Daily Women's Health Policy Report

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Daily Women's Health Policy Report by the National Partnership for Women & Families
Updated: 1 hour 43 min ago

Walker v. Jesson

Fri, 11/21/2014 - 22:57

Demand for declaratory and injunctive relief against the state Department of Human Services (DHS), accusing DHS of using public funds to pay for non-therapeutic abortions for indigent women.

Walker v. Jesson

Demand for declaratory and injunctive relief against the state Department of Human Services (DHS), accusing DHS of using public funds to pay for non-therapeutic abortions for indigent women. In Minnesota, public funds may be expended to cover therapeutic abortions for indigent women; Plaintiffs alleged that non-therapeutic procedures have been covered, as well. Plaintiffs requested that the court enjoin all public coverage of abortions until the state can demonstrate that only therapeutic abortions will be covered and then to only allow a narrow subset of circumstances to qualify as “therapeutic.” On May 2, 2013, the state district court dismissed the case with prejudice, meaning that the case cannot be re-filed. Plaintiffs appealed the decision to the Minnesota Court of Appeals. On May 5, 2014, the state Court of Appeals upheld the lower court’s dismissal. Plaintiffs petitioned the Minnesota Supreme Court to review the case. Final Outcome: On August 5, 2014, the Minnesota Supreme Court denied Plaintiffs’ appeal, and the state continues to cover therapeutic abortion care for indigent women. (See the dismissal order here. See the Court of Appeals opinion here. Read more about the case here.)

Choice, Inc. of Texas v. Greenstein

Fri, 11/21/2014 - 22:33

Federal court challenge to Louisiana law that expands the state’s authority to suspend or revoke the licenses of outpatient abortion facilities, thus restricting access to care for Louisiana women.

Choice, Inc. of Texas v. Greenstein

Federal court challenge to Louisiana law that expands the state’s authority to suspend or revoke the licenses of outpatient abortion facilities, thus restricting access to care for Louisiana women. In February 2011, the U.S. District Court for the Middle District of Louisiana dismissed Plaintiff's case as not ripe. Final Outcome: In August 2012, the 5th Circuit Court of Appeals upheld the district court decision. (See the law here. See the complaint here. See the district court opinion here. See the 5th Circuit opinion here. Read more about the case here.)

Hodes & Nauser v. Moser

Fri, 11/21/2014 - 22:17

Federal court challenge to temporary regulations and licensing process adopted and implemented by the Kansas Department of Health and Environment.

Hodes & Nauser v. Moser

Federal court challenge to temporary regulations and licensing process adopted and implemented by the Kansas Department of Health and Environment. In July, 2011, the U.S. District Court for the District of Kansas granted Plaintiffs’ motion for preliminary injunction. Final Outcome: The temporary regulations at issue in this case were superseded by permanent regulations. The permanent regulations were challenged in state court in a case also captioned Hodes & Nauser v. Moser. (See the regulations here. Read more about the case here.)

ACLU of Kansas and Western Missouri v. Praeger

Fri, 11/21/2014 - 22:05

Federal court challenge to a Kansas law that prohibits insurance coverage of abortion and abortion-related services.

ACLU of Kansas and Western Missouri v. Praeger

Federal court challenge to a Kansas law that prohibits insurance coverage of abortion and abortion-related services. In September 2011, the U.S. District Court for the District of Kansas denied a motion for preliminary injunction. In March 2012, the court denied a motion to dismiss and allowed the lawsuit to go forward. Final Outcome: In January 2013, the court ruled that the law was not enacted for the illegitimate purpose of infringing on a woman’s right to abortion. (See the law here. See the 2011 court opinion here. See the 2013 court opinion here.)

McCormack v. Hiedeman

Fri, 11/21/2014 - 20:15

Federal court challenge to an Idaho 1972 criminal abortion restriction and 20-week ban by a woman who was prosecuted under the law for self-inducing an abortion.

McCormack v. Hiedeman

Federal court challenge to an Idaho 1972 criminal abortion restriction and 20-week ban by a woman who was prosecuted under the law for self-inducing an abortion. In August of 2011, the U.S. District Court for the District of Idaho granted a temporary restraining order enjoining prosecution under the 1972 law, but denied a request for an injunction against the 20-week ban because the woman was not being prosecuted under it. In September 2012, the 9th Circuit Court of Appeals largely affirmed the lower court opinion. In March 2013, the district court struck down the 20-week ban, as well as several other laws governing abortion, including those criminalizing abortion when not performed by a physician and in a hospital, as unconstitutional. Current Status: The state appealed the case to the 9th Circuit, which heard oral arguments in July 2014. (See the law here. See the 2011 district court order here. See the Ninth Circuit opinion here. See the 2013 district court opinion here.)

Texas Commission Calls for More Changes to Women's Health Programs

Fri, 11/21/2014 - 17:50

Reproductive health advocates in Texas have raised concern that recommendations from the state's Sunset Advisory Commission could affect family planning services and other preventive care, the Austin Chronicle reports.

Texas Commission Calls for More Changes to Women's Health Programs

November 21, 2014 — Reproductive health advocates in Texas have raised concern that recommendations from the state's Sunset Advisory Commission could affect family planning services and other preventive care, the Austin Chronicle reports.

