Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
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Roe v. Wade 'Effectively Undone' in Much of Texas, Washington Post Editorial Argues

Wed, 08/13/2014 - 16:26

"[P]ro-life groups and lawmakers are negating" the effects of Roe v. Wade with restrictive state laws, including a "frontal assault" on abortion providers in Texas, a Washington Post editorial argues.

Roe v. Wade 'Effectively Undone' in Much of Texas, Washington Post Editorial Argues

July 29, 2014 — "[P]ro-life groups and lawmakers are negating" the effects of Roe v. Wade with restrictive state laws, including a "frontal assault" on abortion providers in Texas, a Washington Post editorial argues.

The Texas legislation (HB 2) has reduced the number of the state's clinics by more than half, and many "of the surviving clinics are expected to close this fall" after more provisions take effect, according to the Post.

"The new requirements have nothing to do with improving women's health or enhancing the safety of clinics, which are already quite safe," the editorial argues. Rather, "their sole purpose is to burden the clinics with expenses that force them to shut their doors," it adds.

"In the absence of adequate numbers of legal and accessible abortion providers, many women will resort to unsafe and unsanitary options closer to home," according to the editorial.

"Very possibly, some women will die as a result; most of these will be poor," the editorial says, concluding that Roe "has been effectively undone by the [Texas] legislature" in much of the state (Washington Post, 7/28).


NYT: Abortion Access Hinges on Judges' 'Willingness' To Oppose Unnecessary Restrictions

Wed, 08/13/2014 - 16:25

In much of the U.S., "women's access to safe and legal abortion care is increasingly coming to depend on the willingness of judges to rigorously examine and reject new (and medically unnecessary) restrictions imposed by Republican legislatures," a New York Times editorial states.

NYT: Abortion Access Hinges on Judges' 'Willingness' To Oppose Unnecessary Restrictions

August 11, 2014 — In much of the U.S., "women's access to safe and legal abortion care is increasingly coming to depend on the willingness of judges to rigorously examine and reject new (and medically unnecessary) restrictions imposed by Republican legislatures," a New York Times editorial states.

The editorial praises a federal judge who recently "struck down as unconstitutional an Alabama law requiring doctors at abortion clinics to have admitting privileges at a local hospital." The ruling should be "an instructive model for other courts," it argues.

Admitting privileges laws -- "advertised, falsely, as necessary to protect women's health -- [are] one of the main strategies being deployed nationally by opponents of abortion rights to shrink the already inadequate number of abortion providers," the editorial continues.

In the Alabama ruling, Judge Myron Thompson wrote that the law "would actually harm women, especially poor women, by forcing them to wait longer and travel longer distances for the procedure," the editorial notes. In addition, he rejected the state's claims that the requirement protects women's safety, given that "[a]bortion complications are exceedingly rare" and there are "reasonable procedures in place to handle them," the editorial explains.

Thompson's ruling "should command attention as the issue continues to play out before different judges on the way toward likely resolution by the Supreme Court," the editorial concludes (New York Times, 8/10).


Court Blocks Miss. Law Threatening State's Sole Abortion Clinic

Wed, 08/13/2014 - 16:24

A federal appeals court blocked a Mississippi law (HB 1390) that would have shut down the state's only abortion clinic, ruling that it illegally shifted Mississippi's constitutional obligations to other states, the New York Times reports.

Court Blocks Miss. Law Threatening State's Sole Abortion Clinic

July 30, 2014 — A federal appeals court on Tuesday blocked a Mississippi law (HB 1390) that would have shut down the state's only abortion clinic, ruling that it illegally shifted Mississippi's constitutional obligations to other states, the New York Times reports (Robertson/Eckholm, New York Times, 7/29).

The Mississippi law, like a Texas law (HB 2) with similar provisions, would require that physicians performing abortions have admitting privileges at nearby hospitals. The 5th U.S. Circuit Court of Appeals previously ruled that the Texas law does not impose an unconstitutional burden on women because abortion access would still be available in the state (Women's Health Policy Report, 4/29).

Tuesday's Ruling

In Tuesday's ruling, a different three-judge panel on the 5th Circuit ruled in a 2-1 decision that the impact of the law in Mississippi, with just one abortion clinic, makes it constitutionally distinct from the law in Texas. Judge Grady Jolly wrote in the majority opinion that the Mississippi law "effectively extinguishes" a woman's constitutional right to abortion in the state and illegally shifts the burden of ensuring that right to neighboring states. "A state cannot lean on its sovereign neighbors to provide protection of its citizens' federal constitutional rights," Jolly wrote (New York Times, 7/29).

Meanwhile, Judge Emilio Garza issued a dissenting opinion, writing, "The sole act of crossing a state border cannot, standing alone, constitute an unconstitutional undue burden of the abortion right because the Constitution envisions free mobility of persons without regard to state borders" (Winfield Cunningham, Politico, 7/29).

Legal Impact

The ruling did not overturn the law or assess whether the admitting privileges requirement is a justified safety measure. Rather, the ruling preserved an existing stay against the law and leaves the lower courts to consider the measure under the now-clarified principle of state responsibility, the Times reports (New York Times, 7/29).

According to legal experts, the ruling only applies to the one clinic, meaning that if another clinic opened in the state, it would have to try to comply with the law (Le Coz, Reuters, 7/29). The physicians at the Mississippi clinic sought admitting privileges at multiple hospitals but were denied, prompting the state to order the clinic to close for violating the law (Politico, 7/29).

Broader Implications

The new ruling, combined with the legal challenges against similar laws in other states, could "set the stage" for a Supreme Court challenge, the Wall Street Journal reports (McWhirter, Wall Street Journal, 7/29).

According to the Times, federal courts have temporarily blocked admitting privileges laws in Alabama, Kansas and Wisconsin, while similar laws are in effect in Missouri, North Dakota, Tennessee, Texas and Utah (New York Times, 7/29).

Julie Rikelman -- director of litigation for the Center for Reproductive Rights, which argued the case on behalf of the Mississippi clinic -- said that while the 5th Circuit's ruling was narrow, it could have implications for other states in similar situations. For example, officials in Wisconsin and Alabama have both argued that women could cross state lines to access abortion if needed (Wagster Pettus, AP/U-T San Diego, 7/30).

Reaction

Mississippi Gov. Phil Bryant (R) expressed disappointment with the ruling and indicated that the state would try to appeal to the full 5th Circuit (Reuters, 7/29).

