Daily Women's Health Policy Report

  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
  • : preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /usr/www/users/simps90n/includes/unicode.inc on line 311.
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Syndicate content
Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 43 min 54 sec ago

ACLU Files Suit Against Ala. Admitting Privileges Law To Protect Sole Tuscaloosa Clinic

Wed, 07/15/2015 - 11:56

The American Civil Liberties Union and the ACLU of Alabama on Friday filed a federal suit against a state antiabortion-rights law (HB 57) to prevent the sole clinic in Tuscaloosa from closing, WSFA 12 News reports.

ACLU Files Suit Against Ala. Admitting Privileges Law To Protect Sole Tuscaloosa Clinic

July 15, 2015 — The American Civil Liberties Union and the ACLU of Alabama on Friday filed a federal suit against a state antiabortion-rights law (HB 57) to prevent the sole clinic in Tuscaloosa from closing, WSFA 12 News reports (WSFA 12 News, 7/11).

Background

The law mandates that abortion clinics must meet the same building standards as ambulatory surgical centers. The law also requires that abortion providers have admitting privileges at nearby hospitals (Women's Health Policy Report, 10/24/14). Alternatively, clinics can arrange a written agreement with a local physician who has admitting privileges (WSFA, 7/11).

Three Alabama abortion clinics, Reproductive Health Services in Montgomery and Planned Parenthood Southeast health centers in Birmingham and Mobile, filed suit challenging the law in 2013.

A federal judge temporarily blocked the law shortly after the lawsuit was filed, later issuing an opinion that struck down the admitting privileges requirement as applied to the plaintiffs in August 2014 (Mason Pieklo, RH Reality Check, 7/13). The state has appealed to the 11th U.S. Circuit Court of Appeals (Women's Health Policy Report, 10/24/14).

Lawsuit Details

ACLU filed a new lawsuit on behalf of the West Alabama Women's Center and Willie Parker, a physician who provides abortion care at the clinic. According to the lawsuit, the law's admitting privileges requirement could force the clinic to close. The plaintiffs said the sole hospital in Tuscaloosa "is unwilling to grant Dr. Parker [admitting] privileges for reasons unrelated to his competency as an abortion provider" (RH Reality Check, 7/13). The plaintiffs added that the regulations are aimed exclusively at abortion providers and do not include physicians who provide different office-based medical procedures that are less safe.

In addition, ACLU noted that the Tuscaloosa clinic provides about 40% of abortions in the state and is one of only two clinics in the state that offer abortion services for women in their second trimester of pregnancy (WSFA 12 News, 7/11).


Judge Extends Restraining Order to Block Tenn. Law

Mon, 07/13/2015 - 15:51

A federal judge in Tennessee on Thursday extended a temporary restraining order blocking a state law (SB 1280) from taking effect that would require abortion clinics in the state to be licensed as ambulatory surgical centers, allowing two clinics to remain open, WBIR reports.

Judge Extends Restraining Order to Block Tenn. Law

July 13, 2015 — A federal judge in Tennessee on Thursday extended a temporary restraining order blocking a state law (SB 1280) from taking effect that would require abortion clinics in the state to be licensed as ambulatory surgical centers, allowing two clinics to remain open, WBIR reports (Barchenger, WBIR, 7/9).

Background

The law, which was scheduled to take effect on July 1, would require all facilities or physician offices that perform more than 50 surgical abortions annually to be licensed as ambulatory surgical centers.

Four of the six abortion clinics in the state that provide surgical abortions currently meet the licensing standards, while a fifth provider, in Knoxville, only provides medication abortion and is, therefore, not subject to the requirement. Bristol Regional Women's Center and the Women's Center in Nashville are the two remaining clinics that provide surgical abortions and are not licensed as ambulatory surgical centers.

Lawsuit Details

The Center for Reproductive Rights last month filed a lawsuit against three antiabortion-rights laws, including the ambulatory surgical licensing requirement, in Tennessee on behalf of three abortion clinics and an ob-gyn in the state. CRR filed suit on behalf of Bristol Regional Women's Center; the Women's Center in Nashville; CHOICES, the Memphis Center for Reproductive Health; and Wesley Adams, an ob-gyn who provides abortion care at the Bristol and Nashville clinics.

CRR asked the court to block the ambulatory surgical center requirement while the lawsuit against all three laws continues. According to lawsuit, the Bristol and Nashville clinics risk closure because they do not meet the ambulatory surgical center standards.

In June, U.S. District Judge Kevin Sharp blocked the ambulatory surgical center requirement and said he would decide at the July 9 hearing about whether to extend the injunction. The injunction did not apply to the two other laws being challenged, including an admitting privileges requirement enacted in 2012 and a 48-hour mandatory delay (SB 1222) that went into effect on July 1 (Women's Health Policy Report, 6/29).

Extension Details

In his order Thursday, Sharp told the state licensing board to work with the clinics to resolve the issue outside of court.

According to WBIR, if they are unable to reach a resolution outside of court, they will return to court Aug. 10 to discuss the possibility of a preliminary injunction (WBIR, 7/9).


House Approves 21st Century Cures Act With Hyde Language

Mon, 07/13/2015 - 14:36

The House last week voted 344-77 to advance a medical research bill (HR 6) that includes an abortion restriction, despite opposition from lawmakers who support abortion rights, CQ Roll Call's "218" reports.

House Approves 21st Century Cures Act With Hyde Language

July 13, 2015 — The House last week voted 344-77 to advance a medical research bill (HR 6) that includes an abortion restriction, despite opposition from lawmakers who support abortion rights, CQ Roll Call's "218" reports (Khurshid, "218," CQ Roll Call, 7/10).

Bill Details

The underlying bill, called the 21st Century Cures Act, is a broad measure that aims to accelerate the development and regulatory approval of medical innovations (Sullivan/Ferris, The Hill, 7/10).

According to The Hill, lawmakers who oppose abortion rights added in language that would expand the Hyde Amendment, which prohibits federal funds from being used for abortion care. Specifically, Diana DeGette (D-Colo.), who opposed the addition, said lawmakers included the provision after the underlying bill passed committee by adding the "annual riders from the Labor-HHS bill" (Ferris, The Hill, 7/9). The Hyde Amendment has been included in appropriations measures since 1976 (Women's Health Policy Report, 7/9).

The Senate is working on its own version of the measure and bill supporters in the House have expressed hope for a vote in the fall (The Hill, 7/10).

Abortion-Rights Supporters Voice Opposition to Hyde Language

According to "218," Rep. Barbara Lee (D-Calif.) introduced an amendment to strike the antiabortion-rights language ("218," CQ Roll Call, 7/10). The amendment garnered support from 176 lawmakers but failed to pass (The Hill, 7/10). Of those supporters, seven voted against the underlying bill.