Proposal Suggests Consolidating Women's Health Programs

The Sunset Advisory Commission audits Texas' Health and Human Services Commission once per decade and proposes changes to state programs that HHSC oversees. In its latest report, the commission has recommended HHSC consolidate three women's programs into one.

Specifically, the commission said that consolidating the state's Expanded Primary Health Care, Family Planning and Texas Women's Health programs into one will help streamline an "unnecessarily complicated" system that "wastes resources," according to the 212-page proposal.

Providers Coalition, Advocates Respond

Janet Realini, chair of the Texas Women's Healthcare Coalition, which includes about 50 organizations, said the group does not completely oppose the consolidation but has "serious concerns" about how the move would affect provider capacity and patient access.

In particular, she noted that the plan suggests a fee-for-service approach, rather than a cost-reimbursement model. She explained that the fee-for-service approach could compound financial difficulties for several clinics, particularly those in rural areas.

Realini added that Texas women's health care cannot afford to lose additional providers. For example, she said the current system can serve only about 30% of women who need publicly funded contraceptive services. She also noted that recent budget cuts have contributed to the closing of almost 80 family planning clinics in Texas.

Meanwhile, NARAL Pro-Choice Texas suggested that Texas eliminate a 2011 "affiliate ban" that prevents Medicaid from reimbursing Planned Parenthood and other affiliates of abortion providers. The affiliate ban and budget cuts have already "ravaged" Texas' preventive care networks, according to the Chronicle.

Amanda Stevenson of the Texas Policy Evaluation Project, a study analyzing the effects of state family planning cuts, suggested the proposal be revised to boost access to long-acting contraceptives. She also suggested that Sunset expand coverage to all Texas residents regardless of immigration status. In addition, NARAL recommended Sunset expand coverage to women with incomes up to 250% of the federal poverty line, up from the proposal's recommendation of 185% (Tuma, Austin Chronicle, 11/21).


Ohio Lawmakers Advance 'Heartbeat' Abortion Ban

Fri, 11/21/2014 - 17:49

An Ohio House committee on Thursday voted 11-6 along party lines to advance a bill (HB 248) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks of pregnancy, the Columbus Dispatch reports.

Ohio Lawmakers Advance 'Heartbeat' Abortion Ban

November 21, 2014 — An Ohio House committee on Thursday voted 11-6 along party lines to advance a bill (HB 248) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks of pregnancy, the Columbus Dispatch reports.

The measure would not apply when a woman's life is in danger, but it would not allow exemptions for pregnancies resulting from rape or incest (Siegel/Candisky, Columbus Dispatch, 11/21). Under the bill, performing an abortion when a fetal heartbeat is detectable would be a fifth-degree felony (Bassett, Huffington Post, 11/20).

Background

State lawmakers have made unsuccessful attempts to pass similar bills in recent years. A "nearly identical" bill passed the state House in 2011 but stalled in the state Senate, according to the Cincinnati Enquirer.

HB 248 was introduced more than one year ago but did not have a hearing until Thursday (Carr Smyth, Cincinnati Enquirer, 11/20).

Abortion-rights supporters argue that the measure would prohibit abortions prior to the time when some women become aware that they are pregnant (Huffington Post, 11/20). In addition, legal scholars contend that the bill would violate Roe v. Wade and noted that similar legislation banning early abortions in Arkansas (Act 301) and North Dakota (HB 1456) has been stuck down (Columbus Dispatch, 11/21). Both states are appealing those federal court decisions (Women's Health Policy Report, 8/8).

Meanwhile, opponents of abortion rights are divided over the measure. Ohio Right to Life, the state's largest antiabortion-rights group, opposes it. In addition, some abortion-rights opponents fear a court challenge to such a law could potentially endanger abortion restrictions that are currently in place, according to the Enquirer (Cincinnati Enquirer, 11/20).

GOP Leaders Restructure Committee To Ensure Passage

According to the Dispatch, before the vote, state House Republican leaders altered the composition of the state House Health and Aging Committee to ensure the measure's passage by replacing Republican members who were expected to vote against it.

Meanwhile, opponents of the bill argued that the measure should have received more than one hearing and that the three hours allotted for testimony prevented some witnesses from weighing in the issue (Columbus Dispatch, 11/21).

NARAL Pro-Choice Ohio Executive Director Kellie Copeland said in a statement, "The members of the Health Committee are so callous that they refused to add amendments to provide exceptions for victims of rape and incest or to remove criminal penalties that could be used to imprison doctors that provide abortion care." She added, "The chilling effect of this crusade is being felt throughout the medical community and will no doubt result in talented physicians leaving Ohio to practice in other states" (Huffington Post, 11/20).

Bill's Prospects

According to the Dispatch, state lawmakers are unlikely to take further action on the measure this year, as several Republican legislators have raised concerns. In particular, state Senate President Keith Faber (R) has noted that similar measures have been declared unconstitutional in other states (Columbus Dispatch, 11/21).

Faber said, "I have grave concerns that if the Heartbeat Bill were to be passed, it would jeopardize some of the good, pro-life work that we've done in the General Assembly" (Huffington Post, 11/20).

Gov. John Kasich (R) said he "share[s] the same concerns as Ohio Right to Life about what it could mean, but it's a long way from getting to my desk." He added that he has shared his concerns with Republican legislative leaders (Columbus Dispatch, 11/21).


