Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 58 min 55 sec ago

Blogs Comment on Support for Working Families, Breastfeeding, More

Tue, 08/05/2014 - 18:01

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from RH Reality Check, Care2 and more.

Blogs Comment on Support for Working Families, Breastfeeding, More

August 5, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from RH Reality Check, Care2 and more.

SUPPORTING WORKING FAMILIES: "How Minnesota Passed a Massive Economic Security Law for Women," Erin Matson, RH Reality Check: The Women's Economic Security Act (HF 2536), which took effect Aug. 1 in Minnesota, "stands out" as a "remarkable" instance of a governor signing "legislation that does something good for women," Matson writes. The law provides "an expansive host of benefits," including "basic accommodations for pregnant workers," protections to address the "economic consequences of domestic violence" and an increase in unpaid leave, she notes, adding that "it's not often we see such a large package of solutions-oriented legislation enacted" to address economic discrimination. In an interview with Matson, Debra Fitzpatrick -- program director of the University of Minnesota's Center on Women and Public Policy -- says that "while our families have changed, our workplaces haven't really adapted," but this law "is a recognition that in most families everybody is working" (Matson, RH Reality Check, 8/4).

What others are saying about supporting working families:

~ "Bold Airport Campaign Exposes States' Treatment of Women," Laura Bassett, Huffington Post blogs.

~ "Montana State Government Leads the Way on Equal Pay with Self-Evaluation of Employee Compensation," Emily Werth, National Women's Law Center blog.

ABORTION RESTRICTIONS: "Repro Wrap: TRAPs Are Working, Buffers Aren't, and Clinics Just Keep Closing," Robin Marty, Care2: Marty reviews a number of targeted regulation of abortion providers measures, noting the "biggest news" last week was a decision by the 5th U.S. Circuit Court of Appeals that a requirement that abortion providers have admitting privileges could not be used to close Mississippi's only abortion clinic. Several states "are finding themselves wondering if their own laws" regarding abortion restrictions "are constitutional or not," Marty writes, noting that Louisiana and Oklahoma are "trying to convince their residents" that TRAP laws there "won't be blocked," she continues. She adds that "clinics are shuttering as they admit they can't adhere to the strict and medically unnecessary regulations," such as facilities in Texas, Kansas and Ohio. At the same time, the "eroding of buffer zones" is "making it that much more difficult for patients to access the front doors" of clinics "without harassment," she writes (Marty, Care2, 8/1).

What others are saying about abortion restrictions:

~ "Another Independent Texas Abortion Provider Shuts its Doors," Andrea Grimes, RH Reality Check.

~ "Federal Court Rules Alabama Admitting Privileges Requirement Unconstitutional," Jessica Mason Pieklo, RH Reality Check.

SEXUAL AND GENDER-BASED VIOLENCE: "Domestic Abuse Victim Marissa Alexander Faces 60 Years in Prison for Self Defense," Crystal Shepeard, Care2: Shepeard comments on a case in which "Marissa Alexander, a mother of three," in August 2010 "fired her gun into the ceiling" in an attempt to stop her husband, who had "repeatedly abused" her and threatened to kill her during a confrontation in front of his children. Shepeard notes that Alexander, who is "a trained and licensed firearm owner and had a concealed carry permit from the state of Florida," "was convicted of three counts of aggravated assault and sentenced to 20 years in prison" less than one year after the incident. According to Shepeard, "women -- especially women of color" have historically "been denied self-defense claims in cases of abuse." The case "prompted the [Florida] [L]egislature to modify" state law to allow people "to brandish a firearm and fire a shot in order to scare off an attacker," Shepeard writes, but the law "will not be applied retroactively and will be of no help to" Alexander (Shepeard, Care2, 8/2).

ABORTION-RIGHTS MOVEMENT: "Women Who Have Abortions Are 'Not Alone': A Q&A With Abortion Story Advocate Beth Matusoff Merfish," Chanel Dubofsky, RH Reality Check: "As high school students, Beth Matusoff Merfish and her sister, Brett, spent their summer afternoons volunteering at Planned Parenthood, encouraged by their mother, Sherry," Dubofsky writes, adding that Beth's mother shared the story of her own abortion with Beth before she left for college. "Years later, all three women sat in the gallery of the Texas state senate building during Wendy Davis's 11-hour speech aimed at filibustering legislation [HB 2] seeking to limit abortions after 20 weeks and impose new regulations that would leave just a few abortion clinics open in the state." According to Dubofsky, after that experience Beth wrote a New York Times opinion piece "urging women to tell their abortion stories in the name of breaking down stigma and shame," and the response has been tremendous. In the blog post, Dubofsky asks Beth a series of questions about her efforts, including founding the Not Alone project, which "aims to change the current climate around abortion stigma" (Dubofsky, RH Reality Check, 8/1).

What others are saying about the abortion-rights movement:

~ "Reproductive Justice: It's About More Than Safe Abortion Care," Rickie Solinger, RH Reality Check.

~ "I'm Having an Abortion This Weekend," Jenny Kutner, Salon.

BREASTFEEDING: "The Contradictory Truth About Breastfeeding," Christa Allard, Huffington Post blogs: Allard, a blogger for CTWorkingMoms.com, discusses the many contradictions of breastfeeding. For instance, she writes that breastfeeding is both "natural," making one "feel connected to something -- someone -- outside of myself, yet an extension of myself" and "foreign ... wrought with complications," such as "nipple shields" and "clogged ducts." Breastfeeding, she writes, is both "incredibly connecting" and "impossibly alienating," causing one to miss out on other activities, and is both a "timesaver" and a "time suck." She says, "Breastfeeding is hard. So why do we do it? Because for every day you feel like you can't continue and are completely touched out, there are the ones where you vow you'll never do anything but snuggle her for the rest of her life." She adds, "Those are the days that keep you going" (Allard, Huffington Post blogs, 8/4).

BREAST CANCER: "The Not-So-Pink Truth About the World of Stage IV," Sarah Amento, Huffington Post blogs: "The way we are fighting" against breast cancer "has to change," argues Amento, who has stage IV breast cancer. She writes, "We see the 'survivors' at these walks with cute pink boas and pink tulle skirts celebrating life, and how proud I am of them. But, all of this pink gives a false sense that we are winning this battle against breast cancer." She says that those with breast cancer must "demand ... personalized care along with integrative care," concluding, "[m]aybe then we will stop burying someone's mother, wife, daughter and friend" (Amento, Huffington Post blogs, 8/4).


