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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Datapoints: LARC Use Increases Among U.S. Teens, Abortion Coverage Data Lack Transparency

Fri, 04/24/2015 - 15:04

In today's graphics, we look at U.S. teenagers' increased use of long-acting reversible contraceptives and declining use of moderate- and least-effective forms of contraception. We also spotlight marketplace health plans' inadequate transparency on abortion coverage and lingering gaps in no-cost contraception coverage.

Datapoints: LARC Use Increases Among U.S. Teens, Abortion Coverage Data Lack Transparency

April 24, 2015 — In today's graphics, we look at U.S. teenagers' increased use of long-acting reversible contraceptives and declining use of moderate- and least-effective forms of contraception. We also spotlight marketplace health plans' inadequate transparency on abortion coverage and lingering gaps in no-cost contraception coverage.

Teenagers' LARC Use Increases



A new CDC report has found that teenagers in the U.S. increasingly are using long-acting reversible contraceptives, such as intrauterine devices and implants, but that overall use remains low compared with other forms of contraception.

This graphic, excerpted from the report, shows that the percentage of teenagers using LARCs has increased from 0.4% in 2005 to about 7% in 2013. Meanwhile, although the use of moderately effective and least effective forms of contraception decreased, they still remained more common than LARCs among teenagers. According to the study, the use of moderately effective methods decreased from 76.9% to 73.4% between 2005 and 2013 and the use of the least effective methods decreased from 22.7% to 19.5% during that time frame (Morbidity and Mortality Weekly Report, 4/7).


Marketplace Abortion Coverage Lacks Transparency



According to a new Guttmacher Institute report, individuals seeking to buy coverage from the Affordable Care Act's (PL 111-148) insurance marketplaces face difficulty locating information on whether the plans include abortion coverage. Specifically, the report found that fewer than half of states that do not restrict abortion coverage in marketplace plans offer at least one plan that publishes resources explaining that they covered the procedure.

This map, excerpted from the report, outlines which states bar most abortion coverage in their marketplace plans and which states do not impose any coverage restrictions (Guttmacher Policy Review, 2015).


No-Cost Contraceptive Coverage Not Yet Universal



The Affordable Care Act has significantly improved access to no-cost contraceptives. However, a new report from the Kaiser Family Foundation and Lewin Group finds that some insurers still are not covering all FDA-approved contraceptives without copayments.

The chart above details coverage from the 20 surveyed insurers for several types of FDA-approved contraception, including emergency contraception and intrauterine devices, among others. The study did not examine coverage of oral contraceptives (KFF/Lewin Group report, 4/16).


Ala. Rep. Files Legislation Targeting Northern Ala.'s Only Abortion Clinic

Fri, 04/24/2015 - 15:02

Alabama Rep. Ed Henry (R) on Tuesday filed a measure (HB 527) that would prevent the state's Department of Public Health from licensing abortion clinics or reproductive health care centers that are located within 2,000 feet of a public school, the Huntsville Times reports.

Ala. Rep. Files Legislation Targeting Northern Ala.'s Only Abortion Clinic

April 24, 2015 — Alabama Rep. Ed Henry (R) on Tuesday filed a measure (HB 527) that would prevent the state's Department of Public Health from licensing abortion clinics or reproductive health care centers that are located within 2,000 feet of a public school, the Huntsville Times reports (Edgemon, Huntsville Times, 4/22).

The measure threatens to close the Huntsville Women's Clinic, the sole clinic in Northern Alabama, which is located almost directly across from a school (Women's Health Policy Report, 11/25/14). According to the Florence Times Daily, the bill also would force most of the state's abortion clinics to close (Sell/Edwards, Florence Times Daily, 4/22).

Background

The Huntsville clinic in October 2014 reopened in a new location after closing in June 2014 because its old location did not comply with a state law (HB 57) that requires abortion clinics to meet the same building standards as ambulatory surgical centers.

The Christian Coalition of Alabama filed suit against the clinic, arguing that it should not be allowed to open unless it applies to be zoned as a surgical center. In November 2014, Madison County Circuit Judge Alan Mann denied CCA's request for a temporary injunction and dismissed the case. He said the plaintiffs did not have standing to bring the case and that the zoning board acted in its normal capacity when it zoned the clinic.

In response to the ruling, CCA's James Henderson said the group would ask local lawmakers to support a measure that would require a 2,000-foot minimum distance between a school and an abortion clinic (Women's Health Policy Report, 11/25/14).

Lawmakers File School Zoning Measure

Henry filed such a measure on Tuesday. The bill is co-sponsored by state Reps. Terri Collins (R) and Ken Johnson (R) (Florence Times Daily, 4/22).

The bill would prohibit DPH from issuing or renewing health center licenses to abortion or reproductive health clinics located with 2,000 feet of a public school's campus or property (Huntsville Times, 4/22). According to the Times Daily, the bill does not specify what constitutes a public school or whether the measure would apply to property owned by state colleges or universities (Florence Times Daily, 4/22).

According to Henderson, CCA drafted the legislation with the intent to close the Huntsville clinic. Henderson added that he believes the legislation would survive a legal challenge because it would only affect clinics seeking an operating license (Huntsville Times, 4/22).

Meanwhile, Henry said he "did not know" the measure "would impact closing (a clinic)," but he noted that such legislation had been requested "by several of the [antiabortion-rights] groups around the state."

Abortion-Rights Supporters Voice Concerns

Dalton Johnson, clinic administrator at HWC, said the clinic currently is the only one in Alabama that has "a physician on staff [who] actually does the procedures and has admitting privileges at a hospital." He added that if a legal challenge against a state law requiring abortion providers to have admitting privileges at nearby hospitals is not successful, the clinic would be "the only one left in the entire state, and now they are coming at us with this legislation to try to close us down" (Florence Times Daily, 4/22).

Meanwhile, Susan Watson, executive director of the American Civil Liberties Union of Alabama, said the bill would be subject to litigation if it becomes law. She noted, "You can't pass a law taking away somebod[y's] business just because you don't like it."

Mia Raven, legislative affairs director for Alabama Reproductive Rights Advocates, said she was not surprised the bill was filed and is "always ready for ... attacks ... that target Alabamian women and their reproductive healthcare." She added, "We remain as committed as ever to fight for women and their Constitutional right to make their own decisions about their healthcare along with maintaining unfettered access to reproductive services in Alabama" (Hunstville Times, 4/22).


Datapoints: LARC Use Increases Among U.S. Teens, Abortion Coverage Data Lack Transparency

Thu, 04/23/2015 - 16:46

In today's graphics, we look at U.S. teenagers' increased use of long-acting reversible contraceptives and declining use of moderate- and least-effective forms of contraception. We also spotlight marketplace health plans' inadequate transparency on abortion coverage and lingering gaps in no-cost contraception coverage.

Datapoints: LARC Use Increases Among U.S. Teens, Abortion Coverage Data Lack Transparency

April 23, 2015 — In today's graphics, we look at U.S. teenagers' increased use of long-acting reversible contraceptives and declining use of moderate- and least-effective forms of contraception. We also spotlight marketplace health plans' inadequate transparency on abortion coverage and lingering gaps in no-cost contraception coverage.

