Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
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Featured Blogs

Fri, 02/27/2015 - 20:07

"Oregon Bill Would Ensure Coverage for Reproductive Health Care, Abortions" (Liss-Schultz, RH Reality Check, 2/26); "The Cost of Getting an Abortion is Higher if You're Poor" (Dusenbery, Feministing, 2/26).

February 27, 2015

FEATURED BLOG

"Oregon Bill Would Ensure Coverage for Reproductive Health Care, Abortions," Nina Liss-Schultz, RH Reality Check: Oregon lawmakers on Thursday proposed legislation that "would make Oregon the first state in the nation to ensure every state resident is covered for every type of reproductive health care, including abortion, under all forms of insurance," Liss-Schultz writes. According to Liss-Schultz, the bill is "part of a larger progressive legislative effort ... that will also tackle sexual assault and domestic violence issues." Specifically, the bill would require all insurers to "cover contraception, abortion, prenatal care, childbirth, and postpartum care, including breast-feeding support and folic acid without prescription," she explains. Further, she writes that the bill would bar insurers "from imposing cost-sharing for abortions at more than 10 percent of the cost of the procedure"; prohibit "deductibles for abortions ... altogether"; and "strengthe[n] and protec[t] existing abortion coverage under [the Oregon Health Plan] by removing it from the annual budget and codifying such coverage" (Liss-Schultz, RH Reality Check, 2/26).

What others are saying about the abortion rights movement:

~ "Texans Demand 'Trust. Respect. Access.' From Lawmakers on Reproductive Health," Andrea Grimes, RH Reality Check.

~ "76-Year-Old Texas Man Bikes 300 Miles To Raise Money for Planned Parenthood," Jenny Kutner, Salon.

FEATURED BLOG

"The Cost of Getting an Abortion is Higher if You're Poor," Maya Dusenbery, Feministing: Dusenbery highlights two recent analyses that demonstrate how "[w]hen trying to get an abortion ... it's very expensive to be poor." She writes that a Center for American Progress' "ThinkProgress" report "estimates that 'the process of obtaining an abortion'" in Wisconsin, which has fewer than five abortion clinics and mandates that women take "two trips to the clinic to get an abortion" could be "'up to $1,380 for a low-income single mother saddled with charges related to gas, a hotel stay, childcare, and taking time off work.'" By comparison, she notes the analysis found that the cost would be about $590 "[f]or a middle-income woman living comfortably in a city with no children and public transit options to the clinic," which is not "even accounting for the fact that the middle-income woman might have insurance that covers the procedure, while the low-income woman's Medicaid definitely won't." Dusenbery adds that a recent RH Reality Check analysis found that "the abortion price tag for a poor woman living in Texas's Rio Grande Valley is similar: up to $1,599, not to mention a seven-hour round-trip drive" (Dusenbery, Feministing, 2/26).

What others are saying about abortion restrictions:

~ "Arkansas Governor Signs Telemedicine Abortion Ban," Teddy Wilson, RH Reality Check.

Va. Budget Compromise Excludes Two Antiabortion-Rights Amendments

Fri, 02/27/2015 - 19:48

Virginia General Assembly budget negotiators over the weekend agreed on a compromise plan that does not include two antiabortion-rights amendments from the state House budget proposal, the Washington Post reports.

Va. Budget Compromise Excludes Two Antiabortion-Rights Amendments

February 27, 2015 — Virginia General Assembly budget negotiators over the weekend agreed on a compromise plan that does not include two antiabortion-rights amendments from the state House budget proposal, the Washington Post reports (Vozzella, Washington Post, 2/25).

Both chambers of the state Legislature approved the budget on Thursday, sending it to Gov. Terry McAuliffe (D) (Vozzella, Washington Post, 2/26).

The state House budget proposal had included an amendment (4-5.04 #2h), proposed by state Delegate Steve Landes (R), that would have barred the state's Medicaid program from covering abortions in cases of serious fetal anomalies. The state Medicaid program currently covers abortions in those instances, in addition to cases of rape or incest.

The budget negotiators also agreed not to include an amendment (4-5.04 #6h), proposed by state Del. Robert Marshall (R), that was aimed at preventing McAuliffe from easing certain abortion clinic regulations (Washington Post, 2/25).

The Virginia Board of Health in December voted 13-2 to begin a process to revise several onerous abortion clinic regulations. The process is expected to take up to two years, and the current rules will remain in place in the meantime (Women's Health Policy Report, 12/5/14).


Ohio Abortion-Rights Supporters Speak Out Against Proposed Bans

Fri, 02/27/2015 - 19:31

Ohio abortion-rights groups, college students and some state lawmakers on Wednesday spoke out against abortion restrictions expected to be debated this legislative session, the Cleveland Plain Dealer reports.

Ohio Abortion-Rights Supporters Speak Out Against Proposed Bans

February 27, 2015 — Ohio abortion-rights groups, college students and some state lawmakers on Wednesday spoke out against abortion restrictions expected to be debated this legislative session, the Cleveland Plain Dealer reports (Borchardt, Cleveland Plain Dealer, 2/25).

Earlier this month, state lawmakers introduced a bill (HB 69) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks (Women's Health Policy Report, 2/19).

In addition, Ohio Right to Life has said it will advocate for bills banning abortion at 20 weeks of pregnancy and if genetic tests indicate the fetus has Down syndrome.

A 2011 Ohio law (HB 78) bans abortions at 24 weeks or when a fetus is considered viable. Under the law, physicians are required to determine if the fetus could be viable after 20 weeks (Cleveland Plain Dealer, 2/25).

Comments

Speaking at an event on Wednesday, NARAL Pro-Choice Ohio Executive Director Kellie Copeland said, "One of the things we know about abortion is when it's not legal it still happens, but it's not safe" (Everhart-Sullivan, "The Daily Briefing," Columbus Dispatch, 2/26).

Several lawmakers who support abortion-rights attended a press conference with NARAL Pro-Choice Ohio. State Rep. Kathleen Clyde (D) said, "Instead of respecting women as full human beings capable of making their own decisions and with the right to control their own bodies, legislatures dominated by men around the country spend their time creating more obstacles to women's rights" (Cleveland Plain Dealer, 2/25).


Ohio Abortion-Rights Supporters Speak Out Against Proposed Bans

Fri, 02/27/2015 - 19:28

Ohio abortion-rights groups, college students and some state lawmakers on Wednesday spoke out against abortion restrictions expected to be debated this legislative session, the Cleveland Plain Dealer reports.

Ohio Abortion-Rights Supporters Speak Out Against Proposed Bans

February 27, 2015 — Ohio abortion-rights groups, college students and some state lawmakers on Wednesday spoke out against abortion restrictions expected to be debated this legislative session, the Cleveland Plain Dealer reports (Borchardt, Cleveland Plain Dealer, 2/25).

Earlier this month, state lawmakers introduced a bill (HB 69) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks (Women's Health Policy Report, 2/19).

In addition, Ohio Right to Life has said it will advocate for bills banning abortion at 20 weeks of pregnancy and if genetic tests indicate the fetus has Down syndrome.

A 2011 Ohio law (HB 78) bans abortions at 24 weeks or when a fetus is considered viable. Under the law, physicians are required to determine if the fetus could be viable after 20 weeks (Cleveland Plain Dealer, 2/25).

Comments

Speaking at an event on Wednesday, NARAL Pro-Choice Ohio Executive Director Kellie Copeland said, "One of the things we know about abortion is when it's not legal it still happens, but it's not safe" (Everhart-Sullivan, "The Daily Briefing," Columbus Dispatch, 2/26).

