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contraception

More birth control by mail options

Good to see.

“We want women to see us and say, ‘These are people who believe that if you want birth control you should have it,'” said Hans Ganeskar, co-founder and CEO of Nurx, a California-based site founded in 2015 that can both dispense and prescribe by way of computer or app.

Nurx (pronounced New RX) became available to Texas women in June, bringing the total number of states it serves to 17.

Women answer a series of health questions or in some cases undergo video consultation, and then their prescriptions are written by a state-licensed doctor affiliated with the company. The prescription is then sent to a local pharmacy to handle delivery. With insurance, the cost is generally free; without, it is $15 for a one-month supply of pills.

A similar company, The Pill Club, entered the Texas market in early July. It, too, is a California-based startup touting the same message of accessibility and inclusiveness.

The Pill Club differs from Nurx in that it provides all prescriptions and products in-house, without involving local pharmacies.

While it is possible to get an online exam and first-time prescription in some states through The Pill Club, founder Nick Chang said the exam service is not yet available to Texas women. In states where it is unavailable, women upload an existing prescription. The cost is typically covered by insurance.

Chang, a Stanford Law School graduate who also attended medical school, said his company takes its cues from the many personalized niche shopping sites such as Birch Box with its makeup or the Dollar Shave Club.

“All of these things are being delivered, but not birth control. There’s something wrong with that,” he thought as far back as 2014, although his company did not officially launch until last year. It is now in 13 states.

Contraceptives have been available through online pharmacies long before these new, more hip entrants, but Chang said for reasons not entirely clear many women were not taking advantages of them.

[…]

At Prjkt Ruby (note the text message spelling), contraception comes paired with social conscience. Also launched in 2015, the service arrived in Texas earlier this year, chief marketing officer Daniel Snyder said.

It also offers its own in-house mail-order pharmacy and prescription services. In Texas, those come after a video consultation. But the company does not accept insurance, instead charging the $20-per-cycle prescription services by cash or credit card.

For every order of a three-month cycle, the company donates 75 cents to Population Services International, a nonprofit organization that supports access for birth control to women in developing nations.

“We’re like the TOMS Shoes of birth control,” said Snyder, referring to the shoe seller that donates either a pair of shoes or a portion of the profits from other items to those in need.

Despite the white-hot political glow that surrounds all things reproductive these days, online contraceptive marketing has mostly flown under the radar, even as they also fill the controversial morning-after pills, said Dr. Kristyn Brandi, an obstetrician-gynecologist in Los Angeles and an advocacy fellow for the Physicians for Reproductive Health.

Despite some initial reservations, she said, the potential boost to access outweighs potential safety concerns in misdiagnosis.

“A lot of the trouble with contraception is getting it,” she said.

Snyder agreed, adding it’s impossible to extract the current political climate from what it happening with his company. In the days after the November election, he said they experienced a noticeable surge in business.

“People were panicking,” he said.

Indeed they were. I noted the existence of Nurx after its appearance in Texas. I think there’s a lot to be said for this business model, but I continue to be worried that it’s just a matter of time before it’s in the crosshairs of the the anti-abortion fanatics. It hasn’t happened yet – several more ridiculous anti-abortion items were on the agenda for this special session, so perhaps Greg Abbott hasn’t been informed about birth control by mail – but I’m sure it’s just a matter of time. Until then, if this is something that might be good for you or someone you know, check it out.

Birth control by mail

This is interesting, but doesn’t address a couple of key points.

About half the counties in Texas don’t have the number of public clinics required to meet the contraceptive needs of the population. So Nurx, an at-home birth control delivery app, decided to give women in the state the option to get birth control whenever they want and without ever needing to step into a clinic or even physically see a doctor.

Starting today, those in the Lone Star State will be able to tap the Nurx app and get contraceptives delivered straight to their door.

While Texas isn’t the only state with a giant “contraceptive desert,” or an area without at least 1 clinic to every 1,000 women in need of publicly funded contraception, it is certainly the biggest area of land in the United States not meeting these needs.