Teenagers' LARC Use Increases



A new CDC report has found that teenagers in the U.S. increasingly are using long-acting reversible contraceptives, such as intrauterine devices and implants, but that overall use remains low compared with other forms of contraception.

This graphic, excerpted from the report, shows that the percentage of teenagers using LARCs has increased from 0.4% in 2005 to about 7% in 2013. Meanwhile, although the use of moderately effective and least effective forms of contraception decreased, they still remained more common than LARCs among teenagers. According to the study, the use of moderately effective methods decreased from 76.9% to 73.4% between 2005 and 2013 and the use of the least effective methods decreased from 22.7% to 19.5% during that time frame (Morbidity and Mortality Weekly Report, 4/7).


Marketplace Abortion Coverage Lacks Transparency



According to a new Guttmacher Institute report, individuals seeking to buy coverage from the Affordable Care Act's (PL 111-148) insurance marketplaces face difficulty locating information on whether the plans include abortion coverage. Specifically, the report found that fewer than half of states that do not restrict abortion coverage in marketplace plans offer at least one plan that publishes resources explaining that they covered the procedure.

This map, excerpted from the report, outlines which states bar most abortion coverage in their marketplace plans and which states do not impose any coverage restrictions (Guttmacher Policy Review, 2015).


No-Cost Contraceptive Coverage Not Yet Universal



The Affordable Care Act has significantly improved access to no-cost contraceptives. However, a new report from the Kaiser Family Foundation and Lewin Group finds that some insurers still are not covering all FDA-approved contraceptives without copayments.

The chart above details coverage from the 20 surveyed insurers for several types of FDA-approved contraception, including emergency contraception and intrauterine devices, among others. The study did not examine coverage of oral contraceptives (KFF/Lewin Group report, 4/16).


Obama Signs Medicare Legislation With Hyde Language, Sexuality Education Funding

Thu, 04/23/2015 - 16:31

President Obama on Thursday signed legislation (HR 2) designed to reform Medicare physician reimbursements, Reuters reports.

Obama Signs Medicare Legislation With Hyde Language, Sexuality Education Funding

April 17, 2015 — President Obama on Thursday signed legislation (HR 2) designed to reform Medicare physician reimbursements, Reuters reports (Mason, Reuters, 4/16).

The law includes Hyde Amendment language in a provision aimed at funding community health centers (Women's Health Policy Report, 4/15). It also includes funding for both comprehensive and abstinence-only sexuality education (Wetzstein, Washington Times, 4/15).

Background

The Medicare legislation aims to put in place a long-term solution to a problematic formula that Medicare uses to determine physician reimbursements. Congress has been addressing the issue with short-term fixes for years.

Abortion-rights advocates raised concern about the abortion restriction in the community health centers provision. Specifically, the provision includes Hyde Amendment language that restricts federal funding for abortion.

However, the Senate on Tuesday passed the measure after rejecting six amendments to the underlying bill, including one that would have directed more funding to women's health care and removed the abortion funding restriction (Women's Health Policy Report, 4/15).

Sexuality Education Funding Details

The law also will renew funding for a program that supports comprehensive sexuality education, called the Personal Responsibility Education Program, at $75 million annually for two years.

In addition, the law will increase annual funding for the Title V Abstinence Education grant program by $25 million. Overall, the abstinence program will receive a total of $75 million annually for two years.

Advocacy Groups Comment on Sexuality Education Funding

The Sexuality Information and Education Council of the United States said the funding for the PREP program would ensure that teenagers and young people receive "medically accurate and evidence-based" sexuality education. However, SIECUS said it was "incredibly disappointed" that Title V program funding would increase, noting that "abstinence-only-until-marriage" programs can harm young people, particularly individuals who are sexually active or in a same-sex relationship.

Meanwhile, Valerie Huber, president of the National Abstinence Education Association, expressed support for the bill's passage and for the increase in Title V funding and flexibility (Washington Times, 4/15).


Fla. House Advances 24-Hour Mandatory Delay Bill

Thu, 04/23/2015 - 16:31

The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports.

Fla. House Advances 24-Hour Mandatory Delay Bill

April 23, 2015 — The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports (Cotterell, Tallahassee Democrat, 4/22).

The state Senate is set to take up an identical bill (SB 724) on Thursday (Menzel, News Service of Florida/CBS Miami, 4/22). Through a procedural move, the state Senate is expected to substitute its measure for the House bill before voting on its final passage. According to the Democrat, the state Senate's approval of the measure "appears certain" (Tallahassee Democrat, 4/22).

Bill Details

The bill, proposed by state Rep. Jennifer Sullivan (R), would require a woman to meet in person with a physician at least 24 hours prior to having an abortion (Women's Health Policy Report, 4/3). According to the Democrat, Florida already requires women to receive counseling from a physician prior to the procedure (Tallahassee Democrat, 4/22).

The state House on Tuesday approved an amendment to the legislation to waive the delay for women who are survivors of rape, incest, human trafficking or domestic violence. However, the exemptions would only be provided if women could produce certain documentation, such as medical records, police reports or restraining orders (News Service of Florida/CBS Miami, 4/22).

Comments

Sullivan said the legislation is intended to "empower[r] women."

However, state House Minority Leader Mark Pafford (D) said, "The presumption that there has not already been 24 hours to make that decision is perplexing to me," adding, "This is an example of government intrusion" (Sweeney, South Florida Sun-Sentinel, 4/23).

Meanwhile, state Rep. Victor Torres (D) criticized the documentation requirement for waiving the mandatory delay. He said, "As a retired cop, I look at the victim of rape, the victim who is violated by a family member. You think she's going to have documentation? She's going to run to the police and report it?" (McGrory, Tampa Bay Times, 4/22).

Several state lawmakers who support abortion rights also said the measure, if made law, likely would be challenged on constitutional grounds in the courts. According to the Sun-Sentinel, the Florida Constitution requires laws that invade individuals' privacy to be as unobtrusive and narrow as feasible, a more stringent standard than the U.S. Constitution.

State Rep. Lori Berman (D) said, "Requiring two in-person visits with a doctor is far from the least intrusive means necessary" (South Florida Sun-Sentinel, 4/23).


La. Officials Publish Final Version of Revamped Abortion Clinic Regulations

Thu, 04/23/2015 - 16:31

Louisiana's Department of Health and Hospitals this week published the final version of updated licensing standards for abortion clinics, AP/ABC News reports.

La. Officials Publish Final Version of Revamped Abortion Clinic Regulations

April 23, 2015 — Louisiana's Department of Health and Hospitals this week published the final version of updated licensing standards for abortion clinics, AP/ABC News reports.

According to AP/ABC News, the finalized regulations are not substantively different than changes that were proposed in December 2014. Those changes garnered more than 1,800 public comments opposed to the proposed regulations (DeSlatte, AP/ABC News, 4/21).

Background

In February, the state DHH said the then-proposed regulations would revise current rules to accommodate several recently enacted laws and would outline clearly the state's clinic licensing and staffing requirements. If the clinics do not comply, they could face closure. Among other rules, the regulations include requirements that clinics must maintain detailed records of "every 'job skill' of every employee" and annual employee evaluations on the specific job skills.