Several lawmakers who support abortion-rights attended a press conference with NARAL Pro-Choice Ohio. State Rep. Kathleen Clyde (D) said, "Instead of respecting women as full human beings capable of making their own decisions and with the right to control their own bodies, legislatures dominated by men around the country spend their time creating more obstacles to women's rights" (Cleveland Plain Dealer, 2/25).


Blogs Discuss Ore. Bill To Protect Repro Health, Why Abortion Costs More for Low-Income Women, More

Fri, 02/27/2015 - 19:09

Read the week's best commentaries from bloggers at RH Reality Check, Feministing and more.

Blogs Discuss Ore. Bill To Protect Repro Health, Why Abortion Costs More for Low-Income Women, More

February 27, 2015 — Read the week's best commentaries from bloggers at RH Reality Check, Feministing and more.

ABORTION-RIGHTS MOVEMENT: "Oregon Bill Would Ensure Coverage for Reproductive Health Care, Abortions," Nina Liss-Schultz, RH Reality Check: Oregon lawmakers on Thursday proposed legislation that "would make Oregon the first state in the nation to ensure every state resident is covered for every type of reproductive health care, including abortion, under all forms of insurance," Liss-Schultz writes. According to Liss-Schultz, the bill is "part of a larger progressive legislative effort ... that will also tackle sexual assault and domestic violence issues." Specifically, the bill would require all insurers to "cover contraception, abortion, prenatal care, childbirth, and postpartum care, including breast-feeding support and folic acid without prescription," she explains. Further, she writes that the bill would bar insurers "from imposing cost-sharing for abortions at more than 10 percent of the cost of the procedure"; prohibit "deductibles for abortions ... altogether"; and "strengthe[n] and protec[t] existing abortion coverage under [the Oregon Health Plan] by removing it from the annual budget and codifying such coverage" (Liss-Schultz, RH Reality Check, 2/26).

What others are saying about the abortion rights movement:

~ "Texans Demand 'Trust. Respect. Access.' From Lawmakers on Reproductive Health," Andrea Grimes, RH Reality Check.

~ "76-Year-Old Texas Man Bikes 300 Miles To Raise Money for Planned Parenthood," Jenny Kutner, Salon.

ABORTION RESTRICTIONS: "The Cost of Getting an Abortion is Higher if You're Poor," Maya Dusenbery, Feministing: Dusenbery highlights two recent analyses that demonstrate how "[w]hen trying to get an abortion ... it's very expensive to be poor." She writes that a Center for American Progress' "ThinkProgress" report "estimates that 'the process of obtaining an abortion'" in Wisconsin, which has fewer than five abortion clinics and mandates that women take "two trips to the clinic to get an abortion" could be "'up to $1,380 for a low-income single mother saddled with charges related to gas, a hotel stay, childcare, and taking time off work.'" By comparison, she notes the analysis found that the cost would be about $590 "[f]or a middle-income woman living comfortably in a city with no children and public transit options to the clinic," which is not "even accounting for the fact that the middle-income woman might have insurance that covers the procedure, while the low-income woman's Medicaid definitely won't." Dusenbery adds that a recent RH Reality Check analysis found that "the abortion price tag for a poor woman living in Texas's Rio Grande Valley is similar: up to $1,599, not to mention a seven-hour round-trip drive" (Dusenbery, Feministing, 2/26).

What others are saying about abortion restrictions:

~ "Arkansas Governor Signs Telemedicine Abortion Ban," Teddy Wilson, RH Reality Check.

CONTRACEPTION: "The Birth Control Method That Doctors Want To Use Themselves," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": Culp-Ressler writes about the findings of a new study published in Contraception showing that "[w]omen's health providers are more than three times as likely," at about 42%, "to select a long-acting reversible contraceptive -- like an [intrauterine device] or an implant -- than the general population." Culp-Ressler adds that the high use among the providers "makes sense, considering the fact that IUDs have been hailed as the 'best birth control' out there" and have been "enthusiastically endorsed by pediatricians and gynecologists alike." Culp-Ressler notes that the researchers suggested sharing the findings of higher LARC use by women's health providers with their patients, "'while maintaining patient choice and autonomy,'" as a means of "spreading the word about " IUDs' benefits (Culp-Ressler, "ThinkProgress," Center for American Progress, 2/24).

ABORTION PROVIDERS AND ACCESS: "Hot Off the Press! Our Published Research on Training and Access," Reproductive Health Access Project blog: The Reproductive Health Access Project highlights findings from its "annual survey of family medicine residents trained in abortion care." According to RHAP, the survey found that "[t]raining in abortion in family medicine residency leads to intention to provide"; "[t]here is a dose-response relationship for training to intention to provide manual vacuum aspiration (MVA) and medication abortion"; there is a strong correlation for "[m]ore complex procedures ... between the number of procedures [performed] and future intention to provide the service"; and "[e]xposure to different abortion procedures has a cumulative impact on the likelihood that the resident intends to provide MVA and medication abortion in the future." RHAP says the findings show that abortion training for family physicians needs to be expanded to ensure reproductive health care is "accessible to everyone" (RHAP blog, 2/25).


Blogs Comment on 'Buffer Zone' Ruling, Gun Violence, More

Fri, 02/27/2015 - 17:02

We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from the Center for American Progress, Care2 and more.

Blogs Comment on 'Buffer Zone' Ruling, Gun Violence, More

February 27, 2015 — We've compiled some of the most thought-provoking commentaries from around the Web. Catch up on the conversation with bloggers from the Center for American Progress, Care2 and more.

BUFFER ZONES: "What Today's Supreme Court Ruling Means for Other Laws That Protect Clinic Patients," Nicole Flatow, Center for American Progress' "ThinkProgress": Flatow notes that in striking down Massachusetts' "buffer zone" law on Thursday, five of the justices reasoned that the law, "among the nation's broadest," was unconstitutional because the state "could not punish such a broad swath of conduct." Although other buffer zone laws could be challenged in wake of the ruling, it is possible that many of them, especially Colorado's and others that are "more specific about the types of conduct they prohibit," might "very well survive the Supreme Court's new test," she writes (Flatow, "ThinkProgress," Center for American Progress, 6/26).

What others are saying about buffer zones:

~ "What is Left of Hill v. Colorado?" Kevin Russell, SCOTUSblog.

GENDER-BASED AND PARTNER VIOLENCE: "NRA Thinks Same-Sex Domestic Violence is No Big Deal," Mindy Townsend, Care2: Townsend takes issue with the National Rifle Association's opposition to Sen. Amy Klobuchar's (D-Minn.) bill (S 1290) "that would make it harder" for convicted stalkers and "people who abuse their partners but don't live together or have children together to buy guns" because the restrictions could apply to same-sex couples. She argues that the "loophole" that allows certain abusers "to get their hands on weapons" is "something that has to be corrected." It is "shameful [of NRA] to use cultural misunderstandings to keep those loopholes in place," she says, adding, "Gay men and lesbians need these protections just as much as heterosexual women do" (Townsend, Care2, 6/26).

GLOBAL ISSUES: "Why #BringBackOurGirls Isn't Enough," Zak Newman, American Civil Liberties Union's "Washington Markup": Despite the popularity of widespread social media campaigns like #BringBackOurGirls, the U.S. government "cannot combat gender-based violence and sex discrimination from the convenience of a Twitter handle," Newman argues, referring to the hashtag used in response to the kidnapping of girls in Nigeria. Instead, "we must commit ourselves to global efforts to eliminate gender-based violence," by passing and ratifying measures such as the International Violence Against Women Act (S 2307) and the Women's Equality Treaty. Supporting both measures "will help us move from words of condemnation to a system of comprehensive action," he argues (Newman, "Washington Markup," ACLU, 6/26).

