional birth control benefits and protections, the New York Daily News reports (Blain, New York Daily News, 5/10).

Background

Federal guidance on the contraceptive coverage rules under the ACA states that insurers must cover the full range of FDA-approved contraceptive methods without cost sharing (Women's Health Policy Report, 4/17). However, some insurers have denied full coverage of some methods or imposed copays, according to recent reports, the Daily News reports (New York Daily News, 5/10).

On Thursday, Schneiderman requested information from 11 insurers in the state regarding their contraceptive coverage. Schneiderman's office has requested that the insurers respond to a list of 10 questions regarding coverage for birth control by May 28.

Bill Details

Schneiderman's bill, called the Comprehensive Contraception Coverage Act of 2015, would allow individuals to receive one year's supply of birth control at one time (Hughes, Albany Times Union, 5/11).

In addition, it would prohibit insurers from denying or limiting birth control coverage by using medical management techniques (New York Daily News, 5/10). The ACA permits insurers to use "reasonable medical management techniques" to curb costs, such as only covering the generic version of an approved contraceptive (Women's Health Policy Report, 4/17).

Further, the bill would require New York insurers to cover men's contraceptive methods, including condoms and vasectomies.

Comments

Schneiderman said, "New Yorkers should not be penalized by their insurance companies for using the birth control method that they and their medical provider agree is most appropriate for them" (Albany Times Union, 5/11).

Meanwhile, Leslie Moran, senior vice president of the New York Health Plan Association, said insurers in the state currently are complying with the ACA's contraceptive coverage rules. She said, "There is a shared goal of the state and the health plans to provide access to coverage, including contraception" (New York Daily News, 5/10).


Report: More Than Half of Texas Women Face Barriers to Reproductive Health Services

Wed, 05/13/2015 - 11:37

More than 50% of Texas women encountered at least one barrier while trying to access reproductive health services in the years following the state's overhaul of its family planning services program, according to a recent report from the Texas Policy Evaluation Project, the Kaiser Health News/Texas Tribune reports.

Report: More Than Half of Texas Women Face Barriers to Reproductive Health Services

May 12, 2015 — More than 50% of Texas women encountered at least one barrier while trying to access reproductive health services in the years following the state's overhaul of its family planning services program, according to a recent report from the Texas Policy Evaluation Project, the Kaiser Health News/Texas Tribune reports (Ura, Kaiser Health News/Texas Tribune, 5/12).

Background

In 2011, the Texas Legislature cut the state's family planning budget by two-thirds and blocked funding to Planned Parenthood and other women's health clinics affiliated with abortion providers. As a result of the cuts, 76 of Texas' family planning clinics closed or stopped providing family planning services, according to a survey by University of Texas-Austin researchers.

To mitigate the effect of the 2011 cuts, Texas legislators during the 2013 session increased women's health funds to $214 million for the 2014-2015 state budget, up from $109 million in the previous budget. The funding was dedicated to expanding primary care, operating the Texas Women's Health Program and replacing the family planning grants that the federal government awarded to another organization to distribute (Women's Health Policy Report, 7/21/14).

Report Details

For the report, researchers from TxPEP reviewed women's access to reproductive health services -- including cervical cancer screenings, contraceptives and family planning -- beginning in 2011, the year the cuts took place. Researchers surveyed 779 Texas women between the ages of 18 and 49.

The report found that 55% of the respondents encountered barriers to access. Specifically, 18% of respondents experienced one barrier to access and 37% experienced at least two barriers to access.

The report also identified the types of barriers women encountered between 2011 and 2014. Specifically, 38% of women said they faced financial difficulties accessing such care, 23% said they could not take time away from school or work, 20% reported insurance issues and 15% said there were no nearby services. Other barriers included discomfort with health care providers, a lack of childcare, no transportation options, language barriers or a lack of support from partners or family.

Overall, the report found that young women with low incomes and low education levels, especially Hispanic women who spoke Spanish and were born in Mexico, experienced the most barriers to accessing reproductive health services (Kaiser Health News/Texas Tribune, 5/12).