DHH spokesperson Olivia Watkins acknowledged that some of the new requirements "are outside of the specific legislative mandates" (Women's Health Policy Report, 2/2).

Reaction

Melissa Flournoy, the state's director for Planned Parenthood Gulf Coast, said her group is "deeply disappointed that [its] call[s] for regulations based on medicine were ignored." She said Louisiana Gov. Bobby Jindal's (R) "administration has instead decided to risk patient health and safety by imposing further restrictions on a woman's ability to have a safe, legal abortion in" the state.

According to AP/ABC News, it is not clear whether anyone will challenge the final rules in court. Jewel Bush, a spokesperson for PPGC, said the group "is committed to protecting access to safe, legal abortion and views this as an urgent situation, and ... will explore all options" (AP/ABC News, 4/21).


Blogs Comment on Curbing CPC Misinformation, Protecting Pregnant Women's Rights, More

Thu, 04/23/2015 - 15:49

Read some of the week's best commentaries from bloggers at RH Reality Check, National Women's Law Center and more.

Blogs Comment on Curbing CPC Misinformation, Protecting Pregnant Women's Rights, More

April 17, 2015 — Read some of the week's best commentaries from bloggers at RH Reality Check, National Women's Law Center and more.

CPCs: "California Bill Would Require Crisis Pregnancy Centers To Discuss Abortion Options," Nina Liss-Schultz, RH Reality Check: The California Assembly Committee on Health on Tuesday approved a bill (AB 775) aimed at "regulat[ing] the information anti-choice crisis pregnancy centers (CPCs) provide to clients," Liss-Schultz writes. She explains that CPCs "have the either explicit or unstated goal of preventing clients from obtaining abortions," a goal they aim to accomplish by "regularly dol[ing] out misinformation about the procedure" and "disguising themselves as abortions clinics, advertising their services as unbiased counseling and buying up or leasing space near abortion clinics." According to Liss-Schultz, some cities in the state, such as San Francisco, "have taken steps to curb the influence of CPCs." She writes that the new, statewide bill would require licensed facilities that "'provide family planning and pregnancy-related services to inform patients about available assistance for affordable contraception, abortion, and prenatal care, including how to obtain that assistance.'" In addition, it would mandate that "facilities without medical licenses that offer similar services to post a notice saying they have neither a license nor licensed providers on staff" (Liss-Schultz, RH Reality Check, 4/16).

PREGNANT WOMEN'S RIGHTS: "'Marlise's Law' Could Give End-of-Life Rights to Pregnant Texans," Andrea Grimes, RH Reality Check: The family of a pregnant woman, Marlise Muñoz, "whose body was kept on mechanical support against her wishes for months," on Wednesday testified in favor of a measure [HB 3183] "that would give end-of-life decision-making rights to pregnant Texans," Grimes writes. Grimes explains that under current Texas law, pregnant women are prevented "from being able to issue advance directives about their end-of-life care, requiring doctors and hospitals to keep pregnant Texans on mechanical support against their consent and regardless of their, or their families' instructions." According to Grimes, the new bill, proposed by state Rep. Elliott Naishtat, would enable pregnant women in Texas to have more control over their end-of-life care by "strik[ing] a line in the state's advance directives code that bars the code from applying in cases where a patient is pregnant." She notes that the bill "was left pending in committee," while a separate bill (HB 1901) that "directly counters the intention of" HB 3183 has "not yet been assigned a hearing" (Grimes, RH Reality Check, 4/15).

RELIGIOUS REFUSALS: "Denied Care When Losing a Pregnancy: Pharmacies Refuse To Fill Needed Prescriptions," Kelli Garcia, National Women's Law Center's "Womenstake": "A provider's personal beliefs should not be allowed to dictate whether someone gets the healthcare they need," writes Garcia, citing the recent case of a Georgia woman, Brittany Cartrett, who was denied medication for a miscarriage. According to Garcia, Cartrett "needed the drug Misoprostol to help her complete a miscarriage and avoid a more invasive surgical procedure" but opted to undergo the surgical procedure after being "'lecture[d]'" by a pharmacist. Garcia writes, "Georgia is among six states that specifically allow pharmacists to refuse to provide any medication to patients," adding that the state "doesn't even require that pharmacists refer the customer elsewhere or transfer the prescription." Further, Garcia notes that "it's not just pharmacists who refuse to provide care," citing instances of "[r]eligiously affiliated hospitals ... den[ying] women medically appropriate treatment" and "[r]ape survivors ... be[ing] denied emergency contraception in the" emergency department, among other situations (Garcia, "Womenstake," National Women's Law Center, 4/16).

What others are saying about religious refusals:

~ "The Scary Law That Allowed Pharmacists To Deny This Woman the Drugs She Needed After Her Miscarriage," Molly Redden, Mother Jones.

SEXUALITY EDUCATION: "'Safe Sex Is Kind of a Misnomer': Bioethicist Live-Tweets Insane Abstinence-Only Sex Ed Lesson," Jenny Kutner, Salon: Recently, a "[f]eminist bioethicist" named Alice Dreger learned that "her son's school health class included the sort of delusional, fear-mongering abstinence-only instruction that attempts to scare students out of ever touching each other or engaging in healthy sexual relationships," Kutner writes. Dreger decided to sit in on the class, Kutner writes, and live-tweet the lesson "to document the insane 'wisdom' imparted to thousands of American public school students." According to Dreger, the teacher giving the lesson "promoted 'abstinence stories' while being 'completely condescending.'" Kutner notes that similar lessons are used "to shame and misinform students, which have proven ineffective in anti-comprehensive-sex ed strongholds such as Texas and Mississippi -- two states that have some of the highest teen pregnancy and repeat teen pregnancy rates in the country" (Kutner, Salon, 4/15).

ABORTION RESTRICTIONS: "Anti-Choicers Are Going To Take Away Second-Trimester Abortion Without Much Notice," Amanda Marcotte, RH Reality Check: "Kansas and Oklahoma, both of which have passed laws [SB 95, HB 1721] banning the dilation and evacuation (D and E) procedure that is used in most abortions after 13 weeks, have graduated to a new level in their efforts to stamp out reproductive rights," Marcotte writes. She notes that if the Supreme Court were "to agree with the anti-choice side about these bans," it "would open the door to just banning abortion outright." While similar legislation is "being considered in Missouri [HB 920], South Carolina [SB 531], and South Dakota," the mainstream media has made limited mention of the issue, and there has "been little outrage or fear," Marcotte writes. According to Marcotte, the strategy behind such laws is twofold, with abortion-rights opponents aiming to "[o]verwhelm the news cycle with restrictions on abortion so that the public starts to tune the stories out" and make the regulations seem "minor" so that people "shrug" off the news. Marcotte questions whether "a weary public is going to shrug off [these laws] as no big deal," adding, "by the time we're all panicked enough to stop shrugging, it will be too late" (Marcotte, RH Reality Check, 4/16).

What others are saying about abortion restrictions:

~ "Senate Passes Medicare 'Doc Fix' Bill, Including Anti-Choice Language," Emily Crockett, RH Reality Check.