CRR President Nancy Northup said the ruling "ensures women who have decided to end a pregnancy will continue, for now, to have access to safe, legal care in their home state." However, she added that there is "still only one clinic in the entire state, and it is still threatened by a law advanced by politicians over the opposition of respected medical associations, with the sole intent of closing that clinic permanently" (Politico, 7/29).

Similarly, Elizabeth Nash of the Guttmacher Institute said that while "[t]he fact that the Mississippi clinic can stay open is good news," there "are a lot of other cases pending in federal courts, and it's impossible to know if those laws will be upheld or struck down" (New York Times, 7/29).


Federal Judge Finds Ala. Admitting Privileges Law Unconstitutional

Wed, 08/13/2014 - 16:23

A federal judge ruled that an Alabama law requiring abortion providers to have admitting privileges at nearby hospitals is unconstitutional because it imposes an "impermissible undue burden" on the state's five clinics, the Wall Street Journal reports.

Federal Judge Finds Ala. Admitting Privileges Law Unconstitutional

August 5, 2014 — A federal judge on Monday ruled that an Alabama law requiring abortion providers to have admitting privileges at nearby hospitals is unconstitutional because it imposes an "impermissible undue burden" on the state's five clinics, the Wall Street Journal reports (McWhirter, Wall Street Journal, 8/4).

U.S. District Judge Myron Thompson began hearing arguments in the trial in May after rejecting summary judgment requests from the state and the plaintiffs. He issued a temporary restraining order against the law to keep it from taking effect until a final judgment is issued (Women's Health Policy Report, 7/11).

A spokesperson for Alabama Attorney General Luther Strange (R) said he would appeal the decision (Wall Street Journal, 8/4).

Monday's Ruling

Thompson on Monday said the law was unconstitutional, writing, "If this requirement would not, in the face of all the evidence in the record, constitute an impermissible undue burden ... then almost no regulation, short of those imposing an outright prohibition on abortion, would."

Thompson noted that three clinics -- located in Montgomery, Birmingham and Mobile -- could not meet the law's requirements because abortion providers working there do not live nearby. A local residence is required for admitting privileges at nearby hospitals. Thompson said that if the three clinics were to close, only clinics in Huntsville and Tuscaloosa would remain open, seriously hindering women's access to abortion services in the state (Eckholm, New York Times, 8/4).

Thompson also noted that the state's argument about how the law would improve the quality of care for abortion patients was "exceedingly weak" (Wall Street Journal, 8/4).

According to Reuters, Thompson's ruling keeps in place the temporary injunction issued against the law (Gates, Reuters, 8/4). Thompson has requested additional information from attorneys in the case before he issues a final order (AP/Clarion-Ledger, 8/4).

Implications

According to the Times, the ruling "adds to a swirl of contradictory court decisions" on the admitting privileges requirement, particularly among states in the South (New York Times, 8/4). Roughly 11 states have passed admitting privileges requirements, resulting in the closure of clinics in Texas and other states (Wall Street Journal, 8/4).

Comments

In a statement, Alabama Gov. Robert Bentley (R) said "we are extremely disappointed by today's ruling," adding, "I will always fight for the rights of the unborn, and support an appeal of today's decision" (New York Times, 8/4).

Meanwhile, Louise Melling, deputy legal director at the American Civil Liberties Union, praised the ruling. "The justifications offered for this law are weak at best," she said, adding, "Politicians, not doctors, crafted this law for the sole purpose of shutting down women's health care centers and preventing women from getting safe, legal abortions" (Wall Street Journal, 8/4).


Admitting Privileges Mandates Create Hurdles for Abortion Providers

Wed, 08/13/2014 - 16:22

Admitting privileges requirements, enacted in several states, have proven to be "a potent tool" for abortion-rights opponents in their goal of limiting abortion access, the Washington Post reports.

Admitting Privileges Mandates Create Hurdles for Abortion Providers

August 11, 2014 — Admitting privileges requirements, enacted in several states, have proven to be "a potent tool" for abortion-rights opponents in their goal of limiting abortion access, the Washington Post reports (Somashekhar, Washington Post, 8/10).

The laws require physicians who perform abortions to have admitting privileges at a nearby hospital. Clinics that cannot meet the requirement are forced to close.

About Admitting Privileges

According to NPR's "Shots," admitting privileges give a physician the right to admit patients to a particular hospital and provide certain services on hospital grounds.

Hospitals typically consider a physician's medical credentials, license and history of malpractice when weighing his or her admitting privileges request. Many hospitals also require that physicians admit a minimum number of patients each year or live within a certain distance of the hospital.

Fifteen states require that abortion providers "have some affiliation with a local hospital," while 11 states have laws that specifically require providers to have admitting privileges, according to the Guttmacher Institute. However, many of the laws are not in effect because courts have temporality blocked them or they have not been implemented yet (Rovner, "Shots," NPR, 8/8).

Compliance Difficulties

Admitting privileges requirements pose a particularly difficult hurdle for abortion providers because often they live too far away from the hospitals or do not typically admit the minimum number of patients. In addition, many religiously affiliated hospitals object to abortion, while other hospitals do not want to be involved with a politically controversial issue.

Physician Willie Parker, who provides abortions at Mississippi's only abortion clinic, said he was not surprised that so many hospitals rejected his application for admitting privileges or did not respond. "For a hospital to [extend admitting privileges], it would be making a conscious decision to take on the state legislature," he said.

More than a dozen abortion clinics have closed under Texas' requirements, at least one closed in Tennessee, and several could close in Oklahoma, Louisiana and Wisconsin if courts allow admitting privileges laws to take effect in those states, according to the Post (Washington Post, 8/10).

Abortion-Rights Supporters, Opponents Debate Motivation

According to "Shots," abortion-rights opponents contend that the laws are medically necessary and that clinics would only close if they are unable to meet basic safety standards ("Shots," NPR, 8/8). Abortion-rights supporters argue that the laws are medically unnecessary because anyone can be admitted through an emergency room (Washington Post, 8/10).

Jeanne Conry, former president of the American Congress of Obstetricians and Gynecologists, said, "Admitting-privileges legislation would impose stricter requirements on facilities where abortions are performed than on facilities that perform much riskier procedures." For example, colonoscopies have a mortality rate 40 times higher than abortion.

Abortion-rights supporters also point out that the reason abortion providers are often unable to meet the minimum requirements for admissions is because so few of their patients require hospitalization.

