“A Crisis Turned Catastrophe In Texas”: Women Have Been Relegated To Second Class Citizenship
Last night, a decision by the 5th Circuit Court of Appeals left Texas with no more than eight remaining abortion clinics. You would think by now the willingness of state lawmakers to deliberately create a health crisis among their constituents – and the willingness of the courts to allow it – would be no surprise. But I continue to be shocked.
“All Texas women have been relegated today to a second class of citizens whose constitutional rights are lesser than those in states less hostile to reproductive autonomy, and women facing difficult economic circumstances will be particularly hard hit by this devastating blow,” said the Center for Reproductive Rights’ Nancy Northrup.
House Bill 2 could be the grand finale in Texas’ efforts to completely dismantle its reproductive health infrastructure on which women – particularly poor women, women of color, young women, and immigrant women – have relied for decades. Pretty soon there won’t be any clinics left to close. Just three years ago, conservative lawmakers gutted the state’s family planning program, which closed approximately 80 family planning providers across the state, caused 55 more to reduce hours, and left hundreds of thousands of women without access to reproductive healthcare. Even before those programs were eviscerated, they provided care and services to only 20 percent of women in need.
And as if that wasn’t enough, lawmakers introduced HB2, a bill that imposes onerous restrictions on abortion providers and demands that all clinics meet costly – upwards of $1 million – building requirements to qualify them as ambulatory surgical centers (ASCs). Lawmakers claimed these regulations were critical to protecting the lives and health of Texas women, but that’s simply not the case. Currently more than three-quarters of the state’s ASCs have waivers that allow them to circumvent certain requirements: unsurprisingly, abortion providers are prohibited from obtaining those same waivers. HB2 quickly closed the majority of the state’s 41 clinics that offered abortion services – clinics that also provided birth control, pap smears, breast exams, pregnancy tests, and a host of other services. There are few, if any, providers to take their place.
These new restrictions add an unbearable weight to the burdens that too many of Texas’ women already shoulder. Texas has one of the nation’s highest unintended and teen birth rates. The nation’s lowest percentage of pregnant women receiving prenatal care in their first trimester. The highest percentage of uninsured children in the nation. High rates of poverty and unemployment and a woefully inadequate social safety net. And lawmakers who refuse to expand Medicaid, leaving nearly 700,000 women who would qualify for coverage without it.
Just a few weeks ago, Judge Lee Yeakel of the United States District Court in Austin gave health advocates an iota of hope when he ruled HB2 to be an undue burden on women’s constitutionally guaranteed right to an abortion. Yeakel’s decision wasn’t just significant because it delivered a win for humanity in Texas after countless losses, or because the concept of an undue burden was finally being used to protect – not erode – women’s right to chose, but because it was based on facts. Facts! Judge Yeakel relied on incontrovertible data to call BS on a law that purports to protect women, but has only ever been about abolishing abortion access.
He argued that for many women, HB2 might as well be an outright ban on abortion. He asked how the eight (at most) providers left could ever each serve between 7,500 and 10,000 patients. How would they cope with the more than 1,200 women per month who would be vying for limited appointments? “That the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity,” he said.
Yeakel acknowledged the complex intersections of women’s health and economic (in)security:
The record conclusively establishes that increased travel distances combine with practical concerns unique to every woman. These practical concerns include lack of availability of child care, unavailability of appointments at abortion facilities, unavailability of time off from work, immigration status and inability to pass border checkpoints, poverty level, the time and expense involved in traveling long distances, and other inarticulable psychological obstacles. These factors combine with increased travel distances to establish a de facto barrier to obtaining an abortion for a large number of Texas women of reproductive age who might choose seek a legal abortion.
Yeakel warned that the stated goal of improving women’s health would not come to pass. And it won’t. The increased delays in seeking early abortion care, risks associated with longer travel, the potential increases in self-induced abortions “almost certainly cancel out any potential health benefit associated with the requirement,” he said.
But Yeakel’s arguments were not compelling enough for the 5th Circuit, which finds it perfectly acceptable that more than one million women now need to travel more than 300 miles (and many women even further) to access health care that is constitutionally guaranteed to them.