L.A. Times: Kansas, Okla. Laws Do Not 'Even Bother To Pretend To Protect Women's Health'

Thu, 04/23/2015 - 15:49

New antiabortion-rights laws in Kansas (SB 95) and Oklahoma (HB 1721) that "ban the safest, most widely used method of abortion in the second trimester," do not "even bother to pretend to protect women's health" and go "straight for the drama," a Los Angeles Times editorial states.

L.A. Times Op-Ed: Kansas, Okla. Laws Do Not 'Even Bother To Pretend To Protect Women's Health'

April 20, 2015 — New antiabortion-rights laws in Kansas (SB 95) and Oklahoma (HB 1721) that "ban the safest, most widely used method of abortion in the second trimester," do not "even bother to pretend to protect women's health" and go "straight for the drama," a Los Angeles Times editorial states.

The editorial notes that the "nearly identical laws" ban a "procedure known as 'dilation and evacuation,'" allowing exceptions when the woman's life is in danger. "The bills were designed to make the procedure sound as gruesome as possible in nonmedical, emotion-laden terms," the editorial states.

However, according to the editorial, the procedure is used "in about 95% of second trimester abortions because it is the most effective method at that stage of pregnancy." The alternative procedure, called a medical abortion, "takes longer, is less certain to work and sometimes requires a second procedure," according to the editorial.

The editorial states, "No matter how abortion opponents describe the ... procedure, their efforts represent nothing more than another attack on access to legal and safe abortions" (Los Angeles Times, 4/19).


Colo. Senate Leader Introduces 'Fetal Homicide' Measure

Thu, 04/23/2015 - 15:48

Colorado Senate President Bill Cadman (R) on Tuesday introduced a bill (SB 15-268) that would allow prosecutors to bring murder charges against an individual who ends a woman's pregnancy, the Washington Post's "GovBeat" reports.

Colo. Senate Leader Introduces 'Fetal Homicide' Measure

April 17, 2015 — Colorado Senate President Bill Cadman (R) on Tuesday introduced a bill (SB 15-268) that would allow prosecutors to bring murder charges against an individual who ends a woman's pregnancy, the Washington Post's "GovBeat" reports.

The bill now proceeds to the Colorado Senate Judiciary Committee (Ohlheiser, "GovBeat," Washington Post, 4/15).

Background

The measure comes in response to a recent incident in the state in which a woman responding to an online ad for baby clothes was stabbed and cut open in her abdomen to remove the fetus, which did not survive. The woman, who survived, was seven months pregnant, meaning the fetus could have been viable.

Boulder County District Attorney Stan Garnett said many in the community have called for him to file a homicide charge against the woman accused of the crime, but he explained that such a charge "is not possible under Colorado law without proof of a live birth."

Currently, the state's Crimes Against Pregnant Women Act (HB 13-11054) addresses violence against pregnant women and their fetuses. The law makes it a crime to end a pregnancy through unlawful action by recognizing the woman as the victim of the crime. The measure explicitly withholds legal personhood from the fetus or embryo (Women's Health Policy Report, 4/3).

Bill Details

Cadman's legislation would revise the definition of "person" in Colorado's homicide and assault statutes so that it refers to "a human being and includes an unborn child at every stage of gestation from conception until live birth."

The bill would allow three exceptions: acts by the woman carrying the fetus; "a medical procedure performed by a physician or licensed medical professional" at the request of the woman or her legal guardian; and "the lawful dispensation or administration of lawfully prescribed medication."

Comments

State Sen. Pat Steadman (D) said he was "disappointed" that some lawmakers "are choosing to use what happened [in the latest incident] to get 'personhood' into law."

According to "GovBeat," some opponents have said the bill bares similarities to "personhood" measures that have been repeatedly rejected in the state. They have noted that such personhood language could increase restrictions on abortion or be used as a complete ban on the procedure.

Separately, state Rep. Mike Foote (D) said Colorado's current law already allows severe punishment for crimes involving the death of a fetus, even if the crime is not called "murder" by the state.

Meanwhile, National Right to Life and the Colorado Catholic Conference have expressed support for the measure ("GovBeat," Washington Post, 4/15).


Fla. House Advances 24-Hour Mandatory Delay Bill

Thu, 04/23/2015 - 15:48

The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports.

Fla. House Advances 24-Hour Mandatory Delay Bill

April 23, 2015 — The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports (Cotterell, Tallahassee Democrat, 4/22).

The state Senate is set to take up an identical bill (SB 724) on Thursday (Menzel, News Service of Florida/CBS Miami, 4/22). Through a procedural move, the state Senate is expected to substitute its measure for the House bill before voting on its final passage. According to the Democrat, the state Senate's approval of the measure "appears certain" (Tallahassee Democrat, 4/22).

Bill Details

The bill, proposed by state Rep. Jennifer Sullivan (R), would require a woman to meet in person with a physician at least 24 hours prior to having an abortion (Women's Health Policy Report, 4/3). According to the Democrat, Florida already requires women to receive counseling from a physician prior to the procedure (Tallahassee Democrat, 4/22).

The state House on Tuesday approved an amendment to the legislation to waive the delay for women who are survivors of rape, incest, human trafficking or domestic violence. However, the exemptions would only be provided if women could produce certain documentation, such as medical records, police reports or restraining orders (News Service of Florida/CBS Miami, 4/22).

Comments

Sullivan said the legislation is intended to "empower[r] women."

However, state House Minority Leader Mark Pafford (D) said, "The presumption that there has not already been 24 hours to make that decision is perplexing to me," adding, "This is an example of government intrusion" (Sweeney, South Florida Sun-Sentinel, 4/23).

Meanwhile, state Rep. Victor Torres (D) criticized the documentation requirement for waiving the mandatory delay. He said, "As a retired cop, I look at the victim of rape, the victim who is violated by a family member. You think she's going to have documentation? She's going to run to the police and report it?" (McGrory, Tampa Bay Times, 4/22).

Several state lawmakers who support abortion rights also said the measure, if made law, likely would be challenged on constitutional grounds in the courts. According to the Sun-Sentinel, the Florida Constitution requires laws that invade individuals' privacy to be as unobtrusive and narrow as feasible, a more stringent standard than the U.S. Constitution.

State Rep. Lori Berman (D) said, "Requiring two in-person visits with a doctor is far from the least intrusive means necessary" (South Florida Sun-Sentinel, 4/23).


Guttmacher: More School-Based Health Centers Should Provide Birth Control

Thu, 04/23/2015 - 15:48

More school-based health centers should provide contraceptives, which have been a major driver of recent declines in the teen pregnancy rate, according to a new Guttmacher Institute analysis, The Hill reports.

Guttmacher: More School-Based Health Centers Should Provide Birth Control

April 23, 2015 — More school-based health centers should provide contraceptives, which have been a major driver of recent declines in the teen pregnancy rate, according to a new Guttmacher Institute analysis, The Hill reports.