Dispute Over VAWA Tribal Authority Provision Prompts Senator To Reverse Stance

Tue, 08/05/2014 - 18:01

Sen. Lisa Murkowski (R-Alaska) is trying to repeal a provision she added to the 2013 reauthorization of the Violence Against Women Act (PL 113-4) that bars Alaska Native tribes from prosecuting certain domestic violence crimes committed by non-Native Americans, the Washington Post reports.

Dispute Over VAWA Tribal Authority Provision Prompts Sen. To Reverse Stance

August 5, 2014 — Sen. Lisa Murkowski (R-Alaska) is trying to repeal a provision she added to the 2013 reauthorization of the Violence Against Women Act (PL 113-4) that bars Alaska Native tribes from prosecuting certain domestic violence crimes committed by non-Native Americans, the Washington Post reports (Horwitz, Washington Post, 8/2).

President Obama signed the reauthorization into law in 2013. Among other provisions, the law grants authority to tribal courts to hear cases involving non-Native Americans accused of assaulting Native American women on reservations (Women's Health Policy Report, 3/8/13). The provision also allows tribal courts to enforce civil protections against such individuals.

However, Murkowski added Section 910, also called the "Alaska exception," before the bill was approved by Congress to exempt Alaska Native tribes. At the time, she said the provision did not notably change the bill because VAWA only applied to "Indian country," where tribes live on reservations with their own court systems. By definition under federal law, there is very little Indian country in Alaska.

Impact Disputed

Alaska Natives and others have voiced concern about the provision, which has spurred confusion among law enforcement officials and fueled debates over the authority of Alaska Native tribes, according to the Post.

Alaska Associate Attorney General Tony West said a repeal is needed to allow the state to enforce tribal civil protection orders in domestic violence cases. "It's important to send a very clear signal that tribal authority means something, that tribal authority is an important component to helping to protect Native women and Native children from violence," West said.

However, other Alaska officials have said that the state already enforces such civil protection orders and that the impact would be minimal.

Murkowski said that while she still has concerns about repeal and the "expansion of jurisdiction over non-members of a tribe is a controversial issue" in Alaska, "[w]e must turn the tide of the rates of sexual assault, domestic violence, and child abuse" in the state (Washington Post, 8/2).


Federal Judge Finds Ala. Admitting Privileges Law Unconstitutional

Tue, 08/05/2014 - 17:59

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

Federal Judge Finds Ala. Admitting Privileges Law Unconstitutional

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

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

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

Monday's Ruling

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

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

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

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

Implications

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

Comments

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

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


Lawyers, Experts Discuss Impact of Texas Antiabortion Law During First Day of Trial

Tue, 08/05/2014 - 14:57

A federal court on Monday heard opening arguments in a case over the constitutionality of a provision in a Texas law (HB 2) that requires abortion facilities to meet the same building requirements as hospital-style surgical centers, the New York Times reports.

Lawyers, Experts Discuss Impact of Texas Antiabortion Law During First Day of Trial

August 5, 2014 — A federal court on Monday heard opening arguments in a case over the constitutionality of a provision in a Texas law (HB 2) that requires abortion facilities to meet the same building requirements as hospital-style surgical centers, the New York Times reports (Fernandez/Eckholm, New York Times, 8/4).

The ambulatory surgical centers provision is scheduled to take effect on Sept. 1. The Center for Reproductive Rights, which filed the suit on behalf of several abortion providers in the state, is asking the U.S. District Court for the Western District of Texas to block the provision (Women's Health Policy Report, 8/4).

Initial Arguments

On Monday, Jan Soifer, a lawyer representing CRR, argued that if the provision took effect, roughly one million women of reproductive age in Texas would live more than 150 miles from an abortion facility. She said the distance would "expos[e] women to greater health risks," such as self-induced abortion.

Daniel Grossman -- a co-investigator with the Texas Policy Evaluation Project and expert witness at the trial -- said that the provision will cause more than 12 clinics to shut down, leaving Texas with fewer than 10 abortion facilities. According to the Times, those facilities will all be located in major metropolitan areas, while there will be no provider in mostly rural areas south and west of San Antonio.

The plaintiff's attorneys also contested the law's admitting privileges requirement as unwarranted, noting that one of the plaintiffs -- Whole Woman's Health in the Rio Grande Valley -- had to shut down primarily because the physicians working there were unable to comply with the requirement.

Meanwhile, James Blacklock, a state deputy attorney general, said that abortion providers were not having difficulty complying with the mandate but rather were opting not to comply "because they disagree with the law." In court Monday and through filings, lawyers from the state attorney general's office also argued that abortion providers were exaggerating the effect of the provision. Further, they said that new facilities currently under construction or being considered would be able to meet the demand for abortion services.

The state noted that at least 27 states have similar laws, although the specific building requirements differ, and they contested claims that women would have to travel more than 500 miles from El Paso to San Antonio for an abortion, noting that women in El Paso could easily access a more convenient facility in New Mexico (New York Times, 8/4).


Insurer To Stop Covering Hysterectomy Procedure Amid Cancer Warnings

Tue, 08/05/2014 - 13:43

One of the nation's largest Blue Cross Blue Shield health plans is ending coverage of laparoscopic power morcellation amid FDA scrutiny of the procedure's safety, the Wall Street Journal reports.

Insurer To Stop Covering Hysterectomy Procedure Amid Cancer Warnings

August 5, 2014 — One of the nation's largest Blue Cross Blue Shield health plans is ending coverage of laparoscopic power morcellation amid FDA scrutiny of the procedure's safety, the Wall Street Journal reports.

The insurer, Highmark, provides coverage for about 5.2 million residents in Delaware, Pennsylvania and West Virginia. According to the Journal, it is the first insurer to end coverage of procedures involving laparoscopic power morcellation, which can unintentionally spread cancer during hysterectomy procedures (Levitz, Wall Street Journal, 8/2).

Background

Laparoscopic power morcellation was developed as an alternative to invasive surgery for women who undergo hysterectomies to treat symptomatic uterine fibroids. The method uses a power device to grind uterine tissue so it can be removed through a tiny incision and is used in about 50,000 procedures annually in the U.S.

The technique has come under fire for its potential to spread a type of cancer -- known as a uterine sarcoma -- within the body. A recent study in the Journal of the American Medical Association estimated that one in 368 women undergoing morcellation had uterine cancer that was undetected until after the procedure (Women's Health Policy Report, 8/1).

