“The New Wedge Issue”: It’s A Scary Time To Be A Woman
Last Friday, the Obama campaign released an ad in several swing states attacking Mitt Romney for his stance on abortion. “It’s a scary time to be a woman—Mitt Romney is just so out of touch,” says a woman named Jenni. A narrator explains that Mitt Romney opposes requiring insurance coverage for contraceptives, supports overturning Roe v. Wade, and once backed a bill that would outlaw all abortion, even in cases of rape or incest. The ad concludes: “We need to attack our problems, not a woman’s choice.”
In recent elections, presidential candidates have been wary of diving into explosive abortion politics; in 2008, only $4 million was spent on abortion-related advertising, compared with $39 million on budget-related ads or $88 million on environmental ones. It’s an issue the public remains divided on. According to Gallup, the proportion of Americans identifying as “pro-choice” hit a record low of 41 percent this year, while those describing themselves as “pro-life” hovered around 50 percent. “The minute you take positions on the abortion issue, there are a lot of people you’re alienating,” explains Susan Carroll, a Senior Scholar at the Center for American Women and Politics at Rutgers University. “Usually, candidates try to run away from the issue.” So why is the Obama campaign running toward it?
One reason might be to remind voters of the “War on Women.” Republican lawmakers’ and presidential candidates’ ugly policy proposals this spring—forcing vaginal ultrasounds, defunding Planned Parenthood, weakening the Violence Against Women Act, fighting access to contraception—created an opportunity for Democrats to shave off women voters from the GOP. President Obama had the support of fewer than half of women under 50 in February; by April he was polling above 60 percent, outgunning Romney 2-to-1. But the gap has narrowed in recent months. The Obama ad serves both to remind women of the GOP’s recent history and to tie Romney to the attack on reproductive rights.
Still, the question remains why the Obama campaign didn’t stick to safer ground, focusing on the GOP’s attacks on contraception or maternity care—both broadly unpopular. The answer lies in the Republican Party’s shift to the right. A decade ago, between 30 and 40 percent of Republicans identified as pro-choice. This May, that number was a scant 22 percent. It’s hard to know whether that’s the result of Republicans changing their minds about abortion, or pro-choice respondents ceasing to identify as Republicans. But the result is the same: The party is increasingly uniform in its opposition to abortion.
This, in turn, has opened up an opportunity for Democrats. For most Americans, the abortion question is not all-or-nothing—it’s about where one draws the line. Opinion polling on abortion is highly sensitive to phrasing; despite a majority of the country identifying as “pro-life,” polls also consistently show that a majority of respondents supports access to abortion in at least some circumstances. Politicians have been walking this tightrope for years—“I’m personally pro-life but believe in a woman’s right to choose”; “I believe the issue should be left up to the states to decide”; “Abortion should be safe, legal, and rare.” With the GOP moving further to the right, a wider space has opened for Democrats to pick up abortion moderates. As Ed Kilgore wrote in Washington Monthly earlier this year, if a woman’s right to choose continues to be eroded around the country, it could become more likely that the quiet pro-choice sentiments of the American majority will emerge as a political force.
Romney, meanwhile, is feeling the squeeze. His campaign has disputed the charge that the former Massachusetts governor wants to ban abortion in all circumstances, pointing to remarks he’s made that he supports exceptions for rape, incest, and maternal health. But Romney is limited in how forcefully he can counter the Obama team’s claims lest he upset the conservative base. It’s the basic problem Romney faces across the board: He must appease absolutists while still appearing reasonable enough for the general election. It’s a balancing act the Republican Party’s standardbearers are going to have to struggle with as long as the party champions ideological purity.
By: Daniel Townsend, The American Prospect, August 2, 2012
“Unexpanded Medicaid”: Millions Of Women Could Remain Uninsured If States “Opt Out”
It can seem like just a mirage created by the summer heat: only a few weeks ago the Supreme Court actually handed down a decision that progressives could celebrate. It held that the Affordable Care Act is constitutional, including the individual mandate, meaning that implementation can roll on full steam ahead. I was one of the first to celebrate, in particular for all the ways that the law will help women who need healthcare (which is all of us). As Katha Pollitt recently wrote here, women will benefit dramatically from the ACA. The law bars practices like charging women more just for being women, dropping women’s coverage if they become pregnant or sick, and denying coverage due to “pre-existing conditions” like having had breast cancer or being a victim of domestic violence. It adds new benefits like birth control coverage at no cost to the patient, expanded coverage of preventative services like prenatal care, mammograms, pap smears, and bone-density screenings through Medicare, and requiring insurance companies to cover maternity care.