Meanwhile, Ovide Lamontagne, general counsel for Americans United for Life, said, "Once a physician assumes the responsibility for overseeing the provision of a medical procedure, there's an obligation on the physician to follow the care through to its ultimate conclusion," including any potential emergencies ("Shots," NPR, 8/8).

Legal Landscape

A divide among federal appeals courts over the constitutionality of admitting privileges requirements could persuade the Supreme Court to review the issue, according to the Texas Tribune/New York Times (Edelman, Texas Tribune/New York Times, 8/9).

Elizabeth Nash, states-issues manager for the Guttmacher Institute, said that the laws, if upheld, could have a "huge" effect on clinics compared with other abortion restrictions. "It has just really taken over, in a sense, because it has such the potential for shutting down clinics," she said (Washington Post, 8/10).


Administration To Release New Contraceptive Coverage Accommodation by Aug. 22

Wed, 08/13/2014 - 14:26

The Obama administration has notified a federal appeals court that it will release by Aug. 22 a modified accommodation for religious not-for-profits that object to the federal contraceptive coverage rules, Politico's "Pulse" reports.

Administration To Release New Contraceptive Coverage Accommodation by Aug. 22

August 13, 2014 — The Obama administration has notified a federal appeals court that it will release by Aug. 22 a modified accommodation for religious not-for-profits that object to the federal contraceptive coverage rules, Politico's "Pulse" reports (Villacorta, "Pulse," Politico, 8/13).

Under the current accommodation, religiously affiliated not-for-profits can fill out a form that enables a third party to arrange and pay for contraceptive coverage. However, many such organizations argued that filling out the form would itself violate their religious beliefs.

Last month, the administration indicated in a brief filed with the 10th U.S. Circuit Court of Appeals that it would modify the accommodation for religiously affiliated not-for-profits to provide a second option for organizations that object.

Earlier that month, the Supreme Court in a spilt decision granted an injunction to Wheaton College, an evangelical Christian college in Illinois, that prevents the federal government from enforcing the contraceptive coverage rules for the school while the case is pending in the lower courts. The justices said that the college did not have to fill out the form to meet the terms of the injunction, but instead could simply inform HHS that it has religious objections (Women's Health Policy Report, 7/23).

The administration's latest filing -- a status report dated Aug. 8 -- informed the 10th Circuit that the "process [to develop the rules] is proceeding according to schedule, and the Departments expect to issue these interim final rules on or before August 22." According to "Pulse," it is unclear what the changes will be ("Pulse," Politico, 8/13).


New Novel Examines 'Ambiguities' of Abortion Debate

Wed, 08/13/2014 - 14:24

A new novel, called "Dirty Work," follows an ob-gyn who provides abortions and is led to "re-examine her life and what she does for a living" after a mistake leaves a patient comatose, NPR reports in an interview with the author.

New Novel Examines 'Ambiguities' of Abortion Debate

August 13, 2014 — A new novel, called "Dirty Work," follows an ob-gyn who provides abortions and is led to "re-examine her life and what she does for a living" after a mistake leaves a patient comatose, NPR reports in an interview with the author.

Discussing the book with NPR's Lourdes Garcia-Navarro, author Gabriel Weston said that she "was very interested in interrogating what it is that all of us feel we can't say to people," which led her to write about abortion.

According to Weston, she could not "find any writing or any voice anywhere within the abortion debate that didn't seem incredibly stark, either for or against abortion." She added, "People seem to feel that there's a great sort of burden upon them to have a very, very clear and formulated position on this very, very serious subject," and she "felt ... fiction was a perfect medium in which to examine the ambiguities of the subject."

Weston -- who is an ear, nose and throat surgeon -- said that her own opinions on abortion "evolved" but did not necessarily change while writing the book. "I think that everyone who has a strong opinion on this subject is doing it from the best part of their heart," she said, adding, "I think the more we can have an ambiguous, nuanced discussion about this subject in which people feel they're allowed to admit, perhaps, there are little contradictory feelings and thoughts that they have, the better" (NPR, 8/9).


Universities' Decisions To Limit Abortion Coverage Prompts Investigation

Wed, 08/13/2014 - 13:43

The California Department of Managed Health Care is investigating whether two Catholic universities violated state law by ending coverage for most abortions in their health plans, the San Francisco Chronicle reports.

Universities' Decisions To Limit Abortion Coverage Prompts Investigation

August 13, 2014 — The California Department of Managed Health Care is investigating whether two Catholic universities violated state law by ending coverage for most abortions in their health plans, the San Francisco Chronicle reports.

Legal Issues

According to the Chronicle, a 1975 California law requires managed care plans to cover all "medically necessary" health procedures. In addition, the state guarantees the right to abortion by statute and under privacy protections in the state constitution. DMHC has not publicly stated whether an employer can withhold certain abortion coverage, but insurers in the state typically treat all abortions as medically necessary.

However, Kaiser Permanente in 2012 submitted a policy to DMHC that excluded coverage for "voluntary termination of pregnancy," according to company spokesperson Won Ha. DMHC did not object to the proposal, so Kaiser started offering the plan to "purchasers who requested it," he said.

Santa Clara University and Loyola Marymount University -- both purchasers of Kaiser health plans -- announced in the fall of 2013 that their employee health plans would no longer cover "elective" abortions. Santa Clara's policy is not scheduled to take effect until 2015, while Loyola Marymount's decision went into effect this year, with the option for employees to pay more for abortion coverage through a private administrator.

On Monday, DMHC Chief Deputy Director Marta Green said that the agency would conduct "an in-depth analysis of the issues surrounding coverage for abortion services under California law."

Comments

According to the Chronicle, abortion-rights supporters and many faculty members from both universities are urging California Gov. Jerry Brown's (D) administration to "change course" on approving Kaiser's health plan and require it to cover all abortions.

Beth Parker, chief counsel for Planned Parenthood Affiliates of California, said, "Termination of pregnancy obviously is a basic medical service." She added, "Abortion can be elective, but it's medically necessary if recommended by my physician to treat a medical condition."

However, Catherine Short, legal director of the Life Legal Defense Foundation, argued that DMHC's rationale in approving the plan was clear. "An elective abortion is one that is done for [reasons] other than medical reasons," she said (Egelko, San Francisco Chronicle, 8/11).


Privacy Concerns Prompt Ob-Gyns, Midwives To Take Down Baby Photos

Wed, 08/13/2014 - 13:31

Some obstetrics and midwifery practices are abandoning the long-held tradition of displaying pictures of the infants they have delivered because doing so violates the Health Insurance Portability and Accountability Act (PL 104-191), the New York Times reports.