This decision will have a ripple effect. Other anti-choice lawmakers across the country are following Texas’ lead, imposing similar restrictions on clinics and physicians who provide abortions. The vindication of Texas lawmakers who have used their legislative power to wreak havoc on the lives of women and families will only continue to embolden other states seeking the same goals.
Conservatives like to argue that they are not waging a war on women. Today there are a whole lot of us who find it impossible to argue otherwise.
By: Andrea Flynn, Fellow at the Roosevelt Institute, The National Memo, October 3, 2014
“In Case Anyone Is Confused”: Don’t Fall For The GOP’s Over-The-Counter Contraception Racket
It’s time to call bullshit on the GOP’s embrace of over-the-counter birth control. Several Republican candidates, under fire for radical positions on women’s health, have recently adopted the idea in a naked attempt to woo female voters. These politicians say they’re all in favor of access to contraception. But sudden calls for the pill to be available without a prescription do not signal a real shift in conservative attitudes toward reproductive rights. They simply mask tired opposition to the Affordable Care Act’s mandate that insurers cover birth control.
The list of Republicans that have endorsed the idea includes Senate nominees Cory Gardner (Colorado), Tom Tillis (North Carolina), Ed Gillespie (Virginia) and Mike McFadden (Minnesota). Republicans running for the House have also spoken up for over-the-counter access.
None of these people were championing the proposal before their campaigns. Instead, they were working to limit women’s access to abortion and other healthcare. Gardner, who started the over-the-counter trend in June with an op-ed in The Denver Post, has campaigned for “personhood” measures that would outlaw abortion and possibly some forms of birth control since at least 2006. Early in his campaign Gardner denounced the state-level personhood legislation he’d supported—yet he’s still a co-sponsor on a federal bill that would have the same impact. Gardner has resorted to claiming that bill doesn’t exist.
Then there’s Tom Tillis, who endorsed over-the-counter birth control during a debate with Democratic incumbent Kay Hagan in September. As the top Republican in the state House, Tillis shepherded extreme anti-choice legislation in a decisively dishonest manner, inserting restrictions into unrelated bills like one ostensibly about motorcycle safety. Tillis, like other Republicans trumpeting their support for over-the-counter contraception, opposes not only the ACA’s birth control mandate but the healthcare law in general, which has a range of other benefits for women.
The latest candidate to pivot to contraception when confronted about her record is Joni Ernst, a Senate hopeful in Iowa who supports a personhood amendment as well as criminal prosecution of doctors who provide abortions. “When it does come to a woman’s access to contraception, I will always stand with our women on affordable access to contraception,” she said. Her campaign did not respond to a request to clarify which specific policies she supports that would increase affordability and accessibility.
In case anyone is confused: while affordable contraception does dramatically reduce rates of unintended pregnancy, it does not solve the problems created by cutting off women’s access to abortion services. In fact, attempts to block abortion access—for example, by cutting funds for clinics like Planned Parenthood that provide a range of services besides abortion—can have the perverse effect of making it more difficult for women to get other healthcare, birth control included.
Nor is making contraception available without a prescription an alternative to the birth control mandate (or, needless to say, the entire healthcare law). Over-the-counter birth control has support from the American College of Obstetricians and Gynecologists, a point that several Republican candidates have pointed out when their motives were questioned. Yet the same medical association is quite clear that women still need insurance coverage for contraception. Not all women can or want to take the pill, and other forms of birth control like the IUD are expensive and require a doctor’s appointment. In June, ACOG warned politicians against using calls for over-the-counter contraception “as a political tool.”
That Republicans need such a tool to alter their reputation among women is obvious. Young women are the key demographic in many midterm battlegrounds, and according to a Wall Street Journal/NBC News poll conducted in July and August, they prefer a Democrat-controlled Congress by a fourteen-point margin. (Men, on the other hand, favor Republicans by seventeen points.)