Jerrold Nadler (D-N.Y.), one of the lawmakers who voted against the underlying bill, said, "I am voting today to … say 'no more' to the [conservative] contempt for women's, doctor's and scientist's right to make their own personal, professional or intellectual choices" ("218," CQ Roll Call, 7/10).

Meanwhile, Rep. Jackie Speier (D-Calif.) voiced concerns about how the Hyde language was included, noting that it was added to the bill "in the dead of night." She said, "I cannot stand by while these provisions are slipped into an otherwise excellent bill through underhanded maneuvers that run contrary to our democratic process."

Rosa DeLauro (D-Conn.), who also opposed the abortion rider, said, "The majority is yet again using this bill as a vehicle for [the] anti-choice Hyde Amendment" (The Hill, 7/9).


LA Times Op-Ed Discredits Opponents' Arguments Against Federal Contraceptive Coverage Rules

Mon, 07/13/2015 - 14:31

In a Los Angeles Times opinion piece, columnist Jon Healey calls for critics of the Affordable Care Act's (PL 111-148) contraceptive coverage rules "to drop the pretense," writing that opponents' challenges to the rules are "no longer about employers being required to pay for contraceptives" but rather "about employees being able to obtain them."

LA Times Op-Ed Discredits Opponents' Arguments Against Federal Contraceptive Coverage Rules

July 13, 2015 — In a Los Angeles Times opinion piece, columnist Jon Healey calls for critics of the Affordable Care Act's (PL 111-148) contraceptive coverage rules "to drop the pretense," writing that opponents' challenges to the rules are "no longer about employers being required to pay for contraceptives" but rather "about employees being able to obtain them."

According to Healy, under "final rules released Friday, like the ones that have been in effect since last August ... religious-affiliated nonprofits and closely held for-profit firms [have] an easy way to disassociate themselves completely from their employees' use of birth control." He explains that eligible "[e]mployers simply have to notify" HHS that they offer insurance and "have a religious objection to providing contraceptive coverage." HHS then "instructs the employer's insurer to provide contraceptive coverage to the firm's female employees at no out-of-pocket cost," which means that the "coverage is paid for by the insurer" or a third-party administrator.

Despite the accommodation, "some opponents of the rules continue to claim that they are being forced to promote actions that are, to them, immoral," Healey writes. However, he notes that "by the same logic, religious employers are helping to execute prisoners, grant divorces and issue marriage licenses to gay couples simply by paying sales taxes to state and local governments." He writes, "In other words, money is fungible. If you're trying to insulate yourself from other people's behavior, the best you can hope to do is make sure you're not paying for it directly."

Further, Healey contends that "it's fallacious to argue that employers are forced to be complicit in their workers' use of contraceptives." He explains that the contraceptive coverage rules were put in place by the federal government, "which requires that all adult women carry insurance policies that make contraceptives available at no extra charge -- and that all large employers provide such plans."

"Five federal appeals courts have noted the fallacy in the employers'" legal challenges to the rules, Healy writes. However, he notes that "[t]he Supreme Court is still reviewing similar cases, so the circuit rulings may not be the final word on the subject" (Healey, Los Angeles Times, 7/11).


Medicare To Cover Joint Pap Test and HPV Testing

Mon, 07/13/2015 - 13:52

CMS in a final coverage decision released Thursday said Medicare will now cover for women joint Pap tests and human papillomavirus testing to screen for cervical cancer every five years.

Medicare To Cover Joint Pap Test and HPV Testing

July 13, 2015 — CMS in a final coverage decision released Thursday said Medicare will now cover for women joint Pap tests and human papillomavirus testing to screen for cervical cancer every five years, Modern Healthcare reports (Dickson, Modern Healthcare, 7/9).

Background

Previously, Medicare covered a Pap test and pelvic exam every 12 or 24 months for all female beneficiaries. The program did not cover HPV testing.

In April, CMS in a proposed coverage expansion memo recommended that Medicare cover HPV testing every five years -- in conjunction with Pap tests -- for female beneficiaries ages 30 to 65. The proposal followed an analysis CMS conducted last year on expanding such coverage among Medicare's younger beneficiaries, who are eligible for Medicare because of disabilities.

The proposal aligns with guidelines released by the U.S. Preventive Services Task Force in March 2012 (Women's Health Policy Report, 4/20).

Coverage Details

CMS in the coverage notice wrote the agency "determined that the evidence is sufficient to add HPV testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic beneficiaries aged 30 to 65 years in conjunction with the Pap smear test."

CMS did not disclose whether it performed an analysis of how much the expended coverage will cost. According to Modern Healthcare, Pap tests usually cost around $40 per test, while HPV tests usually cost $50 to $100 (Dickson, Modern Healthcare, 7/9).


Judge Extends Restraining Order to Block Tenn. Law

Mon, 07/13/2015 - 13:49

A federal judge in Tennessee on Thursday extended a temporary restraining order blocking a state law (SB 1280) from taking effect that would require abortion clinics in the state to be licensed as ambulatory surgical centers, allowing two clinics to remain open, WBIR reports.

Judge Extends Restraining Order to Block Tenn. Law

July 13, 2015 — A federal judge in Tennessee on Thursday extended a temporary restraining order blocking a state law (SB 1280) from taking effect that would require abortion clinics in the state to be licensed as ambulatory surgical centers, allowing two clinics to remain open, WBIR reports (Barchenger, WBIR, 7/9).

Background

The law, which was scheduled to take effect on July 1, would require all facilities or physician offices that perform more than 50 surgical abortions annually to be licensed as ambulatory surgical centers.

Four of the six abortion clinics in the state that provide surgical abortions currently meet the licensing standards, while a fifth provider, in Knoxville, only provides medication abortion and is, therefore, not subject to the requirement. Bristol Regional Women's Center and the Women's Center in Nashville are the two remaining clinics that provide surgical abortions and are not licensed as ambulatory surgical centers.

Lawsuit Details

The Center for Reproductive Rights last month filed a lawsuit against three antiabortion-rights laws, including the ambulatory surgical licensing requirement, in Tennessee on behalf of three abortion clinics and an ob-gyn in the state. CRR filed suit on behalf of Bristol Regional Women's Center; the Women's Center in Nashville; CHOICES, the Memphis Center for Reproductive Health; and Wesley Adams, an ob-gyn who provides abortion care at the Bristol and Nashville clinics.

CRR asked the court to block the ambulatory surgical center requirement while the lawsuit against all three laws continues. According to lawsuit, the Bristol and Nashville clinics risk closure because they do not meet the ambulatory surgical center standards.

In June, U.S. District Judge Kevin Sharp blocked the ambulatory surgical center requirement and said he would decide at the July 9 hearing about whether to extend the injunction. The injunction did not apply to the two other laws being challenged, including an admitting privileges requirement enacted in 2012 and a 48-hour mandatory delay (SB 1222) that went into effect on July 1 (Women's Health Policy Report, 6/29).

Extension Details

In his order Thursday, Sharp told the state licensing board to work with the clinics to resolve the issue outside of court.