Abortion-Rights Groups Grow in Texas Amid Increased Abortion Restrictions

In related news, a growing coalition of volunteer-led abortion-rights groups in Texas are working to protect abortion access in the state amid increasing restrictions on the procedure, the Texas Observer reports.

For example, one group called Fund Texas Choice uses up to $5,000 monthly to help women seeking abortion care pay for their travel and accommodations costs, with individual trips ranging between $35 to $1,000. According to the Observer, the group between November 2013 and March 2015 helped to plan and pay for 158 trips for women to receive abortions.

Occasionally, Fund Texas Choice will put women in touch with another group, called the Lilith Fund, which runs a hotline women can call for help funding the abortion procedure. The Lilith Fund gives women in Central and South Texas small stipends for the procedure, while other groups -- the Texas Equal Access Fund and the West Fund -- do the same for women in North Texas and El Paso, respectively.

Meanwhile, according to the Observer, still other volunteer-led organizations help women by providing a ride to an abortion clinic in certain areas of the state. For example, Clinic Access Support Network helps provide rides for women in Houston, while the Bridge Collective provides this assistance to women in Austin and the Cicada Collective works for women in North Texas.

Lenzi Sheible, founder of Fund Texas Choice, said of the network of groups, "We fight on our own terms. Giving up is not an option ... Texans are not just going to sit here and let this happen to us" (Garcia-Ditta, Texas Observer, 5/11).


Obama Admin Clarifies ACA Birth Control Rules, Other Preventive Services Requirements

Tue, 05/12/2015 - 16:48

The Obama administration on Monday issued new guidance clarifying several aspects of the Affordable Care Act's (PL 111-148) requirement that plans provide a range of preventive services at no cost, the New York Times reports.

Obama Admin Clarifies ACA Birth Control Rules, Other Preventive Services Requirements

May 12, 2015 — The Obama administration on Monday issued new guidance clarifying several aspects of the Affordable Care Act's (PL 111-148) requirement that plans provide a range of preventive services at no cost, the New York Times reports.

The guidance was jointly released by HHS and the departments of Labor and Treasury (Pear, New York Times, 5/11). It will go into effect in 60 days, although most consumers will not experience major changes until their next plan year, according to AP/U-T San Diego (Alonso-Zaldivar, AP/U-T San Diego, 5/11).

Background

The ACA's preventive services provision, which took effect in 2012, requires insurers to cover a range of services without copayments or deductibles.

Federal guidance on the contraceptive coverage rules under the ACA states that insurers must cover the full range of FDA-approved contraceptive methods without cost-sharing. Insurers are permitted to use "reasonable medical management techniques" to curb costs, such as only covering the generic version of an approved contraceptive (Women's Health Policy Report, 4/30).

However, some insurers have not been adhering to the ACA's preventive services requirements, according to a Kaiser Family Foundation report and two separate National Women's Law Center studies, all released last month. KFF and NWLC both found that some plans were not covering all FDA-approved contraceptives without copayments (New York Times, 5/11). Meanwhile, the NWLC report also found that some insurers were not covering care for transgender individuals (Owens, National Journal, 5/11).

Guidance Details on Birth Control

The new guidance states that insurers must cover at least one version of each of the 18 FDA-approved birth control methods without cost-sharing (AP/U-T San Diego, 5/11). However, the guidance also states that insurers are permitted to charge a copayment or deductible to encourage beneficiaries to use a particular brand or generic version of a given contraceptive method (Galewitz, Kaiser Health News, 5/11).

NWLC had found that some insurers said they did not provide coverage for the ring or the patch because they already covered oral contraceptives, which deliver the same hormones (Women's Health Policy Report, 4/30). However, the new guidance clarifies that insurers "may not impose cost-sharing on the ring or the patch" (New York Times, 5/11).

Additional Guidance Details

In addition, the guidance states that insurers are required to cover, without cost-sharing, maternity care and all other women's health services for dependents also covered by a plan (Radnofsky, Wall Street Journal, 5/11). It notes that insurers must cover without copayments or deductibles prenatal benefits and other services intended to assist with healthy pregnancies for plans that have children covered as dependents (AP/U-T San Diego, 5/11).