Appeals Court Maintains Block on Miss. Admitting Privileges Law

Fri, 11/21/2014 - 17:47

The full 5th U.S. Circuit Court of Appeals on Thursday refused to review a ruling that blocked a state law (HB 1390) that could close the state's only abortion clinic, the AP/Huffington Post reports.

Appeals Court Maintains Block on Miss. Admitting Privileges Law

November 21, 2014 — The full 5th U.S. Circuit Court of Appeals on Thursday refused to review a ruling that blocked a state law (HB 1390) that could close the state's only abortion clinic, the AP/Huffington Post reports.

The ruling means that the law remains on hold for now and that the Jackson Women's Health Organization can remain open while the underlying lawsuit proceeds (Wagster Pettus, AP/Huffington Post, 11/20).

Background

The law requires that physicians performing abortions in Mississippi have admitting privileges at nearby hospitals. The physicians at the Mississippi clinic sought admitting privileges at multiple hospitals but were denied, prompting the state to order the clinic to close for violating the law.

In July, a three-judge panel of the 5th Circuit ruled in a 2-1 decision that the law would have illegally shifted Mississippi's constitutional obligations to other states by eliminating abortion access inside the state. The ruling did not overturn the law or assess whether the admitting privileges requirement is a justified safety measure. Rather, the ruling preserved an existing stay against the law and left the lower courts to consider the measure under the now-clarified principle of state responsibility (Women's Health Policy Report, 7/30).

However, Mississippi's attorney general in August asked the full 5th circuit to review the panel's ruling (Women's Health Policy Report, 8/14).

Next Steps

When asked whether Mississippi would now ask the U.S. Supreme Court to intervene, Jan Schaefer, a spokesperson for state AG Jim Hood (D), said the AG's office is "in the process of reviewing the order and considering our options" (AP/Huffington Post, 11/20).

Meanwhile, the Center for Reproductive Rights, which brought the lawsuit on behalf of JWHO, noted that the underlying case heads back to the U.S. District Court (CRR release, 11/20).

CRR President and CEO Nancy Northup said, "We are confident the federal district court will once again see through the sham justifications for this underhanded clinic shutdown law and ultimately strike it down permanently as a gross violation of women’s constitutional rights" (AP/Huffington Post, 11/20).


Appeals Court Maintains Block on Miss. Admitting Privileges Law

Fri, 11/21/2014 - 17:41

The full 5th U.S. Circuit Court of Appeals on Thursday refused to review a ruling that blocked a state law (HB 1390) that could close the state's only abortion clinic, the AP/Huffington Post reports.

Appeals Court Maintains Block on Miss. Admitting Privileges Law

November 21, 2014 — The full 5th U.S. Circuit Court of Appeals on Thursday refused to review a ruling that blocked a state law (HB 1390) that could close the state's only abortion clinic, the AP/Huffington Post reports.

The ruling means that the law remains on hold for now and that the Jackson Women's Health Organization can remain open while the underlying lawsuit proceeds (Wagster Pettus, AP/Huffington Post, 11/20).

Background

The law requires that physicians performing abortions in Mississippi have admitting privileges at nearby hospitals. The physicians at the Mississippi clinic sought admitting privileges at multiple hospitals but were denied, prompting the state to order the clinic to close for violating the law.

In July, a three-judge panel of the 5th Circuit ruled in a 2-1 decision that the law would have illegally shifted Mississippi's constitutional obligations to other states by eliminating abortion access inside the state. The ruling did not overturn the law or assess whether the admitting privileges requirement is a justified safety measure. Rather, the ruling preserved an existing stay against the law and left the lower courts to consider the measure under the now-clarified principle of state responsibility (Women's Health Policy Report, 7/30).

However, Mississippi's attorney general in August asked the full 5th circuit to review the panel's ruling (Women's Health Policy Report, 8/14).

Next Steps

When asked whether Mississippi would now ask the U.S. Supreme Court to intervene, Jan Schaefer, a spokesperson for state AG Jim Hood (D), said the AG's office is "in the process of reviewing the order and considering our options" (AP/Huffington Post, 11/20).

Meanwhile, the Center for Reproductive Rights, which brought the lawsuit on behalf of JWHO, noted that the underlying case heads back to the U.S. District Court (CRR release, 11/20).

CRR President and CEO Nancy Northup said, "We are confident the federal district court will once again see through the sham justifications for this underhanded clinic shutdown law and ultimately strike it down permanently as a gross violation of women’s constitutional rights" (AP/Huffington Post, 11/20).


Video Round Up: 'Unacceptable' Rape Kit Backlog Addressed, Pollitt Reads From New Book on Abortion Rights

Fri, 11/21/2014 - 16:41

In today's clips, Manhattan District Attorney Cyrus Vance explains why his office is providing $35 million to help other cities reduce their rape kit backlogs, while feminist author Katha Pollitt and MSNBC's Irin Carmon talk about the state of abortion rights in the U.S.

Video Round Up: 'Unacceptable' Rape Kit Backlog Addressed, Pollitt Reads From New Book on Abortion Rights

November 21, 2014 — In today's clips, Manhattan District Attorney Cyrus Vance explains why his office is providing $35 million to help other cities reduce their rape kit backlogs, while feminist author Katha Pollitt and MSNBC's Irin Carmon talk about the state of abortion rights in the U.S.