Key Findings

The analysis, written by Guttmacher Director of Public Policy Heather Boonstra, found that the teenage pregnancy rate has declined to 57 per 1,000 women, marking the lowest rate in 40 years. It said the decline "is overwhelmingly due to improved contraceptive use and use of more effective methods." However, the analysis also found that only 37% of school-based health centers provide male condoms, while only 26% provide oral contraceptives.

According to the analysis, one major obstacle to such contraceptive access is that state or local governments prohibit about half of the roughly 1,900 school-based health centers in the U.S. from providing contraceptives. However, the figure marks an improvement compared with 1998, when state and local governments prohibited nearly 80% of such health centers from providing birth control.

In addition, the analysis countered objections to teenagers being able to access birth control at school-based health centers. For example, it noted that there is no evidence that access to contraceptives increases the percentage of teenagers who engage in sexual activity (Sullivan, The Hill, 4/21). Further, the analysis said parents often are involved in oversight and planning at school-based health centers (Boonstra, Guttmacher Policy Review, Winter 2015).

The analysis urged Congress to provide more funds for school-based health centers. According to The Hill, the Affordable Care Act (PL 111-148) provided federal funds for the centers in 2010, but the funding expired in 2013. The analysis cited a bill (HR 2632), by Rep. Lois Capps (D-Calif.), that would have provided such funding through 2019.

Boonstra said in a statement, "School-based health centers can play a key role in addressing teen pregnancy, and failing to provide contraceptive services on-site, for whatever reason, is self-defeating." She added, "We know contraception has been the main driver of the steep decline in the U.S. teen pregnancy rate, which is why it's so important to give students easy access to the information and services they need" (The Hill, 4/21).


Blogs Comment on Slew of 2015 Abortion Restrictions, Efforts To Protect Abortion Rights, More

Thu, 04/23/2015 - 15:47

Read the week's best commentaries from bloggers at Bustle, Ms. Magazine blog and more.

Blogs Comment on Slew of 2015 Abortion Restrictions, Efforts To Protect Abortion Rights, More

April 21, 2015 — Read the week's best commentaries from bloggers at Bustle, Ms. Magazine blog and more.

ABORTION RESTRICTIONS: "All the 2015 Anti-Abortion Legislation That's Been Passed So Far (Get A Grip, Arkansas!)," Lauren Holter, Bustle: "It's only April, but 2015 has already seen a staggeringly high ... number of anti-abortion laws and restrictions," Holter writes, noting that both "federal and state legislatures have taken major steps backwards for women's reproductive rights so far in 2015, making it increasingly harder for women to seek safe and legal abortion care." Citing data from the Guttmacher Institute, Holter writes that states "collectively introduced 332 provisions aimed at restricting abortion services" during the first four months of 2015, "compared to 335 during the entire 2014 legislative session." She details the antiabortion-rights bills enacted so far this year, including several new abortion restrictions in Arkansas, an abortion "reversal" law (SB 1318) in Arizona, bans on "the safest and most common method for second-trimester abortions" in Kansas (SB 95) and Oklahoma (HB 1721), a telemedicine abortion ban (HB 154) in Idaho and a 20-week abortion ban (HB 2568) in West Virginia (Holter, Bustle, 4/17).

ABORTION PROTECTIONS: "In Some States, Access to Abortion Care Is Expanding," Stephanie Hallett, Ms. Magazine blog: While there were more antiabortion-rights laws enacted in the U.S. between 2011 and 2013 than over the previous 10 years, lawmakers in several states and localities have proposed measures to expand abortion access, Hallett writes. For example, she writes that "legislators in states like Washington and Oregon have proposed bills that would require insurance providers to cover abortions as they would any other type of reproductive care." In addition, she notes that "cities across the country have also moved to include abortion care in public insurance coverage," including Madison, Wis., where "the city council unanimously passed a resolution in March asking federal and state lawmakers to remove barriers to abortion care for women covered by public health insurance programs." Hallett adds that the goal of such legislation often is "to prevent situations ... where women can't afford the care they need and have to make do with subpar options or forgo treatment altogether" (Hallett, Ms. Magazine blog, 4/20).

CONTRACEPTION: "New Report Shows Insurers Are Falling Short on Covering Contraception," Amanda Marcotte, Slate's "XX Factor": Marcotte discusses the findings of a new Kaiser Family Foundation report, which found that many insurers are interpreting the contraceptive coverage rules under the Affordable Care Act (PL 111-148) "in ways that limit women's access to certain forms of contraception, especially the vaginal ring, emergency contraception, and the [intrauterine device]." She notes that some insurers in the report were refusing to cover some contraceptives at no cost because they "believe that there's a more cost-effective way to get the same results," for example, by "pushing a woman to switch from the [vaginal ring] to the birth control pill." However, Marcotte contends that "[j]ust because the pill and the ring may look the same on paper doesn't mean that they work the same way for every woman -- and unplanned pregnancy costs a lot more than even the most expensive kinds of contraception." She adds, "when it comes to contraception, insurers need to err on the side of more generous coverage" (Marcotte, "XX Factor," Slate, 4/20).

What others are saying about contraception:

~ "Hobby Lobby Part II Is Barreling Towards The Supreme Court," Ian Millhiser, Center for American Progress' "ThinkProgress."

~ "Colorado GOP Works To Kill Successful Teen Pregnancy Prevention Program," Jason Salzman, RH Reality Check.

ABORTION-RIGHTS MOVEMENT: "Sharing Abortion Stories Isn't Just About Changing Policy," Renee Bracey Sherman, RH Reality Check: "If abortion isn't talked about in our communities, is only reflected in a negative light in the media, and the laws in most states are restrictive, abortion stigma is locked in place," Bracey Sherman writes. She explains that "speaking out is crucial and makes a difference in our communities, not as a secondary effort but as a critical step in advocates' overall goal of expanding public support for abortion." For example, a recent Vox poll found individuals "were more likely to be supportive of abortion ... when a woman was mentioned in questions about abortion, rather than addressing abortion only as a political issue," she writes, adding, "Other rigorous research and program evaluations also confirm that when people hear abortion stories, they become more supportive of abortion rights." Further, Bracey Sherman notes that "the ultimate goal of sharing abortion stories is not to change policies" but rather to "normalize a stigmatized experience, to connect the stigmatized people who often live in isolation, and to increase understanding about a taboo issue" (Bracey Sherman, RH Reality Check, 4/20).

MINORITY REPRODUCTIVE CARE: "As We Celebrate National Minority Health Month, Let's Challenge Stigma and Shame," Aimee Thorne-Thomsen, Huffington Post blogs: "April is dedicated to focusing on health care needs and disparities within communities of color in the [U.S.]," and HHS' Office of Minority health this month "joins with its partners in raising public awareness about health and health care disparities that continue to affect racial and ethnic minorities and efforts to advance health equity," Thorne-Thomsen, vice president of strategic partnerships for Advocates for Youth, writes. In particular, Thorne-Thomsen calls attention to reproductive health care among Latino communities, a subject she notes "rarely gets the attention it deserves." She explains that despite assumptions that the Latino community is "conservative in [its] attitude" toward sexuality, surveys conducted over the past few years "have consistently shown that when it ... comes to accessing reproductive health [care], Latinos are supportive of ensuring access to sex education, contraception, and abortion." Thorne-Thomsen notes that "ensuring access to ... the full range of health care" services in the Latino community "is a must," which is why Advocates for Youth and several other advocacy groups have launched the Yo Soy campaign "to reduce shame and stigma and raise awareness in the Latino community about sexual and reproductive health" (Thorne-Thomsen, Huffington Post blogs, 4/19).