Further, the guidance clarifies that insurers are required to cover "preventive screening, genetic counseling, and genetic testing" for BRCA1 and BRCA2 genetic mutations "without cost-sharing, if appropriate, for a woman as determined by her attending provider." The requirement applies "[a]s long as the woman has not been diagnosed with BRCA-related cancer."

The genetic tests -- which the guidance states could be appropriate for women with family histories of breast, ovarian, peritoneal or tubal cancer-- can help women determine whether to have pre-emptive surgery to reduce their cancer risk (Berkrot, Reuters, 5/11).

Meanwhile, the guidance also clarifies that insurers cannot limit "sex-specific recommended preventive services" based on the sex an individual was assigned at birth or an individual's gender identity (New York Times, 5/11). For example, insurers cannot refuse to cover a mammogram for a transgender woman over age 50, even if the woman's insurance records lists her as a man (National Journal, 5/11).

Comments

Sen. Patty Murray (D-Wash.) said the new guidance would help make sure that "women receive 'the health care they are entitled to" under the ACA, including birth control.

Gretchen Borchelt, NWLC's vice president for health and reproductive rights, commended the guidance, saying, "It is now absolutely clear that all means all -- all unique birth control methods for women must be covered" (New York Times, 5/11).

Meanwhile, America's Health Insurance Plans CEO Karen Ignagni said the "guidance takes important steps to support health plans' use of medical management in providing women with safe, affordable healthcare services" (Herman, Modern Healthcare, 5/11).

Op-Ed Urged Obama Administration To Ensure Contraceptive Coverage Under the ACA

Just before the administration issued the new guidance, Deborah Nucatola, senior director of medical services at Planned Parenthood Federation of America, and Hal Lawrence, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, explained why "[o]ffering women the full range of FDA-approved birth control methods is an essential part of health care" in a Roll Call opinion piece urging such guidance.

For example, the authors note that "[s]ome insurers restrict access to certain birth control methods ... by forcing women to undergo 'step therapy,'" under which a woman "may be forced to use one birth control method, such as the pill, regardless of whether it works for her, before getting coverage for the ring, patch, [intrauterine device] or other method she and her doctor have decided is best for her." Meanwhile, "[s]ome insurers ... requir[e] prior authorization, an extra step that gives the insurer the right to reject a doctor's prescription," Nucatola and Lawrence write.

The authors explain that as medical professionals, they "see firsthand there is no one-size-fits-all method of birth control." For example, they note that some women cannot use certain methods because of "medical conditions," some "suffer from side effects when they use certain contraceptives" and "conversely, some may seek out hormonal methods to regulate conditions such as endometriosis." Further, they point out that "[s]ome women have lifestyles that just don't allow for birth control that depends on daily doses for effectiveness."

In addition, Nucatola and Lawrence write that "[m]any forms of birth control are prohibitively expensive for many women if they must foot the bill out of pocket." They note that "more than half of all American female voters ages 18 to 34 have struggled with the cost of birth control at some point, and as a result have used birth control inconsistently." However, the authors add that "[t]hanks to the birth control benefit, women and families saved more than $483 million in out-of-pocket costs for the birth control pill -- an average of $269 per woman -- in the first year alone" and "prevented unintended pregnancies" (Nucatola/Lawrence, Roll Call, 5/8).


Report: More Than Half of Texas Women Face Barriers to Reproductive Health Services

Tue, 05/12/2015 - 15:49

More than 50% of Texas women encountered at least one barrier while trying to access reproductive health services in the years following the state's overhaul of its family planning services program, according to a recent report from the Texas Policy Evaluation Project, the Kaiser Health News/Texas Tribune reports.

Report: More Than Half of Texas Women Face Barriers to Reproductive Health Services

May 12, 2015 — More than 50% of Texas women encountered at least one barrier while trying to access reproductive health services in the years following the state's overhaul of its family planning services program, according to a recent report from the Texas Policy Evaluation Project, the Kaiser Health News/Texas Tribune reports (Ura, Kaiser Health News/Texas Tribune, 5/12).