And with Trumpcare looming, and Trump’s recent “Religious Freedom” order, which allows businesses to deny birth control coverage based on religious reasons, many women could lose access to their publicly funded birth control pills and even more publicly funded clinics could go under, leaving a large and vulnerable population wide open to other, possibly dangerous methods of preventing birth.

As the story notes, there are other birth control delivery services on the market, but Nurx appears to be the only one operating in Texas. The legislative session is over, but I can easily imagine someone taking aim at this in a future session, though to be fair I thought there would be a reaction to the Mexican abortion option, too. Be that as it may, the real issue here isn’t lack of places to buy the pill, it’s the increasing restrictions on insurance coverage for it, which will become a crisis if Trumpcare passes in any form. It doesn’t matter what your delivery options are if you can’t afford to buy it in the first place. Still, it’s good that Nurx exists, and I hope it has some company in the market soon. I also hope it doesn’t have a large chunk of that market taken away from it by Congress.

Let’s talk about sex education

We’re not good at it.

Rep. Mary Gonzalez

A Democratic state lawmaker is looking to bolster high school sex education requirements in hopes that Texas can lower its teen birth rates.

Rep. Mary González, D-Clint, filed House Bill 1547 to require sex education classes to include “medically accurate, age-appropriate” human sexuality education. The bill would allow students to be excused from the course with the written request of a parent or guardian.

“It’s deeply troubling that Texas has one of the highest teen birth rates in the nation,” González said Tuesday. “Our young people deserve to have correct, accurate information.”

Teen birth rates in Texas are among the highest in the country. According to a 2014 report from U.S. Department of Health and Human Services, the teen birth rate among Texas women ages 15 to 19 was nearly 40 in 1,000 girls. The national birth rate in 2015 for teenagers of the same age was 22 births per 1,000 girls, according to the agency.

González filed the bill on the heels of the Texas Freedom Network’s most recent report that found that more than 80 percent of the state’s public school districts are not teaching sex education or exclusively teach abstinence-only birth control.

The study found that the number of school districts that do not teach sex education has increased to more than 25 percent in 2016 from 2.3 percent in 2008.

The group also found that another 58 percent of school districts took an abstinence-only approach to sex education last year. Those districts did not include information about condoms or other forms of contraceptives.

“All of these findings make clear that policy makers need to create common-sense, very necessary solutions,” González said.

That would be nice, wouldn’t it? For lots of things. There are lots of reasons why this would be a good thing for the Lege to do, and at least as many reasons why they won’t. We’re going to need a different Lege for that. The Trib and the Observer have more.

SCOTUS punts on birth control lawsuit

Wow.

Zubik v. Burwell was supposed to be an epic showdown over the power of religious objectors to limit the rights of others. A sequel to the Court’s 2014 decision in Burwell v. Hobby Lobby, Zubik involved regulations expanding women’s access to birth control that the conservative justices appeared to endorse in Hobby Lobby — even as they struck down a more direct method of providing contraceptive coverage to working women.

At oral arguments, however, the four remaining conservatives seemed to have a change of heart. Even Justice Anthony Kennedy, the justice who signaled the loudest in Hobby Lobby that he would tolerate the kind of regulations at issue in Zubik, appeared openly hostile towards the Obama administration’s arguments. The case seemed to be barreling towards a 4-4 non-decision. If conservative Justice Antonin Scalia had not died last February, it is all but certain that the case would have ended in a crushing defeat for the administration and for many women who hoped to benefit from the administration’s birth control rules.

But that’s not going to happen — at least not yet. On Monday, the Supreme Court handed down a brief, three-page opinion that effectively punts the case until next year at the earliest (and, presumably, after someone has been confirmed to fill Justice Scalia’s seat). The opinion explicitly “expresses no view on the merits” of Zubik and a raft of related cases. Instead, it sends these cases back down to the lower courts to consider the views expressed by both parties in supplemental briefing requested by the justices themselves.

[…]

As the Supreme Court notes in Monday’s opinion, the administration “has confirmed that the challenged procedures ‘for employers with insured plans could be modified to operate in the manner posited in the Court’s order while still ensuring that the affected women receive contraceptive coverage seamlessly, together with the rest of their health coverage.’” However, that’s not the end of the story. The administration also explained to the Court that the justices’ proposed compromise may not work for employers that self-insure (that is, employers who pay out health claims directly to employees rather than joining them into a broader insurance pool).