MSNBC's Ronan Farrow talks with Manhattan District Attorney Cyrus Vance, who announced last week that his office will provide $35 million in funding to help other cities reduce their backlogs of untested rape kits. Vance calls the rape kit backlog an "unacceptable" injustice for survivors, adding that it also holds law enforcement back from convicting assailants and exonerating innocent suspects (Farrow, "Ronan Farrow Daily," MSNBC, 11/13).




At a forum hosted by the New School, feminist critic and The Nation essayist Katha Pollitt reads an excerpt from her new book, "Pro: Reclaiming Abortion Rights," and discusses the state of abortion rights with MSNBC reporter Irin Carmon (New School, 11/7).

Blogs Comment on 'Year of the Abortion Story,' Female Sexual Dysfunction, More

Fri, 11/21/2014 - 16:17

Read the week's best commentaries from bloggers at Care2, Our Bodies Ourselves and more.

Blogs Comment on 'Year of the Abortion Story,' Female Sexual Dysfunction, More

November 21, 2014 — Read the week's best commentaries from bloggers at Care2, Our Bodies Ourselves and more.

ABORTION-RIGHTS MOVEMENT: "2014: The Year of the Abortion Story?" Heather Buchheim, Care2: Although "1 in 3 women will have an abortion in her lifetime ... [t]he abortion war has often failed to acknowledge the real lived emotional experience of people who have abortions, whether they feel relief, guilt, sadness, renewal -- a combination, or anything beyond," writes Buchheim, senior manager at National Engagement Exhale. Buchheim contends that if people began talking about how they feel about abortion instead of which side of the debate they are on, "[a]bortion stigma and shame would be transformed to support and respect" by "connect[ing people] on more personal, human terms." She writes that this "broader culture shift" could be occurring this year, given that "the abortion story [has been] amplified like never before, gaining momentum and building support for people who may not have felt heard" (Buchheim, Care2, 11/18).

What others are saying about the abortion-rights movement:

~ "These Women Are Brave Enough To Share Their Abortion Stories," Tara Culp-Ressler, Center for American Progress' "ThinkProgress."

~ "Reproductive Health on National Rural Health Day," Melanie Zurek, Huffington Post blogs.

FEMALE SEXUAL DYSFUNCTION: "Why Doesn't a Viagra Equivalent Exist for Women?" Rachel Walden, Our Bodies Ourselves' "Our Bodies, Our Blog": "Given the historical exclusion of women from clinical trials and social attitudes about female sexual desire, it's easy to assume that no Viagra-like drug is available for women because women's sexual pleasure is not taken seriously enough to develop one," but the issue "is more complicated than a case of gender bias," Walden writes. She notes that FDA has repeatedly rejected drugs to treat the disorder because they lacked the necessary "safety and efficacy data" and that attempts to push FDA to approve the drugs have been largely funded by the drugs' manufacturers. Walden writes that instead of advocating for the approval of the drugs, advocates should "look critically at the safety and efficacy of drugs proposed to treat a lack of sexual desire or sexual satisfaction in women"; "question the over-medicalization of women's sexual function"; and "encourage sound research" into such drugs (Walden, "Our Bodies, Our Blog," OurBodies Ourselves, 11/19).

GLOBAL: "How a GOP Congress Could Harm Women Worldwide," John Seager, Huffington Post blogs: "For the nearly quarter-billion women around the world who would like to prevent or delay pregnancy but don't have access to affordable and appropriate birth control, expanding international family planning assistance is crucial," but "a slew of Republicans in Congress ... remain committed to efforts to drain U.S. aid from international family planning programs," writes Seager, president of the Population Connection Action Fund. Given that "[u]niversal access to contraceptives could avert nearly one-third of all maternal deaths and a significant proportion of infant deaths," the U.S. "should be increasing, not decreasing, its current investment of $610 million in funding to international family planning programs," ideally boosting such investments to "at least $1 billion," Seager writes. However, he notes that a conservative Congress could "slash aid to ... the United National Population Fund" and re-implement the "global gag rule," which would "hinder international family planning programs." Seager urges President Obama to circumvent the "serious threats posed by this new Congress" by clarifying that the 1973 Helms Amendment permits abortion funding in instances of rape or threats to a woman's life (Seager, Huffington Post blogs, 11/18).

CONTRACEPTION: "Condoms Are Way More Effective Than the New York Times Says They Are," Martha Kemper, RH Reality Check: Kemper writes that while she "loved the sentiment" behind a recent New York Times column discussing teenage pregnancy, she was "disappointed" with the columnist's "use of a statistic that inaccurately describe[d] condom efficacy as cumulative," incorrectly implying that "someone who uses condoms as birth control for years will inevitably get pregnant." She notes that condom efficacy rates "are not a matter of simple probability" but rather "completely within the user's control," pointing out also that the Times' cited rate is based on a couple's first year of use and that unintended pregnancy "numbers get better as the years go by." Kemper writes that while she agrees with the columnist's premise that adults are at least partly responsible for teenage pregnancy rates, the "first step" to lowering the teenage pregnancy rate is to "make sure" information about condoms is "accurate and easy to understand," especially since condoms are the only "way sexually active individuals can protect themselves from sexually transmitted infections" (Kemper, RH Reality Check, 11/18).


Ohio Lawmakers Advance 'Heartbeat' Abortion Ban

Fri, 11/21/2014 - 16:14

An Ohio House committee on Thursday voted 11-6 along party lines to advance a bill (HB 248) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks of pregnancy, the Columbus Dispatch reports.