Background

In 2011, the Texas Legislature cut the state's family planning budget by two-thirds and blocked funding to Planned Parenthood and other women's health clinics affiliated with abortion providers. As a result of the cuts, 76 of Texas' family planning clinics closed or stopped providing family planning services, according to a survey by University of Texas-Austin researchers.

To mitigate the effect of the 2011 cuts, Texas legislators during the 2013 session increased women's health funds to $214 million for the 2014-2015 state budget, up from $109 million in the previous budget. The funding was dedicated to expanding primary care, operating the Texas Women's Health Program and replacing the family planning grants that the federal government awarded to another organization to distribute (Women's Health Policy Report, 7/21/14).

Report Details

For the report, researchers from TxPEP reviewed women's access to reproductive health services -- including cervical cancer screenings, contraceptives and family planning -- beginning in 2011, the year the cuts took place. Researchers surveyed 779 Texas women between the ages of 18 and 49.

The report found that 55% of the respondents encountered barriers to access. Specifically, 18% of respondents experienced one barrier to access and 37% experienced at least two barriers to access.

The report also identified the types of barriers women encountered between 2011 and 2014. Specifically, 38% of women said they faced financial difficulties accessing such care, 23% said they could not take time away from school or work, 20% reported insurance issues and 15% said there were no nearby services. Other barriers included discomfort with health care providers, a lack of childcare, no transportation options, language barriers or a lack of support from partners or family.

Overall, the report found that young women with low incomes and low education levels, especially Hispanic women who spoke Spanish and were born in Mexico, experienced the most barriers to accessing reproductive health services (Kaiser Health News/Texas Tribune, 5/12).

Abortion-Rights Groups Grow in Texas Amid Increased Abortion Restrictions

In related news, a growing coalition of volunteer-led abortion-rights groups in Texas are working to protect abortion access in the state amid increasing restrictions on the procedure, the Texas Observer reports.

For example, one group called Fund Texas Choice uses up to $5,000 monthly to help women seeking abortion care pay for their travel and accommodations costs, with individual trips ranging between $35 to $1,000. According to the Observer, the group between November 2013 and March 2015 helped to plan and pay for 158 trips for women to receive abortions.

Occasionally, Fund Texas Choice will put women in touch with another group, called the Lilith Fund, which runs a hotline women can call for help funding the abortion procedure. The Lilith Fund gives women in Central and South Texas small stipends for the procedure, while other groups -- the Texas Equal Access Fund and the West Fund -- do the same for women in North Texas and El Paso, respectively.

Meanwhile, according to the Observer, still other volunteer-led organizations help women by providing a ride to an abortion clinic in certain areas of the state. For example, Clinic Access Support Network helps provide rides for women in Houston, while the Bridge Collective provides this assistance to women in Austin and the Cicada Collective works for women in North Texas.

Lenzi Sheible, founder of Fund Texas Choice, said of the network of groups, "We fight on our own terms. Giving up is not an option ... Texans are not just going to sit here and let this happen to us" (Garcia-Ditta, Texas Observer, 5/11).


Blogs Comment on Threat to Tennessee Clinics, Spread of Catholic Hospital Restrictions on Care, More

Tue, 05/12/2015 - 15:29

Read the week's best commentaries from bloggers at Bustle, Salon and more.

Blogs Comment on Threat to Tennessee Clinics, Spread of Catholic Hospital Restrictions on Care, More

May 12, 2015 — Read the week's best commentaries from bloggers at Bustle, Salon and more.

ABORTION RESTRICTIONS: "Tennessee's New Abortion Law Could Leave the State With Just Four Abortion Clinics," Lauren Barbato, Bustle: "Following the path cleared by abortion foes in Texas, Tennessee Gov. Bill Haslam [R] signed an extreme anti-abortion measure [SB 1280] that could close a handful of the state's clinics by July 1," Barbato writes. She explains that the new law requires "all clinics and physicians' offices that perform more than 50 abortions per year to be licensed as ambulatory surgical treatment centers," meaning that they "will need to meet the same building requirements as hospital-style outpatient surgery centers," including "creating wider hallways and entrances ... and changing the size of the exam rooms." According to Barbato, only "about half of Tennessee's clinics -- just four in all -- meet the requirements of an ambulatory surgical center" and the remaining clinics, including those in more populous areas of the state, will "be forced to close unless they can upgrade their facilities by July 1." Citing figures from the Guttmacher Institute, Barbato notes that 23 states currently mandate similar requirements and that in one of those states, Texas, "the requirement has been successful at not only shutting clinics, but rendering abortion nearly obsolete for women outside metropolitan areas" (Barbato, Bustle, 5/9).