According to WBIR, if they are unable to reach a resolution outside of court, they will return to court Aug. 10 to discuss the possibility of a preliminary injunction (WBIR, 7/9).


Wis. Assembly Sends 20-Week Abortion Ban to Governor

Mon, 07/13/2015 - 10:24

The Wisconsin Assembly on Thursday voted 61-34 to approve a bill (S 179) that would ban abortion at 20 weeks of pregnancy, Reuters reports.

Wis. Assembly Sends 20-Week Abortion Ban to Governor

July 10, 2015 — The Wisconsin Assembly on Thursday voted 61-34 to approve a bill (S 179) that would ban abortion at 20 weeks of pregnancy, Reuters reports.

The state Senate approved the bill in June. A spokesperson for Gov. Scott Walker (R) has said the governor will sign the measure (O'Brien, Reuters, 7/9).

Bill Details

Current state law bans abortion after fetal viability, which is estimated to be at about 24 weeks.

The legislation is based on the unfounded notion that a fetus can feel pain at that point of development. The American Congress of Obstetricians and Gynecologists has said there is no legitimate scientific evidence showing that fetuses are capable of feeling pain at 20 weeks.

Physicians who violate the ban could face felony charges, fines of up to $10,000 and potential jail time of up to three years and six months. In addition, a woman who received an abortion after 20 weeks could sue the physician who performed the abortion for damages. The man involved in the pregnancy also would be allowed to sue the physician, except in cases in which the pregnancy was the result of rape or incest.

Further, the bill would require physicians to tell women the probable post-fertilization age of the fetus and estimate the probability of the fetus surviving outside of the womb. It would also require doctors to tell women that perinatal hospice care is available for infants who are expected to live short lives. State law already requires physicians to tell women seeking abortions the fetus' likely gestational age in writing and orally (Women's Health Policy Report, 6/10).

According to the AP/Minneapolis Star Tribune, the measure permits physicians to perform abortions after 20 weeks of pregnancy if a woman likely will experience permanent injuries or die within 24 hours. The bill does not include exceptions for instances of rape or incest (Richmond, AP/Minneapolis Star Tribune, 7/9).

Implications

According to the Guttmacher Institute, the bill, if signed, will make Wisconsin the 13th state with a 20-week ban.

However, in May, the 9th U.S. Circuit Court of Appeals ruled that a 20-week abortion ban in Idaho was unconstitutional (Reuters, 7/9). Similar bans have been blocked in Arizona and Georgia, while a federal appeals court in May ruled that a 12-week ban in Arkansas also was unconstitutional (AP/Minneapolis Star Tribune, 7/9).


HHS Finalizes Accommodations to Federal Contraceptive Coverage Rules

Fri, 07/10/2015 - 19:21

HHS on Friday released regulations on the federal contraceptive coverage rules to help ensure that women who work for certain companies that object to providing such coverage will be able to access contraception without copayments, The Hill reports.

HHS Finalizes Accommodations to Federal Contraceptive Coverage Rules

July 10, 2015 — HHS on Friday released regulations on the federal contraceptive coverage rules to help ensure that women who work for certain companies that object to providing such coverage will be able to access contraception without copayments, The Hill reports (Ferris, The Hill, 7/10).

Background

The contraceptive coverage rules, which are being implemented under the Affordable Care Act (PL 111-148), require most employers to offer contraceptive coverage in their employer-sponsored health plans. Houses of worship are exempt from the requirement, and not-for-profits that hold themselves out as religious and oppose contraception are eligible for an accommodation that ensures they do not have to pay for or directly provide the coverage to their employees (Women's Health Policy Report, 6/30/14).

Specifically, the accommodation for not-for-profits that hold themselves out as religious and oppose contraception allows such organizations to notify their insurers or third-party administrators of their objection so the insurers or third-party administrators can facilitate contraceptive coverage for members of their health plans. To claim the accommodation, the not-for-profits can either complete a form to send to the insurers or third-party administrators or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans (Women's Health Policy Report, 8/22/14).

Final Regulations

Among other rules, the regulations released Friday finalize that not-for-profits that hold themselves out as religious and oppose contraception can seek a religious accommodation by submitting a letter to their insurers or third-party administrators or by notifying HHS of their opposition (CMS fact sheet, 7/10). HHS will then inform the insurers or third-party administrators so that people insured by such employers can receive contraceptive coverage without copays and at no additional cost or involvement by the objecting organization.

In addition, the rules respond to the Supreme Court's ruling in Hobby Lobby (HHS press release, 7/10). In that ruling, the high court held that closely held corporations cannot be required to provide contraceptive coverage to their employees if the corporations' owners have religious objections to contraception (Women's Health Policy Report, 6/30/14).

Specifically, the rules extend to eligible for-profit companies the same accommodation given to not-for-profits that hold themselves out as religious and oppose contraception (HHS press release, 7/10). Companies only are eligible if they are not publicly traded and if at least 50% of the company is owned by no more than five people, with family members counting as one individual (Gerson Uffalussy, Yahoo! Health, 7/10). Further, the company's "highest governing body," such as its board of directors or owners, must adopt a formal statement on how it objects to providing contraceptive coverage because of its religious beliefs (CMS fact sheet, 7/10).

Comments

HHS Secretary Sylvia Mathews Burwell said the finalized regulations "secur[e] women's access to important preventive services at no additional cost under the [ACA], while respecting religious beliefs."

Sen. Patty Murray (D-Wash.) said, "Today's announcement allows a wide range of businesses power over the health care decisions of the women they employ, and shows once again why the Supreme Court's deeply harmful ruling in Burwell v. Hobby Lobby is completely unacceptable" (The Hill, 7/10).

Cecile Richards, president of Planned Parenthood Action Fund, noted, "While we are pleased that the Obama Administration is ensuring that women will get to keep birth control coverage regardless of their employers' personal beliefs, this accommodation shouldn't be necessary in the first place. A private company shouldn't be able to pick and choose what health care services they provide to their employees because they are women, LGBT, or any other class of people." She added, "The Supreme Court was wrong to allow companies to discriminate against their employees this way, and Congress needs to pass legislation to fix it" (Yahoo! Health, 7/10).

Meanwhile, according to National Journal, it "remains to be seen" whether companies that oppose contraception will accept the finalized accommodations. According to the Kaiser Family Foundation, courts currently are weighing more than 40 challenges to the rules, with many plaintiffs contending that the accommodations violate their religious freedom because contraception remains covered (Scott, National Journal, 7/10).


Universities Appeal to Supreme Court in Challenge to Contraceptive Coverage Rules

Fri, 07/10/2015 - 17:48

Several universities on Wednesday asked the Supreme Court to review a federal appeals court ruling that overturned an injunction against the federal contraceptive coverage rules, the Houston Chronicle reports.