Ohio Lawmakers Advance 'Heartbeat' Abortion Ban

November 21, 2014 — An Ohio House committee on Thursday voted 11-6 along party lines to advance a bill (HB 248) that would ban abortion once a fetal heartbeat is detectable, which can be as early as six weeks of pregnancy, the Columbus Dispatch reports.

The measure would not apply when a woman's life is in danger, but it would not allow exemptions for pregnancies resulting from rape or incest (Siegel/Candisky, Columbus Dispatch, 11/21). Under the bill, performing an abortion when a fetal heartbeat is detectable would be a fifth-degree felony (Bassett, Huffington Post, 11/20).

Background

State lawmakers have made unsuccessful attempts to pass similar bills in recent years. A "nearly identical" bill passed the state House in 2011 but stalled in the state Senate, according to the Cincinnati Enquirer.

HB 248 was introduced more than one year ago but did not have a hearing until Thursday (Carr Smyth, Cincinnati Enquirer, 11/20).

Abortion-rights supporters argue that the measure would prohibit abortions prior to the time when some women become aware that they are pregnant (Huffington Post, 11/20). In addition, legal scholars contend that the bill would violate Roe v. Wade and noted that similar legislation banning early abortions in Arkansas (Act 301) and North Dakota (HB 1456) has been stuck down (Columbus Dispatch, 11/21). Both states are appealing those federal court decisions (Women's Health Policy Report, 8/8).

Meanwhile, opponents of abortion rights are divided over the measure. Ohio Right to Life, the state's largest antiabortion-rights group, opposes it. In addition, some abortion-rights opponents fear a court challenge to such a law could potentially endanger abortion restrictions that are currently in place, according to the Enquirer (Cincinnati Enquirer, 11/20).

GOP Leaders Restructure Committee To Ensure Passage

According to the Dispatch, before the vote, state House Republican leaders altered the composition of the state House Health and Aging Committee to ensure the measure's passage by replacing Republican members who were expected to vote against it.

Meanwhile, opponents of the bill argued that the measure should have received more than one hearing and that the three hours allotted for testimony prevented some witnesses from weighing in the issue (Columbus Dispatch, 11/21).

NARAL Pro-Choice Ohio Executive Director Kellie Copeland said in a statement, "The members of the Health Committee are so callous that they refused to add amendments to provide exceptions for victims of rape and incest or to remove criminal penalties that could be used to imprison doctors that provide abortion care." She added, "The chilling effect of this crusade is being felt throughout the medical community and will no doubt result in talented physicians leaving Ohio to practice in other states" (Huffington Post, 11/20).

Bill's Prospects

According to the Dispatch, state lawmakers are unlikely to take further action on the measure this year, as several Republican legislators have raised concerns. In particular, state Senate President Keith Faber (R) has noted that similar measures have been declared unconstitutional in other states (Columbus Dispatch, 11/21).

Faber said, "I have grave concerns that if the Heartbeat Bill were to be passed, it would jeopardize some of the good, pro-life work that we've done in the General Assembly" (Huffington Post, 11/20).

Gov. John Kasich (R) said he "share[s] the same concerns as Ohio Right to Life about what it could mean, but it's a long way from getting to my desk." He added that he has shared his concerns with Republican legislative leaders (Columbus Dispatch, 11/21).


Texas Commission Calls for More Changes to Women's Health Programs

Fri, 11/21/2014 - 15:46

Reproductive health advocates in Texas have raised concern that recommendations from the state's Sunset Advisory Commission could affect family planning services and other preventive care, the Austin Chronicle reports.

Texas Commission Calls for More Changes to Women's Health Programs

November 21, 2014 — Reproductive health advocates in Texas have raised concern that recommendations from the state's Sunset Advisory Commission could affect family planning services and other preventive care, the Austin Chronicle reports.

Proposal Suggests Consolidating Women's Health Programs

The Sunset Advisory Commission audits Texas' Health and Human Services Commission once per decade and proposes changes to state programs that HHSC oversees. In its latest report, the commission has recommended HHSC consolidate three women's programs into one.

Specifically, the commission said that consolidating the state's Expanded Primary Health Care, Family Planning and Texas Women's Health programs into one will help streamline an "unnecessarily complicated" system that "wastes resources," according to the 212-page proposal.

Providers Coalition, Advocates Respond

Janet Realini, chair of the Texas Women's Healthcare Coalition, which includes about 50 organizations, said the group does not completely oppose the consolidation but has "serious concerns" about how the move would affect provider capacity and patient access.

In particular, she noted that the plan suggests a fee-for-service approach, rather than a cost-reimbursement model. She explained that the fee-for-service approach could compound financial difficulties for several clinics, particularly those in rural areas.

Realini added that Texas women's health care cannot afford to lose additional providers. For example, she said the current system can serve only about 30% of women who need publicly funded contraceptive services. She also noted that recent budget cuts have contributed to the closing of almost 80 family planning clinics in Texas.

Meanwhile, NARAL Pro-Choice Texas suggested that Texas eliminate a 2011 "affiliate ban" that prevents Medicaid from reimbursing Planned Parenthood and other affiliates of abortion providers. The affiliate ban and budget cuts have already "ravaged" Texas' preventive care networks, according to the Chronicle.