What others are saying about global issues:

~ "Lucy Liu: Child Trafficking Must End Now," Lucy Liu, Daily Beast.

~ "She The People's Guide to the International Women's Rights Treaty You Have Never Heard Of," Jackie Kucinich, Washington Post's "She The People."

~ "The Clock's Ticking: Can We Still Meet U.N. Goals for Maternal and Child Health?" James Hildebrand, Ms. Magazine blog.

~ "Why We Must Act When Women in Iraq Document Rape," Clare Winterton, Huffington Post blogs.

WORKING FAMILIES: "What Do Working Families Need? The White House Has the Answer," Robin Marty, Care2: President Obama at the White House Summit on Working Families proposed several "basic, simple steps to make sure that more people [can] give birth, house and feed their children," including paid family leave and "living wage[s]" for families, among other issues, Marty writes. However, she adds that while the Obama administration "can work on policies to address federal workplaces, getting real reforms that will help families across the country still seem doomed for as long as the Republican party controls Congress." Marty writes that the GOP, which "presents itself as the party of family values," should "step up and join the Democrats and the White House and promote real laws that make all families stronger" (Marty, Care2, 6/24).

What others are saying about working families:

~ "What was Achieved at the White House Summit on Working Families?" Emily Shugerman, Ms. Magazine blog.

BREASTFEEDING: "Creating a Space for (Talking About) Breastfeeding in Public," Amanda Barnes Cook, Our Bodies Ourselves' "Our Bodies, Our Blog": Barnes Cook, a student teacher at the University of North Carolina-Chapel Hill, discusses the "injustice ... that the real struggles of women's lives cannot be discussed in a public forum" when it comes to breastfeeding "because this issue makes people uncomfortable." In particular, she comments on the role of college faculty in helping to "normalize breastfeeding." She writes, "College professors are in a unique position to do this, since breastfeeding can be discussed in many different departments and used as an example for so many different issues," adding, "Let's remind students, during what may very well be the height of their objectification of women and of their glorification of frivolous sex, that breasts have a purpose, and that sex produces hungry babies" (Barnes Cook, "Our Bodies, Our Blog," Our Bodies Ourselves, 6/24).

What others are saying about breastfeeding:

~ "Facebook No Longer Treats Breastfeeding Photos Like They're Obscene," Tara Culp-Ressler, Center for American Progress' "ThinkProgress."

PEACE CORPS: "Following Senate's Lead, House Appropriations Committee Lifts Peace Corps Abortion Restriction," Emily Crockett, RH Reality Check: The House Appropriations Committee voted to "lift a discriminatory, decades-old restriction" and allow abortion coverage for Peace Corps volunteers in cases of rape, incest or threats to a woman's life, "indicating bipartisan support for a measure that the Senate Appropriations Committee" previously passed, Crockett writes. "Under current law, Peace Corps volunteers, who typically make about $300 per month, cannot receive insurance coverage for abortion care under any circumstance," she explains. She cites a recent report that found that "97 percent of returning volunteers surveyed thought the policy should be changed" (Crockett, RH Reality Check, 6/24).


Va. Budget Compromise Excludes Two Antiabortion-Rights Amendments

Fri, 02/27/2015 - 17:02

Virginia General Assembly budget negotiators over the weekend agreed on a compromise plan that does not include two antiabortion-rights amendments from the state House budget proposal, the Washington Post reports.

Va. Budget Compromise Excludes Two Antiabortion-Rights Amendments

February 27, 2015 — Virginia General Assembly budget negotiators over the weekend agreed on a compromise plan that does not include two antiabortion-rights amendments from the state House budget proposal, the Washington Post reports (Vozzella, Washington Post, 2/25).

Both chambers of the state Legislature approved the budget on Thursday, sending it to Gov. Terry McAuliffe (D) (Vozzella, Washington Post, 2/26).

The state House budget proposal had included an amendment (4-5.04 #2h), proposed by state Delegate Steve Landes (R), that would have barred the state's Medicaid program from covering abortions in cases of serious fetal anomalies. The state Medicaid program currently covers abortions in those instances, in addition to cases of rape or incest.

The budget negotiators also agreed not to include an amendment (4-5.04 #6h), proposed by state Del. Robert Marshall (R), that was aimed at preventing McAuliffe from easing certain abortion clinic regulations (Washington Post, 2/25).

The Virginia Board of Health in December voted 13-2 to begin a process to revise several onerous abortion clinic regulations. The process is expected to take up to two years, and the current rules will remain in place in the meantime (Women's Health Policy Report, 12/5/14).


House Conservatives Add Antiabortion-Rights Amendment to Education Bill

Fri, 02/27/2015 - 17:01

House conservatives on Wednesday added an amendment to an education bill (HR 5) that would withhold federal funding from school districts where school-based health centers provide abortion-related information, the Huffington Post reports.

House Conservatives Add Antiabortion-Rights Amendment to Education Bill

February 27, 2015 — House conservatives on Wednesday added an amendment to an education bill (HR 5) that would withhold federal funding from school districts where school-based health centers provide abortion-related information, the Huffington Post reports.

The House used a "manager's amendment" to add the language to the Student Success Act, which aims to overhaul the No Child Left Behind Act (PL 107-110). Manager's amendments typically are used to make uncontroversial tweaks to legislation, according to the Huffington Post.

The House is expected to vote on the bill on Friday. The White House has said that President Obama would veto the bill if it reaches his desk.

Amendment Details

The amendment, authored by Rep. Randy Neugebauer (R-Texas), would require school-based health centers in school districts that receive federal funding to certify that they do not provide information to students about abortion or perform abortions, even though school-based health centers already do not provide abortion services, according to the Huffington Post (Bassett, Huffington Post, 2/26).

In addition, the bill would prohibit the health centers from providing students with "abortion related materials, referrals or directions."

Comments

Rep. Jared Polis (D-Colo.) said that the amendment represented "a secret attempt to get language into a bill." In addition, he expressed concern that the amendment's ban on distributing materials related to abortion would restrict schools from providing information about other options (Phenicie, CQ Roll Call, 2/26).

Planned Parenthood Action Fund President Cecile Richards said, "This amendment is a cowardly attack on young people's access to the full range of information about their reproductive health care," adding, "This provision ties the hands of health care professionals in schools, and would deny teens access to important and basic information about their health care options" (Huffington Post, 2/26).

Meanwhile, Rep. Virginia Foxx (R-N.C.) said that the bill reflects the viewpoint that abortion-related topics should not be talked about at school (CQ Roll Call, 2/26).

Attempt To Add Birth Control Language Fails

House conservatives also attempted to add an amendment to the bill that would have withheld funding from schools that provide emergency contraception prescriptions or the drugs themselves, but the amendment was ruled out-of-order, according to the Huffington Post (Huffington Post, 2/26).


Large Study Links Mental Illness, Lower Contraceptive Adherence Among Female Veterans

Thu, 02/26/2015 - 22:46

A study examining contraceptive adherence and continuation among nearly 10,000 female veterans found that those with mental illness had higher odds of experiencing gaps of longer than 30 days between contraceptive refills. Veterans with both mental illness and substance use disorder were especially likely to experience long gaps and other disruptions, the researchers found. Reducing barriers to consistent contraceptive use, such as ensuring that long-acting reversible contraceptives are available, or providing the largest allowable supply of user-depended contraceptives to reduce the need for refills, could be beneficial to such women, they wrote.