Universities Appeal to Supreme Court in Challenge to Contraceptive Coverage Rules

July 10, 2015 — Several universities on Wednesday asked the Supreme Court to review a federal appeals court ruling that overturned an injunction against the federal contraceptive coverage rules, the Houston Chronicle reports.

According to the Chronicle, attorneys with the Becket Fund for Religious Liberty filed the appeal on behalf of Houston Baptist University, East Texas Baptist University and the Westminster Theological Seminary in Pennsylvania (Turner, Houston Chronicle, 7/8).

Background

The contraceptive coverage rules, which are being implemented under the Affordable Care Act (PL 111-148), require most employers to offer coverage to their workers. The rules include an exemption for houses of worship and an accommodation for not-for-profits that hold themselves out as religious and oppose contraception.

The accommodation enables such not-for-profits to notify their insurers or third-party administrators of their objection so the insurers or third-party administrators can facilitate contraceptive coverage for members of their health plans. To claim the accommodation, the not-for-profits may either complete a form to send to the insurers or third-party administrators or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans.

In December 2013, a federal judge granted East Texas Baptist and Houston Baptist a preliminary injunction against the mandate. The two universities had argued that the rules violate the Religious Freedom Restoration Act (PL 103-141).

In June, a three-judge panel of the 5th U.S. Circuit Court of Appeals overturned the decision granting the preliminary injunction and ruled that contraceptive coverage rules do not place a "substantial burden" on the organizations' exercise of religion because a third party is providing the contraceptives (Women's Health Policy Report, 6/24).


Blogs Comment on Proactive Abortion-Rights Bill, $1.4B in Contraceptive Cost Savings, More

Fri, 07/10/2015 - 16:36

Read the week's best commentaries from bloggers at the Center for American Progress' "ThinkProgress," RH Reality Check and more.

Blogs Comment on Proactive Abortion-Rights Bill, $1.4B in Contraceptive Cost Savings, More

July 10, 2015 — Read the week's best commentaries from bloggers at the Center for American Progress' "ThinkProgress," RH Reality Check and more.

ABORTION PROTECTIONS: "Members of Congress Introduce Groundbreaking Bill To Help More Women Afford Abortion," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": "A group of U.S. congressmembers ... introduced a landmark bill [HR 2972] on Wednesday" that "would restore insurance coverage for abortion services for women who rely on the government for their health care," among other abortion-rights protections, Culp-Ressler writes. According to Culp-Ressler, the measure "seeks to undo the Hyde Amendment, a policy dating back nearly four decades that bans taxpayer funding for abortion services," including for women in the Medicaid program. She writes that proposed measure is part of a "renewed" effort "to educate Americans about the harmful effects of the Hyde Amendment and convince U.S. lawmakers to finally revisit the decades-old abortion coverage restriction." Culp-Ressler cites Kierra Johnson -- URGE executive director and part of the All* Above All coalition -- noting that the "legislative push to finally repeal the Hyde Amendment represents where the movement for reproductive health is headed: Toward proactive efforts to meaningfully expand access to abortion, after years of weathering relentless attacks on the state and federal levels" (Culp-Ressler, "ThinkProgress," Center for American Progress, 7/8).

What others are saying about abortion protections:

~ "Unbowed, Undaunted, and Bold: Restoring Abortion Coverage and Achieving Reproductive Justice," Vania Leveille, American Civil Liberties Union's "Washington Markup."

CONTRACEPTION: "Contraceptive Pill Users Save $1.4 Billion on Birth Control After ACA Implementation," Andrea Grimes, RH Reality Check: "Americans who use birth control pills saved $1.4 billion on the cost of their contraception in 2013 after the implementation of the Affordable Care Act [PL 111-148], according to a new report published in the policy journal Health Affairs," Grimes writes. She adds, "In fact, out-of-pocket spending on most reversible contraceptive methods has gone down as of January 2013, and the savings are being passed on directly to families." According to Grimes, researchers "found that on average, contraceptive pill and [intrauterine device] users spent 20 percent less out-of-pocket on their chosen family planning methods post-ACA." She explains that while "[s]ome contraceptive brands are still not required to be covered by the ACA ... researchers found that their sample group -- nearly 800,000 women -- cut their pill expenses by 50 percent during the first half of 2013, and by 70 percent on [IUDs]." Grimes writes, "While researchers did not draw a direct causal relationship between the ACA and out-of-pocket contraception savings, the director of women's health policy at the Kaiser Family Foundation" said the "study was 'persuasive and consistent with what other studies are finding,' and that there was a 'clear pattern in the research'" (Grimes, RH Reality Check, 7/8).

What others are saying about contraception:

~ "Free IUD Programs Work. Why Are Conservatives Opposed to Them?" Amanda Marcotte, Slate's "The XX Factor."

~ "Beyond the IUD: What You Might Not Know About the Contraceptive Implant," Katharine Simmons, Feministing.

ABORTION STIGMA: "Google, AdBlade Bar Abortion Clinic From Advertising," Nina Liss-Schultz, RH Reality Check: "Abortion care services continue to be stonewalled by some of the web's most visited sites, as these Internet giants charge that abortion is not a family friendly topic," writes Liss-Schultz. According to Liss-Schultz, "[t]he refusal to use abortion-related ads continues even as providers push to remove the stigma from the procedure with unapologetic online advertisements." She writes that Google ran Washington, D.C., clinic Carafem's ads "for two weeks before finally rejecting them ... in an email to the clinic" citing a restriction on "'non-family safe' ads," even though "[a]bortion is not listed as an example of 'non-family safe' advertising" in the company's policies. As a result, the ads "will only appear in Google Search and never via Google Display ... which runs video and display ads on third-party sites." Similarly AdBlade, which "publishes ads on sites owned by ... Fox News, the Hearst Corporation, and McClatchy," rejected Carafem's ads "'due to the sensitivity of the topic,'" despite no mention of "abortion nor any other medical procedure" in their policies on ad restriction, Liss-Schultz writes. According to Liss-Schultz, Carafem Vice President Melissa Grant in response to the decisions said the clinic's ads are "'not flippant or outlandish'" but rather "a crucial aspect of the clinic's larger mission to break down the silence and taboo surrounding the procedure" (Liss-Schultz, RH Reality Check, 7/7).

REPRODUCTIVE JUSTICE: "New Study Shows Black Communities Want Clinic Access," Anita Little, Ms. Magazine blog: "As reproductive health services continue to be cut, especially in the South, low-income women and women of color will be disproportionately affected," Little writes. She cites a recent survey that finds "85 percent of black women and men agree that black women should be trusted to make their own reproductive choices, and 71 percent believe abortion should be available in their communities." The survey also found that "86 percent of African Americans see contraception, such as birth control pills, [intrauterine devices], Depo-Provera shots and diaphragms, as part of women's basic health care." However, Little notes, "As clinics shutter, black women not only lose access to abortion but also to the many other reproductive health services that clinics provide, such as [sexually transmitted infection] testing and cancer screenings" (Little, Ms. Magazine blog, 7/9).