But why over-the-counter birth control, specifically? It’s a win-win-win for Republicans trying to appeal to female voters, while bashing Obamacare and boosting their free-market street cred. Candidates can say they support access to contraption while celebrating a “market-based approach to medicine,” as the editorial board of National Review described it recently. The editors commended Republicans for “running…to get government out of the birth-control business as much as possible, and to free up access to it for the women who want it.”
To understand why this sudden embrace of “access” is a racket, and a dangerous one, consider Kevin Williamson, National Review’s self-described “roving correspondent.” In a recent post titled “Five Reasons Why You’re Too Dumb to Vote,” Williamson characterizes women who care about preserving access to abortion or the birth control mandate as “women who cannot figure out how to walk into Walgreens, lay down the price of a latte, and walk out with her own birth-control pills, no federal intervention necessary.” He goes on to applaud the editorial board’s endorsement of the over-the-counter birth control fad.
A few days later, Williamson declared that women who have abortions should be hanged. “I’m torn on capital punishment generally; but treating abortion as homicide means what it means,” he said on Twitter. To be clear: what “pro-life” Williamson is arguing for is putting one in every three women in the United States to death.
“Democrats are not resisting the GOP’s suggestion because of any quibbles with its policy substance,” National Review said in response to suggestions that the GOP’s embrace of over-the-counter birth control smacks of opportunism. “They hem and haw because they want to continue to depict Republicans as intent on keeping contraceptives away from women.”
It doesn’t matter what Republicans are or aren’t intent on. The bottom line is that a variety of conservative positions, from opposition to the ACA to federal funding for women’s clinics, have had or would have the very real effect of making it more difficult for women to access healthcare in general and contraceptives specifically.
Furthermore, contraception is hardly the sum of women’s medical needs. When conservatives fight to empower women to make decisions about their own bodies in all cases, regardless of income, then maybe we’ll take them seriously. In the meantime, there’s little of substance in an ideology that promotes birth control without a prescription for some women and hanging for others.
By: Zoe Carpenter, The Nation, October 3, 2014
“Nowhere To Hide”: Chris Christie Suddenly Suffers The Unbearable Specificity Of Running For President
Chris Christie went to Iowa this week, bringing what reporters inevitably call his “trademark New Jersey style” to the heartland, where he could mix and mingle with the small number of Republican voters who have the power, a year and a half hence, to either elevate him or crush his White House dreams. And in the process he got an education in what running for president means. While we often describe candidates as having to “move to the right” in the primaries (or to the left for Democrats), what actually happens is often not a move to the edge, but a descent from the general to the specific.
And in practice, that can mean much the same thing. Here’s a report from one of Christie’s events:
New Jersey Gov. Chris Christie (R) said Thursday that he backs the Supreme Court’s Hobby Lobby ruling, after declining to give an opinion on the outcome of the case earlier this month.
Christie voiced his support in response to a question from an attendee at a meet-and-greet event in Marion, Iowa, where Christie was campaigning for Iowa Gov. Terry Branstad (R). The Democratic research super PAC American Bridge caught the exchange on video.
“Do I support the Supreme Court decision in the Hobby Lobby case? I do,” Christie said, according to the video posted by American Bridge.
“Do you support Hobby Lobby’s position on birth control for its employees?” the attendee pressed.
“Well I just said I support the case, so if I support the case and they support the Hobby Lobby–” Christie said before moving on to greet other attendees.
If you’re a governor, you can dodge questions for long periods simply because you don’t have to answer that many of them. I don’t know how often Christie does a press conference, but it’s not that frequent. And when he goes out to do events around his state, people are going to ask him about whatever local issues they’re concerned about. He doesn’t need a well-considered position on every national issue that comes up.
But once you go to Iowa to meet with people who are only thinking of you as a presidential candidate, not only do you have to answer more questions, they come at you in contexts like a Des Moines living room or a Sioux City diner. Unlike when you’re giving a press conference, you can’t say, “That’s all the time we have today, folks” and walk out. If you don’t answer to someone’s satisfaction, they’re going to keep pressing you until you do, and you might just lose them. Back a zillion years ago when I was working on a presidential campaign, I gave one voter a compelling argument for why he should vote for my candidate, and he replied that though I made some sense, a few weeks before he went to an event with my candidate, and he had a question for him but never got the chance to ask it, so he was voting for somebody else. I wanted to throttle the guy.