Privacy Concerns Prompt Ob-Gyns, Midwives To Take Down Baby Photos

August 13, 2014 — Some obstetrics and midwifery practices are abandoning the long-held tradition of displaying pictures of the infants they have delivered because doing so violates the Health Insurance Portability and Accountability Act (PL 104-191), the New York Times reports.

HIPAA protects consumers by making it illegal to reveal a patient's private health information, including photos, without written authorization from the patient via a HIPAA-compliant form. Since the passage of the 2009 economic stimulus package, which allotted funds to promote electronic health records, the federal government has dedicated more resources to enforcing the law.

As a result, some medical offices, especially those that have internal compliance officers, have stopped exhibiting patients' baby photos. According to the Times, fertility clinics are the most likely to have abandoned the practice, both to comply with the law and avoid betraying patients' confidence, especially because of concerns that photos could end up online.

Doctors Weigh In

Some doctors say HIPAA should make clearer distinctions about what should be covered under the law. Pasquale Patrizio, director of the Yale Fertility Clinic, said, "For me, the face of a baby, that is really an anonymous face," adding that the photos were "representative of so much happiness, so much comfort, so much reassurance. It is purely a clinical office now."

Jacques Moritz, director for the division of gynecology at Mount Sinai Roosevelt Hospital, has continued to display baby photos in his office and argues that doctors should use "common sense" when dealing with HIPAA. He said, "To leave medical records open to the public, to throw lab results in the garbage without shredding them, that makes sense" to prohibit, "[b]ut if somebody wants to post a picture of something that's been going on for a millennium and is a tradition, it seems strange to me not to do that."

However, Rachel Seeger, a spokesperson for HHS's Office of Civil Rights, said photos can only be displayed if there is "specific authorization from the patient or personal representative," including elements like an expiration date. Seeger said she is not aware of any medical office that has been fined over the issue (Hartocollis, New York Times, 8/9).


Lawsuit Over Texas Antiabortion Law Also Involves N.M. Abortion Clinic

Tue, 08/12/2014 - 17:32

The trial over the constitutionality of a Texas antiabortion-rights law (HB 2) that could close abortion clinics there also involves an out-of-state clinic, located in Santa Teresa, N.M., the New York Times reports.

Lawsuit Over Texas Antiabortion Law Also Involves N.M. Abortion Clinic

August 12, 2014 — The trial over the constitutionality of a Texas antiabortion-rights law (HB 2) that could close abortion clinics there also involves an out-of-state clinic, located in Santa Teresa, N.M., the New York Times reports (Fernandez, New York Times, 8/8).

Several abortion providers in Texas are asking the U.S. District Court for the Western District of Texas to block a provision in HB 2 that requires abortion facilities to meet the same building requirements as ambulatory surgical centers. Currently, just six clinics meet the provision's requirements, and all of them are located in major cities (Women's Health Policy Report, 8/4).

According to the Times, closing arguments in the trial are scheduled for Wednesday.

Importance of N.M. Clinic

Supporters of the law have said that women would not be unduly burdened if multiple Texas clinics close because about 86% of Texas women of reproductive age will still live within 150 miles of an abortion facility. However, the state's analysis includes the New Mexico clinic, called Hilltop Women's Reproductive Clinic.

Meanwhile, opponents argue that the law is unconstitutional because it will close most of the clinics in the state, including the only one located in El Paso, Texas, which is the closest facility to the New Mexico clinic. Under this scenario, roughly one million women in the state will live more than 150 miles from the nearest in-state abortion facility.

They also have said that the state cannot rely on the New Mexico clinic, citing a federal appeals court ruling that found Mississippi could not enforce a similar law because it would close the state's sole clinic and make women reliant on out-of-state clinics to meet their constitutional right to abortion.

Jan Soifer, one of the lawyers for the Texas abortion providers, said the Mississippi ruling is "really important" because in a state the size of Texas, "for the state to say, 'Well, it's O.K., you can cross the border and go to a clinic in another state,' is the state shirking its requirements to ensure that the constitutional rights of the women in the state are met."

According to the Times, some information on the New Mexico clinic is lacking, and Soifer said the issue highlights the plaintiffs' arguments that Texas officials do not know the status of the clinic. Although the clinic lists a license number on its website, a spokesperson for the New Mexico Department of Health said that the posted number "is not a license number issued by the New Mexico Department of Health." The state, which does not require health department licenses, permits abortion clinics to seek other forms of accreditation, and the clinic is owned by a licensed physician, the Times reports (New York Times, 8/8).


Houston Leaders Urge Passage of Women's Health Protection Act, Repeal of Texas Law

Tue, 08/12/2014 - 17:31

Houston Mayor Annise Parker (D) and eight members of the City Council on Monday called on the Texas Legislature to repeal a state law (HB 2) that threatens to close most of Texas' abortion clinics and urged Congress to pass the Women's Health Protection Act (S 1696, HR 3471), News 92 FM reports.

Houston Leaders Urge Passage of Women's Health Protection Act, Repeal of Texas Law

August 12, 2014 — Houston Mayor Annise Parker (D) and eight members of the City Council on Monday called on the Texas Legislature to repeal a state law (HB 2) that threatens to close most of Texas' abortion clinics and urged Congress to pass the Women's Health Protection Act (S 1696, HR 3471), News 92 FM reports.

The officials made the comments in a letter sent to members of the Texas Legislature and U.S. Congress.

Criticism of HB 2

The letter said, "When the Texas legislature passed HB2, we knew Houston residents could be harmed by it," adding, "Houston would become one of the very few places left to get an abortion (and in some cases, any reproductive health care) in Texas," which would put "women's health and lives ... at risk" (De Hoyos, "News 92 FM," 8/11).

An ongoing trial in federal court is testing the constitutionality of a provision in HB 2 that requires abortion clinics to meet the same standards as ambulatory surgical centers. Closing arguments are set for Wednesday, and the court should issue a ruling within two weeks, according to Politico's "Pulse" (Villacorta, "Pulse," Politico, 8/12).

Earlier this year, a panel of three judges on the 5th U.S. Circuit of Appeals upheld two other provisions in the law, ruling that they do not unduly burden abortion rights. One provision requires that abortion providers have admitting privileges at nearby hospitals. The other provision mandates that providers follow FDA protocols when administering medication abortion, rather than the evidence-based regimen that is commonly used (Women's Health Policy Report, 8/4).