Amanda Stevenson of the Texas Policy Evaluation Project, a study analyzing the effects of state family planning cuts, suggested the proposal be revised to boost access to long-acting contraceptives. She also suggested that Sunset expand coverage to all Texas residents regardless of immigration status. In addition, NARAL recommended Sunset expand coverage to women with incomes up to 250% of the federal poverty line, up from the proposal's recommendation of 185% (Tuma, Austin Chronicle, 11/21).


'Abortion Speak-Out' Challenges 'Hierarchy of Good and Bad Abortions'

Fri, 11/21/2014 - 15:12

"Though the majority of people in America ... and so many other places believe abortion should be legal, too many of us still think about reproductive rights as if there's a hierarchy of good and bad abortions -- the kind that women 'deserve', and the kind women should be ashamed of," writes The Guardian columnist Jessica Valenti.

'Abortion Speak-Out' Challenges 'Hierarchy of Good and Bad Abortions'

November 21, 2014 — "Though the majority of people in America ... and so many other places believe abortion should be legal, too many of us still think about reproductive rights as if there's a hierarchy of good and bad abortions -- the kind that women 'deserve', and the kind women should be ashamed of," writes The Guardian columnist Jessica Valenti.

On Thursday, Valenti joined other women in "a live-streamed, national abortion speak-out" organized by the 1 in 3 Campaign, which gets its name from "the fact that 1 in 3 American women will have an abortion," she writes.

Valenti notes that while she has previously written about ending a wanted pregnancy because of a life-threatening medical condition and "the turmoil [she] faced with the decision," she has never spoken publicly about an earlier abortion that ended an unwanted pregnancy in her 20s -- "not because [she] was ashamed, but because it truly didn't have that tremendous of an impact on [her] life." Valenti notes that although some people might find her views "callous ... the truth is that, despite the abortion stories that often dominate the public pro-choice narrative -- the wanted pregnancies that must end because of health concerns or severe fetal abnormalities -- most people who end their pregnancies do it for the same reason" she did the first time: "Some women just don't want to be pregnant -- and there's nothing wrong with that."

Valenti adds that "for too many women, the consequences [of sharing their abortion stories] are just not worth it," such as job loss, online harassment or fractured family relationships. Still, she writes that "if some of us do choose to share" abortion stories to help "combat the stigma against all of us who have abortions, there's really no explanation necessary" (Valenti, The Guardian, 11/20).


Video Round Up: 'Unacceptable' Rape Kit Backlog Addressed, Pollitt Reads From New Book on Abortion Rights

Thu, 11/20/2014 - 19:09

In today's clips, Manhattan District Attorney Cyrus Vance explains why his office is providing $35 million to help other cities reduce their rape kit backlogs, while feminist author Katha Pollitt and MSNBC's Irin Carmon talk about the state of abortion rights in the U.S.

Video Round Up: 'Unacceptable' Rape Kit Backlog Addressed, Pollitt Reads From New Book on Abortion Rights

November 20, 2014 — In today's clips, Manhattan District Attorney Cyrus Vance explains why his office is providing $35 million to help other cities reduce their rape kit backlogs, while feminist author Katha Pollitt and MSNBC's Irin Carmon talk about the state of abortion rights in the U.S.



MSNBC's Ronan Farrow talks with Manhattan District Attorney Cyrus Vance, who announced last week that his office will provide $35 million in funding to help other cities reduce their backlogs of untested rape kits. Vance calls the rape kit backlog an "unacceptable" injustice for survivors, adding that it also holds law enforcement back from convicting assailants and exonerating innocent suspects (Farrow, "Ronan Farrow Daily," MSNBC, 11/13).




At a forum hosted by the New School, feminist critic and The Nation essayist Katha Pollitt reads an excerpt from her new book, "Pro: Reclaiming Abortion Rights," and discusses the state of abortion rights with MSNBC reporter Irin Carmon (New School, 11/7).

Ebola Outbreak Presents Special Challenges for Women's Health

Thu, 11/20/2014 - 18:33

The Ebola outbreak in West Africa has increased maternal mortality and complicated pregnancy and postpartum care for women and their newborns, NPR's "Goats and Soda" reports.

Ebola Outbreak Presents Special Challenges for Women's Health

November 20, 2014 — The Ebola outbreak in West Africa has increased maternal mortality and complicated pregnancy and postpartum care for women and their newborns, NPR's "Goats and Soda" reports.

Typically, a person who receives treatment for Ebola has about a 40% chance of survival, but among pregnant women and their fetuses, the survival rate can be as low as 5%, one small study found. A pregnant woman is highly likely to transmit the virus to the fetus, often leading to stillbirth or death shortly after birth, according to "Goats and Soda."

Further, the risk of infection has discouraged providers from caring for pregnant Ebola patients. Providing care for a pregnant Ebola patient is especially challenging because the virus is present in both the amniotic fluid and the woman's blood.

When a woman is bleeding, providers often must respond within a relatively short time frame, meaning that a provider could have to decide between saving the woman and fetus or taking the time to put on protective gear. Given the large volume of bodily fluid released during such cases, even providers with access to protective gear run the risk of contracting Ebola, according to "Goats and Soda."

In Liberia, many clinics refuse to treat pregnant women, and hospitals have closed their maternity wards. In addition, many midwives will not care for patients because so many nurses and midwives who have helped pregnant women have died (Doucleff, "Goats and Soda," NPR, 11/18).