In any event, the one thing that’s absolutely clear from the Court’s very brief, unsigned opinion inZubik is that it will not resolve any of the nuances of how employers should exempt themselves, what should happen to women who seek birth control after an employer exempts itself, and whether self-insurance or other situations present unique problems that call for a distinct rule. The Court wants this case to go away, at least for now.

See here for the background. This is just amazing. SCOTUSBlog provides some further analysis:

One reading of Monday’s developments was that the Court, now functioning with eight Justices, was having difficulty composing a majority in support of a definite decision on the legal questions. Thus, what emerged had all of the appearance of a compromise meant to help generate majority support among the Justices. With this approach, the Court both achieved the practical results of letting the government go forward to provide the contraceptive benefits and freeing the non-profits of any risk of penalties, even though neither side has any idea — at present — what the ultimate legal outcome will be and, therefore, what their legal rights actually are under the mandate.

Those uncertainties are now likely to linger through the remainder of President Obama’s term in office, which ends next January. The appeals courts may well order the filing of new legal briefs, and may hold new hearings, before issuing a new round of rulings on the controversy. However, the entire future of the ACA, including its birth-control mandate, may now depend upon who wins the presidential election this year and which party has control of Congress when it reassembles in 2017.

The three issues that the Court had agreed to rule on, and then left hanging at least for now, were whether the ACA mandate violates the federal Religious Freedom Restoration Act by requiring religious non-profits that object to contraceptives to notify the government of that position, whether the government had a “compelling interest” in assuring cost-free access to contraceptives, and whether the move by the government to go ahead and arrange access to those benefits for those non-profits’ employees and students was the “least restrictive means” to carry out the mandate.

Doing on Monday much the same that it had done in several temporary orders at earlier stages of this controversy, the Court accepted that the non-profits already had given the federal government sufficient notice of their objection to the mandate, and that the government could use that notice as the basis for going ahead to provide actual access, at no cost, to the employees and students of those institutions.

The unsigned opinion that the Chief Justice announced included an attempt to explain why the Court was bypassing a definitive ruling on the legal issues. It cited the replies that both sides had filed, after the cases had been argued, in reaction to a suggested compromise plan devised by the Court.

The Court on Monday interpreted those filings as containing concessions that move the two sides somewhat closer together, but at the least provided a basis for letting the federal appeals courts be the first to analyze the meaning and impact of those concessions. The Court expressed the hope that the two sides would use this new opportunity, in the appeals courts, to work toward common ground that would protect the religious sensibilities of the non-profit institutions at the same time that women of child-bearing age would not be deprived of contraceptive devices and methods.

“We anticipate,” the Court said, “that the courts of appeals will allow the parties sufficient time to resolve any outstanding issues between them.” That appeared to be an invitation for the lower courts at least to explore whether the two sides could reach agreement without prolonging the court battles. It conceded, though, that there may still be “areas of disagreement” between the two sides.

It may just be my cynicism showing, but I don’t expect any of the litigants to go seeking common ground. This was from the beginning an ideological fight, and they’re not going to settle for anything less than victory. As the Trib noted, the district court in Texas originally found for the plaintiffs, HBU and East Texas Baptist University, but the Fifth Circuit overturned that verdict. I have no idea what happens from here, but I look forward to a Supreme Court with either a Justice Merrick Garland or a President Clinton-named Justice getting the case again in the future. TPM, Dahlia Lithwick, Rewire, and Daily Kos have more.

Once more with SCOTUS and birth control

Here we go.

In another major case concerning Texas women’s reproductive care, the U.S. Supreme Court on Wednesday will consider if the right to religious freedom is broad enough to completely exempt nonprofits with religious objections to birth control from providing women access to it through their insurance plans.

The case, formally known as Zubik v. Burwell, pits religious nonprofit groups — including East Texas Baptist University and Houston Baptist University — against the federal government over a provision of the Affordable Care Act requiring some employers to provide contraceptive coverage to female workers.