So not only do you have to answer more questions, those questions come with follow-ups, and the activist voters you’re hoping to win over at this stage aren’t going to accept “Well, it’s complicated” as an answer on anything. So candidates have to come out clearly in favor of something like the Hobby Lobby ruling—absolutely non-negotiable with the Republican base, but broadly unpopular with the general public.
What that means is that “moving to the right” is produced by the practicalities of running in a retail election, where voters in some places (two states in particular) want to stick their finger in your chest and take the measure of you before they’ll deign to bestow their vote up on you. In that context, there’s nowhere to hide.
By: Paul Waldman, Contributing Editor, The American Prospect, July 18, 2014
“The High Court’s Highhandedness”: Rulings Are Based Less In Law Than In The Personal Beliefs Of The Men On The Tribunal
It is a case of Supreme hypocrisy.
The adjective refers to that nine-person tribunal at the top of the American legal system, the noun to its latest act of judicial malpractice. Meaning not the notorious Hobby Lobby decision handed down at the end of June, but a less-noticed ruling a few days later.
We have to revisit the former to provide context for the latter. On June 30, the court ruled that a “closely held” corporation may deny employees health insurance covering any contraceptive method that conflicts with the company’s religious beliefs. Writing for the majority, Justice Samuel Alito faulted the government for failing, under the Affordable Care Act, to choose the “least restrictive” means of ensuring women access to all FDA-approved methods of birth control. He pointed out that the ACA already makes an exemption for nonprofit groups with religious objections; simply fill out a form certifying those objections and they are relieved from having to provide the disputed contraceptives.
Alito saw this as a win-win. Employees get the birth control they want — they pay directly to the insurance company — but the government does not “impinge” on the organization’s religious beliefs.
Three days later, the court issued an injunction freeing a Christian school — Wheaton College in Illinois — from having to fill out the certification form. The school had argued that simply doing the paperwork — the form asks only for name, contact information, signature and date — infringed upon its religious liberty because it would trigger the employee’s ability to get the disputed contraception. So the same form that the court held to be a reasonable compromise on Monday was judged an unreasonable burden on Thursday. Or as Justice Sonia Sotomayor put it in a withering dissent, “Those who are bound by our decisions usually believe they can take us at our word. Not so today.”
Indeed, the malleability of the court’s logic suggests these rulings are based less in law than in the personal beliefs of the men on the tribunal. One gets the sense they chose the desired result first, then backfilled whatever “reasoning” would get them there.
Which is not just Supreme hypocrisy, but also Supreme faithlessness. And, yes, Supreme sexism.
I once saw a protest sign to the effect that if men gave birth, contraception would be bacon flavored and dispensed from vending machines. Can anyone argue the truth in that? Would we even be having this debate if some company had a religious objection to Viagra — or vasectomies?
And how far down the line must a company’s religious scruples be honored anyway? If it is too much to ask Wheaton College to fill out a form because an employee will be “triggered” to buy contraception on her own, does the school also have a right to scrutinize and approve other purchases made with the salary she earns from them? If she buys whiskey or pornography with “their” money, does the school have a right to object?
Not to mention the frightening precedent the court is setting in the name of religious liberty. It makes faith a potential get-out-of-jail-free card, exempting the holder from any law he finds onerous. Given that Mormons once embraced a theology of racism and evangelical Christians still deny basic freedoms to gay people, the danger of this is obvious.
In its rush to confer personhood on organizations and constrain women’s choices, the court steers us toward a day in which corporate rights would trump human rights and you could no longer take for granted that you would be served by a given business without first checking to make sure you didn’t offend the owner’s religious sensibilities. It’s hard to imagine what that world would be like.
Pretty soon, we may not have to.