RELIGION AND REPRODUCTIVE HEALTH: "When the Catholic Church Owns Your Doctor: The Insidious New Threat to Affordable Birth Control," Patricia Miller, Salon: Having an obstetrician/gynecologist who is not able to prescribe contraceptives "could be a reality if your doctor's practice is purchased by a Catholic health system that then imposes the Ethical & Religious Directives for Catholic Health Care Services, a set of rules created by the U.S. Bishop's Conference that prohibits doctors from doing everything from prescribing [birth control pills] to performing sterilizations or abortions," Miller writes. Health systems are purchasing "physician practices at an unprecedented rate," Miller continues, noting that "with Catholic hospital systems accounting for eight of the 10 ... largest nonprofit health systems in the U.S., these hospitals are poised to become major owners of doctors' offices, which could severely impede access to contraceptives if doctors are forced to follow the Directives." She notes that the Directives not only could require women "to face the inconvenience of making -- and paying -- for another doctor's appointment to get one of the most basic gynecological services," but also contribute to "a bigger problem" of stigmatizing and sidelining reproductive health care (Miller, Salon, 5/11).

ABORTION-RIGHTS MOVEMENT: "Why Are We Still Asking if a Dying Woman Should Be Able To Get an Abortion To Save Her Life?" Jennifer Dalven, Huffington Post blogs: "All too often, we're still asking the wrong questions when it comes to gauging public opinion on abortion" that "do little to illuminate the reality of most women's lives and the range of feelings people have about abortions that happen in the real world," Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project, writes. For example, she expresses doubt about whether one such extreme question -- "whether a woman should be forced to die rather than have an abortion" -- is "really still up for debate when it comes to public opinion." She explains that "it's been clear" for years "that when you ask people about how abortion impacts real women's lives -- instead of party-line questions about abortion under all circumstances or no circumstances -- you get surprising answers and high levels of agreement." For example, she notes that, when asked more nuanced questions, people's responses show "overwhelming agreement that a woman who has decided to get an abortion should be able to get one without additional hurdles," that "we shouldn't be passing laws that make a woman who has decided to get an abortion feel ashamed about her decision" and "that lawmakers who are determined to restrict access to abortion are moving our country in the wrong direction" (Dalven, Huffington Post blogs, 5/8).

ANTIABORTION-RIGHTS MOVEMENT: "Is Your OB-GYN a Member of This Anti-Choice Group?" Anita Little, Ms. Magazine blog: Little writes about the American Association of Pro-Life Obstetricians and Gynecologists, "an organization of doctors, nurses and other medical professionals who strongly oppose abortion and some forms of contraception." While the group is "[u]nderreported and under the radar," Little writes, "they've been around for more than 40 years and have fought to dismantle pro-choice victories," such as "over-the-counter availability of Plan B" and FDA's approval of medication abortion drug Mifeprex. She lists several "falsehoods" held by AAPLOG and debunked by the American Congress of Obstetricians and Gynecologists, including claims that "[a]bortion is not safer than childbirth"; "ultrasound requirements before an abortion are necessary"; "[e]mergency contraception, also known as Plan B, should not be available over-the-counter"; "[b]reast cancer and abortion could be linked and further studies are required"; and "AAPLOG is somehow affiliated with or under the umbrella of ACOG." Little writes, "AAPLOG is the academic, institutionalized face of an extremist anti-abortion movement that has been whittling away at abortion access in communities across the country" (Little, Ms. Magazine blog, 5/11).