FDA has advised doctors not to use the technique and is weighing whether to take further regulatory action.

Highmark's Decision

Highmark spokesperson Aaron Billger said the company studied the issue for months and determined that the procedure's risks outweighed its benefits. He said the insurer evaluated medical evidence and data, including patient outcomes, potential risks of alternative methods and the implications for halting coverage. Highmark will end the coverage effective September 1.

Billger said the Highmark-owned Allegheny Health Network, a multi-hospital health system, also has stopped providing the procedure.

Meanwhile, the University of Pittsburgh Medical Center on Saturday announced it also no longer offers the procedure (Wall Street Journal, 8/2).


Democrats Shift From 'War on Women' Rhetoric To Broaden Voter Appeal

Tue, 08/05/2014 - 13:39

In an effort to make their 2014 midterm strategy less politically divisive and more focused on individual issues, Democrats are eschewing the "war on women" rhetoric they used effectively against Republican candidates during the 2012 election, National Journal reports.

Democrats Shift From 'War on Women' Rhetoric To Broaden Voter Appeal

August 5, 2014 — In an effort to make their 2014 midterm strategy less politically divisive and more focused on individual issues, Democrats are eschewing the "war on women" rhetoric they used effectively against Republican candidates during the 2012 election, National Journal reports.

According to National Journal, Democrats used the phrase in the 2012 election to target Mitt Romney's presidential campaign and appeal to women in swing states, which helped propel President Obama to re-election.

However, Democrats are stepping back from the language in their current election strategies, even though many of the issues that were important in 2012 -- including women's reproductive rights and the wage gap, among others -- still are potent, particularly in states like Colorado and Kentucky that have competitive Senate races.

Pollsters Weigh In

Democratic pollster Celinda Lake said Democrats have found that saying "'Republicans are waging a war on women' actually doesn't test very well" among female voters, who find the terminology "divisive" and "political." Lake said it is more effective to use language that casts Republican policies as "too extreme" or "out of touch with women's lives."

Similarly, Mark Mellman, another Democratic pollster, said that the party is "on much stronger ground when we talk about the specifics than when we talk about the category." He added, "And so when we talk about Republicans who want to make abortion illegal, Republicans who want to ban equal pay for equal work ... the specific policy issues matter. That's where the power is."

For example, Sen. Mark Udall (D-Colo.) is campaigning against a challenge from Republican Rep. Cory Gardner (Colo.) by focusing in large part on Gardner's prior support for a "personhood" amendment. Meanwhile, Democrat Alison Lundergan Grimes -- seeking to unseat Senate Minority Leader Mitch McConnell (R-Ky.) -- is highlighting McConnell's votes against equal pay measures and reauthorizing the Violence Against Women Act.

Republican Response

Meanwhile, Republicans have adopted the "war on women" rhetoric to criticize Democrats and attempt to turn the phrase's negative connotations back on the Democratic Party, National Journal reports.

For example, Terri Lynn Land, a Senate candidate in Michigan, said in an ad that Democrats want voters to believe she is "waging a war on women," while Carly Fiorina, former Hewlett Packard CEO, launched a super PAC to "shame Democrats who play the 'war on women' game."

Republican pollster Kellyanne Conway said Democrats "may be dressing it up in kinder, gentler terms, but it still ignores the fact that the reason the majority of women disapprove of the president's performance is because they don't see the economy doing well."

However, Marcy Stech, press secretary for EMILY's List, said, "Republicans would much rather talk about the rhetoric surrounding women's issues than the issues themselves because they don't really have an agenda to run on" (Schultheis, National Journal, 7/31).


Texas Rule Aims To Increase IUDs, Implant Access for Low-Income Women

Mon, 08/04/2014 - 15:24

A change to Texas' Medicaid program and the state's Women's Health Program aims to increase access to long-acting reversible contraceptives, including intrauterine devices and implants, Kaiser Health News/Texas Tribune reports.

Texas Rule Aims To Increase IUDs, Implant Access for Low-Income Women

August 4, 2014 — A change to Texas' Medicaid program and the state's Women's Health Program aims to increase access to long-acting reversible contraceptives, including intrauterine devices and implants, Kaiser Health News/Texas Tribune reports.

Under the rule change by the state Health and Human Services Commission, participating physicians will be able to order LARC from three specialty pharmacies instead of from a drug wholesaler. Doing so will lower upfront costs for physicians because the pharmacies will be responsible for billing Medicaid and the Women's Health Program to cover the costs. The state hopes the change will result in more physicians offering LARC methods for those patients.

In addition, the rule allows physicians to return unopened LARC products through a "buyback" program. The products will be available at pharmacies in Houston, Fort Worth and Frisco and can be delivered by mail.

Linda Edwards Gockel, a spokesperson for HHSC, noted that paying upfront for LARC products "can be costly for [providers] because these products are fairly expensive."

Ob-Gyns Note Concerns

However, some ob-gyns are concerned that they have received few details about the program from the state. For example, they have not been told how to place orders or how long they must keep a product before they can return it through the buyback program.

Ob-gyn Tony Dunn, vice chair of the Texas branch of the American Congress of Obstetricians and Gynecologists and steering committee chair for the Texas Women's Healthcare Coalition, said, "I don't know how much of an improvement this will be or if it's going to exchange some headaches for other headaches." However, it "is a step in the right direction until we know all the details," he added (Ura, Kaiser Health News/Texas Tribune, 7/31).


Texas Law That Could Close Abortion Clinics Goes To Court

Mon, 08/04/2014 - 15:22

A trial beginning in federal court on Monday will test the constitutionality of a provision in a Texas law (HB 2) that requires abortion clinics to meet the same standards as ambulatory surgical centers, Kaiser Health News/Texas Tribune reports.

Texas Law That Could Close Abortion Clinics Goes To Court

August 4, 2014 — A trial beginning in federal court on Monday will test the constitutionality of a provision in a Texas law (HB 2) that requires abortion clinics to meet the same standards as ambulatory surgical centers, Kaiser Health News/Texas Tribune reports (Ura/Edelman, Kaiser Health News/Texas Tribune, 8/4).

Earlier this year, a panel of three judges on the 5th U.S. Circuit of Appeals upheld two other provisions in the law, ruling that they do not unduly burden abortion rights. One provision requires that abortion providers have admitting privileges at nearby hospitals. The other provision mandates that providers follow FDA protocols when administering medication abortion, rather than the evidence-based regimen that is commonly used (Women's Health Policy Report, 4/11).