Wis. Assembly Sends 20-Week Abortion Ban to Governor

Fri, 07/10/2015 - 16:33

The Wisconsin Assembly on Thursday voted 61-34 to approve a bill (S 179) that would ban abortion at 20 weeks of pregnancy, Reuters reports.

Wis. Assembly Sends 20-Week Abortion Ban to Governor

July 10, 2015 — The Wisconsin Assembly on Thursday voted 61-34 to approve a bill (S 179) that would ban abortion at 20 weeks of pregnancy, Reuters reports.

The state Senate approved the bill in June. A spokesperson for Gov. Scott Walker (R) has said the governor will sign the measure (O'Brien, Reuters, 7/9).

Bill Details

Current state law bans abortion after fetal viability, which is estimated to be at about 24 weeks.

The legislation is based on the unfounded notion that a fetus can feel pain at that point of development. The American Congress of Obstetricians and Gynecologists has said there is no legitimate scientific evidence showing that fetuses are capable of feeling pain at 20 weeks.

Physicians who violate the ban could face felony charges, fines of up to $10,000 and potential jail time of up to three years and six months. In addition, a woman who received an abortion after 20 weeks could sue the physician who performed the abortion for damages. The man involved in the pregnancy also would be allowed to sue the physician, except in cases in which the pregnancy was the result of rape or incest.

Further, the bill would require physicians to tell women the probable post-fertilization age of the fetus and estimate the probability of the fetus surviving outside of the womb. It would also require doctors to tell women that perinatal hospice care is available for infants who are expected to live short lives. State law already requires physicians to tell women seeking abortions the fetus' likely gestational age in writing and orally (Women's Health Policy Report, 6/10).

According to the AP/Minneapolis Star Tribune, the measure permits physicians to perform abortions after 20 weeks of pregnancy if a woman likely will experience permanent injuries or die within 24 hours. The bill does not include exceptions for instances of rape or incest (Richmond, AP/Minneapolis Star Tribune, 7/9).

Implications

According to the Guttmacher Institute, the bill, if signed, will make Wisconsin the 13th state with a 20-week ban.

However, in May, the 9th U.S. Circuit Court of Appeals ruled that a 20-week abortion ban in Idaho was unconstitutional (Reuters, 7/9). Similar bans have been blocked in Arizona and Georgia, while a federal appeals court in May ruled that a 12-week ban in Arkansas also was unconstitutional (AP/Minneapolis Star Tribune, 7/9).


Sen. Committee Passes Budget Measure Scrapping 'Global Gag Rule'

Fri, 07/10/2015 - 15:00

The Senate Appropriations Committee on Thursday voted 17-13 to add to a $49 billion State-Foreign Operations spending bill (SB 1725) an amendment that would repeal a policy barring U.S. aid from international groups that provide abortion services, CQ News reports.

Sen. Committee Passes Budget Measure Scrapping 'Global Gag Rule'

July 10, 2015 — The Senate Appropriations Committee on Thursday voted 17-13 to add to a $49 billion State-Foreign Operations spending bill (SB 1725) an amendment that would repeal a policy barring U.S. aid from international groups that provide abortion services, CQ News reports.

According to CQ News, the amendment was adopted with bipartisan support. The committee voted 27-3 to advance the underlying bill (Oswald, CQ News, 7/9).

'Global Gag Rule' Details

The policy, known as the "global gag rule" or the "Mexico City Policy," blocks U.S foreign aid to organizations that use their own money to offer abortion services or provide information about or referrals for abortion services.

The policy was first put in place in 1984 and has been intermittently enforced ever since then, depending on the administration. President Obama repealed the policy shortly after taking office in 2009 (Women's Health Policy Report, 6/20/14).

Amendment Details

The amendment, proposed by Sen. Jeanne Shaheen (D-N.H.), would codify the repeal of the gag rule (CQ News, 7/9). In addition, it would provide about $600 million in funding for international contraceptive services, including $35 million for the United Nations Population Fund (Ferris, The Hill, 7/9). However, the amendment would bar funding to UNFPA from going toward abortion.

The amendment also would allocate $538 million in funding for the United States Agency for International Development's family planning and reproductive health account, an increase of $80 million. In addition, it would allocate an additional $39.6 million to the State Department's Economic Support Fund for family planning.

According to Shaheen, the amendment's appropriated funding is unallocated and would not increase the underlying bill's top-line figure.

Shaheen in a statement said, "An estimated 225 million women in developing countries are unable to access family planning services." She added, "Providing greater access to family planning and reproductive health services improves the health of mothers and children, empowers women to make their own choices about how to grow their families, and is a smart investment that helps reduce poverty."

Meanwhile, House lawmakers last month advanced a foreign aid bill (HR 2772) that would renew the global gag rule and would not provide any funding for UNFPA (CQ News, 7/9).


CDC Data Affirms Safety of Abortion Procedures

Fri, 07/10/2015 - 14:19

According to CDC numbers released Wednesday and published in Obstetrics & Gynecology's August issue, deaths associated with abortion care remain very rare, the Huffington Post reports.

CDC Data Affirms Safety of Abortion Procedures

July 10, 2015 — According to CDC numbers released Wednesday and published in Obstetrics & Gynecology's August issue, deaths associated with abortion care remain very rare, the Huffington Post reports.

Study Details

CDC analyzed data from the national Pregnancy Mortality Surveillance System. The system includes information found on death certificates and other sources, such as clinic reports, hospital data and certain media reports.

Researchers examined the data to validate causes of death. According to the Post, researchers classified deaths as abortion-related if they resulted from "a direct or indirect complication from the procedure," or if an individual's pre-existing condition was exacerbated by an abortion. The researchers did not exclude any deaths from being categorized as abortion-related based on the time between when an abortion was performed and when an individual died.

CDC spokesperson Brittany Behm said the agency performed the review because "[w]e know that legal abortion is one of the most frequently used medical interventions in the United States, with more than 1 million performed per year, so it's important to minimize the risk."

Data Details

According to the data, the mortality rate for abortion care is very low, at approximately 0.7 deaths per 100,000 legal abortions. Specifically, the researchers found that of the roughly 16.1 million legal abortions performed in the U.S. from 1998 to 2010, there were only 108 abortion-related deaths. The study found that, among the rare instances of mortalities, the main causes were blood clots, complications with anesthesia, hemorrhage and infection.

Behm said the data affirms the safety of abortion care and should reassure women and physicians. She noted, "I think we are encouraged to see that deaths related to legal abortions continue to be rare, but there's always more that we can do from a public health perspective," such as increasing access to contraceptives to help reduce the U.S. unintended pregnancy rate (Pearson, Huffington Post, 7/8).


Quote Round Up: Women's Health Supporters Introduce Bill To End Hyde, Praise ACA Ruling, More

Thu, 07/09/2015 - 18:13

Media outlets and key stakeholders in women's health comment on a bill that would ensure abortion coverage in federally funded insurance plans, the Supreme Court's decision to uphold tax credits for the Affordable Care Act's federal insurance marketplace and more.