Large Study Links Mental Illness, Lower Contraceptive Adherence Among Female Veterans

February 26, 2015 —Summary of "Contraceptive Adherence Among Women Veterans With Mental Illness and Substance Use Disorder," Callegari et al., Contraception, Jan. 17, 2015.

Emerging research suggests that mental illness and substance use disorder (SUD) are risk factors for inconsistent contraceptive use or nonuse, which in turn contribute to unintended pregnancy. These risk factors are especially critical for female veterans, given their high rates of certain mental illnesses, according to researchers led by Lisa Callegari of the Department of Veterans Affairs' Puget Sound Health Care System and the University of Washington School of Medicine's Department of Obstetrics and Gynecology.

In prior research, Callegari and colleagues found that female veterans in the VA system who had comorbid mental illness and SUD were less likely than women without such diagnoses to have a documented contraceptive method. The researchers developed a new study to examine contraceptive adherence and continuation among female veterans.

Methods

The study included female veterans ages 18 to 45 who visited a VA primary care or women's health clinic from Oct. 1, 2012, to Sept. 30, 2013. The researchers focused on women who had "hormonal contraceptive coverage (pills, patch, ring, or injection)" in the first week of the study and excluded women who had undergone sterilization or had a long-acting reversible contraceptive method in place. They obtained the data from nationwide VA administrative databases that included pharmacy and clinical records, as well as demographic information.

The researchers used two measurements to evaluate contraceptive adherence among women with refills:

~ The number of gaps in refills lasting at least seven days; and

~ The length of gaps, classified as either seven to 30 days or more than 30 days.

They also used two outcomes to assess continuation:

~ The number of months of contraceptive coverage during the 12-month study period; and

~ Whether women had contraceptive coverage in the last week of the study period, including whether coverage had been continuous over the previous 12 months.

The researchers used diagnostic codes in women's medical records to determine mental illness and SUD, classifying each woman as having mental illness only, comorbid mental illness with SUD or neither diagnosis. They then assessed contraceptive adherence and continuation based on mental illness and SUD groups and conducted multivariable analyses to examine additional associations.

Results

The final sample included 9,780 female veterans, of whom 43.6% had mental illness alone, 9.4% had comorbid mental illness and SUD, and 47% had neither. The most common mental illnesses were depression (67.8%), anxiety (40.4%) and post-traumatic stress disorder (36.9%), while SUD diagnoses were divided into alcohol use disorder (70.3%), drug abuse disorder (55.5%) and both (25.8%). Oral contraceptives were the most commonly used method among women in the sample (68.5%), followed by injectables (15.9%). Just 3.6% of women changed methods during the 12-month study period.

A total of 65% of women with refills experienced at least one gap of at least seven days, with an average of 1.5 gaps per person-year on contraception. There were no significant differences in such gaps among women with or without mental illness and/or SUD.

However, gaps greater than 30 days were more common among women with comorbid mental illness and SUD (48.1%) and mental illness without SUD (45%), compared with women without mental illness (38.5%). Women with mental illness with or without SUD also "had slightly fewer months covered by contraception," the researchers wrote.

In multivariable analyses, the average number of gaps was 12% higher among women with both mental illness and SUD, compared with women with mental illness alone or neither diagnosis. Gaps of longer than 30 days were more common among women with mental illness, both with or without SUD, than among women with neither diagnosis.

Compared with women with neither mental illness nor SUD, women with mental illness alone had 0.4 months less coverage over the study period, and women with both mental illness and SUD had nearly one month less coverage. Further, compared with women with neither diagnosis, women with comorbid mental illness and SUD had 24% reduced likelihood of having continuous coverage during the study period.

Discussion

Overall, "mental illness without or with SUD was associated with poor contraceptive adherence and continuation," Callegari and colleagues wrote. The findings suggest that veterans "with mental illness, particularly those with comorbid SUD, are at increased risk of inconsistent contraceptive use and thus unintended pregnancy," according to the researchers.

For example, they noted that while the majority of women in the study experienced at least one gap in refills, gaps were longer among those with mental illness. Likewise, women with mental illness "had fewer months covered by contraceptives" and those with comorbid diagnoses "had lower odds of continuous 12-month coverage without gaps," the study found.

"[P]rovider education and policy efforts to address unintended pregnancy risk in [Veterans Affairs] are particularly critical," the researchers wrote. They called for "[c]ontinued efforts" to improve access to LARC methods and education to female veterans about the benefits of such methods. In addition, for women with comorbid mental illness and SUD who rely on user-dependent methods, health care providers should provide the largest allowable supply, which research suggests increases compliance and decreases unintended pregnancy.


Focus Groups Show Gaps in Family Planning Services Following Texas Policy Changes

Thu, 02/26/2015 - 22:45

Through focus groups with low-income women and adolescents in Texas, researchers explored the effects of changes to publicly funded family planning programs after the state Legislature cut the programs' budgets and excluded many providers. The study found that while participants had long faced barriers to accessing family planning services, the policy changes compounded these challenges and created new costs and access barriers. Participants and the study authors also offered several recommendations for improving the situation.

Focus Groups Show Gaps in Family Planning Services Following Texas Policy Changes

February 26, 2015 —Summary of "Women's Experience Seeking Publicly Funded Family Planning Services in Texas," Hopkins et al., Perspectives on Sexual and Reproductive Health, June 2015.

In this study, researchers led by Kristine Hopkins of the University of Texas at Austin Population Research Center sought to gauge low-income women's and teenagers' experiences accessing publicly funded family planning services after Texas policymakers enacted "significant changes ... to the funding and administration of the state family planning programs."

Past research has found that low-income women often face barriers "maintaining [family planning] coverage and getting timely services even when services have been expanded," Hopkins and colleagues wrote. However, less is known about low-income women's experiences after family planning access has been "restricted," according to the researchers.

The study is part of the Texas Policy Evaluation Project, a five-year project "documenting the impact of reproductive health legislation implemented by the 2011 and 2013 (HB 2) Texas Legislatures on family planning services, the provision of abortion, and women's contraceptive use and preferences."

For this analysis, the researchers focused on changes after Texas policymakers cut the fiscal year 2012-2013 family planning budget from $111 million to $38 million and created a system that gave specialized family planning providers the lowest priority for funding. As a result, 77% of these specialized providers, such as Planned Parenthood, lost funding from January 2012 to March 2013.

The state also put into effect a previously unenforced ban on the participation of affiliates of abortion providers in the state's Medicaid family planning waiver program, called the Women's Health Program (WHP). As a result, the federal government refused the state's request to renew the waiver program, which had been 90% funded through the federal government. On Jan. 1, 2013, the state launched a state-funded program, known as the Texas Women's Health Program (TWHP).

Methods

The researchers gathered information through focus groups conducted from July 2012 to October 2012, approximately one year after the family budget cuts and priority funding system took effect and before the new TWHP was in place. Using a "semistructured interview guide," the researchers leading the focus groups "assess[ed] participants' perceptions of reproductive health services in their communities and any changes they may have experienced in the last year, as well as their views on how to improve family planning services in Texas."

Participants included adult women ages 18 to 44 and teenage women ages 15 to 17 who were recruited from community-based organizations that offered services other than health care to low-income populations. Sixty-three percent of participants were Hispanic, 29% were black and 7% were white; one participant (1%) identified as multiracial. Sessions were led in Spanish for participants who predominantly spoke Spanish, while other sessions were conducted in English.