BY: Leonard Pitts, Jr., Syndicated Columnist, The Miami Herald; Published in The Seattle Times, July 13, 2014
“The Default Setting”: Why Your Employer Can’t Cut Off Your Contraception Coverage
On the Fourth of July, while you were stuffing your face with patriotic burgers and watching patriotic fireworks, the Supreme Court handed down an emergency injunction in a case involving Wheaton College’s objection to the Affordable Care Act’s contraception benefit, a decision that acted as an addendum to the Hobby Lobby decision. As I ranted over here, this is the decision that could really open the floodgates to thousands of claims from all kinds of organizations and companies that don’t want to let their employees get contraception. But after thinking and reading about it for a while, there’s something I think everyone seems to be missing, and it could mean that no one is actually going to lose their coverage, even temporarily.
I should say that it’s entirely possible that I’m completely wrong about this, and there’s some bureaucratic detail deep within the ACA that I’ve overlooked. But the first thing to remember is that the ACA requires that insurance plans cover a variety of kinds of preventive care, including contraception; this issue is about what exactly a company or organization has to do when they have an objection to contraception coverage. The Obama administration constructed an alternative arrangement, which until now was supposed to be used only for religiously affiliated non-profits but, after the Hobby Lobby decision, may have to be used for basically anyone, including for-profit companies. The way it works is that if your group doesn’t want to be tainted by the sin of contraception, there’s a form you file with the government stating your objection. You send a copy to your insurer or third-party administrator (TPA), and the insurer/TPA (I’m just going to say insurer from this point on) arranges for the coverage with the government, by getting reimbursed out of other funds.
The problem is that Wheaton College, along with dozens of other organizations that have filed suit, believes that just filling out this form and sending it to their insurer makes them complicit in sin, because doing so triggers the arrangement under which their employees will get coverage. Let’s leave aside the merit of this belief, but by granting the emergency injunction the Court’s majority essentially accepted that filling out the form and sending a copy to their insurer was indeed a burden on Wheaton’s religious freedom. This made Sonia Sotomayor absolutely livid, since just four days before the Court had used the existence of that very form as proof that there was a less restrictive alternative than the contraception mandate available.
So what Wheaton would prefer is that they not fill out the form and send it to the insurer. Instead, they want to send a letter to the government just stating their objection—a letter which wouldn’t have to inform the government of who their insurer is. In her dissent, Sotomayor warned that this could become a bureaucratic nightmare, because now the government has to figure out who the insurer is for every company that sends a letter, so they can get in touch with the insurer and arrange the alternate payment procedure for contraceptive coverage.
And this is where I’m puzzled. Because under the ACA, ordinary insurance coverage has to provide prescription contraception with no cost-sharing (meaning without copayment or deductable). That’s the default setting. So let’s say I’ve started a new non-profit aimed at educating America’s youth about the important cultural contributions of 1980s hair metal bands. I get health insurance for my employees, and because of the requirement in the ACA, it includes coverage for contraception. Then after spending an extended period listening to Stryper, I realize that contraception is sinful and try to deprive my employees of it.
Depending on the outcome of these cases, I may have a couple of options. I can file the original form with the government and send a copy to my insurer, in which case those two will arrange for my employees’ contraception coverage to continue. If I object to the form, as Wheaton College does, I’ll just send a letter to the government saying “I’ll have none of this!”
But since I don’t want to inform my insurer and thus trigger the alternate arrangement, my insurer has no idea that I object to contraception coverage. That means they’ll continue to provide it to my employees, as the law requires. If because of ordinary bureaucratic slowness it takes the government a while to find my insurer and inform them of my objection, my employees will still have contraception coverage in the meantime. Whether I’m active or passive the coverage continues, either because the alternate arrangement has been triggered, or because the insurer keeps doing what they’ve been doing because they don’t know of my objection.
To repeat, there may be something I’m missing here. But it seems that even if the Hobby Lobby and Wheaton cases impose more bureaucracy and make things more cumbersome for the government and insurers, as long as contraception coverage without cost-sharing is the default setting for insurance plans, people won’t actually have their coverage interrupted, no matter what the preferences of their employer.
By: Paul Waldman, Contributing Editor, The American Prospect, July 7, 2014
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