Report: Some Insurers Not Covering all FDA-Approved Contraceptives Without Copays

Thu, 04/23/2015 - 15:46

While the Affordable Care Act (PL 111-148) has significantly increased access to no-cost contraceptives, some insurers still are not covering all FDA-approved contraceptives without copayments, according to a report released Thursday from the Kaiser Family Foundation and Lewin Group, the Huffington Post reports.

Report: Some Insurers Not Covering all FDA-Approved Contraceptives Without Copays

April 17, 2015 — While the Affordable Care Act (PL 111-148) has significantly increased access to no-cost contraceptives, some insurers still are not covering all FDA-approved contraceptives without copayments, according to a report released Thursday from the Kaiser Family Foundation and Lewin Group, the Huffington Post reports (Young, Huffington Post, 4/16).

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.

However, 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, 2/6). In addition, some plans qualify for an exemption to the rules because they have "grandfathered" status or are for certain religious employers. Court rulings also currently allow some private businesses to deny the benefit (Women's Health Policy Report, 9/19/14).

Report Details

For the report, researchers from KFF and the Lewin Group conducted a survey of 20 insurers located in California, Georgia, Michigan, New Jersey and Texas.

The report examined "coverage of emergency contraception; hormonal implants; hormonal injections; hormonal patches; the intrauterine device, or IUD; vaginal rings; and sterilization." It did not examine coverage for oral contraceptives, which are the "most popular form" of contraception among those who use birth control, according to Huffington Post.

Key Findings

The researchers found that "[f]or many women, the ACA's contraceptive coverage provision has reduced their health care out-of-pocket costs and given them the opportunity to use more effective but more costly methods of contraception that had been unaffordable to them in the past." However, they added that for some women, "their choice of plan may still result in limitations of their contraceptive options."

For example, the report found that the brand-name vaginal ring NuvaRing was the contraceptive method least likely to be covered by the insurers with no cost sharing. According to the report, five of the 20 insurers only covered NuvaRing with cost sharing, while one did not cover the method.

In addition, researchers found that insurers that did not provide coverage for methods such as hormonal implants, hormonal injections, hormonal patches or vaginal rings said they did not do so because they covered oral contraceptives that deliver the same hormones (Huffington Post, 4/16). However, HHS officials have said that because they are different types of methods, they all must be covered (Women's Health Policy Report, 2/6).

Further, the report found that it was very difficult "to ascertain the limits on contraceptive coverage used by different carriers." The researchers wrote that "[t]he contraceptive coverage policies used by health insurance carriers were not easily accessible" and that such "information is even more opaque in many of the plan materials available to policyholders."

Meanwhile, the researchers also found that many insurers had not established an appeals system for women to gain access to certain methods if they are denied by insurers. Insurers are required to establish such a system under the ACA, according to the Post (Huffington Post, 4/16).

Reaction

HHS spokesperson Katie Hill said the agency "plan[s] to release more guidance soon" on women's contraceptive access under the ACA, noting, "The [Obama] [a]dministration strongly supports ensuring that women can access contraceptive services as authorized by the women's preventive services provision in the" law (Kliff, Vox, 4/16).

Meanwhile, Planned Parenthood Federation of America President Cecile Richards in a statement said the report demonstrated "that while many women are receiving their birth control without a copay, some insurance companies are not covering the full range [of] methods as required by the" ACA.

She added that Planned Parenthood "encourage[s] the [Obama] administration to provide guidance and clarity to insurance companies to ensure all women can access the birth control methods that work for them without cost barriers, as the law intended" (Planned Parenthood statement, 4/16).


Op-Ed: 'Latest Wave' of Antiabortion-Rights Laws 'Based on Bad Medicine'

Thu, 04/23/2015 - 15:44

"The latest wave of state legislation to restrict abortion access is based on bad medicine and would prevent doctors from providing medical care based on their judgment of what's best for each patient," Vanessa Cullins, vice president for external medical affairs at Planned Parenthood Federation of America, writes in an opinion piece for The Hill's "Congress Blog."

Op-Ed: 'Latest Wave' of Antiabortion-Rights Laws 'Based on Bad Medicine'

April 21, 2015 — "The latest wave of state legislation to restrict abortion access is based on bad medicine and would prevent doctors from providing medical care based on their judgment of what's best for each patient," Vanessa Cullins, vice president for external medical affairs at Planned Parenthood Federation of America, writes in an opinion piece for The Hill's "Congress Blog."

For example, Cullins cites an Arizona law (SB 1318) that "forces doctors to tell women medication abortion can be reversed (which is simply untrue)" and measures in Kansas (SB 95) and Oklahoma (HB 1721) "that ban abortion methods that are proven to be safe and effective."

Cullins writes that, "[a]ccording to the [CDC] and decades of research, abortion is one of the safest medical procedures performed in the United States," with "a 99 percent safety record." However, she notes that despite this fact, "some politicians have worked for years to pass laws they say are meant to enhance women's health and safety, but in fact do the opposite," such as "laws that put restrictions on abortion providers that serve no medical purpose."

Cullins notes several examples, including a law (HB 2) in Texas that "forced dozens of health centers providing safe and quality care to close" and a measure in Wisconsin (Act 37) that was "blocked by a federal judge who held the law would impose significant health risks on women in Wisconsin by significantly limiting access to legal abortions in that state." Meanwhile, she notes that other such laws "require doctors to use inferior, outdated and less effective protocols for early abortions provided by medication."

"Today abortion is safe, but we know it is safe because it is legal," Cullins writes, explaining that because the procedure is legal, it can be "taught in medical schools," "subject to ongoing research" and "subject to rigorous standards with multiple layers of oversight."

She contends that lawmakers "who are pushing bad medicine in the halls of Congress and state legislatures are on the wrong side of the medical community [and] of the American people," adding that should their efforts succeed, "it's [her] very real fear that the health of women across America ... will suffer again as it did many years ago" (Cullins, "Congress Blog," The Hill, 4/17).


Senate Passes Human Trafficking Bill, Moves Forward on Lynch Confirmation

Thu, 04/23/2015 - 15:43

The Senate on Wednesday voted 99-0 to pass a human trafficking bill (S 178) after reaching a compromise on antiabortion-rights language included in the legislation, The Hill's "Floor Action" reports.

Senate Passes Human Trafficking Bill, Moves Forward on Lynch Confirmation

April 23, 2015 — The Senate on Wednesday voted 99-0 to pass a human trafficking bill (S 178) after reaching a compromise on antiabortion-rights language included in the legislation, The Hill's "Floor Action" reports (Carney, "Floor Action," The Hill, 4/22).