Support for Women's Health Protection Act

In their letter, Parker and the council members also urged Congress to pass the Women's Health Protection Act. The bill would prohibit states from unconstitutionally restricting reproductive health care, according to NARAL Pro-Choice Texas Executive Director Heather Busby (News 92 FM, 8/11).

"Because women of reproductive age deserve equal access to comprehensive reproductive health care, we believe federal legislation limiting government interference with the delivery of the full range of reproductive health services is necessary to ensure that women in all states have equal access to these services," the letter said ("Pulse," Politico, 8/12).


Houston Leaders Urge Passage of Women's Health Protection Act, Repeal of Texas Law

Tue, 08/12/2014 - 16:35

Houston Mayor Annise Parker (D) and eight members of the City Council on Monday called on the Texas Legislature to repeal a state law (HB 2) that threatens to close most of Texas' abortion clinics and urged Congress to pass the Women's Health Protection Act (S 1696, HR 3471), News 92 FM reports.

Houston Leaders Urge Passage of Women's Health Protection Act, Repeal of Texas Law

August 12, 2014 — Houston Mayor Annise Parker (D) and eight members of the City Council on Monday called on the Texas Legislature to repeal a state law (HB 2) that threatens to close most of Texas' abortion clinics and urged Congress to pass the Women's Health Protection Act (S 1696, HR 3471), News 92 FM reports.

The officials made the comments in a letter sent to members of the Texas Legislature and U.S. Congress.

Criticism of HB 2

The letter said, "When the Texas legislature passed HB2, we knew Houston residents could be harmed by it," adding, "Houston would become one of the very few places left to get an abortion (and in some cases, any reproductive health care) in Texas," which would put "women's health and lives ... at risk" (De Hoyos, "News 92 FM," 8/11).

An ongoing trial in federal court is testing the constitutionality of a provision in HB 2 that requires abortion clinics to meet the same standards as ambulatory surgical centers. Closing arguments are set for Wednesday, and the court should issue a ruling within two weeks, according to Politico's "Pulse" (Villacorta, "Pulse," Politico, 8/12).

Earlier this year, a panel of three judges on the 5th U.S. Circuit of Appeals upheld two other provisions in the law, ruling that they do not unduly burden abortion rights. One provision requires that abortion providers have admitting privileges at nearby hospitals. The other provision mandates that providers follow FDA protocols when administering medication abortion, rather than the evidence-based regimen that is commonly used (Women's Health Policy Report, 8/4).

Support for Women's Health Protection Act

In their letter, Parker and the council members also urged Congress to pass the Women's Health Protection Act. The bill would prohibit states from unconstitutionally restricting reproductive health care, according to NARAL Pro-Choice Texas Executive Director Heather Busby (News 92 FM, 8/11).

"Because women of reproductive age deserve equal access to comprehensive reproductive health care, we believe federal legislation limiting government interference with the delivery of the full range of reproductive health services is necessary to ensure that women in all states have equal access to these services," the letter said ("Pulse," Politico, 8/12).


Blogs Comment on Supreme Court's 'Fourth Feminist,' Work-Life Balance, More

Tue, 08/12/2014 - 16:19

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from Slate, Feministe and more.

Blogs Comment on Supreme Court's 'Fourth Feminist,' Work-Life Balance, More

August 12, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from Slate, Feministe and more.

CONTRACEPTION: "The Fourth Feminist," Dahlia Lithwick, Slate's "Jurisprudence": While "the headlines across the boards this summer have trumpeted the notion that the women were applying a special kind of women's justice at the highest court in the land ... it's worth offering up a brief shout out to the unsung feminist at the court, Justice Stephen Breyer," Lithwick writes, adding that he "has been a staunch defender of women's rights and freedoms for a long time, often without getting too much credit, especially from the ladies." She continues, "The fact that Breyer ... can comprehend the interests of the women in both Hobby Lobby and Harris ... is proof that the system works in ways that are not confined to gender, and that we can all transcend personal experience to imagine someone else's life." Breyer proves "that you needn't be a wom[a]n to be a passionate advocate for gender fairness at the court. You only need to listen to one," Lithwick concludes (Lithwick, "Jurisprudence," Slate, 8/11).

What others are saying about contraception:

~ "After Hobby Lobby Decision, State Legislators Mobilize To Protect Employees' Access to Reproductive Healthcare Services," Sarah Brafman, National Women's Law Center's "Womenstake."

~ "No One Is Paying for my Birth Control but Me," Caperton, Feministe.

SUPPORTING WORKING FAMILIES: "Now That Male CEOs Are Trying To Balance Family and Work, Will Workplaces Change?" Robin Marty, Care2: Marty writes about technology company CEO Max Schireson's recent decision to move to a less demanding role "in order to try to 'balance' his professional and family life." She writes that the news was significant because while stories "about a woman who leaves a successful career to spend more time with her family are a dime a dozen," stories "about a man doing the same ... are few and far between." Marty adds, "That it takes a man finally weighing in on a need for work/family balance is sad, but if it opens up real conversation, it is welcome, no matter how we got here" (Marty, Care2, 8/10).

GLOBAL: "Iran Bans Some Forms of Birth Control To Encourage Women To Have More Babies," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": "Iran's parliament has voted to ban some forms of birth control, as well as advertising promoting the use of birth control, in an effort to spur more women to have babies" amid concerns about the country's "declining fertility rate," Culp-Ressler writes, adding that the bill now heads to a panel of theologians that is "tasked with determining whether [the] proposed legislation complies with Islam." The measure would outlaw sterilization procedures "like vasectomies and tubal [ligation]," impose fines on doctors who perform them and make members of the media "subject to prosecution if they choose to publicize birth control or other family planning efforts," Culp-Ressler explains. She notes that the policy marks "a sharp departure" for reproductive health policy in Iran, which once had "one of the best family planning systems in the world" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/11).

What others are saying about global issues:

~ "Women Want the Global Gag Rule Gone for Good," Suzanne Petroni, Ms. Magazine blog.

~ "El Salvador's Right-Wing Media Begins Sustained Campaign Against Releasing 17 Women Imprisoned on Abortion-Related Charges," Kathy Bougher, RH Reality Check.