U.S. District Court Judge Lee Yeakel -- who temporarily blocked the admitting privileges provision last year, before it was appealed to the 5th Circuit -- is presiding over the ambulatory surgical centers trial, which is expected to continue at least through Thursday. Yeakel has speculated that at least one of the cases filed against HB2 will be appealed to the Supreme Court.

The ambulatory surgical centers provision is scheduled to take effect on Sept. 1. The Center for Reproductive Rights, which filed the suit on behalf of several abortion providers in the state, is asking the U.S. District Court for the Western District of Texas to block the provision.

Plaintiffs' Arguments

CRR argues that the provision unconstitutionally limits women's access to abortion because it would leave Texas with fewer than 10 abortion facilities, none of which are south or west of San Antonio. According to the KHN/Tribune, only six clinics currently meet the provision's requirements, and all of them are located in major cities.

Esha Bhandari, an attorney for the abortion providers, said that the current case "is a little different" than the one filed against the law's admitting privileges and medication abortion requirements because the burden posed by the ambulatory surgical centers mandate will be immediately felt. "[W]e're talking about building facilities that cost millions of dollars," Bhandari said of the changes that would be required to meet the mandate, adding, "Either they already exist, or they're not going to magically appear on Sept. 1."

Meanwhile, CRR also is asking the court to suspend the law's admitting privileges provision for two clinics in the state -- Whole Woman's Health in McAllen and Reproductive Services in El Paso -- that had to close after they were unable to meet the requirement (Kaiser Health News/Texas Tribune, 8/4).

CRR President and CEO Nancy Northup said that requiring "every abortion clinic to become a mini-hospital is medically unjustified and will push already scant reproductive health care services that much further -- if not entirely -- out of reach for Texas women" (Koppel, Wall Street Journal, 8/3).

State's Defense

The state's court filings claim that abortions are more dangerous than providers acknowledge and that the ambulatory surgical centers requirement will improve safety and patient care.

According to KHN/Tribune, the filings dispute CRR's arguments about the "alleged burdens of travel and cost" that would result from the clinic closures, adding, "Receiving optimal care is not an undue burden." The state adds that it "would be safer for patients to drive further to receive an abortion at a surgical facility with a credentialed and privileged physician than to seek an abortion at a nearby, substandard clinic."

Texas Right to Life spokesperson Melissa Conway said that she thinks the court will uphold the law, which she said represents the "best practice standards of care" (Kaiser Health News/Texas Tribune, 8/4).


Texas Law That Could Close Abortion Clinics Goes To Court

Mon, 08/04/2014 - 14:18

A trial beginning in federal court on Monday will test the constitutionality of a provision in a Texas law (HB 2) that requires abortion clinics to meet the same standards as ambulatory surgical centers, Kaiser Health News/Texas Tribune reports.

Texas Law That Could Close Abortion Clinics Goes To Court

August 4, 2014 — A trial beginning in federal court on Monday will test the constitutionality of a provision in a Texas law (HB 2) that requires abortion clinics to meet the same standards as ambulatory surgical centers, Kaiser Health News/Texas Tribune reports (Ura/Edelman, Kaiser Health News/Texas Tribune, 8/4).

Earlier this year, a panel of three judges on the 5th U.S. Circuit of Appeals upheld two other provisions in the law, ruling that they do not unduly burden abortion rights. One provision requires that abortion providers have admitting privileges at nearby hospitals. The other provision mandates that providers follow FDA protocols when administering medication abortion, rather than the evidence-based regimen that is commonly used (Women's Health Policy Report, 4/11).

U.S. District Court Judge Lee Yeakel -- who temporarily blocked the admitting privileges provision last year, before it was appealed to the 5th Circuit -- is presiding over the ambulatory surgical centers trial, which is expected to continue at least through Thursday. Yeakel has speculated that at least one of the cases filed against HB2 will be appealed to the Supreme Court.

The ambulatory surgical centers provision is scheduled to take effect on Sept. 1. The Center for Reproductive Rights, which filed the suit on behalf of several abortion providers in the state, is asking the U.S. District Court for the Western District of Texas to block the provision.

Plaintiffs' Arguments

CRR argues that the provision unconstitutionally limits women's access to abortion because it would leave Texas with fewer than 10 abortion facilities, none of which are south or west of San Antonio. According to the KHN/Tribune, only six clinics currently meet the provision's requirements, and all of them are located in major cities.

Esha Bhandari, an attorney for the abortion providers, said that the current case "is a little different" than the one filed against the law's admitting privileges and medication abortion requirements because the burden posed by the ambulatory surgical centers mandate will be immediately felt. "[W]e're talking about building facilities that cost millions of dollars," Bhandari said of the changes that would be required to meet the mandate, adding, "Either they already exist, or they're not going to magically appear on Sept. 1."

Meanwhile, CRR also is asking the court to suspend the law's admitting privileges provision for two clinics in the state -- Whole Woman's Health in McAllen and Reproductive Services in El Paso -- that had to close after they were unable to meet the requirement (Kaiser Health News/Texas Tribune, 8/4).

CRR President and CEO Nancy Northup said that requiring "every abortion clinic to become a mini-hospital is medically unjustified and will push already scant reproductive health care services that much further -- if not entirely -- out of reach for Texas women" (Koppel, Wall Street Journal, 8/3).

State's Defense

The state's court filings claim that abortions are more dangerous than providers acknowledge and that the ambulatory surgical centers requirement will improve safety and patient care.

According to KHN/Tribune, the filings dispute CRR's arguments about the "alleged burdens of travel and cost" that would result from the clinic closures, adding, "Receiving optimal care is not an undue burden." The state adds that it "would be safer for patients to drive further to receive an abortion at a surgical facility with a credentialed and privileged physician than to seek an abortion at a nearby, substandard clinic."

Texas Right to Life spokesperson Melissa Conway said that she thinks the court will uphold the law, which she said represents the "best practice standards of care" (Kaiser Health News/Texas Tribune, 8/4).


Nearly 80% of U.S. Infants Breastfed in 2011, State Rates Vary Widely, CDC Finds

Mon, 08/04/2014 - 14:08

About 79.2% of infants born in the U.S. in 2011 were breastfed for some length of time, but rates of breastfeeding varied significantly by state, according to CDC's 2014 Breastfeeding Report Card, the Washington Post's "To Your Health" reports.