The Texas case is among seven related lawsuits the high court agreed to hear together in which religious nonprofits argue the mandate infringes on their religious freedom. The Obama administration says the groups are offered a way around the requirement through a mechanism that still gives women access to free contraception.

Under the federal health care act, employers with 50 or more full-time employees are required to offer health plans with “minimum essential coverage,” including access to federally approved contraception for women, without co-payments or deductibles.

Religious nonprofits can seek “accommodations” to be exempted from the contraceptive mandate by submitting a form or notification certifying the organization’s objection on religious grounds. Doing so transfers the administrative duties of providing contraception coverage from the employer to the insurance company or a third party, which takes over handling the claims.

But the nonprofits argue they should be exempted from the requirement altogether because they are still “being forced to facilitate access” to contraceptives they oppose. In this case, the religious groups object to emergency contraceptives, including the so-called morning-after-pill, and intrauterine devices, which they liken to so-called “abortifacients” — or drugs that induce an abortion. (Health experts and scientists have disputed that claim.)

That parenthetical statement really understates the matter. People are free to believe what they want, but when those beliefs are contradicted by objective reality, I’m not sure why the law needs to accommodate them. Too bad I’m not on the Supreme Court.

Anyway. I’ve been following the HBU/East Texas Baptist lawsuit from the beginning – see here, here, and here for the basics, and remember that the full Fifth Circuit – yes, that Fifth Circuit – refused to uphold the initial lower court ruling in HBU’s favor.

Given the current composition of the Court, the fact that nearly every appeals court rejected the plaintiffs’ arguments, and the way things went with the HB2 case, there was a fair amount of optimism going into this one that the good guys would prevail. Unfortunately, it looks like perhaps the Bad Anthony Kennedy showed up for oral arguments.

In Burwell v. Hobby Lobby, the last major case brought by religious objectors to birth control, the Court’s five justice conservative majority effectively wrote the “substantially burden” requirement out of the law. As Justice Samuel Alito wrote for the Court in that case, the Hobby Lobby plaintiffs “sincerely believe that providing the insurance coverage demanded by the HHS regulations lies on the forbidden side of the line, and it is not for us to say that their religious beliefs are mistaken or insubstantial.”

It quickly becomes clear during the Zubik argument, however, that the Court’s four justice liberal bloc wants to put the words “substantially burden” back into the law. Justice Sonia Sotomayor notes that, under the conservatives’ truncated reading of RFRA, it is unlikely that a plaintiff would ever fail to show a substantial burden because “we’re not asking you to do anything except identify yourself.” Justice Stephen Breyer even goes so far as to wax philosophic about how much easier life was in the few years before RFRA was enacted.

Kennedy, however, wants no part of this project to make “substantially burden” mean something again. “It seems to me that there is a substantial burden” in this case, Kennedy tells Solicitor General Don Verrilli in an uncharacteristically candid moment. About a minute later, Kennedy is even more candid, disclosing that he believes that this entire case comes down to whether the government could have used a less restrictive alternative (the third prong of RFRA) to provide birth control to women whose employers object to birth control.

For most of Verrilli’s time at the podium, however, Kennedy is sphinx-like, saying little and revealing little about whether he believes the government has made its case. Chief Justice John Roberts and Justice Alito spend this period taking shots at Verrilli. At a major argument over abortion earlier this month, the Court’s conservative wing appeared stilted and unsure how to seize the offensive with Scalia absent from the bench. Today, with Scalia’s seat literally absent from the Courtroom and just eight chairs facing the audience and the attorneys, it was clear that Roberts and Alito had their mojo back.

In their briefs, the religious objectors argue that requiring them to fill out a form in order to receive a contraceptive plan is not the “least restrictive means” of ensuring access to birth control. The government could have created a new birth control entitlement program funded by taxpayers (an alternative that Kennedy briefly appears skeptical of), or they could have offered birth control-only plans in the Affordable Care Act’s health care exchanges to women whose employers refuse to provide them with contraceptive coverage.