ABORTION RESTRICTIONS: "You're 40 Times More Likely To Die From a Colonoscopy Than From an Abortion," Culp-Ressler, Center for American Progress' "ThinkProgress": Although "[f]ear of medical risk is being used to enact harsh restrictions on abortion clinics throughout the nation," there are no "data proving that patients at abortion clinics are receiving substandard care," Culp-Ressler writes. The rate of complications that could result in hospitalization from a first-trimester abortion "is less than 0.05 percent," while "[t]he risk of dying from an abortion is considerably smaller, estimated as occurring in 0.0006 percent of all legal surgical abortions," she adds. The risk of death is higher for many other types of medical care, such as childbirth, which has a risk of death about 14 times higher than abortion, and knee replacement surgery. Further, other "non-surgical procedures sometimes performed outside of hospital settings," such as colonoscopies, "are more likely to kill people than abortion, but [they] don't face the same type of regulation that abortion does" (Culp-Ressler, "ThinkProgress," Center for American Progress, 8/8).

What others are saying about abortion restrictions:

~ "It's a TRAP: Targeting Mandatory Delays, Ultrasounds, and Other Clinic Abuse," Caperton, Feministe.

SEXUAL AND GENDER-BASED VIOLENCE: "A Brief History of Sexual Violence Activism in the U.S.," Caroline Heldman/Baillee Brown, Ms. Magazine blog: "In the past year, survivor-activists and allies have effectively put sexual violence on the national agenda, spurring White House, congressional, and state-level policy action," Heldman -- the lead complainant in a Title IX complaint against Occidental College -- and Brown -- an Occidental student -- write. However, "this is not the first time activists have organized around issues of sexual violence in the U.S.," they note. Heldman and Brown review past efforts to combat sexual violence in the country, touching on activism during the Civil War and the civil rights movement, as well as a "new coalitional movement" in the 1970s (Heldman/Brown, Ms. Magazine blog, 8/8).

What others are saying about sexual and gender-based violence:

~ "The Ray Rice Teachable Moment: Coaching Boys Into Men," M.L. Carr/Peter Harvey, Huffington Post blogs.

~ "Buzzfeed's Video About Street Harassment is a Must-See," Lauren McEwen, Washington Post's "She The People."

~ "Connecting Sexual Violence With the Need for Comprehensive Sex Education," Pamela Zimmerman/Katharine Bodde, Huffington Post blogs.

~ "These Often-Invisible Women Experience Sexual Assault at an Alarming Rate," Robbie Couch, Huffington Post blogs.


Calif. Lawmakers Consider 'Affirmative Consent' Standard for Campus Sexual Assault Cases

Tue, 08/12/2014 - 15:31

The California Assembly this month is expected to consider a bill (SB 967) that would require colleges and universities that receive public funds to determine whether "affirmative consent" occurred when investigating or adjudicating alleged sexual assaults on campuses, the AP/Contra Costa Times reports.

Calif. Lawmakers Consider 'Affirmative Consent' Standard for Campus Sexual Assault Cases

August 12, 2014 — The California Assembly this month is expected to consider a bill (SB 967) that would require colleges and universities that receive public funds to determine whether "affirmative consent" occurred when investigating or adjudicating alleged sexual assaults on campuses, the AP/Contra Costa Times reports.

In May, the state Senate voted 27-4 in favor of the legislation. The measure also incorporates a White House task force's recommendations on how colleges can better address sexual assaults on their campuses.

If the measure becomes law, California would be the first state to have an affirmative consent standard, according to the AP/Times (AP/Contra Costa Times, 8/11).

About 'Affirmative Consent'

Under the affirmative consent standard, sexual partners would be responsible for ensuring the other person explicitly consents, in contrast to the more common "no means no" standard in most sexual assault cases, which relies on a person expressing lack of consent (Women's Health Policy Report, 2/12).

Specifically, the standard would be defined as "an affirmative, unambiguous and conscious decision" by each party to consent to sexual activity. The consent must be "ongoing" and could be "revoked at any time."

The measure specifies that silence or the lack of physical resistance would not constitute consent, nor could consent be given in a situation in which a person is asleep, drugged, drunk or unconscious. However, the legislation does note that consent could be nonverbal (AP/Contra Costa Times, 8/11).

The legislation also would establish policies aimed at improving protections and services for sexual assault survivors, as well as on-campus education and intervention efforts (Women's Health Policy Report, 2/12).

Debate Over Bill

State Sen. Kevin de León (D), a co-author of the bill, said, "California needs to provide our students with education, resources, consistent policies and justice so that the system is not stacked against survivors."

However, in an editorial published shortly after the state Senate vote, the Los Angeles Times questioned whether the legislation is "reasonable" and "enforceable."

Ada Meloy, general counsel of the American Council on Education, which represents college presidents, said, "Frequently these cases involve two individuals, both of whom maybe were under the influence of alcohol or drugs, and it can be very tricky to ascertain whether consent was obtained."

However, University of California-Berkeley student Meghan Warner, who leads student workshops on consent, said that the measure was needed because "[m]ost students don't know what consent is." She added, "I've asked at the workshops how many people think if a girl is blacked out drunk that it's OK to have sex with her. The amount of people who raised their hands was just startling" (AP/Contra Costa Times, 8/11).


Lawsuit Over Texas Antiabortion Law Also Involves N.M. Abortion Clinic

Tue, 08/12/2014 - 15:25

The trial over the constitutionality of a Texas antiabortion-rights law (HB 2) that could close abortion clinics there also involves an out-of-state clinic, located in Santa Teresa, N.M., the New York Times reports.

Lawsuit Over Texas Antiabortion Law Also Involves N.M. Abortion Clinic

August 12, 2014 — The trial over the constitutionality of a Texas antiabortion-rights law (HB 2) that could close abortion clinics there also involves an out-of-state clinic, located in Santa Teresa, N.M., the New York Times reports (Fernandez, New York Times, 8/8).

Several abortion providers in Texas are asking the U.S. District Court for the Western District of Texas to block a provision in HB 2 that requires abortion facilities to meet the same building requirements as ambulatory surgical centers. Currently, just six clinics meet the provision's requirements, and all of them are located in major cities (Women's Health Policy Report, 8/4).

According to the Times, closing arguments in the trial are scheduled for Wednesday.

Importance of N.M. Clinic

Supporters of the law have said that women would not be unduly burdened if multiple Texas clinics close because about 86% of Texas women of reproductive age will still live within 150 miles of an abortion facility. However, the state's analysis includes the New Mexico clinic, called Hilltop Women's Reproductive Clinic.