Nearly 80% of U.S. Infants Breastfed in 2011, State Rates Vary Widely, CDC Finds

August 4, 2014 — About 79.2% of infants born in the U.S. in 2011 were breastfed for some length of time, but rates of breastfeeding varied significantly by state, according to CDC's 2014 Breastfeeding Report Card, the Washington Post's "To Your Health" reports (Bernstein, "To Your Health," Washington Post, 8/1).

According to the report, the 2011 breastfeeding rate marks an increase from CDC's last report, which found that 76.5% of U.S. infants were breastfed in 2010.

Reasons for Increased Breastfeeding

This year's report showed that much of the increase was in exclusive breastfeeding. CDC said that the rate of exclusive breastfeeding at six months increased from 16.4% in 2010 to 18.8% in 2011 (Molla, "The Numbers," Wall Street Journal, 7/31). Overall, breastfeeding rates were 49.4% at six months and 26.7% at one year in the most-recent report ("To Your Health," Washington Post, 8/1).

CDC also credited an increase in board-certified lactation consultants for the improved breastfeeding rates. The number of certified lactation consultants increased from 2.1 per 1,000 live births in 2006 to 3.5 per 1,000 live births in 2013.

State laws that support breastfeeding mothers and bar formula promotions at hospitals also helped drive the increase in breastfeeding rates ("The Numbers," Wall Street Journal, 7/31).

According to "To Your Health," only about 22% of infants were breastfed in 1972. The findings suggest that CDC is on track to reach its goal of having 81.9% of infants breastfed by 2020, although its goal to have 60.6% of infants still breastfeeding at six months seems less attainable, "To Your Health" reports.

Regional Discrepancies

The report noted discrepancies in breastfeeding rates across different regions of the U.S., with western states reporting some of the highest breastfeeding rates and southern states reporting some of the lowest.

Specifically, the report found that the highest breastfeeding rates were in California, at 92.8%; Oregon, at 91.9%; Washington, at 91.8%; and Montana, at 91.2%. Vermont -- at 90% -- was the only other state that met or reached 90% ("To Your Health," Washington Post, 8/1). Vermont also had the highest rate for exclusive breastfeeding at six months, at 29.6% ("The Numbers," Wall Street Journal, 7/31).

By comparison, several southeastern states reported the lowest rates of breastfeeding in the country, including Louisiana, at 56.9%; Kentucky, at 61.3%; Mississippi, at 61.5%; Arkansas, at 67.1%; and Alabama, at 67.3%. Outside the southeast, Delaware, Missouri and West Virginia reported similarly low rates ("To Your Health," Washington Post, 8/1).

Disparities Linked to Culture, Availability of Lactation Consultants

Larry Grummer-Strawn, chief of CDC's nutrition branch, said the agency does not "fully know" what accounts for the differences among regions. However, he ascribed at least some of it to a "different culture ... in the general population and among health professionals," with physicians in the South being more likely to say that breastfeeding "doesn't matter that much."

In addition, the CDC report found that hospitals in areas that reported lower breastfeeding rates had fewer lactation consultants and a smaller percentage of infants who were born in "baby-friendly facilities" ("To Your Health," Washington Post, 8/1).

The Daily Beast notes that some of the states with the lowest breastfeeding rates -- including Delaware, Kentucky, Louisiana, Mississippi and West Virginia -- also have some of the nation's lowest median income levels. Other than Oregon and Montan -- two states with below-median income levels but breastfeeding rates over 90% -- breastfeeding rates tend to increase with states' income levels, the Daily Beast reports (Zadrozny, Daily Beast, 7/31).


Servicewomen Face Barriers to Reproductive Health Services, Report Finds

Mon, 08/04/2014 - 14:05

Women serving in active duty in the military face substantial barriers to reproductive health care services through the military's health system, according to a new Center for American Progress report, the Navy Times reports.

Servicewomen Face Barriers to Reproductive Health Services, Report Finds

August 4, 2014 — Women serving in active duty in the military face substantial barriers to reproductive health care services through the military's health system, according to a new Center for American Progress report, the Navy Times reports.

The report found disparities between services for civilians and those for servicewomen, including access to emergency contraception, other medications and abortion. The report also identified stigma and sexism within military health policies and on the job.

Further, the report noted that rates of sexually transmitted infections among active-duty women are seven times higher than among civilians. Meanwhile, 10% of active-duty women become pregnant each year, with more than half of the pregnancies unintended. The researchers wrote that the unintended pregnancy rate suggests that "accessing appropriate contraception is a real obstacle," contrary to the belief "that service women are irresponsible."

For example, the military's TRICARE insurance program covers sterilization, some birth control pills, diaphragms and intrauterine devices, but it does not cover other common methods like vaginal rings or the Depo-Provera shot. In a survey of servicewomen, 41% said they faced difficulties getting prescriptions for birth control filled while deployed and 50% said they felt uncomfortable accessing care in such settings.

Meanwhile, abortion coverage is only available for pregnancies resulting from rape or incest or if a woman's life is in danger. The lack of coverage can lead to financial hardship, productivity loss and loss of unit cohesion if women are forced to leave their commands, according to the Times.

Recommendations

The report called for lifting the ban on abortion coverage in TRICARE and for allowing women to obtain the procedure at military treatment facilities in all circumstances. It also urged Congress to pass legislation that mandates that the Department of Defense ensures sufficient care for women who have been sexually assaulted.

In addition, the report recommended that DOD provide support to pregnant servicewomen, as well as provide timely and adequate access to gynecological care and contraceptives (Kime, Navy Times, 7/30).


Texas Rule Aims To Increase IUDs, Implant Access for Low-Income Women

Mon, 08/04/2014 - 14:01

A change to Texas' Medicaid program and the state's Women's Health Program aims to increase access to long-acting reversible contraceptives, including intrauterine devices and implants, Kaiser Health News/Texas Tribune reports.

Texas Rule Aims To Increase IUDs, Implant Access for Low-Income Women

August 4, 2014 — A change to Texas' Medicaid program and the state's Women's Health Program aims to increase access to long-acting reversible contraceptives, including intrauterine devices and implants, Kaiser Health News/Texas Tribune reports.

Under the rule change by the state Health and Human Services Commission, participating physicians will be able to order LARC from three specialty pharmacies instead of from a drug wholesaler. Doing so will lower upfront costs for physicians because the pharmacies will be responsible for billing Medicaid and the Women's Health Program to cover the costs. The state hopes the change will result in more physicians offering LARC methods for those patients.

In addition, the rule allows physicians to return unopened LARC products through a "buyback" program. The products will be available at pharmacies in Houston, Fort Worth and Frisco and can be delivered by mail.