Ebola is also affecting maternity care in Sierra Leone, according to Newsweek. For example, birth rates have declined at the hospital in Freetown, the nation's capital, with more women giving birth at home. A Doctors Without Borders clinic in Gondama, Sierra Leone, also closed because of the risk of staff becoming infected (Westcott, Newsweek, 11/17).

Given the situation, the United Nations Population Fund has predicted that tens of thousands of women and their infants could die in the region if maternity wards and other providers do not resume offering services, according to "Goats and Soda" ("Goats and Soda," NPR, 11/18).

Teen Pregnancy, Gender-Based Violence Appear Higher During Ebola Epidemic

In related news, nurses in a Freetown hospital have noted an increase in teenage pregnancies, possibly because widespread school closures during the Ebola outbreak are leading to increased sexual activity among teens and making girls more susceptible to sexual violence, Yahoo! News reports.

Humanist Watch Salone, a rights group, has observed an increase in gender-based violence in eastern Sierra Leone, an area hit harshly by the epidemic since July.

"We are expecting to see a surge of gender-based violence and exploitation and abuse in the coming months," according to Matthew Dalling, UNICEF's head of child protection in Sierra Leone.

Dalling also noted that it is "logical" to assume that school closures have contributed to the teenage pregnancy rate, adding that even prior to the outbreak, 38% of women in Sierra Leone became pregnant before age 18.

Dalling pointed out that transactional sex -- exchanging sex for a favor or goods -- also could be driving up teen pregnancy. Increased incidence of transactional sex could be tied to harsh living conditions that are worsened by the Ebola outbreak (Chaon, Yahoo! News, 11/18).


Transgender People Face Obstacles Accessing Reproductive Health Care, Survey Finds

Thu, 11/20/2014 - 18:33

Some transgender individuals face increased barriers to health care services, including those related to reproductive health care, according to a University of California-San Francisco study released earlier this month, the San Francisco Chronicle reports.

Transgender People Face Obstacles Accessing Reproductive Health Care, Survey Finds

November 20, 2014 — Some transgender individuals face increased barriers to health care services, including those related to reproductive health care, according to a University of California-San Francisco study released earlier this month, the San Francisco Chronicle reports.

For the study, USCF researches surveyed 41 transgender men who have given birth.

Key Findings

The researchers found that while some respondents said being pregnant was "distressing and awkward" for them, others reported that the experience helped them to be more comfortable with their bodies. Meanwhile, others said they view pregnancy as a "necessary but unpleasant" way to create a family, while some respondents said they were excited about and enjoyed pregnancy.

The study also found that transgender individuals are more likely than non-transgender women to seek prenatal care from nontraditional providers such as midwives, and they were more likely to have home deliveries. Many respondents reported feeling alone or isolated during their pregnancies because they were unaware of others who had gone through similar experiences.

Further, the study found that nearly one-third of respondents experienced an unplanned pregnancy and slightly more than one-third said they do not regularly use contraceptives.

Authors' Comments

Study co-author Alexis Light, an ob-gyn at Washington Hospital Center, said the findings suggest that providers could improve how they discuss contraceptives, fertility and other family planning options with transgender individuals.

Jae Sevelius, another study co-author and psychologist at the UCSF Center of Excellence for Transgender Health, added, "[T]he main thrust of this paper is that ... the health care field is not adequately serving" transgender individuals. Providers are "not equipped to answer their questions" or "to anticipate how ... [to] best support them," Sevelius said (Allday, San Francisco Chronicle, 11/19).


Federal Appeals Court Hears Oral Arguments Over Contraceptive Coverage Accommodation

Thu, 11/20/2014 - 18:31

A federal appeals court on Wednesday heard oral arguments in a case brought by two Catholic dioceses and an evangelical college in Pennsylvania challenging the government's contraceptive coverage accommodation for not-for-profits that hold themselves out as religious, the Pittsburgh Post-Gazette reports.

Federal Appeals Court Hears Oral Arguments Over Contraceptive Coverage Accommodation

November 20, 2014 — A federal appeals court on Wednesday heard oral arguments in a case brought by two Catholic dioceses and an evangelical college in Pennsylvania challenging the government's contraceptive coverage accommodation for not-for-profits that hold themselves out as religious, the Pittsburgh Post-Gazette reports (Langley, Pittsburgh Post-Gazette, 11/20).

Background

The accommodation aims to ensure that enrollees in health plans for not-for-profits that hold themselves out as religious and oppose contraception still have access to contraceptive coverage benefits under the Affordable Care Act (PL 111-148). The accommodation enables such not-for-profits to notify their insurer or third-party administrator of their objection so the insurer or third-party administrator can facilitate contraceptive coverage for members of their health plans.

In August, in an effort to address ongoing court challenges, HHS announced a new rule that maintains the accommodation but creates a second way for those entities to provide notice of their objections. Under the new option, religiously affiliated not-for-profits can send a letter to HHS stating that they object to offering contraceptive coverage in their health plans (Women's Health Policy Report, 11/17).

In separate lawsuits filed last year, Geneva College -- an institution affiliated with the Reformed Presbyterian Church -- and the Catholic Dioceses of Pittsburgh and Erie, along with their affiliated schools and charities, challenged the original accommodation as inadequate. Separate courts granted Geneva College a preliminary injunction and the dioceses a permanent injunction. The Department of Justice then appealed both cases to the U.S. Court of Appeals for the 3rd Circuit (Women's Health Policy Report, 2/13).