Alito focuses on the later of these two opinions, in a series of questions for Verrilli that can fairly be described as combative and nasty. At one point, Alito demands to know how the government can claim that Obamacare’s exchanges are “so unworkable” that they cannot provide an alternative for women that need birth control-only plans. It’s the sort of remark that seems more at home on Fox News than in the Supreme Court of the United States, and its delivered in a tone that seems to betray Alito’s bitterness over the fact that he has twice tried and failed to gut Obamacare by judicial decree.

In response, Verrilli argues that offering birth control-only coverage in the exchanges would not be a workable solution. For one thing, it’s not currently legal to sell such single-subject plans in the exchanges. For another, it’s far from clear that any private insurer would agree to offer such a plan. And even if they did, there’s no guarantee that a woman would be able to buy a plan that included the same doctors she relies upon for other medical care. This could lead to a world where a woman’s regular physician would be unable to prescribe contraception or even counsel the woman on many issues related to her reproductive health. And it would add an additional layer of complication that would discourage many women from seeking out contraceptive care.

Roberts, meanwhile, embraces the religious objectors’ argument that the government is “hijacking employers’” health plans via its fill-out-the-form regulation. This proves to be a very effective argument for Roberts, largely because it appears to sway Kennedy near the end of Verrilli’s time at the podium. In response to Verrilli’s attempt to explain some of the details of how the fill-out-the-form rules operate, Kennedy snaps back “that’s why it’s necessary to hijack the plans!”

In contentious cases, Kennedy often appears to play the role of Hamlet, asking questions of both sides and giving off an air of uncertainty about how he will ultimately vote. But when Kennedy shows real emotion in one of his questions, or when he adopts the loaded language of one of the parties, that’s normally a good sign that he’s made up his mind. When the votes are cast and the Court’s decision is released, it’s a good bet that Kennedy will vote against Team Birth Control.

Yeesh. The good news from our perspective in Texas is that a 4-4 split would leave the Fifth Circuit ruling against the plaintiffs in place. That’s a small consolation for anyone in a state governed by the Eighth Circuit, which was the one to buy into that dumb argument, of course. Perhaps some day we can get a ninth Justice confirmed and settle this once and for all. In the meantime, this may be the best we can do. Have I mentioned that this election is super important? A transcript of the oral arguments is here, while TPM, SCOTUSBlog, Kevin Drum, and the Trib have more.

HBU contraception lawsuit goes to SCOTUS

Here we go.

The U.S. Supreme Court will decide whether religious nonprofits should be required to provide birth control benefits to female employees even if the employers object to certain contraceptives on religious grounds.

The court announced Friday that it would consider a case brought by East Texas Baptist University and Houston Baptist University against the federal government over a provision of the Affordable Care Act requiring some employers to provide contraceptive coverage. It is one of seven related cases from around the country that the high court agreed to hear at once.

The religious universities oppose emergency contraceptives, including the so-called morning-after pill, and intrauterine devices, which they liken to “abortifacients” — or drugs that induce an abortion. (Health experts and scientists have disputed that claim.)

[…]

Under federal religious freedom laws, religious nonprofits can seek “accommodations” to be exempted from the contraceptive mandate by submitting a form or notification certifying the organization’s objection to paying for contraception coverage on religious grounds. Doing so transfers the administrative obligations of providing contraception coverage from the employer to the insurance company or a third party, which takes over handling the claims.

But the universities argue that requirement infringes on their religious freedom because female employees may still be able to obtain contraception under that process.

See here, here, here, and here for the background. As the Chron notes, the Supremes actually took appeals from seven related contraception/insurance cases and combined them. They’ll hear oral arguments in March and render their decision in June as usual, just in time to capture people’s attention during the Presidential race. ThinkProgress, RH Reality Check, and SCOTUS Blog, which details all seven cases, have more.

Full Fifth circuit denies HBU in contraception lawsuit

Still no joy for them.

A federal appeals court will not reconsider its ruling, delivered in June, that the Affordable Care Act’s contraceptive rules do not violate the religious freedom of church-based organizations in Texas.

The religious organizations, including two Catholic dioceses and the University of Dallas, had asked the full 5th U.S. Circuit Court of Appeals to reject the ruling by a three-judge panel.

The court refused 11-4, issuing an opinion that did not discuss the merits of the case.