Linda Edwards Gockel, a spokesperson for HHSC, noted that paying upfront for LARC products "can be costly for [providers] because these products are fairly expensive."

Ob-Gyns Note Concerns

However, some ob-gyns are concerned that they have received few details about the program from the state. For example, they have not been told how to place orders or how long they must keep a product before they can return it through the buyback program.

Ob-gyn Tony Dunn, vice chair of the Texas branch of the American Congress of Obstetricians and Gynecologists and steering committee chair for the Texas Women's Healthcare Coalition, said, "I don't know how much of an improvement this will be or if it's going to exchange some headaches for other headaches." However, it "is a step in the right direction until we know all the details," he added (Ura, Kaiser Health News/Texas Tribune, 7/31).


Featured Blogs

Fri, 08/01/2014 - 17:28

"Mass. Governor Signs Abortion Clinic Access Bill Into Law" (Walden, "Our Bodies, Our Blog," OurBodies, Ourselves, 7/30) and "'It's Hard for Them To Accept That I Do Abortions Because I'm a Christian'" (Dusenbery, Feministing, 7/31).

August 8, 2014

FEATURED BLOG

 "Mass. Governor Signs Abortion Clinic Access Bill Into Law," Rachel Walden, Our Bodies Ourselves' "Our Bodies, Our Blog": Massachusetts Gov. Deval Patrick (D) on Wednesday signed a bill (S 2281) into law "to protect access to health clinics where abortions are performed," Walden writes. The law, which "will be implemented immediately," was "passed quickly through the legislative process following" the Supreme Court decision striking down the state's "buffer zone" law, which the "[j]ustices said ... went too far in restricting free speech," Walden explains. "Under the new law, protesters may not block access to a clinic entrance or driveway," and it "prohibits the use of force, physical act or threat of force to injure or intimidate someone attempting to enter or leave a reproductive health care facility," she adds (Walden, "Our Bodies, Our Blog," OurBodies, Ourselves, 7/30).

What others are saying about abortion restrictions and access:

~ "Good News: Mississippi's Only Abortion Clinic Can Remain Open," Callie Beusman, Jezebel.

~ "Putting More Restrictions on Abortions Doesn't Magically Inspire Women To Embrace Their Pregnancies," Amanda Marcotte, Slate's "XX Factor."

FEATURED BLOG

"'It's Hard for Them To Accept That I Do Abortions Because I'm a Christian,'" Maya Dusenbery, Feministing: Willie Parker is "one of the two doctors who flies in from out-of-state to work at Mississippi's sole embattled abortion clinic," and his "decision to become an abortion provider is deeply rooted in his Christian faith," Dusenbery writes. She recommends and excerpts a recent Esquire profile that describes Parker as a practical physician who gave up a "'fancy career to become an abortion provider.'" The profile "captures Dr. Parker's motivation for doing this work and the great care and empathy he brings to it," Dusenbery writes (Dusenbery, Feministing, 7/31).

What others are saying about the abortion-rights movement:

~ "We're Fighting for Access, Not Choice," Dawn Laguens, Huffington Post blog.




Ohio Orders Closure of Only Abortion Clinic in Toledo

Fri, 08/01/2014 - 17:24

An Ohio health official on Wednesday signed an adjudication order revoking the license of Toledo's last abortion clinic, effective Aug. 12, the Toledo Blade reports.

Ohio Orders Closure of Only Abortion Clinic in Toledo

August 1, 2014 — An Ohio health official on Wednesday signed an adjudication order revoking the license of Toledo's last abortion clinic, effective Aug. 12, the Toledo Blade reports.

Ohio Department of Health Interim Director Lance Himes signed the order on a recommendation issued in June by a state hearing examiner. The examiner said the clinic, Capital Care Network, should be closed because it does not have a valid emergency transfer agreement with a nearby hospital, which is required by state law.

The clinic has 15 days after the notice is postmarked to appeal the order and ask a court to stay the order pending the appeal.

Clinic's Response

Clinic owner Terrie Hubbard said she would appeal the order and contact every nearby hospital to request an emergency transfer agreement. According to the Blade, Hubbard reached such an agreement with the University of Michigan, but the state rejected it. She has been unable to find another hospital that will sign an agreement with the clinic.

Hubbard's attorney, Jennifer Branch, said, "I'm not surprised by the ruling because the [state] Department of Health seems to be making decision[s] that are not based on medicine or health care but based on politics" (Toledo Blade, 7/30).


Justice Ginsburg Explains 'Buffer Zone' Ruling, Criticizes Hobby Lobby Decision

Fri, 08/01/2014 - 17:23

Supreme Court Justice Ruth Bader Ginsburg on Thursday defended the high court's decision to overturn a Massachusetts "buffer zone" law, the AP/ABC News reports.

Justice Ginsburg Explains 'Buffer Zone' Ruling

August 1, 2014 — Supreme Court Justice Ruth Bader Ginsburg on Thursday defended the high court's decision to overturn a Massachusetts "buffer zone" law, the AP/ABC News reports.

During an interview with the Associated Press, Ginsburg said that the high court's decision to reject the 35-foot buffer zone around abortion clinics in Massachusetts "was not a compromise decision but a good decision to say yes, you can regulate, but it is speech so you have to be careful not to go too far."

She added that the state's defense of the law was weak. "If you looked at what they had in evidence, it was pitiful compared to some in-your-face demonstrations," she said, noting that the state had since replaced the law (Sherman, AP/ABC News, 8/1).




Blogs Discuss 'Real Way To Improve Contraceptive Access,' Profile Abortion Provider, More

Fri, 08/01/2014 - 17:07

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from The Hill, RH Reality Check and more.

Blogs Discuss 'Real Way To Improve Contraceptive Access,' Profile Abortion Provider, More

August 1, 2014 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from The Hill, RH Reality Check and more.

CONTRACEPTION: "The Real Way To Improve Contraceptive Access," Kelly Blanchard et al., The Hill's "Congress Blog": Some Republican lawmakers have "voice[d] support for moving the birth control pill over the counter," but "it's a political maneuver to circumvent the contraceptive coverage guarantee under the Affordable Care Act," according to Blanchard, Daniel Grossman and Britt Wahlin, all of Ibis Reproductive Health. Simply "removing the prescription barrier to birth control is a narrow fix," the authors argue, adding that "cost will continue to be an obstacle for many women" if the pill is not covered by their insurance. "The movement to bring an oral contraceptive over the counter" should be about "increasing access to contraception for all women, not taking contraception out of the political arena or excluding it from insurance coverage," they conclude (Blanchard et al., "Congress Blog," The Hill, 7/30).