"To maximize the geographic diversity," the focus groups included participants from each of the Texas Department of State Health Services' regions. In total, the researchers conducted nine focus groups for adults and two for teenagers.

The researchers then analyzed the focus group transcripts to identify the main themes of the discussions.

Results

In total, the researchers surveyed 92 adult women and 15 teenagers. The adult participants had an average of 2.3 children, and two-thirds of the teenagers were mothers.

In general, participants reported "experienc[ing] difficulties accessing affordable care after the 2011 legislative changes."

The researchers identified three themes that reflected these challenges:

~ Participants had difficulty obtaining publicly funded family planning services prior to the 2011 changes;

~ There were "substantial gaps" in the reproductive health safety net; and

~ Parental consent requirements compounded barriers to care for teens.

The focus groups also revealed that some women preferred obtaining family planning care from specialized providers, while others preferred obtaining such services as part of comprehensive primary care.

Access to Services

The researchers found that while the "vast majority" of participants were not aware of the 2011 legislative changes, they had realized that they were being charged for a larger portion of their care. For example, one black woman in Houston commented that a clinic that had once been "free" had started charging $50 for a well-woman visit.

In response to the increased cost burden, participants described feelings of "shock," anger and distress. Some women described choosing between paying for contraceptives or other needs, such as gas; discontinuing the highly effective contraceptive methods that they preferred; or not visiting clinics at all because of costs.

Qualifying for Subsidized Care

Participants in all nine groups reported long-term difficulties that existed prior to 2011 "in obtaining affordable reproductive health services" and commented "that qualifying for family planning programs could be very difficult," the researchers wrote. Further, women in most of the groups displayed a lack of awareness of the existence of the Women's Health Program, and "[m]any were frustrated by the low-income eligibility criteria" and the processes for applying.

In addition, several participants "pointed out that it was easier to obtain publicly funded pregnancy-related services than contraceptive and reproductive health services, and voiced dismay that they were not better supported in their efforts to prevent pregnancy and provide for their children," according to the study.

Safety Net Issues

The researchers also found that gaps in coverage offered through publicly funded programs disrupted continuity of care. For example, some participants in the Austin area qualified for a "discount card" used for health services, but the federally qualified health centers in the area had few appointments available to women with the card. Others described that some visits or screenings were covered but that prescriptions and treatments related to the same services were not.

According to the study, "[s]everal" participants had experienced rapid repeat pregnancies following the loss of pregnancy-related Medicaid coverage after giving birth. Further, some young adults had "aged out of programs," lost services and then become pregnant.

Participants also experienced barriers to preventive screening services. For example, women who were sterilized reported being unable to obtain Pap tests through the WHP because the program "was only for women at risk for pregnancy," the researchers wrote.

Parental Consent Requirements

The researchers found that minors faced "an additional challenge to accessing family planning services" because of a Texas law that requires they obtain parental consent unless they are at least age 16, not living with their parents and are financially independent. According to the researchers, the requirement deterred teens from accessing services because they would have had to disclose to their parents that they were sexually active or considering having sex.

Participants' Recommendations

The participants shared several recommendations for how "to improve the delivery of family planning and reproductive health services for low-income women in Texas," the researchers wrote.

Some participants liked the idea of having comprehensive health care services for the whole family consolidated in one location, while others favored specialized clinics that only focus on women's reproductive health. Participants also suggested offering more clinics in more locations.

In addition, participants recommended broadening eligibility so it would be easier for working women to qualify for the services. Meanwhile, teens said the parental consent requirement should be removed.

Discussion

In summary, the researchers wrote that low-income women in 2012 faced "higher fees" and "had less access to the highly effective contraceptive methods that they wanted," compared with the time period before policy changes took effect. Further, women "were sometimes forgoing care altogether," they added.

The findings "highlight the need for a robust network of subsidized family planning providers," the researchers wrote. They offered several policy changes that could improve the situation, including:

~ Automatic enrollment of low-income women in the TWHP after the conclusion of their pregnancy-related Medicaid coverage;

~ Enactment of the state Sunset Advisory Commission's recommendation to consolidate women's health and family planning services "into a single program that would start in 2017," for reproductive-age women with incomes up to 185% of the federal poverty level;

~ Steps to ensure "access to a range of qualified providers"; and

~ Ending the parental consent requirement for minors seeking family planning services.

"Any policy changes whose goal is to reduce the fragmentation of services and improve continuity of care should take into consideration these women's and teenagers' experiences with barriers to care and preferences about care providers," the researchers concluded.


Study: Evidence-Based Medical Abortion Regimen 'Highly Effective,' Safe

Thu, 02/26/2015 - 22:42

A study of more than 13,000 women who received "an evidence-based alternative to the FDA-approved regimen" for medical abortion found the evidenced-based regimen to be "highly effective" and safe. According to the researchers, the study "supports the conclusion that legislative efforts to restrict medical abortion to the FDA regimen are based on political goals to restrict abortion services, not efficacy or patient safety."

Study: Evidence-Based Medical Abortion Regimen 'Highly Effective,' Safe

February 26, 2015 —Summary of "Efficacy and Safety of Medical Abortion Using Mifepristone and Buccal Misoprostol Through 63 Days," Gatter et al., Contraception, Jan. 14, 2015.

"Despite the growing literature supporting evidence-based provision of medical abortion, some providers are required by law to limit the provision of medical abortion to that regimen which was FDA-approved more than a decade ago," according to a study by Mary Gatter of Planned Parenthood Los Angeles and colleagues.

Gatter and colleagues sought "to assess, in a much larger cohort of patients [than a previous 2008 prospective study], the safety and efficacy of an evidence-based medical abortion regimen utilizing 200 milligrams mifepristone orally followed by home use of 800 micrograms misoprostol buccally 24-48 hours later through 63 days estimated gestational age."

Methods

The researchers analyzed data from PPLA's network of urban health care clinics in Los Angeles on women presenting for medical abortion between April 1, 2006, and May 31, 2011.

The PPLA facilities since April 2006 have used an evidence-based regimen for medical abortions that "consists of mifepristone 200 mg orally at the health center followed by misoprsotol 800 mcg buccally used by the patient at home 24 to 48 hours later." In February 2009, "the upper gestational age limit for this regimen" increased from 56 days to 63 days. In addition, patients as of 2007 "also received routine antibiotic coverage beginning on the day of the mifepristone administration."

Throughout the study, "[a]ll patients were scheduled to return in 7 to 14 days for a post abortion evaluation" and the study's medical protocols "allowed for repeat doses of misoprostol for patients who had an incomplete medical abortion," according to the researchers.

The researchers defined a "successful abortion" for the purposes of the study "as expulsion of the pregnancy without the need for aspiration." They wrote that "[p]atients who required aspiration for an ongoing pregnancy or symptoms such as pain or bleeding were considered to have had unsuccessful medical abortions."

Results

Overall, the study results included 13,373 women who completed an evidence-based medical abortion regimen and returned for a follow-up visit during the study period. According to the study, the most frequent gestational age range that was between 43 and 49 days (36%), while the least common was 22 to 28 days (4.1%).

The researchers found that 97.7% of women who received medical abortion using the evidence-based regimen had a successful abortion.

Only 307 (2.3%) of the women underwent aspiration, including 70 (0.5%) women who had a continuing pregnancy and 237 (1.8%) women who needed aspiration for a reason other than ongoing pregnancy, most often because of reported bleeding and/or pain symptoms. According to the study, the odds of ongoing pregnancy were 0.15% for a gestational age range of 36 to 42 days and 1.63% for a gestational age range of 57 to 63 days. The researchers noted that when "[c]ompared with the reference category (43 to 49 days), odds of ongoing pregnancy were greater for those at the highest gestational age."