Three of the justices on the losing side, however, issued a scathing dissent that called the original ruling “ironic and tragic” for denying the free exercise of religion and placing “literally millions of dollars in fines and immortal souls on the line.”

“This should have been an easy case for upholding religious liberty,” said the dissent, issued Thursday and written by Justice Edith Jones and joined by Justices Edith Brown Clement and Priscilla Owen. The three are among the court’s most conservative members.

See here, here, and here for the background. It would be far more accurate to say that those three are among the most ideologically driven judges, not just on that court but any federal court, though I suppose it’s not polite to say things like that. As of August, when Ken Paxton found time in his busy schedule to file an amicus brief on behalf of the plaintiffs, there wasn’t a circuit split in cases like this, but now there is and there’s been an even more radical anti-contraception ruling in another federal court, so the likelihood of SCOTUS hearing some case related to this, whether it’s HBU’s or one of the others out there, seems pretty high. And after Obergfell, one can only imagine the caterwauling and chest-thumping vows of defiance that will ensue if the plaintiffs lose there as well. The Press has more.

Paxton files amicus brief in HBU contraception lawsuit

Of course he does.

Female employees of religious nonprofits should not be given insurance coverage for birth control if their employers object to certain contraceptives on religious grounds, according to a brief filed at the U.S. Supreme Court by Texas Attorney General Ken Paxton.

Paxton’s “friend of the court” brief was filed Monday in support of a lawsuit brought by East Texas Baptist University and Houston Baptist University against the federal government over a provision of the Affordable Care Act requiring some employers to offer health plans that include contraceptive coverage.

The religious universities oppose emergency contraceptives, including the so-called morning-after pill, and intrauterine devices, which they liken to abortifacients. (Health experts and scientists have disputed that claim.)

[…]

In the brief filed by Paxton’s office, state attorneys wrote that the “supposed ‘accommodation’” will still “coerce employers to proceed with a course of action despite a belief in its religious impermissibility.”

“Many employers around the country feel driven by their faith to care for their employees by providing them health insurance,” the brief reads. “But some employers find it incompatible with their religious convictions to provide that health insurance when it means contracting with a company that then, by virtue of that very relationship, becomes obligated to pay for drugs regarded as abortifacients.”

A federal district court previously sided with the universities, blocking the requirement from going into effect. The U.S. Department of Health and Human Services appealed the case to the New Orleans-based U.S. 5th Circuit Court of Appeals — considered the most conservative appellate court in the country — which reversed that decision, saying the universities had “not shown and are not likely to show that the requirement substantially burdens their religious exercise under established law.”

In its ruling, the panel of the appellate court sided with the federal government in its argument that the universities’ religious exemption from providing contraception coverage did not extend to third parties left to administer insurance plans if a religious organization is exempted.

See here, here, and here for the background. While HBU and ETBU won in district court, no plaintiffs have prevailed at the appellate level yet. As such, there isn’t a district split yet for SCOTUS, though as we saw with the Obamacare subsidies case they don’t need to have one to take up an appeal. I’ll be surprised if it’s not on their docket by next year.

HBU appeals contraceptive case to SCOTUS

Here we go.

Houston Baptist University on Wednesday turned to the U.S. Supreme Court in its battle to avoid providing employees with forms of contraception it finds morally objectionable.

The appeal of a 5th U.S. Circuit Court of Appeals ruling was filed on behalf of the Houston university, East Texas Baptist University and the Westminster Theological Seminary in Pennsylvania by lawyers with the Becket Fund for Religious Liberty.

The Press fills in some important details.

HBU’s is just one of many cases challenging the Affordable Care Act’s birth control mandate. Under the law, religious employers who object to some or all forms of birth control (HBU, for example, takes issue with some emergency contraception that it wrongly likens to abortion) can seek an exemption from the feds. Typically this just means filling out a form letting the feds know of your objection to birth control and naming the company that administers your employee health plan. The government then works separately with the insurance company to make sure workers can get birth control coverage on another health plan if they want it.