What others are saying about contraception:

~ "Hobby Lobby Allegedly Fired Employee Due to Pregnancy," Sofia Resnick, RH Reality Check.

~ "Ruth Bader Ginsburg: Male Justices Don't Understand What Hobby Lobby Meant for Women," Nicole Flatow, Center for American Progress' "ThinkProgress."

~ "New Legislation Would Cover Contraception for Military Servicewomen," Emily Crockett, RH Reality Check.

ABORTION RESTRICTIONS AND ACCESS: "Mass. Governor Signs Abortion Clinic Access Bill Into Law," Rachel Walden, Our Bodies Ourselves' "Our Bodies, Our Blog": Massachusetts Gov. Deval Patrick (D) on Wednesday signed a bill (S 2281) into law "to protect access to health clinics where abortions are performed," Walden writes. The law, which "will be implemented immediately," was "passed quickly through the legislative process following" the Supreme Court decision striking down the state's "buffer zone" law, which the "[j]ustices said ... went too far in restricting free speech," Walden explains. "Under the new law, protesters may not block access to a clinic entrance or driveway," and it "prohibits the use of force, physical act or threat of force to injure or intimidate someone attempting to enter or leave a reproductive health care facility," she adds (Walden, "Our Bodies, Our Blog," OurBodies, Ourselves, 7/30).

What others are saying about abortion restrictions and access:

~ "Good News: Mississippi's Only Abortion Clinic Can Remain Open," Callie Beusman, Jezebel.

~ "Putting More Restrictions on Abortions Doesn't Magically Inspire Women To Embrace Their Pregnancies," Amanda Marcotte, Slate's "XX Factor."

ABORTION-RIGHTS MOVEMENT: "'It's Hard for Them To Accept That I Do Abortions Because I'm a Christian,'" Maya Dusenbery, Feministing: Willie Parker is "one of the two doctors who flies in from out-of-state to work at Mississippi's sole embattled abortion clinic," and his "decision to become an abortion provider is deeply rooted in his Christian faith," Dusenbery writes. She recommends and excerpts a recent Esquire profile that describes Parker as a practical physician who gave up a "'fancy career to become an abortion provider.'" The profile "captures Dr. Parker's motivation for doing this work and the great care and empathy he brings to it," Dusenbery writes (Dusenbery, Feministing, 7/31).

What others are saying about the abortion-rights movement:

~ "We're Fighting for Access, Not Choice," Dawn Laguens, Huffington Post blog.

SEXUAL AND GENDER-BASED VIOLENCE: "Senators Introduce Bipartisan Bill To Address Campus Sexual Assault," Crockett, RH Reality Check: "A bipartisan group of eight senators introduced legislation [S 2692] on Wednesday that aims to improve how college campuses respond to sexual assault," Crockett writes. According to the senators, "the bill is necessary because one in five college women experience sexual assault, and young women are more likely to be sexually assaulted if they are in college than if they are not," Crockett adds. She notes that too often, college sexual assault "survivors are re-traumatized ... because colleges fail to take their claims seriously or do enough to address them" (Crockett, RH Reality Check, 7/30).

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

~ "Why Do We Still Insist Women Share Responsibility for 'Provoking' Their Abuse?" Syreeta McFadden, Feministing.

~ "Gripping New Ad Shows What Happens When You Mix Guns With Domestic Violence," Flatow, Center for American Progress' "ThinkProgress."

~ "Meet Carolina, Who Brought Her Daughters 1,500 Miles to the U.S. So They Wouldn't Be Raped," Jack Jenkins/Esther Yu-Hsi Lee, Center for American Progress' "ThinkProgress."

SUPPORTING WORKING FAMILIES: "Moms Leave the Workforce Because They're Rational Actors, Not Maternal Softies," Jessica Grose, Slate's "XX Factor": "There's an insidious undercurrent of thought in the American corporate world" that "[m]others just don't make good workers" because "[t]heir brains get hormonally addled when they have children, and they take their eyes off the prize and onto their newborns," Grose writes, adding that similar thinking also "often lurks behind public discussions" about the issue. "But the truth is women are rational economic actors, just like men are," she continues, adding that new research shows "that women who get paid maternity leave are less likely to leave their jobs." Grose explains that "more American women are knocked out of the workforce when they have biological children: not because of some magical mind-meld between mother and child, but because having a baby is exhausting and requires a measure of physical recovery," meaning that women have "to take a break ... whether it's paid or not, while a male partner can get by without time off unless he's paid to take it" (Grose, "XX Factor," Slate, 7/29).

What others are saying about supporting working families:

~ "Congress Should Explore Greater Flexibility in the Workplace," Bradford Fitch, Roll Call.


Ohio Orders Closure of Only Abortion Clinic in Toledo

Fri, 08/01/2014 - 16:12

An Ohio health official on Wednesday signed an adjudication order revoking the license of Toledo's last abortion clinic, effective Aug. 12, the Toledo Blade reports.

Ohio Orders Closure of Only Abortion Clinic in Toledo

August 1, 2014 — An Ohio health official on Wednesday signed an adjudication order revoking the license of Toledo's last abortion clinic, effective Aug. 12, the Toledo Blade reports.

Ohio Department of Health Interim Director Lance Himes signed the order on a recommendation issued in June by a state hearing examiner. The examiner said the clinic, Capital Care Network, should be closed because it does not have a valid emergency transfer agreement with a nearby hospital, which is required by state law.

The clinic has 15 days after the notice is postmarked to appeal the order and ask a court to stay the order pending the appeal.

Clinic's Response

Clinic owner Terrie Hubbard said she would appeal the order and contact every nearby hospital to request an emergency transfer agreement. According to the Blade, Hubbard reached such an agreement with the University of Michigan, but the state rejected it. She has been unable to find another hospital that will sign an agreement with the clinic.

Hubbard's attorney, Jennifer Branch, said, "I'm not surprised by the ruling because the [state] Department of Health seems to be making decision[s] that are not based on medicine or health care but based on politics" (Toledo Blade, 7/30).


Hysterectomy Device Recalled Amid Cancer Warnings

Fri, 08/01/2014 - 16:12

Johnson & Johnson on Wednesday asked surgeons to stop using its laparoscopic power morcellator amid growing concerns about the device's potential to unintentionally spread deadly cancers during hysterectomies, the AP/USA Today reports.