Among all the women in the study, six needed to be hospitalized for any reason, including two as the result of an infection and four for transfusion. Incidence of the need for hospitalization was at or below 0.1% among all ranges of gestational ages.

In addition, the study found that among the 7,335 women for whom data on the need for a repeat dose of misoprostol were available, 87 (1.2%) of the women received a repeat dose.

Discussion

"This study demonstrates that the evidence-based regimen for medical abortion ... is highly effective" and "safe ... through 63 days estimated gestational age," the researchers wrote.

They noted that the study's 97.7% overall success rate "is higher than the efficacy rates reported in two pivotal trials used in submission for FDA approval of mifepristone, yet utilizes one-third the dose of mifepristone ... and buccal administration and home use of misoprostol rather than oral administration in the clinic."

They added that even though "efficacy is lower at later gestational ages, even in the 57 to 63 day range, this evidence-based regimen was still more effective than rates reported in the FDA-approved regimen, which sets the upper gestational age limit at 49 days."

Further, the researchers wrote that "the rates of unsuccessful abortion in this study are lower than the rates reported in the two trials that were initially submitted to the FDA for approval of mifepristone."

According to the researchers, the study "adds to the growing literature supporting provision of medical abortion using evidence-based regimens, and supports the conclusion that legislative efforts to restrict medical abortion to the FDA regimen are based on political goals to restrict abortion services, not efficacy or patient safety."


Datapoints: LARC Use Up, Unintended Pregnancies Down

Thu, 02/26/2015 - 19:49

In today's charts, see how use of the most effective birth control methods has grown over the past decade. Plus, find out where each state stands on unintended pregnancy rates.

Datapoints: LARC Use Up, Unintended Pregnancies Down

February 27, 2015 — In today's charts, see how use of the most effective birth control methods has grown over the past decade. Plus, find out where each state stands on unintended pregnancy rates.

Latest on LARCs



Use of long-acting reversible contraceptives has risen sharply in the U.S. since the early 2000s, after years of steady rates dating to the late 1980s, according to this graph of new CDC statistics on women ages 15 to 44.

LARCs include intrauterine devices and hormonal implants, and they are more effective at preventing pregnancy than other contraceptive methods, like the pill and the patch.

From the 2006-2010 time period to 2011-2013, LARC use rose among every age and racial group that CDC examined. LARC use increased nearly 10-fold during that time period among women with no previous births, while use among women who had given birth before increased by nearly 70% (NCHS data brief, February 2015).


Providers Prefer LARCs



This Vox chart details a survey that found that LARCs are particularly popular among women's health providers, who identified effective pregnancy prevention as their No. 1 concern when choosing a contraceptive method.

Although LARC use is rising among the general population, birth control pills and condoms remain the most commonly used methods among women who use contraception. However, LARCs were the top method among women's health providers in the survey, with 42% using either an IUD or implant (Vox, 2/23).


Unintended Pregnancy, State by State



Unintended pregnancy rates declined by at least 5% in the majority of states from 2006 to 2010, but 28 states still ended the decade with more than half of all pregnancies being unintended, according to a Guttmacher Institute study that examined such trends from 2002 through 2010.

In 2010, most states' unintended pregnancy rates fell into the range of 41 to 54 per 1,000 women ages 15 through 44. The highest rates were mostly clustered in the South and in densely populated states, Guttmacher found (Guttmacher release, 1/26).


Datapoints: LARC Use Up, Unintended Pregnancies Down

Thu, 02/26/2015 - 19:48

In today's charts, see how use of the most effective birth control methods has grown over the past decade. Plus, find out where each state stands on unintended pregnancy rates.

Datapoints: LARC Use Up, Unintended Pregnancies Down

February 26, 2015 — In today's charts, see how use of the most effective birth control methods has grown over the past decade. Plus, find out where each state stands on unintended pregnancy rates.

Latest on LARCs



Use of long-acting reversible contraceptives has risen sharply in the U.S. since the early 2000s, after years of steady rates dating to the late 1980s, according to this graph of new CDC statistics on women ages 15 to 44.

LARCs include intrauterine devices and hormonal implants, and they are more effective at preventing pregnancy than other contraceptive methods, like the pill and the patch.

From the 2006-2010 time period to 2011-2013, LARC use rose among every age and racial group that CDC examined. LARC use increased nearly 10-fold during that time period among women with no previous births, while use among women who had given birth before increased by nearly 70% (NCHS data brief, February 2015).


Providers Prefer LARCs



This Vox chart details a survey that found that LARCs are particularly popular among women's health providers, who identified effective pregnancy prevention as their No. 1 concern when choosing a contraceptive method.

Although LARC use is rising among the general population, birth control pills and condoms remain the most commonly used methods among women who use contraception. However, LARCs were the top method among women's health providers in the survey, with 42% using either an IUD or implant (Vox, 2/23).


Unintended Pregnancy, State by State



Unintended pregnancy rates declined by at least 5% in the majority of states from 2006 to 2010, but 28 states still ended the decade with more than half of all pregnancies being unintended, according to a Guttmacher Institute study that examined such trends from 2002 through 2010.

In 2010, most states' unintended pregnancy rates fell into the range of 41 to 54 per 1,000 women ages 15 through 44. The highest rates were mostly clustered in the South and in densely populated states, Guttmacher found (Guttmacher release, 1/26).


Calif. Permits Signature Collection for Parental Involvement Initiative

Thu, 02/26/2015 - 19:09

California Secretary of State Alex Padilla (D) on Monday gave permission for supporters to begin collecting signatures to attempt to qualify a ballot initiative (14-0014) that would require physicians to notify a parent when a minor seeks an abortion, the Marina Del Rey Patch reports.

Calif. Permits Signature Collection for Parental Involvement Initiative

February 26, 2015 — California Secretary of State Alex Padilla (D) on Monday gave permission for supporters to begin collecting signatures to attempt to qualify a ballot initiative (14-0014) that would require physicians to notify a parent when a minor seeks an abortion, the Marina Del Rey Patch reports.

According to the Patch, supporters have until Aug. 19 to submit 585,407 valid signatures to qualify the measure for the ballot.

Similar measures have been defeated in 2005, 2006 and 2008, the Patch reports.

Measure Details

The measure would require physicians or other medical professionals to notify a minor's parent or legal guardian in writing 48 hours before the minor can obtain an abortion. The measure would provide exceptions for instances involving medical emergencies or when parental waivers or abuse are documented by a notarized statement from specific relatives or law enforcement. In addition, judges would be able to waive the requirement if a minor appears in court and shows maturity or that a waiver would be in her best interest.

In addition, the measure would require providers to report certain information about abortions to the state.

According to an analysis from the California Legislative Analyst and Department of Finance, the measure would cost the state a minimum of $1 million in administrative costs and possibly several million dollars annually. The measure's net fiscal impact on state social service and health programs could be in the millions annually if it affects the number of live births and abortions that occur in the state, according to the analysis (Austin, Marina Del Rey Patch, 2/24).


Vt. Man Files Federal Lawsuit Over Concerns About Marketplace Abortion Coverage

Thu, 02/26/2015 - 19:08

A Vermont man last month filed a lawsuit in federal court against the state's health insurance marketplace for not including any plans that do not include a fee for abortion coverage beyond cases of rape, incest and life endangerment, the Burlington Free Press reports.