East Texas Baptist University and Westminster Theological Seminary joined HBU in challenging the mandate. The schools have argued that by simply informing the feds of their objection – either by filling out a form or by some other means – they’re triggering or facilitating birth control coverage in violation of their religious beliefs. In their challenge, they’ve cited the federal Religious Freedom Restoration Act (RFRA), which says the federal government can’t, except in limited circumstances, “substantially burden a person’s exercise of religion.”

That the Fifth Circuit didn’t buy that argument is notable for a couple of reasons. First, every single federal appeals court that’s so far considered the issue has ruled that religious nonprofits can’t block their workers from getting coverage for birth control. Secondly, the Fifth Circuit, as we’ve written before, is perhaps the most conservative federal appeals court in the country. If anyone was going to buck the trend in favor of religious institutions, you’d have thought it would be the Fifth.

See here and here for some background. Basically, this is about employers attempting to control how their employees are spending their money, based on their belief in a demonstrable falsehood than none of them even gave a thought about as recently as a couple of years ago. But hey, religious freedom! Obamacare oppression! We’ll move to Irion County if we have to! You get the idea.

HBU contraceptive coverage decision overturned

Good.

The U.S. Court of Appeals for the Fifth Circuit has turned back a challenge brought by several Texas religious organizations that oppose offering insurance contraceptive coverage to their employees, concluding that the plaintiffs have no right to challenge the conduct of third parties.

The recent decision also found that U.S. Supreme Court’s controversial 2014 Hobby Lobby decision was of “no help” to the plaintiffs, which included East Texas Baptist University and the Catholic Diocese of Beaumont, among others. That 5-4 high court decision held that corporations opposed to offering contraceptive coverage to their employees are exempt under the Religious Freedom Restoration Act [RFRA].

[…]

In his decision, Judge Jerry Smith wrote that the Fifth Circuit was joining several other circuit courts in finding that the ACA’s contraception coverage mandate doesn’t present a substantial burden to the plaintiffs’ religious freedom.

“Although the plaintiffs have identified several acts that offend their religious beliefs, the acts they are required to perform do not include providing access to contraceptives. Instead, the acts that violate their faith are those of third parties,” Smith wrote, reversing the trial court decisions in the cases.

“Because RFRA confers no right to challenge the independent conduct of third parties, we join our sister circuits in concluding that the plaintiffs have not shown a substantial burden on their religious exercise,” Smith wrote.

While the plaintiffs complain that sending in a notion of opposition will authorize or trigger payments for contraceptives, that is “not so,” wrote Smith, who explained that “the ACA already requires contraceptive coverage.”

Smith also noted that the Hobby Lobby decision mentions that certain religious organizations have already been “effectively exempted” through the ACA’s accommodation.

“Thus, Hobby Lobby is of no help to the plaintiffs’ position, and the requirement to offer a group health plan does not burden their religious exercise,” Smith wrote.

See here for some background, and here for a copy of the opinion. As Think Progress reminds us, Judge Smith is a very conservative Reagan appointee who is a reliable vote against abortion rights, so it’s not a case of getting lucky with the three-judge panel. The full circuit may be asked to review this, and it will certainly go to SCOTUS, though as RH Reality Check notes, every appeals court so far has sided with the feds on this. So there’s some hope that the dreadful Hobby Lobby decision will not expand any farther in scope. Hair Balls has more.

State-run Women’s Health Program continues to be a failure

Quelle surprise.

Right there with them

Right there with them

Thousands fewer women are getting health services through the now state-run Women’s Health Program after Planned Parenthood was barred from being a provider.

A report released Monday by the state Health and Human Services Commission showed that almost 30,000 fewer women were served through the program in 2013 than in 2011, and 63,581 fewer claims were filed for birth control.

The program became fully state-funded in 2013 after lawmakers voted to prohibit taxpayer dollars from going to abortion providers or their affiliates. Planned Parenthood served about 40 percent of the women in the program before it was excluded for being affiliated with separate, privately funded abortion clinics.

Texas lost federal matching money that kicked in $9 for every one dollar the state spent, now costing the state about $36 million annually.

The program provides well woman’s exams, cancer screenings, contraception and tests for sexually transmitted diseases and infections to low-income women between the ages of 18 and 44.