LGBT: "Oregon Bans 'Conversion Therapy' of LGBTQ Youth," Nina Liss-Schultz, RH Reality Check: Oregon is set to become "the fourth jurisdiction, following California, New Jersey, and Washington, D.C., to ban so-called conversion therapy for minors" under a bill (HB 2307) passed Friday by the state Senate, Liss-Schultz writes. She notes that conversion therapy, "in which mental health professionals seek to change a person's sexual identity or orientation, relies on both the outdated belief that non-straight sexual orientation is a mental health disorder and the discriminatory belief that same-sex orientation is of less value than heterosexuality." Conversion therapy "has been lambasted by the medical and mental health professional communities, including the American Academy of Pediatrics, the American Psychological Association and the American Psychiatric Association," she adds, noting that bills similar to HB 2307 have been introduced in 17 states. Further, she notes that "[b]oth the California and New Jersey laws have recently held up in court" and that the Obama administration in April "threw its support behind the bans" (Liss-Schultz, RH Reality Check, 5/11).

CONTRACEPTION: "The New War on Your Birth Control: How Big Pharma and Hobby Lobby-Types Put IUDs Out of Reach," Valerie Tarico, Salon: Tarico discusses how the Liletta intrauterine device, a new IUD out this month, "may be a game changer" by "shatter[ing] the monopoly that has put top-tier contraceptives out of reach for many women." She writes that "an IUD is more than 20 times as effective as the pill" and is "far cheaper in the long run." However, she notes that "monopoly pricing," including high upfront costs, "has put top-tier birth control methods like IUD's and implants out of reach for many" U.S. women, including those who work for certain companies whose owners have religious objections to IUDs. "Enter Medicines360," Terico writes, explaining that the company, which manufactures the Liletta IUD, will help women by providing the device "to federally qualified health centers serving low income women for less than one fifth of what they are paying today ... substantially drop[ping the] wholesale IUD price for other clinics" and providing women with more choices (Tarico, Salon, 5/11).


Op-Ed Examines 'Systematic Failures' of U.S. Reproductive Health Care Behind Feticide Cases

Tue, 05/12/2015 - 14:16

The case of Purvi Patel has spurred "the expected anti-abortion and pro-choice debates," but it also can be used to evaluate women's access to reproductive health in the U.S., columnist Sharmila Rudrappa writes in an American Prospect/Public Voices Fellowship opinion piece.

Op-Ed Examines 'Systematic Failures' of U.S. Reproductive Health Care Behind Feticide Cases

May 12, 2015 — The case of Purvi Patel has spurred "the expected anti-abortion and pro-choice debates," but it also can be used to evaluate women's access to reproductive health in the U.S., columnist Sharmila Rudrappa writes in an American Prospect/Public Voices Fellowship opinion piece.

Rudrappa explains that Patel, "a 33-year old Indian immigrant from South Bend, Indiana, was charged with feticide and child neglect" based on allegations that she "attempted to terminate her second-trimester pregnancy with illegal pharmaceutical abortifacients" and disposed of the fetus before seeking medical care.

Rudrappa notes that while some have argued that Patel could have gotten an abortion during the first trimester of her pregnancy, the procedure "is not easily accessible in Indiana," which as of 2011 had "just 12 providers." Further, in Indiana, "[h]ealth plans ... and public funding cover abortions only if the woman's life is endangered, or she is a victim of rape or incest," Rudrappa writes, adding that women seeking abortion in the state also "must receive state-directed, in-person counseling including an ultrasound," be offered a choice to view the ultrasound and "wait 18 hours before any procedures can be initiated."

Further, Rudrappa questions how Patel's situation might "have been different if she had access to easily available, affordable reproductive care" beyond "simply abortion provision." She continues, "What if women and children had the right to broad sex education including contraception and not just abstinence; deeper understanding about pregnancies; comprehensive, easily accessible and high quality prenatal care; equally excellent and accessible post-natal care; and, emotional support for mother and child?"

Rudrappa cites the U.S.'s comparatively high rates of infant mortality and maternal death, adding, "What does it mean to punish women for ... their individual perceived moral failures, while remaining silent on the systemic failures that result in lack of support for women in their pregnancies, and after childbirth?" (Rudrappa, American Prospect, 5/10).