But one aspect of the Supreme Court’s decision could have some very bad results for women: the ruling that states can opt out of the Medicaid expansion. While this could end up harming men and women, women in particular stand to suffer if states refuse to participate in the program.
The Medicaid expansion is a crucial component of the law’s overall goal of extending coverage to over 30 million uninsured Americans by 2019, covering almost half of the total number of people the bill promised to insure. Originally, the law included a provision that the federal government could take away all of a state’s Medicaid funding if it refused to go along with the expansion, which all but ensured participation. But the Court ruled that such a maneuver was unconstitutional. Just a few days after the decision was announced, seven Republican governors said they would flat out reject the money to expand Medicaid rolls, with at least eight more looking to follow suit. More have said no since then.
This could create a no-man’s land for those who earn less than 100 percent of the Federal Poverty Line, making them ineligible for tax subsidies to help them buy insurance, but don’t qualify for their state’s (unexpanded) Medicaid program. These Americans are surely struggling to get by, but not quite enough to get health coverage promised to those above and below them.
And women are likely to fall into this chasm. Remember that unexpanded Medicaid does not cover most childless adults. Currently, a woman must meet both categorical and income criteria to qualify for Medicaid: she must be pregnant, a mother of a child under age 18, a senior citizen, or have a disability, and each category has income criteria, which differ state by state. Given that women are more likely to be pregnant (duh) but also to fall into the other categories, they are already the majority of enrollees in the program. However, given that many women don’t meet categorical criteria, many don’t qualify no matter how poor they are. Over 17 million women lived in poverty last year, compared to 12.6 million men.
By 2016, 13.5 million women were expected to get coverage under the Medicaid expansion. That figure is now in danger. As the Kaiser Family Foundation reported before the Supreme Court decision, “Medicaid will be the foundation of health coverage expansions to very low-income women.” But not if some Republican governors get their way.
Many of the states already rejecting the expansion are home to the greatest number of women who would benefit. Texas and Florida top the list for the most uninsured women in their states: about 2.4 million and 1.5 million, respectively, and both states plan to refuse the expansion. (Some of these women were supposed to get coverage through the Medicaid expansion, but some will still qualify for the subsidies and be able to buy insurance in the state exchanges.)
Using Kaiser’s predictions, I calculate that there are over 4.2 million women who would be eligible for the Medicaid expansion by 2014 in the states either refusing or indicating they will refuse to participate. That’s a huge chunk of the 10 million women that were expected to be covered by that time through Medicaid.
Those are the immediate impacts on low-income, uninsured women. The ruling may have other far-reaching impacts on women’s lives, however. As Jessica Mason Pieklo writes at RH Reality Check, the idea that the federal government can’t withdraw all Medicaid funds from states that don’t follow federal requirements might have other consequences. The first may be states that are trying to prevent Medicaid from contracting with providers that also offer abortions (i.e., in many cases, Planned Parenthood). Such a case is going on in Indiana right now. As Pieklo writes,
Thanks to the majority in NFIB v. Sebelius, conservative states looking to enact state-wide funding bans may have the framing necessary to pin the federal government. That’s because the language of Roberts’ opinion as to the Medicaid expansion is vague enough to argue that the federal government can’t coerce a state into funding Planned Parenthood by threatening to withhold all of that state’s federal Medicaid money, especially, since conservative states argue, they believe cutting Medicaid funds is the only way to guarantee state dollars do not fund abortion services.
Planned Parenthood and its affiliate centers provide services to 3 million people annually, including 4 million tests for sexually transmitted infections, 770,000 Pap tests, and 750,000 breast exams. Banning Medicaid from contracting with Planned Parenthood will hurt the low-income women who need these services—but states may now have a legal leg to stand on if they try to do just that.
Perhaps the worst thing of all? The excuse that Republican governors are using to get out of the Medicaid expansion may not even hold up. They claim to be worried that even though the federal government will pick up the whole tab for the first few years, the portion they’ll have to pay after that (10 percent) is too burdensome on their budgets. Yet there is evidence that expanding Medicaid could actually help their finances. Rejecting the Medicaid expansion may not even make fiscal sense, but no matter what it doesn’t make moral sense. It could leave millions of women exposed, unable to afford health insurance but not able to participate in Medicaid.
By: Bryce Covert, The Nation, July 17, 2012
“Decimation Of Health Care For The Poor And Uninsured”: Mitt Romney Puts Women’s Lives At Risk
If you want to see what women’s health care in America will be like if Mitt Romney becomes president, just look at Texas and Arizona.