Quote Round Up: Women's Health Supporters Introduce Bill To End Hyde, Praise ACA Ruling, More

July 9, 2015 — Media outlets and key stakeholders in women's health comment on a bill that would ensure abortion coverage in federally funded insurance plans, the Supreme Court's decision to uphold tax credits for the Affordable Care Act's federal insurance marketplace and more.

"The passage of the EACH Woman Act [HR 2972] would stop the terrible wrongs of the Hyde Amendment, which, for 37 years, have fallen hardest on people of color, low-income, and youth." -- Yamani Hernandez, executive director of the National Network of Abortion Funds, praising a proposed bill in the House that would end the Hyde Amendment and permit federal funds to be used for abortion coverage. The measure, which has about 70 co-sponsors, would also bar state legislatures from enacting bans that prevent private insurers from covering abortion (Women's Health Policy Report, 7/9).

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them." -- Supreme Court Chief Justice John Roberts, in the majority opinion for King v. Burwell, which upheld the ACA's (PL 111-148) tax credits to help U.S. residents buy coverage through the federal insurance marketplace (Women's Health Policy Report, 6/25).

"The court should strike down this law [HB 2] and make clear that the Texas law and others like it that purport to protect women's health and safety instead put an undue burden on those seeking an abortion, and are unconstitutional." -- A Los Angeles Times editorial, lauding the Supreme Court's decision to stay parts of Texas' omnibus antiabortion-rights law and urging it to consider the case and overturn the statute (Los Angeles Times, 7/1). The high court put parts of the law on hold in June, which, according to the Times, is "a promising indication that the court is concerned about the burdensome and unnecessary law" (Women's Health Policy Report, 7/6).

"Congress is taking an ax to one of the most successful programs in America." -- Planned Parenthood Action Fund President Cecile Richards, on proposed budget cuts to the Title X family planning program. The Senate's Labor-HHS-Education budget proposal would cut $28.7 million in funding for Title X, while the House's version of the budget would eliminate all funding for the Title X family planning program, cut comprehensive sexuality education funding by $100 million and increase abstinence-only education funding (Women's Health Policy Report, 6/24).

"In this country, [it is] not ok to turn doctors into the mouthpieces of politicians in order to make a woman feel bad about her decision." -- Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project, praising the Supreme Court's refusal to hear an appeal from North Carolina over a partly blocked antiabortion-rights law (SL 2011-45). The high court's rejection keeps intact a lower court's decision that found that provisions in the law requiring physicians to perform ultrasounds and describe the images to a woman before an abortion are unconstitutional (Women's Health Policy Report, 6/15).

"If the FDA approves making oral contraceptives available over the counter, Congress should continue to require insurers to cover its cost." -- A Los Angeles Times editorial, on two OTC contraception bills, one (S 1438) of which would not require insurers to cover the cost and another (S 1532) that would. The Times backs the latter, noting that Planned Parenthood Action Fund, the American Congress of Obstetricians and Gynecologists and other groups "have pointed out that birth control isn't really accessible unless it's affordable" (Women's Health Policy Report, 6/16).

8th Circuit Denies Ark. Appeal on Decision Overturning 12-Week Abortion Ban

Thu, 07/09/2015 - 17:58

The 8th U.S. Circuit Court of Appeals on Thursday rejected the Arkansas attorney general's request for the full court to review a three-judge panel's decision overturning part of a state law (Act 301) that would have banned abortion at 12 weeks of pregnancy, AP/Columbus Republic reports.

8th Circuit Denies Ark. Appeal on Decision Overturning 12-Week Abortion Ban

July 9, 2015 — The 8th U.S. Circuit Court of Appeals on Thursday rejected the Arkansas attorney general's request for the full court to review a three-judge panel's decision overturning part of a state law (Act 301) that would have banned abortion at 12 weeks of pregnancy, AP/Columbus Republic reports (AP/Columbus Republic, 7/9).

Background

The Center for Reproductive Rights and the American Civil Liberties Union filed suit in April 2013 against the Arkansas law. The measure includes exceptions in cases of rape, incest, to save a woman's life or when the fetus has a fatal disorder.

In March 2014, a federal judge struck down part of Arkansas' law, ruling that restricting abortion based on fetal heartbeat rather than viability is unconstitutional. However, the judge left in place parts of the law that require physicians to perform an ultrasound and tell a woman if a fetal heartbeat can be detected.

In May, a three-judge panel of the 8th Circuit upheld the lower court's decision, ruling that the Arkansas law's abortion ban is unconstitutional because it violates Supreme Court precedent that permits women to have an abortion before fetal viability. The court left in place provisions in the law that mandate that physicians tell a woman if a fetal heartbeat can be detected.

Arkansas Attorney General Leslie Rutledge (R) last month asked the full 8th Circuit to rehear the case (Women's Health Policy Report, 6/12).

State Ordered To Pay Plaintiffs' Fees, Expenses

In related news, the 8th Circuit earlier this week ordered Arkansas to pay $76.30 in costs, $27,060 in attorneys' fees and $1,375.75 in expenses to the attorneys representing the two physicians in the state who challenged the 12-week abortion ban.

According to the Arkansas Democrat-Gazette, the order did not provide reasons for the final totals. The plaintiffs originally had requested $2,442.44 in expenses and $48,555 in attorneys' fees (Satter, Arkansas Democrat-Gazette, 7/9).


Arizona State Health Director Requests Dismissal of Challenge to Medication Abortion Measure

Thu, 07/09/2015 - 17:58

Arizona's health director is requesting that a federal judge dismiss a challenge to a law (SB 1318) that would require abortion providers to tell women medically unproven information about medication abortion because no physicians have yet been penalized for violating it, the Capitol Media Services/San Tan Valley Sentinel reports.

Arizona State Health Director Requests Dismissal of Challenge to Medication Abortion Measure

July 9, 2015 — Arizona's health director is requesting that a federal judge dismiss a challenge to a law (SB 1318) that would require abortion providers to tell women medically unproven information about medication abortion because no physicians have yet been penalized for violating it, the Capitol Media Services/San Tan Valley Sentinel reports (Fischer, Capitol Media Services/San Tan Valley Sentinel, 7/7).

The law was supposed to take effect on July 3. However, the medication abortion provision has been delayed pending a hearing in federal court, likely in October or September. The delay does not apply to the law's other provisions.

Law Details

The law's medication abortion provision would require physicians to tell women the medically unproven statement that administering high doses of progesterone could reverse a medication abortion. The American Congress of Obstetricians and Gynecologists has said there is no medically accepted evidence that medication abortion can be reversed.

In addition, the law bars women in the state from purchasing health plans that include abortion coverage on the Affordable Care Act's (PL 111-148) insurance marketplace. The restrictions do not apply to pregnancies resulting from rape or incest, or when a pregnancy threatens a woman's life.