Meanwhile, opponents argue that the law is unconstitutional because it will close most of the clinics in the state, including the only one located in El Paso, Texas, which is the closest facility to the New Mexico clinic. Under this scenario, roughly one million women in the state will live more than 150 miles from the nearest in-state abortion facility.

They also have said that the state cannot rely on the New Mexico clinic, citing a federal appeals court ruling that found Mississippi could not enforce a similar law because it would close the state's sole clinic and make women reliant on out-of-state clinics to meet their constitutional right to abortion.

Jan Soifer, one of the lawyers for the Texas abortion providers, said the Mississippi ruling is "really important" because in a state the size of Texas, "for the state to say, 'Well, it's O.K., you can cross the border and go to a clinic in another state,' is the state shirking its requirements to ensure that the constitutional rights of the women in the state are met."

According to the Times, some information on the New Mexico clinic is lacking, and Soifer said the issue highlights the plaintiffs' arguments that Texas officials do not know the status of the clinic. Although the clinic lists a license number on its website, a spokesperson for the New Mexico Department of Health said that the posted number "is not a license number issued by the New Mexico Department of Health." The state, which does not require health department licenses, permits abortion clinics to seek other forms of accreditation, and the clinic is owned by a licensed physician, the Times reports (New York Times, 8/8).


Court Permits Food Company To Deny Contraceptive Coverage in Light of Hobby Lobby Ruling

Tue, 08/12/2014 - 14:44

A federal appeals court on Friday ordered a lower court to grant Freshway Foods an exemption from the federal contraceptive coverage rules in light of the Supreme Court's ruling in the Hobby Lobby case, Bloomberg reports.

Court Permits Food Company To Deny Contraceptive Coverage in Light of Hobby Lobby Ruling

August 12, 2014 — A federal appeals court on Friday ordered a lower court to grant Freshway Foods an exemption from the federal contraceptive coverage rules in light of the Supreme Court's ruling in the Hobby Lobby case, Bloomberg reports.

According to Bloomberg, the ruling appears to be the first exemption granted since the Supreme Court issued the Hobby Lobby decision in June.

Case Details

Francis and Philip Gilardi, the owners of Freshway Foods, filed suit against the rules because they said that offering contraceptive coverage in the company's employer-sponsored health plans would violate their Roman Catholic beliefs.

In March 2013, U.S. District Judge Emmet Sullivan ruled against the Gilardis, saying that he could not permit corporations to assert individuals' religious rights (Zajac, Bloomberg, 8/8). That November, the U.S. Court of Appeals for the District of Columbia Circuit ruled in favor of the Gilardis, sending the case back to a lower court to reconsider the company's request for an injunction (Women's Health Policy Report, 11/4/13).

The government appealed the ruling. Last month, the Supreme Court rejected the government's request to hear the case, remanded the lawsuit back to the appeals court and ordered it to rule in accordance with the high court's Hobby Lobby ruling (Women's Health Policy Report, 7/2).

On Friday, the D.C. Circuit sent the case back to Sullivan. The appeals court ordered the judge to issue a preliminary injunction for Freshway and instructed him to consider extending the injunction to the Gilardis (Bloomberg, 8/8).


Editorial Urges Parents To Vaccinate Their Children Against HPV

Tue, 08/12/2014 - 13:33

Parents can give their children the "gift" of protection from certain cancers by vaccinating them against the human papillomavirus, but experts "agree that [HPV] vaccination rates ... are unacceptably low," according to a Sacramento Bee editorial.

Editorial Urges Parents To Vaccinate Their Children Against HPV

August 12, 2014 — Parents can give their children the "gift" of protection from certain cancers by vaccinating them against the human papillomavirus, but experts "agree that [HPV] vaccination rates ... are unacceptably low," according to a Sacramento Bee editorial.

The editorial explains that the HPV vaccine is "ideally" administered to both girls and boys "between 11 and 13 years old." HPV is the most common sexually transmitted infection and can lead to "some particularly nasty cancers later in life," but "vaccination provides girls more than 90 percent protection from those cancers," the editorial states.

However, according to a recent CDC survey, only 57% of girls and 34% of boys in the U.S. have received the vaccine.

Although public education and providers' suggestions can help to increase vaccination rates, "parents and family members must take responsibility as well," the editorial states (Sacramento Bee, 8/10).


Number of FMLA Lawsuits Spiked From 2012 to 2013

Mon, 08/11/2014 - 15:20

Employees in 2013 filed 877 lawsuits against their employers for allegedly violating the Family and Medical Leave Act, up from 291 in 2012, according to data from the Administrative Office of the U.S. Courts, the Wall Street Journal reports.

Number of FMLA Lawsuits Spiked From 2012 to 2013

August 11, 2014 — Employees in 2013 filed 877 lawsuits against their employers for allegedly violating the Family and Medical Leave Act, up from 291 in 2012, according to data from the Administrative Office of the U.S. Courts, the Wall Street Journal reports (Palazzolo, Wall Street Journal, 8/8).

Under the Family and Medical Leave Act (PL 103-3), eligible employees are allowed to take up to 12 weeks of unpaid leave annually to care for themselves during an illness, a sick family member or a new child (Women's Health Policy Report, 7/31). The law also prohibits employers from retaliating against employees who take such leave.

In FMLA challenges, employees can recover up to double the amount of any lost wages or the cost of caring for family members if leave was denied. However, plaintiffs cannot be awarded punitive damages.

According to the Journal, FMLA cases require a lower threshold of proof than cases challenging most other employment laws. Labor attorney Jeff Nowak of Franczek Radelet PC explained that, unlike discrimination suits that require proof of an employers' intent to discriminate, plaintiffs in FMLA cases must show that their employers deterred them from taking authorized leave under FMLA or interrupted such leave. He added that many employees are more familiar with FMLA laws today than had been in the past.

Meanwhile, Lisa Horn, director of congressional affairs at the Society for Human Resource Management, said that some employers face significant challenges in accommodating leave under FMLA. She noted that the law does not specify what qualifies as a serious health condition warranting leave under the law, adding, "There are opportunities for misuse, and that has been a real challenge for employers and employees who are left picking up the additional work" (Wall Street Journal, 8/8).

NYT Column: Many Factors Affect Impact of Paid Leave

In related news, the New York Times' Claire Cain Miller writes in "The Upshot" that a "paradox" involving U.S. women's participation in the workforce offers insight "about how to shape maternity leave." She explains that "[w]hen measured by who holds a job, American women are falling behind women in other developed countries," but "the American women who are working tend to have more high-achieving careers."