Vt. Man Files Federal Lawsuit Over Concerns About Marketplace Abortion Coverage

February 26, 2015 — A Vermont man last month filed a lawsuit in federal court against the state's health insurance marketplace for not including any plans that do not include a fee for abortion coverage beyond cases of rape, incest and life endangerment, the Burlington Free Press reports.

According to the Free Press, similar cases have been filed in Rhode Island and in Connecticut (Murray, Burlington Free Press, 2/24). The Connecticut suit was dropped after the marketplace during the 2015 open enrollment period began including plans that do not include abortion coverage beyond cases of rape, incest and life endangerment.

Background

The Affordable Care Act (PL 111-148) does not prohibit abortion coverage and lets insurers determine whether they will offer it. However, the law requires health plans to segregate money collected for abortion coverage from other premiums. Insurers are not required to segregate the money for abortion coverage in cases of rape, incest or endangerment to the life of the woman.

The ACA requires marketplaces in all states by 2017 to include at least one multistate plan that does not cover abortion services beyond cases of rape, incest and endangerment to a woman's life (Women's Health Policy Report, 1/20). Vermont is one of a few states that did not have such a marketplace plan available during the second open enrollment period, which ended on Feb. 15.

Lawsuit Details

The Alliance Defending Freedom filed the lawsuit in U.S. District Court on behalf of Alan Lyle Howe.

The defendants named in the suit include the Vermont marketplace, known as Vermont Health Connect; HHS; the Department of Labor; the Department of Treasury; and the Office of Personnel Management.

According to the suit, Howe opposes abortion because of his religious beliefs, and paying a fee for elective abortion coverage would "undermine his public opposition to abortion." He enrolled in a marketplace plan during the initial open enrollment period. However, he declined to sign up for coverage during the second open enrollment period and is currently uninsured, according to the Free Press.

The suit states, "Mr. Howe holds a sincere religious belief that he should responsibly steward his resources to provide for his own healthcare. Going without health insurance could have devastating consequences for his own physical and financial health. Thus, it is essential that he continue to have health insurance."

The suit alleges that the defendants in the case are in violation of the Religious Freedom Restoration Act (PL 103-141), the Vermont Constitution and the First Amendment's free speech and free exercise clauses under the U.S. Constitution.

ADF and the plaintiff are asking that Howe to receive relief from potential fines for not enrolling in health insurance, funds to cover expert costs and attorney fees, and other relief. They are also seeking for insurers selling marketplace plans to provide more information about abortion coverage and funds allocated to pay for abortion.

According to the Free Press, the parties have begun to discuss a settlement (Burlington Free Press, 2/24).


Minn. Lawmakers Introduce Bill To Protect Contraceptive Coverage Access

Thu, 02/26/2015 - 19:07

Minnesota legislators have introduced a bill (HF 1165) that would require most employers in the state to include all FDA-approved contraceptives in their health insurance plans at no additional cost to employees, the AP/Minneapolis Star Tribune reports.

Minn. Lawmakers Introduce Bill To Protect Contraceptive Coverage Access

February 26, 2015 — Minnesota legislators have introduced a bill (HF 1165) that would require most employers in the state to include all FDA-approved contraceptives in their health insurance plans at no additional cost to employees, the AP/Minneapolis Star Tribune reports.

According to the AP/Star Tribune, the state House has previously rejected a similar bill. State Rep. Erin Murphy (D), one of the bill's authors, said she does not yet have support for the bill among House Republicans, who control the chamber (AP/Minneapolis Star Tribune, 2/25).

Background

According to KARE, the measure is a response to the Supreme Court's 2014 decision in the case Burwell v. Hobby Lobby to allow closely held corporations to refuse to include contraceptive coverage in their employer-sponsored health plans if the businesses' owners have religious objections to contraception.

Following the ruling, at least seven Minnesota companies have won approval in federal court to refuse to include contraceptives after citing religious objection to including contraceptive coverage in their employee health plans, according to KARE (Croman, KARE, 2/24).

Bill Details

According to AP/Star Tribune, the bill would require most employers in the state to include contraceptives in their health plans if they offer prescription drug coverage (AP/Minneapolis Star Tribune, 2/25).

Specifically, the bill would apply to eligible employers' commercial health plans, KARE reports. It would not apply to companies that self-insure under the federal Employee Retirement Income Security Act (PL 93-406).

The bill also would not bar employers from opting not to offer contraceptive coverage under the Hobby Lobby ruling. However, according to Murphy, the bill would require such employers to disclose that information to prospective employees before they are hired. In addition, such employers would have to include the information on employees' first two pay stubs and in the employee handbook, and they would have to explain to employees how to apply for such coverage directly.

Planned Parenthood of Minnesota, North Dakota, South Dakota, as well as NARAL Pro-Choice Minnesota, supports the measure. A Minnesota Citizens Concerned for Life spokesperson said the organization is neutral on contraceptives (KARE, 2/24).


Ark. Gov Signs Measure To Restrict Medication Abortion

Thu, 02/26/2015 - 19:06

Arkansas Gov. Asa Hutchinson (R) has signed a measure (SB 53) into law that will require physicians to administer medication abortion drugs in person, the Northwest Arkansas Democrat-Gazette reports.

Ark. Gov Signs Measure To Restrict Medication Abortion

February 26, 2015 — Arkansas Gov. Asa Hutchinson (R) has signed a measure (SB 53) into law that will require physicians to administer medication abortion drugs in person, the Northwest Arkansas Democrat-Gazette reports.

The legislation targets the use of telemedicine in abortion care, a practice that is not currently offered in Arkansas.

The bill is schedule to take effect 90 days after the state Legislature adjourns (Wickline, Northwest Arkansas Democrat-Gazette, 2/26).

Law Details

State Sen. Missy Irvin (R) proposed the measure, which will require abortion providers to administer the drugs in person and "make all reasonable efforts" to see a woman who took the drugs within 12 to 18 days for a follow-up. The bill will allow the woman who received the abortion or the man involved in the pregnancy to sue a physician who does not follow the requirements (Women's Health Policy Report, 2/20).

The law will also require the Arkansas State Medical Board to revoke a doctor's license if it finds that he or she performed an abortion in violation of the measure. In addition, the measure states that a penalty "shall not be assessed against the woman upon whom the abortion is performed or attempted to be performed."

Reaction

Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project, said in a statement that "it's crystal clear that these laws are motivated by a desire to keep a woman who has decided to have an abortion from getting one." She added, "We all want women to be safe, but these laws aren't about improving care for women. They're designed by politicians, not doctors, to cut off access to safe, legal abortion by any means necessary" (Northwest Arkansas Democrat-Gazette, 2/26).

Separately, Angie Remington, spokesperson for Planned Parenthood of the Heartland said, "For years, women in Arkansas have watched as politicians chip away at a woman's right to make her own health care decisions. Now, the governor has signed off on Arkansas legislators' decision to ban an extremely safe medical procedure -- one that isn't even practiced in Arkansas at this time -- in an effort to make sure a women there will never have the option of making a thoughtful decision about what is best for her and her family" (Lyon, Arkansas News, 2/25).

Meanwhile, Arkansas Right to Life applauded Hutchinson for signing the measure, tweeting, "Thank you Gov. Hutchinson, Senator Irvin & Rep. Mayberry ... No webcam abortion in AR!" (Northwest Arkansas Democrat-Gazette, 2/26).


W.Va. Senate Passes 20-Week Ban

Thu, 02/26/2015 - 19:06

The West Virginia Senate on Wednesday voted 29-5 to approve a bill (HB 2568) that would ban abortions at 20 weeks of pregnancy, West Virginia MetroNews reports.