The law also requires physicians to provide documentation to the state Department of Health Services showing that they have hospital admitting privileges. The records will not be made available to the public.

Lawsuit Details

The American Civil Liberties Union challenged the law on behalf of Planned Parenthood Arizona and several other Arizona providers, requesting that the U.S. District Court for the District of Arizona block the medication abortion provision from taking effect.

According to the lawsuit, the measure violates physicians' rights under the First Amendment by requiring them, "unwillingly and against their best medical judgment," to convey "a state-mandated message that is neither medically nor scientifically supported." In addition, the suit argues that the law violates patients' rights under the 14th Amendment because it requires them to receive "false, misleading and/or irrelevant information" (Women's Health Policy Report, 6/17).

The lawsuit notes that while some doctors have "experimented" with administering high doses of progesterone, such practice "does not constitute credible, medically accepted evidence that the experimental practice is effective or safe."

Dismissal Request Details

Douglas Drury, an attorney representing state Health Director Cara Christ, in legal filings wrote the lawsuit should be dismissed because it is not "'ripe' for consideration."

He wrote, "Plaintiffs and their patients have not suffered any injury in fact." According to the CMS/Sentinel, defendants say the challenge should go forward only if a physician refuses to tell a patient that medication abortion is reversible. The filings also reject the plaintiffs' argument that there is "no credible evidence that a medication abortion can be reversed," the CMS/Sentinel reports.

Meanwhile, Andrew Beck, an ACLU attorney, said physicians do not have to risk being penalized under the law for the legal challenge to go forward. "The law is clear that you don't have to engage in an act of civil disobedience in order to have either standing or a ripe case," he said, adding, "That sort of impermissible choice, the fact that you're being compelled to act in an unconstitutional way, is enough to allow you to challenge the statute" (Capitol Media Services/San Tan Valley Sentinel, 7/7).


House Lawmakers Propose Bill To End Hyde Amendment, Facilitate Equal Access to Abortion Coverage

Thu, 07/09/2015 - 17:39

House lawmakers on Wednesday proposed a bill (HR 2972) that would repeal the Hyde Amendment and permit federally funded insurance plans to cover abortion services, according to U.S. News & World Report reports.

House Lawmakers Propose Bill To End Hyde Amendment, Facilitate Equal Access to Abortion Coverage

July 9, 2015 — House lawmakers on Wednesday proposed a bill (HR 2972) that would repeal the Hyde Amendment and permit federally funded insurance plans to cover abortion services, according to U.S. News & World Report.

Background

The Hyde Amendment prohibits federal funds from being used for abortion care, including for women covered through Medicaid. The Guttmacher Institute estimates that about one in six women of reproductive age have coverage through Medicaid (Levy, U.S. News & World Report, 7/8).

Although the amendment is not permanent law, it has been included in appropriations measures since 1976 (Ferris, The Hill, 7/8). The amendment allows exemptions for cases of rape and incest and when the woman's life is in danger (U.S. News & World Report, 7/8).

Bill Details

Reps. Barbara Lee (D-Calif.), Diana DeGette (D-Colo.), Jan Schakowsky (D-Ill.) and Louise Slaughter (D-N.Y.) authored the measure, which would guarantee that women who have insurance through the federal government have abortion coverage (Bassett, Huffington Post, 7/8). The bill has about 70 co-sponsors (HR 2972 status page, 7/8).

The bill -- called the Equal Access to Abortion Coverage in Health Insurance Act, or EACH Woman Act -- would ensure abortion coverage for women enrolled in Medicaid, as well as federal government employees, military service members, volunteers with the Peace Corps and individuals insured via the Indian Health Service. In addition, the measure would bar state legislatures from enacting bans that prevent private insurers from covering abortion (Huffington Post, 7/8).

According to The Hill, the legislation has support from several women's health groups (The Hill, 7/8). Further, a poll conducted in June found that 56% of respondents said they supported legislation that would require Medicaid to cover abortion care (U.S. News & World Report, 7/8).

Comments

Executive Director of the National Network of Abortion Funds Yamani Hernandez said "The passage of the EACH Woman Act would stop the terrible wrongs of the Hyde Amendment, which, for 37 years, have fallen hardest on people of color, low-income, and youth" (All Above All press release, 7/8).

Lee said, "Regardless of how someone personally feels about abortion, none of us, especially elected officials, should be interfering with a woman's right to make her own health care decisions just because she is poor."

Similarly, DeGette said, "We are done playing defense against attacks on women's health." She added, "Today's introduction of the EACH Woman Act marks the first step in our march towards the day when each and every woman can make her own decisions about pregnancy" (U.S. News & World Report, 7/8).

Lee: 'It's Past Time To End Hyde'

In related news, Lee in a San Francisco Chronicle opinion piece writes that the introduction of the EACH Woman Act "make[s] it clear that every woman has a right to make her own health care decisions, especially with such an important decision as whether to become a parent."

Lee explains that Congress approves the Hyde Amendment "each year to strip women of their fundamental right to access all of their health care options" by "prevent[ing] women who receive their health insurance through the federal government from receiving abortion coverage." According to Lee, "these attacks have one goal: preventing women, especially low-income women and women of color, from making the best health care decision for themselves and their families."

By contrast, Lee writes that the EACH Woman Act "is about three things: personal decisions, improved health and basic fairness."

Specifically, she notes that as "[m]ore and more politicians ... are trying to implement laws that restrict the freedom of women to make the personal decision for her and her family," her bill "trusts women to make the right decision for themselves, their health and loved ones." Further, the measure would put a stop to actions by lawmakers "looking for each and every opportunity to put women's health on the line by denying them access to all medical options," she writes. In addition, Lee states that the bill "is about equal treatment," noting that, "each year, members of Congress vote to deny women who are active duty military, veterans or insured through Medicaid access to abortion coverage."

She writes, "No matter how someone personally feels about abortion, we can all agree that allowing politicians to deny women access to all pregnancy care options just because of how she's insured or the amount of money she has is wrong" (Lee, San Francisco Chronicle, 7/8).


Study: Out-of-Pocket Contraceptive Costs Down After ACA Contraceptive Coverage Rule

Thu, 07/09/2015 - 16:47

Women's out-of-pocket spending on most major forms of contraception dropped significantly in the months following the implementation of an Affordable Care Act (PL 111-148) provision that requires insurers to cover contraception at no cost, according to a recent study published in Health Affairs, the New York Times reports.

Study: Out-of-Pocket Contraceptive Costs Down After ACA Contraceptive Coverage Rule

July 8, 2015 — Women's out-of-pocket spending on most major forms of contraception dropped significantly in the months following the implementation of an Affordable Care Act (PL 111-148) provision that requires insurers to cover contraception at no cost, according to a recent study published in Health Affairs, the New York Times reports.