Both states are in the news these past few weeks for trying to prevent women from getting health care at Planned Parenthood. It’s wrong, and it will have devastating consequences for women for years to come—and Mitt Romney wants to do it in all 50 states.
Romney said in November that he wants to eliminate the nation’s family-planning program, which was signed into law by President Richard Nixon in 1970 and provides essential preventive health services to more than 5 million people a year, the vast majority of whom are poor and uninsured.
Beyond the millions of people who are helped by this health-care program, investing in family planning saves the government money—for every dollar spent on family planning, experts say taxpayers save around $4.
Romney said in March that, if elected president, he would “get rid of” Planned Parenthood. He clarified his remarks to say he would end federal funding for Planned Parenthood. Either way, he would seek to dismantle a nationwide network of community-based health centers that one in five American women rely on for care at some point in their lives.
This isn’t about abortion. These health-care programs provide blood pressure and cholesterol monitoring, flu shots, breast-cancer screenings, Pap tests, and birth control. Planned Parenthood is the only medical care many women receive all year.
Michele Azzaro knows what Mitt Romney’s America would look like—because she’s already experiencing it in Texas.
Azzaro has been a Planned Parenthood patient in Dallas for more than 20 years. Planned Parenthood was there when she had a breast-cancer scare, and her local health center has been there when she needs her yearly cholesterol test.
Last year, Texas drastically cut its family-planning funding, the same way Mitt Romney says he would cut federal funding. Michele lost access to annual breast screenings and the birth-control pills she needs to manage her painful uterine fibroids.
She isn’t alone.
An estimated 160,000 women lost their health care when Texas slashed its family-planning program last year. Now, the state is trying to throw more women off health care by taking Planned Parenthood out of the state’s Women’s Health Program. Planned Parenthood health centers provide care to 52,000 women in the program.
Texas’s program provides low-income working women in Texas with lifesaving cancer screenings, well-woman exams, contraception, screenings for diabetes and high blood pressure, and testing for sexually transmitted infections. The program was sponsored and implemented by Republicans less than a decade ago—an indication of how far to the right some in the party have gone in just a few years.
Planned Parenthood sued the state in federal court in order to continue providing these critical health services to women, and last week a federal appeals court blocked the state’s effort to deny women the health care they rely on at Planned Parenthood while the lawsuit proceeds.
Meanwhile, Arizona Gov. Jan Brewer recently signed legislation that cuts state funding for Planned Parenthood’s preventive care. The new law could cut 4,000 women off from the health care they need.
What’s happening in Texas and Arizona isn’t about Planned Parenthood. It’s about Michele Azzaro—and the 3 million people a year who rely on us for cancer screenings, birth control, and well-woman exams.
Our patients aren’t making a political statement when they come to Planned Parenthood. But they’re not afraid to make a political statement to keep the health care they rely on when they vote in November.
“Politics Over Common Sense”: Jan Brewer’s Abortion Grenade, Defunding Planned Parenthood
Arizona’s governor threw yet another political volley at Planned Parenthood Friday night, inking a law aimed at preventing thousands of women on state Medicaid rolls from accessing family-planning services—including breast exams and pap smears—from organizations that also offer abortions.
Jan Brewer signed HB 2800 into law at a gathering of the Susan B. Anthony List, a group that claims on its website that its “grassroots activists” are “on the front lines in the battle to defund America’s abortion giant—Planned Parenthood.”
The bill drew swift reaction from former U.S. surgeon general Richard Carmona, Arizona’s Democratic candidate for senator. At an opening of his campaign office in Phoenix on Saturday, Carmona told The Daily Beast that “anything we do to diminish access of health care to women” is bad policy.
A longtime preventive-health-care advocate, Carmona said in a statement released today: “This is an example of how politics and overheated rhetoric get in the way of common sense. Planned Parenthood provides a vast array of women’s health care services, often reaching under-served communities where health and economic disparities make access to quality care difficult.”
Bryan Howard, president and CEO of Planned Parenthood Arizona, struck a similar note, telling The Daily Beast that the intent of the law is to “score political points” and “demonize” Planned Parenthood to “appease certain segments of the voting public.”
The law will reduce Planned Parenthood’s clients by about 10 percent. About 4,000 women on Medicaid, out of a total of 40,000-45,000 patients overall, visit the organization’s 14 Arizona offices, Howard said.
But the law will likely also impact thousands more who may seek family-planning services from Planned Parenthood when the Affordable Health Care for America Act takes full effect in 2014.
As late as last month, Medicaid officials were still trying to figure out the economic ramifications of the bill, according to The Arizona Republic. Officials were not available for comment on Saturday.