The bill's approval clears the way for the Senate on Thursday to vote to confirm U.S. attorney general nominee Loretta Lynch, who was nominated more than five months ago (Peterson/Barrett, Wall Street Journal, 4/23). Senate Majority Leader Mitch McConnell (R-Ky.) repeatedly said the full Senate would not hold a confirmation vote until after the passage of the human trafficking measure.

Background on Human Trafficking Measure

The underlying legislation, proposed by Senate Majority Whip John Cornyn (R-Texas), includes various provisions aimed at curtailing human trafficking and targeting perpetrators. However, a dispute erupted over language from antiabortion-rights legislators that had been included in the bill.

Supporters of abortion rights who objected to the language said it would have expanded existing restrictions on abortion funding by permanently applying the Hyde Amendment to a survivors' compensation fund, which is financed by fines and penalties paid by convicted federal offenders. Meanwhile, lawmakers who oppose abortion rights had refused to remove the language from the bill.

Agreement Details

Under negotiations led by Sen. Patty Murray (D-Wash.) and Cornyn, the survivors' compensation fund would include two separate pools of money. One pool, with funds collected from criminal fines, would be deposited into the Department of the Treasury's general fund to provide survivors with non-medical services.

Meanwhile, a separate pool of money to provide health care services to survivors would come from funds that had previously been appropriated for community health centers. Such funds are already subject to the Hyde Amendment. The Hyde Amendment includes exemptions for instances of rape and incest and endangerment to the woman's life.

Senate Approves, Rejects Amendments

The Senate on Wednesday also voted on several amendments to the legislation (Women's Health Policy Report, 4/22).

The Senate approved a couple of amendments, including one that requires treating trafficked minors as victims of a crime (Amundson, Forum News Service/Duluth News Tribune, 4/22). Meanwhile, lawmakers voted 43-55 to reject another amendment, proposed by Sen. Patrick Leahy (D-Vt.), that would have removed completely the Hyde language from the measure (Bendery, Huffington Post, 4/22).


Fla. House Advances 24-Hour Mandatory Delay Bill

Thu, 04/23/2015 - 14:47

The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports.

Fla. House Advances 24-Hour Mandatory Delay Bill

April 23, 2015 — The Florida House on Wednesday voted 77-41 to advance a bill (HB 633) that would require a 24-hour mandatory delay period before a woman can have an abortion, the Tallahassee Democrat reports (Cotterell, Tallahassee Democrat, 4/22).

The state Senate is set to take up an identical bill (SB 724) on Thursday (Menzel, News Service of Florida/CBS Miami, 4/22). Through a procedural move, the state Senate is expected to substitute its measure for the House bill before voting on its final passage. According to the Democrat, the state Senate's approval of the measure "appears certain" (Tallahassee Democrat, 4/22).

Bill Details

The bill, proposed by state Rep. Jennifer Sullivan (R), would require a woman to meet in person with a physician at least 24 hours prior to having an abortion (Women's Health Policy Report, 4/3). According to the Democrat, Florida already requires women to receive counseling from a physician prior to the procedure (Tallahassee Democrat, 4/22).

The state House on Tuesday approved an amendment to the legislation to waive the delay for women who are survivors of rape, incest, human trafficking or domestic violence. However, the exemptions would only be provided if women could produce certain documentation, such as medical records, police reports or restraining orders (News Service of Florida/CBS Miami, 4/22).

Comments

Sullivan said the legislation is intended to "empower[r] women."

However, state House Minority Leader Mark Pafford (D) said, "The presumption that there has not already been 24 hours to make that decision is perplexing to me," adding, "This is an example of government intrusion" (Sweeney, South Florida Sun-Sentinel, 4/23).

Meanwhile, state Rep. Victor Torres (D) criticized the documentation requirement for waiving the mandatory delay. He said, "As a retired cop, I look at the victim of rape, the victim who is violated by a family member. You think she's going to have documentation? She's going to run to the police and report it?" (McGrory, Tampa Bay Times, 4/22).

Several state lawmakers who support abortion rights also said the measure, if made law, likely would be challenged on constitutional grounds in the courts. According to the Sun-Sentinel, the Florida Constitution requires laws that invade individuals' privacy to be as unobtrusive and narrow as feasible, a more stringent standard than the U.S. Constitution.

State Rep. Lori Berman (D) said, "Requiring two in-person visits with a doctor is far from the least intrusive means necessary" (South Florida Sun-Sentinel, 4/23).


Senate Passes Human Trafficking Bill, Moves Forward on Lynch Confirmation

Thu, 04/23/2015 - 14:44

The Senate on Wednesday voted 99-0 to pass a human trafficking bill (S 178) after reaching a compromise on antiabortion-rights language included in the legislation, The Hill's "Floor Action" reports.

Senate Passes Human Trafficking Bill, Moves Forward on Lynch Confirmation

April 23, 2015 — The Senate on Wednesday voted 99-0 to pass a human trafficking bill (S 178) after reaching a compromise on antiabortion-rights language included in the legislation, The Hill's "Floor Action" reports (Carney, "Floor Action," The Hill, 4/22).

The bill's approval clears the way for the Senate on Thursday to vote to confirm U.S. attorney general nominee Loretta Lynch, who was nominated more than five months ago (Peterson/Barrett, Wall Street Journal, 4/23). Senate Majority Leader Mitch McConnell (R-Ky.) repeatedly said the full Senate would not hold a confirmation vote until after the passage of the human trafficking measure.

Background on Human Trafficking Measure

The underlying legislation, proposed by Senate Majority Whip John Cornyn (R-Texas), includes various provisions aimed at curtailing human trafficking and targeting perpetrators. However, a dispute erupted over language from antiabortion-rights legislators that had been included in the bill.

Supporters of abortion rights who objected to the language said it would have expanded existing restrictions on abortion funding by permanently applying the Hyde Amendment to a survivors' compensation fund, which is financed by fines and penalties paid by convicted federal offenders. Meanwhile, lawmakers who oppose abortion rights had refused to remove the language from the bill.

Agreement Details

Under negotiations led by Sen. Patty Murray (D-Wash.) and Cornyn, the survivors' compensation fund would include two separate pools of money. One pool, with funds collected from criminal fines, would be deposited into the Department of the Treasury's general fund to provide survivors with non-medical services.

Meanwhile, a separate pool of money to provide health care services to survivors would come from funds that had previously been appropriated for community health centers. Such funds are already subject to the Hyde Amendment. The Hyde Amendment includes exemptions for instances of rape and incest and endangerment to the woman's life.

Senate Approves, Rejects Amendments

The Senate on Wednesday also voted on several amendments to the legislation (Women's Health Policy Report, 4/22).

The Senate approved a couple of amendments, including one that requires treating trafficked minors as victims of a crime (Amundson, Forum News Service/Duluth News Tribune, 4/22). Meanwhile, lawmakers voted 43-55 to reject another amendment, proposed by Sen. Patrick Leahy (D-Vt.), that would have removed completely the Hyde language from the measure (Bendery, Huffington Post, 4/22).


Guttmacher: More School-Based Health Centers Should Provide Birth Control

Thu, 04/23/2015 - 14:41

More school-based health centers should provide contraceptives, which have been a major driver of recent declines in the teen pregnancy rate, according to a new Guttmacher Institute analysis, The Hill reports.