Oral Argument Details

Lawyers for the college and the dioceses argued before a three-judge panel of the 3rd Circuit that the updated accommodation remains insufficient and would still make the plaintiffs "complicit" in providing contraceptives.

However, DOJ attorney Mark Stern said the accommodation is not coercive. "If you're going to provide insurance, you have to tell your insurance company what you want provided. All the plaintiff has to do is tell the government, 'I'm out,'" Stern said (Pittsburgh Post-Gazette, 11/20).


Study: Women With Early Breast Cancer Increasingly Opt for Breast Removal

Thu, 11/20/2014 - 17:09

An increasing number of U.S. women with early-stage breast cancer are opting to undergo mastectomies instead of lumpectomies, according to a study published in JAMA Surgery on Wednesday, the Wall Street Journal reports.

Study: Women With Early Breast Cancer Increasingly Opt for Breast Removal

November 20, 2014 — An increasing number of U.S. women with early-stage breast cancer are opting to undergo mastectomies instead of lumpectomies, according to a study published in JAMA Surgery on Wednesday, the Wall Street Journal reports.

According to the Journal, lumpectomies became the "standard of care" for breast cancer treatment beginning in the 1980s after studies showed that lumpectomies followed by radiation treatment provided equal outcomes to mastectomies (Beck, Wall Street Journal, 11/19). However, the new findings suggest that lumpectomy rates are beginning to decline again.

For the study, researchers at Vanderbilt University Medical Center analyzed National Cancer Data Base data on 1.2 million women who received surgery for early-stage breast cancer between 1998 and 2011. The database includes about 70% of new U.S. cancer diagnoses (Seaman, Reuters, 11/19).

Key Findings

According to the study, the overall increase in mastectomy rates was driven primarily by the increase in women opting for bilateral mastectomies. The researchers found that 19.5% of women who opted for a mastectomy between 1998 and 2011 had a bilateral mastectomy, with the bilateral mastectomy rate increasing from 5.4% in 1998 to 29.7% in 2011 (Kaplan, "Science Now," Los Angeles Times, 11/19).

More specifically, the researchers found that about 38% of women with early-stage breast cancer opted for a mastectomy of the affected breast in 2011, up from 34% in 1998. Similarly, the study found that the number of such patients opting for a bilateral mastectomy increased from 2% to 11% over the same timeframe, with a particularly sharp increase among young women with non-invasive, early breast cancer.

The study also found that the rate of reconstructive surgery among women undergoing mastectomies increased from 12% to 36% over the study's timeframe (Wall Street Journal, 11/19).

Potential Causes for Increase

The researchers wrote that the increasing mastectomy rate could be tied to patient concerns, use of breast MRIs, doctor recommendations and a patient's desire for breast symmetry. They said genetic mutations related to breast cancer risk likely are not driving up mastectomy rates (Reuters, 11/19).

They also noted that the reasons for the increase in the bilateral mastectomy rate "remain unclear." However, they said while all the women assessed in the study had early-stage cancer, women who opted for mastectomies over lumpectomies were more likely to have larger or more-invasive tumors ("Science Now," Los Angeles Times, 11/19). Further, they noted the growing rate of reconstructive surgery could be driving the increase in bilateral mastectomies (Wall Street Journal, 11/19).

The researchers cautioned that while there is no ideal mastectomy rate, the 38.1% rate could be too high ("Science Now," Los Angeles Times, 11/19).


Transgender People Face Obstacles Accessing Reproductive Health Care, Survey Finds

Thu, 11/20/2014 - 17:07

Some transgender individuals face increased barriers to health care services, including those related to reproductive health care, according to a University of California-San Francisco study released earlier this month, the San Francisco Chronicle reports.

Transgender People Face Obstacles Accessing Reproductive Health Care, Survey Finds

November 20, 2014 — Some transgender individuals face increased barriers to health care services, including those related to reproductive health care, according to a University of California-San Francisco study released earlier this month, the San Francisco Chronicle reports.

For the study, USCF researches surveyed 41 transgender men who have given birth.

Key Findings

The researchers found that while some respondents said being pregnant was "distressing and awkward" for them, others reported that the experience helped them to be more comfortable with their bodies. Meanwhile, others said they view pregnancy as a "necessary but unpleasant" way to create a family, while some respondents said they were excited about and enjoyed pregnancy.

The study also found that transgender individuals are more likely than non-transgender women to seek prenatal care from nontraditional providers such as midwives, and they were more likely to have home deliveries. Many respondents reported feeling alone or isolated during their pregnancies because they were unaware of others who had gone through similar experiences.

Further, the study found that nearly one-third of respondents experienced an unplanned pregnancy and slightly more than one-third said they do not regularly use contraceptives.

Authors' Comments

Study co-author Alexis Light, an ob-gyn at Washington Hospital Center, said the findings suggest that providers could improve how they discuss contraceptives, fertility and other family planning options with transgender individuals.

Jae Sevelius, another study co-author and psychologist at the UCSF Center of Excellence for Transgender Health, added, "[T]he main thrust of this paper is that ... the health care field is not adequately serving" transgender individuals. Providers are "not equipped to answer their questions" or "to anticipate how ... [to] best support them," Sevelius said (Allday, San Francisco Chronicle, 11/19).