In a statement released in the wake of the ceremonial bill signing, Brewer said: “This is a common-sense law that tightens existing state regulations and closes loopholes in order to ensure that taxpayer dollars are not used to fund abortions, whether directly or indirectly.”
Asked about the political strategy behind signing the bill alongside the Susan B. Anthony List, the governor’s spokesman, Matthew Benson, wrote in an email: “Susan B. Anthony List is one of the nation’s most prominent supporters of pro-life elected officials, and HB 2800 was a high priority of the group. It only made sense to sign the measure into law in front of this group and its members.”
According to the Center for Responsive Politics, the Susan B. Anthony List donates mostly to Republicans. It contributed $511,416 to Rick Santorum’s presidential campaign in 2012, and in 2010 donated about $23,000 to attempt to defeat congressional Democratic pro-choice candidates Gabrielle Giffords, Raul Grijalva, and Ann Kirkpatrick. (Kirkpatrick lost; the other two won their bids.)
Brewer held off signing the HB 2800 until Tea Party legislators passed one of her top priorities: a bill that would make it easier for her to fire and discipline state employees.
Planned Parenthood is considering a legal challenge as its next step. It’s not “acceptable,” Howard said, to have the state prohibit women from choosing where they want to get birth control.
By: Terry Greene Sterling, The Daily Beast, May 5, 2012
“Not To Worry Ladies”: Rick Perry And The Texas GOP Has Your Back
After doing their best to dismantle the Women’s Health Program—and losing federal funding in the process—the state’s Republicans promise they’ll find the money somehow.
Texas health officials are telling low-income women not to worry. The Women’s Health Program, the Medicaid program serving 130,000 women, will still be there for them. Of course, how it will be paid for and whether enough clinics will be left providing services are still subjects up for debate.
The Republican-dominated Texas Legislature cut funding for the program—which offers poor women basic reproductive health services like birth control and cancer screenings—by two-thirds last year. The cuts came out of fear that the health-care providers were too linked with the so-called abortion industry. Just to be safe, conservative lawmakers barred Planned Parenthood from participating in the program. Of course, since the beginning of the program, no public dollars could go to abortions, and women could only participate if they were not pregnant.
The results were swift. The budget cuts resulted in clinic closings around the state, and the decision to exclude Planned Parenthood violated federal policy, meaning that the federal government, which paid for 90 percent of the $35 million program, would no longer pay for any of it. Protests have broken out around the state. Planned Parenthood has already filed a lawsuit.
But not to worry—Governor Rick Perry promised that the state would take over the Women’s Health Program. Yesterday, state health officials unveiled their plan. Step one: Stay on the federal tab a few months longer. Step two: They’re working on it.
The Texas Health and Human Services Commission will ask the feds to keep funding them through November 1. (Texas was supposed to get cut off at the end of April.) By then, presumably, the state will find some way to free up dollars. That’s hardly a cakewalk. Texas has been in a fiscal crisis since 2011. For the last two-year budget, lawmakers had to deal with a $22 billion shortfall, resulting in unprecedented cuts to education and underfunding of Medicaid programs by almost $5 billion. The state has a structural deficit thanks to a dysfunctional tax structure. Yesterday, Perry announced his “Budget Compact,” which asks lawmakers to pledge no new or increased taxes as well as offering voters a constitutional amendment that would limit spending increases to the population growth.
Given the situation, $35 million isn’t going to be easy to find, unless the state comes up with a way to get more federal money. Which may be its best option. According to The Texas Tribune, officials “hinted the state could free up state dollars to fund the Women’s Health Program by seeking federal block grants for other programs.”
But even if they find the money, there’s still the problem of clinics. Planned Parenthood clinics served almost 50 percent of the women participating in the WHP. With those providers out of the picture, the remaining clinics have to shoulder the burden—and they have to do so with a major funding cut. As the Austin Chronicle notes, non-Planned Parenthood clinic Community Action Inc. has had to close 11 of its 13 clinics in Central Texas. The two remaining ones are in danger as well. In their plan for taking over the program, state officials say they will try to increase the number of providers.
The head of the state’s biggest health agency, Tom Suehs, has promised that things will be fine, dismissing the “scare tactics and misinformation campaigns.” The bigger challenge, he says, is “making sure women get accurate information about the program in the midst of organized attempts to confuse and frighten those who rely on it.”
Maybe it’s just me, but what’s confusing is a health-care policy that makes it hard to access health care.
BY: Abby Rapoport, The American Prospect, April 18, 2012
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