W.Va. Senate Passes 20-Week Ban

February 26, 2015 — The West Virginia Senate on Wednesday voted 29-5 to approve a bill (HB 2568) that would ban abortions at 20 weeks of pregnancy, West Virginia MetroNews reports (Kercheval, West Virginia MetroNews, 2/25). The state House approved the bill earlier this month.

After Wednesday's Senate vote, the bill went back to the House for final approval of a title amendment. It now heads to Gov. Earl Ray Tomblin (D), who has five days to take action on the measure, not including Sundays (West Virginia State Journal, 2/25).

The bill is based on the premise that fetuses can feel pain at 20 weeks gestation. However, the American College of Obstetricians and Gynecologists has said that there is no legitimate scientific evidence showing that fetuses are capable of feeling pain at 20 weeks.

The bill would allow exceptions to the ban for medical emergencies but not for instances when the woman faces severe psychological distress (Women's Health Policy Report, 2/17). According to the Gazette, physicians who violate the measure would not face any criminal penalties, but they could have their medical licenses suspended or revoked.

Amendments Rejected

The state Senate on Wednesday also rejected two amendments to the bill.

According to the Charleston Gazette, the Senate voted 28-6 to reject an amendment that would have made the ban apply when the fetus is viable, or around 24 weeks.

State Sen. Corey Palumbo (D) proposed the viability amendment. "The U.S. Supreme Court has been very clear [that] states may not prohibit abortion prior to viability," Palumbo said, adding, "We all have taken an oath to uphold and protect the Constitution, and if we don't support this amendment, this bill is unconstitutional."

In addition, the Senate rejected an amendment that would have allowed exceptions to the ban in cases of rape or incest. State Sen. Herb Snyder (D), who proposed the amendment, said, "[I]f these two criminal issues are irrelevant, it is a very low day for any legislative body" (Kabler, Charleston Gazette, 2/25).

Prospects for Becoming Law

Gov. Earl Ray Tomblin (D) vetoed a similar measure last year, saying that it was likely unconstitutional and would restrict pregnant women's health care. He also said he vetoed the bill because the medical community believes that the measure's legal penalties would have intruded on the patient-doctor relationship (Women's Health Policy Report, 2/17).

According to the West Virginia MetroNews, Tomblin has not indicated whether his stance on the measure has changed (West Virginia MetroNews, 2/25).

The Gazette reports that state lawmakers still have enough time in the legislative session to potentially override a possible veto from Tomlin (Charleston Gazette, 2/25). Overriding a veto requires a simple majority in both chambers. According to the MetroNews, support for bill is likely to pass that threshold (West Virginia MetroNews, 2/25).


Ark. Gov Signs Measure To Restrict Medication Abortion

Thu, 02/26/2015 - 19:05

Arkansas Gov. Asa Hutchinson (R) has signed a measure (SB 53) into law that will require physicians to administer medication abortion drugs in person, the Northwest Arkansas Democrat-Gazette reports.

Ark. Gov Signs Measure To Restrict Medication Abortion

February 26, 2015 — Arkansas Gov. Asa Hutchinson (R) has signed a measure (SB 53) into law that will require physicians to administer medication abortion drugs in person, the Northwest Arkansas Democrat-Gazette reports.

The legislation targets the use of telemedicine in abortion care, a practice that is not currently offered in Arkansas.

The bill is schedule to take effect 90 days after the state Legislature adjourns (Wickline, Northwest Arkansas Democrat-Gazette, 2/26).

Law Details

State Sen. Missy Irvin (R) proposed the measure, which will require abortion providers to administer the drugs in person and "make all reasonable efforts" to see a woman who took the drugs within 12 to 18 days for a follow-up. The bill will allow the woman who received the abortion or the man involved in the pregnancy to sue a physician who does not follow the requirements (Women's Health Policy Report, 2/20).

The law will also require the Arkansas State Medical Board to revoke a doctor's license if it finds that he or she performed an abortion in violation of the measure. In addition, the measure states that a penalty "shall not be assessed against the woman upon whom the abortion is performed or attempted to be performed."

Reaction

Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project, said in a statement that "it's crystal clear that these laws are motivated by a desire to keep a woman who has decided to have an abortion from getting one." She added, "We all want women to be safe, but these laws aren't about improving care for women. They're designed by politicians, not doctors, to cut off access to safe, legal abortion by any means necessary" (Northwest Arkansas Democrat-Gazette, 2/26).

Separately, Angie Remington, spokesperson for Planned Parenthood of the Heartland said, "For years, women in Arkansas have watched as politicians chip away at a woman's right to make her own health care decisions. Now, the governor has signed off on Arkansas legislators' decision to ban an extremely safe medical procedure -- one that isn't even practiced in Arkansas at this time -- in an effort to make sure a women there will never have the option of making a thoughtful decision about what is best for her and her family" (Lyon, Arkansas News, 2/25).

Meanwhile, Arkansas Right to Life applauded Hutchinson for signing the measure, tweeting, "Thank you Gov. Hutchinson, Senator Irvin & Rep. Mayberry ... No webcam abortion in AR!" (Northwest Arkansas Democrat-Gazette, 2/26).


Minn. Lawmakers Introduce Bill To Protect Contraceptive Coverage Access

Thu, 02/26/2015 - 18:53

Minnesota legislators have introduced a bill (HF 1165) that would require most employers in the state to include all FDA-approved contraceptives in their health insurance plans at no additional cost to employees, the AP/Minneapolis Star Tribune reports.

Minn. Lawmakers Introduce Bill To Protect Contraceptive Coverage Access

February 26, 2015 — Minnesota legislators have introduced a bill (HF 1165) that would require most employers in the state to include all FDA-approved contraceptives in their health insurance plans at no additional cost to employees, the AP/Minneapolis Star Tribune reports.

According to the AP/Star Tribune, the state House has previously rejected a similar bill. State Rep. Erin Murphy (D), one of the bill's authors, said she does not yet have support for the bill among House Republicans, who control the chamber (AP/Minneapolis Star Tribune, 2/25).

Background

According to KARE, the measure is a response to the Supreme Court's 2014 decision in the case Burwell v. Hobby Lobby to allow closely held corporations to refuse to include contraceptive coverage in their employer-sponsored health plans if the businesses' owners have religious objections to contraception.

Following the ruling, at least seven Minnesota companies have won approval in federal court to refuse to include contraceptives after citing religious objection to including contraceptive coverage in their employee health plans, according to KARE (Croman, KARE, 2/24).

Bill Details

According to AP/Star Tribune, the bill would require most employers in the state to include contraceptives in their health plans if they offer prescription drug coverage (AP/Minneapolis Star Tribune, 2/25).

Specifically, the bill would apply to eligible employers' commercial health plans, KARE reports. It would not apply to companies that self-insure under the federal Employee Retirement Income Security Act (PL 93-406).

The bill also would not bar employers from opting not to offer contraceptive coverage under the Hobby Lobby ruling. However, according to Murphy, the bill would require such employers to disclose that information to prospective employees before they are hired. In addition, such employers would have to include the information on employees' first two pay stubs and in the employee handbook, and they would have to explain to employees how to apply for such coverage directly.

Planned Parenthood of Minnesota, North Dakota, South Dakota, as well as NARAL Pro-Choice Minnesota, supports the measure. A Minnesota Citizens Concerned for Life spokesperson said the organization is neutral on contraceptives (KARE, 2/24).