Under the ACA, insurers must cover the full cost of prescription contraception and other preventive services. The rule, which took effect August 2012, required insurers to comply by the start of the new plan period. For many members, that period started Jan. 1, 2013.

Study Details

For the study, researchers at the University of Pennsylvania reviewed health insurance claims from a private insurer that operated in 50 states and Washington, D.C. The researchers used the claims data to assess the contraceptive use of 790,000 women ages 13 to 45 between 2008 and 2013.

According to the Times, the researchers set the 2008 data as a baseline on prescription contraception spending and then compared such spending in the first six months of 2013 -- once the contraceptive coverage rule took effect -- with the first six months of 2012 (Tavernise, New York Times, 7/7). Specifically, the study assessed women's mean and median out-of-pocket medical costs and what percentage of such spending was put toward contraception among women using oral contraception and those who opted for intrauterine devices.

Key Findings

The researchers found that among women who filed at least one claim for oral contraception in both time periods, the mean percentage of out-of-pocket medical spending put toward oral contraception declined from 44% in the first six months of 2012 to 22.4% in first six months of 2013. Similarly, the median percentage of out-of-pocket costs put toward oral contraception between the two time periods declined from 36% to 0%.

Meanwhile, the researchers found that among women who received an IUD during the two time periods, the mean percentage of out-of-pocket medical spending put toward contraception declined from 30.3% to 11.3%, while the median percentage dropped from 13.2% to 0% (Becker/Polsky, Health Affairs, 7/7).

Further, the researchers found that spending on oral contraception declined by about 50%, from about $244 in the first period to $117 in the second (New York Times, 7/7). According to the study, spending on individual oral contraception prescriptions dropped by 38% between the two time periods, from $32.74 to $20.37, while out-of-pocket spending on IUD insertion declined by 68%, from $262.38 to $84.30. Meanwhile, spending dropped by 93% for emergency contraception; by 84% for diaphragms and cervical caps; by 72% for implants; and by 68% for injections. By contrast, spending dropped by only 2% for the ring and by only 3% for the patch.

Nora Becker, lead author and a University of Pennsylvania MD/PhD candidate, said, "We estimate that the ACA is saving the average pill user $255 per year, and the average woman receiving an IUD is saving $248." Overall, she noted that, "[s]pread over an estimated 6.88 million privately insured oral contraceptive users in the United States, consumer annual contribution to spending on the pill could be reduced by almost $1.5 billion annually" (Preidt, HealthDay/U.S. News & World Report, 7/7).

According to the Times, the study did not definitively determine that the ACA was the factor lowering costs, though experts have said that the timing and size of the decline indicate it was the case (New York Times, 7/7).

Out-of-Pocket Costs Not Yet Eliminated

The researchers noted out-of-pocket spending on contraception did not fall to zero because of grandfathered insurance plans and because certain plans were eligible for an exemption to the rule. Further, insurers are not required to cover all brands of each FDA-approved contraceptive method without cost sharing (HealthDay/U.S. News & World Report, 7/7).

In addition, according to Kaiser Health News, some insurers had not been providing no-cost coverage for certain contraception methods -- such as the ring and patch -- contending that they were similar to already covered methods, such as the pill. However, the Obama administration has since clarified that insurers must cover at least one type of each contraceptive method.

Comments

Becker noted that making contraception less costly might not increase the number of women who use it but could cause women to adopt different, more-effective methods. She said, "If prior to the ACA a woman was facing $10 to $30 a month for the pill but hundreds of dollars upfront for an IUD and now both are free, we might see a different choice" (Rovner, Kaiser Health News, 7/7).

Study co-author Daniel Polsky, executive director of the University of Pennsylvania's Institute of Health Economics and professor of medicine, in a statement said, "In the long term, if we do in fact see an increase in the use of contraceptives, that could potentially lead to a lower overall fertility rate, and potentially increased economic opportunities for women and their families" (HealthDay/U.S. News & World Report, 7/7).


States Passed 51 Abortion Restrictions in 2015, Study Finds

Thu, 07/09/2015 - 16:47

States so far in 2015 have passed 51 new abortion restrictions, according to a report from the Guttmacher Institute, The Hill reports.

States Passed 51 Abortion Restrictions in 2015, Study Finds

July 6, 2015 — States so far in 2015 have passed 51 new abortion restrictions, according to a report from the Guttmacher Institute, The Hill reports.

According to the report, the number of new abortion restrictions passed this year surpasses the total number of such laws approved in 2014. However, Guttmacher noted that more laws usually are passed in odd-numbered years than even-numbered years because more state legislatures are in session. Overall, the number of restrictions enacted this year does not yet surpass the 70 antiabortion-rights laws passed in 2013, which currently marks the highest number of such restrictions passed in one year in the last few decades.

Among other restrictions, the report found that four states this year passed laws similar to provisions in an omnibus antiabortion-rights law in Texas (HB 2). The Supreme Court last week put parts of the Texas law on hold, including a provision that requires abortion providers to have admitting privileges at nearby hospitals.

Meanwhile, five states this year also passed laws imposing or extending mandatory delays before an abortion, and two states approved laws that could prohibit abortion as early as 14 weeks' gestation, according to Guttmacher. Providers have filed suit over one of those laws, SB 95 in Kansas.

The report cautioned, "Even though most action on these issues follows recent trends, some states have charted some new directions that may well serve as models for other states going forward" (Sullivan, The Hill, 7/2).


House Lawmakers Urge HHS To Improve Contraception Coverage

Thu, 07/09/2015 - 16:47

House lawmakers in a letter last week asked HHS to issue new regulations that would require insurers to cover one year's worth of contraception in a single batch without cost-sharing, The Hill reports.

House Lawmakers Urge HHS To Improve Contraception Coverage

July 7, 2015 — House lawmakers in a letter last week asked HHS to issue new regulations that would require insurers to cover one year's worth of contraception in a single batch without cost-sharing, The Hill reports.

According to The Hill, most insurers currently cover only one- to three-month supplies of contraception without cost-sharing. Experts have said that the limited batches can lead to gaps in use and increased rates of unintended pregnancies.

Letter Details

In the letter, Rep. Suzanne Bonamici (D-Ore.), Rep. Jackie Speier (D-Calif.) and colleagues asked HHS to change how insurers cover prescriptions for birth control to include 12-month supplies. "Birth control has helped give women the freedom to decide when they want to start a family, and providing a 12-month supply ensures that women can plan long-term rather than for a few months at a time," Speier said.

Speier also cited research showing that a year-long supply of contraception lowered the risk of unintended pregnancy by 30% compared with women who receive one- to three-months' worth of birth control at a time.

According to The Hill, several states have passed or are considering laws requiring insurers to cover 12-month supplies of birth control. For example, Oregon (HB 3343) and Washington, D.C., have advanced such legislation, and New York added a similar provision to a package of bills governing women's health and contraception. Meanwhile, California and Washington state are evaluating related measures (Wheeler, The Hill, 7/2).