Guttmacher: More School-Based Health Centers Should Provide Birth Control

April 23, 2015 — More school-based health centers should provide contraceptives, which have been a major driver of recent declines in the teen pregnancy rate, according to a new Guttmacher Institute analysis, The Hill reports.

Key Findings

The analysis, written by Guttmacher Director of Public Policy Heather Boonstra, found that the teenage pregnancy rate has declined to 57 per 1,000 women, marking the lowest rate in 40 years. It said the decline "is overwhelmingly due to improved contraceptive use and use of more effective methods." However, the analysis also found that only 37% of school-based health centers provide male condoms, while only 26% provide oral contraceptives.

According to the analysis, one major obstacle to such contraceptive access is that state or local governments prohibit about half of the roughly 1,900 school-based health centers in the U.S. from providing contraceptives. However, the figure marks an improvement compared with 1998, when state and local governments prohibited nearly 80% of such health centers from providing birth control.

In addition, the analysis countered objections to teenagers being able to access birth control at school-based health centers. For example, it noted that there is no evidence that access to contraceptives increases the percentage of teenagers who engage in sexual activity (Sullivan, The Hill, 4/21). Further, the analysis said parents often are involved in oversight and planning at school-based health centers (Boonstra, Guttmacher Policy Review, Winter 2015).

The analysis urged Congress to provide more funds for school-based health centers. According to The Hill, the Affordable Care Act (PL 111-148) provided federal funds for the centers in 2010, but the funding expired in 2013. The analysis cited a bill (HR 2632), by Rep. Lois Capps (D-Calif.), that would have provided such funding through 2019.

Boonstra said in a statement, "School-based health centers can play a key role in addressing teen pregnancy, and failing to provide contraceptive services on-site, for whatever reason, is self-defeating." She added, "We know contraception has been the main driver of the steep decline in the U.S. teen pregnancy rate, which is why it's so important to give students easy access to the information and services they need" (The Hill, 4/21).


La. Officials Publish Final Version of Revamped Abortion Clinic Regulations

Thu, 04/23/2015 - 14:38

Louisiana's Department of Health and Hospitals this week published the final version of updated licensing standards for abortion clinics, AP/ABC News reports.

La. Officials Publish Final Version of Revamped Abortion Clinic Regulations

April 23, 2015 — Louisiana's Department of Health and Hospitals this week published the final version of updated licensing standards for abortion clinics, AP/ABC News reports.

According to AP/ABC News, the finalized regulations are not substantively different than changes that were proposed in December 2014. Those changes garnered more than 1,800 public comments opposed to the proposed regulations (DeSlatte, AP/ABC News, 4/21).

Background

In February, the state DHH said the then-proposed regulations would revise current rules to accommodate several recently enacted laws and would outline clearly the state's clinic licensing and staffing requirements. If the clinics do not comply, they could face closure. Among other rules, clinics must maintain detailed records of "every 'job skill' of every employee" and annual employee evaluations on the specific job skills.

DHH spokesperson Olivia Watkins acknowledged that some of the new requirements "are outside of the specific legislative mandates" (Women's Health Policy Report, 2/2).

Reaction

Melissa Flournoy, the state's director for Planned Parenthood Gulf Coast, said her group is "deeply disappointed that [its] call[s] for regulations based on medicine were ignored." She said Louisiana Gov. Bobby Jindal's (R) "administration has instead decided to risk patient health and safety by imposing further restrictions on a woman's ability to have a safe, legal abortion in" the state.

According to AP/ABC News, it is not clear whether anyone will challenge the final rules in court. Jewel Bush, a spokesperson for PPGC, said the group "is committed to protecting access to safe, legal abortion and views this as an urgent situation, and ... will explore all options" (AP/ABC News, 4/21).


States Increasingly Passing Antiabortion-Rights Bills Based on 'Junk,' 'Unsubstantiated Science'

Wed, 04/22/2015 - 18:04

This year's legislative session "is shaping up to be a primer in what abortion rights advocates call 'junk science,'" with state lawmakers across the U.S. passing measures "based on theories that have been called into question or debunked by the wider medical community," the Los Angeles Times reports.

States Increasingly Passing Antiabortion-Rights Bills Based on 'Junk,' 'Unsubstantiated Science'

April 22, 2015 — This year's legislative session "is shaping up to be a primer in what abortion rights advocates call 'junk science,'" with state lawmakers across the U.S. passing measures "based on theories that have been called into question or debunked by the wider medical community," the Los Angeles Times reports.

Montana 'Fetal Anesthesia' Measure

For example, the Times notes that Montana lawmakers have sent a bill (HB 479) to Gov. Steve Bullock (D) that would require anesthesia to be administered to fetuses before abortions if the woman is at least 20 weeks pregnant. It would allow women to refuse the fetal anesthesia after being told the disputed notion that a fetus is capable of feeling pain during a surgery or abortion.

However, according to the Times, an analysis of studies on fetal pain published in 2005 in the Journal of the American Medical Association found that "'evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before'" about 27 weeks' gestation. It said that there was "little or no evidence" to determine the effectiveness of fetal anesthesia or the safety of the procedure "for pregnant women in the context of abortion."

Meanwhile, the American Congress of Obstetricians and Gynecologists in 2012 said subsequent studies published after the JAMA analysis have not "changed this dominant view of the medical profession."

Medication Abortion 'Reversal' Laws

The Times also cites laws in Arkansas (Act 1086) and Arizona (SB 1318) that will require physicians to tell women seeking medication abortions the medically unproven claim that it might be possible for such abortions to be "reversed" by receiving a dose of progesterone after taking mifepristone.

George Delgado, a proponent of the theory and family physician based in California, defended his research into the procedure. "This hasn't been published yet, but it will be," he said, adding, "You can't call it junk science. It's early science."

However, according to the Times, ACOG has said claims that medication abortions can be reversed are "'not supported by the body of scientific evidence.'"

Similarly, Daniel Grossman, a clinical instructor in the University of California-San Francisco's department of obstetrics, gynecology and reproductive sciences, said telling women that there was scientific evidence of the possibility of reversing a medication abortion "would be medically incorrect."

Additional Laws

The Times also notes a new Idaho law (HB 154) will require physicians to be physically present when administering medication abortion drugs based on the disputed claim that using telemedicine for such abortions is risky and unproven.

Meanwhile, laws passed in Kansas (SB 95) and Oklahoma (HB 1721) this year "outlawed what is widely viewed as the safest method of surgical abortion in the second trimester."

Advocates Blast Medically Unproven Laws, Measures

Elizabeth Nash, a policy analyst at the Guttmacher Institute, criticized the medically unfounded laws and measures. "We're seeing more unsubstantiated science. The problem is that legislators are buying into it and using it," she said. In particular, she said the bans such as those in Kansas and Oklahoma were "essentially [about] limiting access to abortion after 12 or 14 weeks."

Separately, Rachel Sussman, director of state policy for Planned Parenthood Federation of America, said of such legislative efforts, "You cannot exist in a world where you care about women's health and safety and require doctors to tell women things that are medically untrue" (La Ganga, Los Angeles Times, 4/20).