Hysterectomy Device Recalled Amid Cancer Warnings

August 1, 2014 — Johnson & Johnson on Wednesday asked surgeons to stop using its laparoscopic power morcellator amid growing concerns about the device's potential to unintentionally spread deadly cancers during hysterectomies, the AP/USA Today reports (AP/USA Today, 7/31).

The company -- which suspended sales of the device in April after FDA advised doctors not to use it -- is sending customers a letter asking them to return the morcellators (Kamp/Levitz, Wall Street Journal, 7/30).

Background

Laparoscopic power morcellation was developed as an alternative to invasive surgery for women with symptomatic uterine fibroids, which are responsible for about 40% of the 500,000 hysterectomies performed each year in the United States. It uses a power device to grind uterine tissue so it can be removed through a tiny incision and is used in about 50,000 procedures annually in the United States.

The technique has come under fire for its potential to spread a type of cancer -- known as a uterine sarcoma -- within the body. A study published last week in the Journal of the American Medical Association estimated that one in 368 women undergoing morcellation had uterine cancer that was undetected until after the procedure.

Earlier this month, an FDA advisory panel said that there are no proven ways to use morcellation for hysterectomies and fibroid removal without risking the spread of malignant cancers to other parts of the body. FDA takes its panelists' recommendations into account when making regulatory decisions, but it has not announced a timeline for making a determination about the use of morcellation (Women's Health Policy Report, 7/24).

Details of J&J Recall

Johnson & Johnson's Ethicon unit, the world's largest manufacturer of laparoscopic morcellators, decided to pull the device from the global market because of the "continued uncertainty" surrounding its use, according to spokesperson Matthew Johnson.

"Ethicon believes that a market withdrawal of Ethicon morcellation devices is the appropriate course of action at this time until further medical guidelines are established and/or new technologies are developed to mitigate the risk," he says (Fay Cortez, Bloomberg, 7/31).

Smaller manufacturers of morcellators, which include German companies Karl Storz GmbH and Richard Wolf GmbH, have not announced plans for the devices (Wall Street Journal, 7/30).


Advocates Call for Better Emergency Contraception Access, One Year After Milestone Victory

Fri, 08/01/2014 - 16:12

Emergency contraception became available over-the-counter without proof-of-age requirements one year ago this week, but federal and state policies continue to limit access to it, according to a new paper from the Reproductive Health Technologies Project, Politico's "Pulse" reports.

Advocates Call for Better Emergency Contraception Access, One Year After Milestone Victory

August 1, 2014 — Emergency contraception became available over-the-counter without proof-of-age requirements one year ago this week, but federal and state policies continue to limit access to it, according to a new paper from the Reproductive Health Technologies Project, Politico's "Pulse" reports (Villacorta, "Pulse," Politico, 8/1).

History of OTC EC

Teva Pharmaceuticals began OTC sales of its EC product Plan B One-Step on Aug. 1, 2013. The move came after U.S. District Judge Edward Korman ruled in April 2013 that age and point-of-sale restrictions should be lifted on all EC drugs, although Korman in June of that year approved an FDA plan of compliance to allow OTC sales only for Plan B One-Step (Women's Health Policy Report, 8/23/2013).

However, FDA this spring said that generic drugmakers also may sell approved versions of the drug OTC without a requirement that consumers provider proof of age. FDA decided to lift the market exclusivity because Teva's "interpretation of the scope of its exclusivity was too broad," an agency official said at the time (Women's Health Policy Report, 3/3).

RHTP Paper

In a two-page paper, RHTP outlined several suggestions for improving access to OTC EC. The group called for contraceptive coverage requirements under the Affordable Care Act's (PL 111-148) preventive services provision to include EC when it is obtained without a prescription, wider access to EC at retail pharmacies, protections from state-level restrictions on EC access and further research into the efficacy of EC in women of higher weights.

RHTP added that the Supreme Court's recent ruling on contraceptive coverage should serve as a reminder "that the fight for unfettered access to safe and effective reproductive health products, like EC, is far from over" ("Pulse," Politico, 8/1).


Justice Ginsburg Explains 'Buffer Zone' Ruling, Criticizes Hobby Lobby Decision

Fri, 08/01/2014 - 16:12

Supreme Court Justice Ruth Bader Ginsburg on Thursday defended the high court's decision to overturn a Massachusetts "buffer zone" law and suggested that the court would have ruled differently in the Hobby Lobby contraceptive coverage case if more of the justices were female, the AP/ABC News reports.

Justice Ginsburg Explains 'Buffer Zone' Ruling, Criticizes Hobby Lobby Decision

August 1, 2014 — Supreme Court Justice Ruth Bader Ginsburg on Thursday defended the high court's decision to overturn a Massachusetts "buffer zone" law and suggested that the court would have ruled differently in the Hobby Lobby contraceptive coverage case if more of the justices were female, the AP/ABC News reports.

During an interview with the Associated Press, Ginsburg said that the high court's decision to reject the 35-foot buffer zone around abortion clinics in Massachusetts "was not a compromise decision but a good decision to say yes, you can regulate, but it is speech so you have to be careful not to go too far."

She added that the state's defense of the law was weak. "If you looked at what they had in evidence, it was pitiful compared to some in-your-face demonstrations," she said, noting that the state had since replaced the law.

Ginsburg during the interview also commented on the Supreme Court's decision in the Hobby Lobby case, noting that "if the court had been composed of nine women the result would have been different" (Sherman, AP/ABC News, 8/1).

Ginsburg also discussed the Hobby Lobby ruling in a separate interview with Katie Couric of Yahoo! News. The justice said that while she "certainly respect[s] the belief of the Hobby Lobby owners ... they have no constitutional right to foist that belief on ... hundreds and hundreds" of female employees (Goodwin, Yahoo! News, 8/1).

However, she added, "I am ever hopeful that if the court has a blind spot today, its eyes will be open tomorrow" (Berenson, Time, 7/31).

Comments on Roe v. Wade

During her interview with Couric, Ginsburg also critiqued the high court's ruling in Roe v. Wade, saying that the "problem with Roe v. Wade was, it not only declared the Texas [antiabortion-rights] law, the most extreme law, unconstitutional, but it made every law in the country, even the most liberal, unconstitutional."

She said the ruling, therefore, "gave the right-to-life people a single" and "very effective target" on which to focus (Yahoo! News, 8/1).