She notes that the U.S. "is the only country besides Papua New Guinea that mandates maternity leave but does not require that it be paid," while "[o]ther developed countries ... offer paid leave" and "other family-friendly benefits like publicly funded child care and the right to demand part-time work."

While "[e]conomists say paid leave is essential to making it possible for women to work," research has shown "that long paid leaves can also hold back women" by having "negative effects on their job opportunities" if, for example, they voluntarily "scale back" or face discrimination from employers who assume women will take leave, according to Cain Miller. Long leaves also can be "expensive for companies, particularly for jobs that build on training and promotions, and employers" may be hesitant to hire people who might leave for a year at a time, she writes.

Cain Miller suggests that one way to "minimize the career penalty women pay for having children is to stop making parental leave all about mothers" and encourage more fathers to take leave. She also calls for policymakers to take steps to "minimize the penalty women pay ... by pulling levers in both policy and culture around the length of leaves and who takes them" (Cain Miller, "The Upshot," New York Times, 8/9).


Admitting Privileges Mandates Create Hurdles for Abortion Providers

Mon, 08/11/2014 - 15:06

Admitting privileges requirements, enacted in several states, have proven to be "a potent tool" for abortion-rights opponents in their goal of limiting abortion access, the Washington Post reports.

Admitting Privileges Mandates Create Hurdles for Abortion Providers

August 11, 2014 — Admitting privileges requirements, enacted in several states, have proven to be "a potent tool" for abortion-rights opponents in their goal of limiting abortion access, the Washington Post reports (Somashekhar, Washington Post, 8/10).

The laws require physicians who perform abortions to have admitting privileges at a nearby hospital. Clinics that cannot meet the requirement are forced to close.

About Admitting Privileges

According to NPR's "Shots," admitting privileges give a physician the right to admit patients to a particular hospital and provide certain services on hospital grounds.

Hospitals typically consider a physician's medical credentials, license and history of malpractice when weighing his or her admitting privileges request. Many hospitals also require that physicians admit a minimum number of patients each year or live within a certain distance of the hospital.

Fifteen states require that abortion providers "have some affiliation with a local hospital," while 11 states have laws that specifically require providers to have admitting privileges, according to the Guttmacher Institute. However, many of the laws are not in effect because courts have temporality blocked them or they have not been implemented yet (Rovner, "Shots," NPR, 8/8).

Compliance Difficulties

Admitting privileges requirements pose a particularly difficult hurdle for abortion providers because often they live too far away from the hospitals or do not typically admit the minimum number of patients. In addition, many religiously affiliated hospitals object to abortion, while other hospitals do not want to be involved with a politically controversial issue.

Physician Willie Parker, who provides abortions at Mississippi's only abortion clinic, said he was not surprised that so many hospitals rejected his application for admitting privileges or did not respond. "For a hospital to [extend admitting privileges], it would be making a conscious decision to take on the state legislature," he said.

More than a dozen abortion clinics have closed under Texas' requirements, at least one closed in Tennessee, and several could close in Oklahoma, Louisiana and Wisconsin if courts allow admitting privileges laws to take effect in those states, according to the Post (Washington Post, 8/10).

Abortion-Rights Supporters, Opponents Debate Motivation

According to "Shots," abortion-rights opponents contend that the laws are medically necessary and that clinics would only close if they are unable to meet basic safety standards ("Shots," NPR, 8/8). Abortion-rights supporters argue that the laws are medically unnecessary because anyone can be admitted through an emergency room (Washington Post, 8/10).

Jeanne Conry, former president of the American Congress of Obstetricians and Gynecologists, said, "Admitting-privileges legislation would impose stricter requirements on facilities where abortions are performed than on facilities that perform much riskier procedures." For example, colonoscopies have a mortality rate 40 times higher than abortion.

Abortion-rights supporters also point out that the reason abortion providers are often unable to meet the minimum requirements for admissions is because so few of their patients require hospitalization.

Meanwhile, Ovide Lamontagne, general counsel for Americans United for Life, said, "Once a physician assumes the responsibility for overseeing the provision of a medical procedure, there's an obligation on the physician to follow the care through to its ultimate conclusion," including any potential emergencies ("Shots," NPR, 8/8).

Legal Landscape

A divide among federal appeals courts over the constitutionality of admitting privileges requirements could persuade the Supreme Court to review the issue, according to the Texas Tribune/New York Times (Edelman, Texas Tribune/New York Times, 8/9).

Elizabeth Nash, states-issues manager for the Guttmacher Institute, said that the laws, if upheld, could have a "huge" effect on clinics compared with other abortion restrictions. "It has just really taken over, in a sense, because it has such the potential for shutting down clinics," she said (Washington Post, 8/10).


CDC Breast, Cervical Cancer Screening Program Has Served Over 4M Low-Income Women

Mon, 08/11/2014 - 15:02

A federally supported breast and cervical cancer screening program has helped millions of low-income women access the screenings since 1991, according to new CDC studies published online in the journal Cancer, HealthDay/U.S. News & World Report reports.

CDC Breast, Cervical Cancer Screening Program Has Served Over 4M Low-Income Women

August 11, 2014 — A federally supported breast and cervical cancer screening program has helped millions of low-income women access the screenings since 1991, according to new CDC studies published online in the journal Cancer, HealthDay/U.S. News & World Report reports (Preidt, HealthDay/U.S. News & World Report, 8/7).

Program Details

According to Medscape, the National Breast and Cervical Cancer Early Detection Program focuses on decreasing breast and cervical cancer disparities among low-income, minority and uninsured women. To be eligible for the program, women must have incomes at or below 250% of the federal poverty level and be uninsured or underinsured.

Congress approved $30 million for the program's first year. Since then, the program has helped a total of more than 10.7 million women access breast and cervical cancer screenings, Medscape reports. In 2010, CDC awarded grants worth more than $161 million through the program (Chustecka, Medscape, 8/7).

Report Findings

More than four million women obtained cancer screenings as a result of the program during its first 20 years of operation, according to the report.

In those two decades, the screenings identified more than 56,000 instances of breast cancer, about 3,200 instances of cervical cancer and more than 152,000 precancerous cervical lesions. The report added that women received appropriate and timely follow-up care in 90% of such cases.

According to the report, the screening program has cost about $145 per woman (HealthDay/U.S. News & World Report, 8/7).