“These numbers are so distressing and I think it shows Texas moving backwards pretty quickly,” said Sarah Wheat, spokeswoman for Planned Parenthood of Greater Texas.

Several Planned Parenthood family planning clinics closed after they lost funding. The report showed that the areas with the highest drops in the number of women served by the program occurred in areas where Planned Parenthood clinics shuttered.

I’ve blogged about this plenty – see here and here for a couple of examples – and by this point it should be clear to everyone that this is a feature, not a bug. The Republicans who did this were told, repeatedly and in detail, exactly what would happen when the cut the funding, gave up the federal match, and kneecapped Planned Parenthood. They went ahead and did it anyway, for the basest of political reasons. And after last year’s elections, who can blame them? It’s not like anyone has been held accountable for it. They should have the courage of their convictions and embrace studies like this with pride. It’s what they wanted to do, and they’ve been hugely successful at it. Newsdesk and the Observer have more.

The cost of unplanned pregnancies

From Wonkblog:

UnplannedPregnanciesMap1

Unintended pregnancies cost American taxpayers $21 billion each year, according to a new analysis released by the Guttmacher Institute. That averages out to a cost of about $366 per every woman of childbearing age in the U.S. Overall, more than half of U.S. pregnancies are unintended, and roughly 1-in-20 American women of reproductive age have an unplanned pregnancy each year.

Nationally there were 1.5 million unplanned births in 2010. Public insurance programs like Medicaid paid for 68 percent of those births. “On average, a publicly funded birth cost $12,770 in prenatal care, labor and delivery, postpartum care and the first 12 months of infant care; care for months 13–60 cost, on average, another $7,947, for a total cost per birth of $20,716,” the study found.

Both the rate and cost of unplanned birth vary considerably by state. As a percent of all births, unplanned births ranged from 31.8 percent in New Hampshire to 56.8 percent in Mississippi. Overall, states in New England and on the West coast had the lowest rates of unplanned birth, while Southern states had the highest.

In some states — Georgia, Mississippi and Oklahoma — more than 80 percent of unplanned births were paid for by public dollars. Georgia taxpayers spent nearly $1 billion on unplanned births in 2010, as did taxpayers in Chicago. California spent $1.8 billion, while unplanned births cost the state of Texas nearly $3 billion dollars in 2010.

As you will see if you read the study, those figures represent both federal and state money. The amount of its own funds spent by Texas was $620 million, which is still a lot of money that didn’t need to be spent. The study points out that were it not for state programs that fund contraception and women’s health programs, the cost incurred, nationally and by each state, would have been much higher. These figures are from 2010. What has Texas been doing since then? Yep, cutting funding for contraception and women’s health, partly for pure budgetary reasons, and partly due to an ideological war against Planned Parenthood. I’m betting that the $620 million we spent in 2010 would be at least that much, possibly quite a bit more, in the subsequent years thanks to this shortsighted and harmful policy. So the next time Texas Republicans whine about the cost of Medicaid, it would be nice if some journalist type asked them about their own role in that problem.

Abbott’s health care small ball

Is that all there is?

Increased funding for preventive care and luring medical professionals to Texas are at the center of gubernatorial candidate Greg Abbott’s health care plan, unveiled at St. Joseph’s Women’s Medical Center here on Wednesday.

The Republican attorney general, running to replace Gov. Rick Perry, unveiled a proposal that includes a $50 million budget increase for women’s health programs, additional funding for medical school residency slots in Texas, loan forgiveness for aspiring doctors who practice in underserved areas and compensation for doctors who provide care via telephone.

Abbott said the cost of the entire plan would be $175 million every two years, but said it could actually save more than it costs. “It may actually reduce the cost of health care,” he said.

The left-leaning policy group Progress Texas criticized Abbott’s proposal because it does not include Medicaid expansion to cover impoverished adults, a tenet of federal health reform that Texas’ Republican leadership has staunchly opposed. Texas has the highest uninsured rate in the nation, with about one in every four people lacking health insurance in 2012, according to U.S. Census data. About one million Texans could qualify for Medicaid coverage if the state were to expand the program under current federal guidelines, according to the Kaiser Family Foundation.

“Texans don’t need more small ideas from Abbott — we need and deserve a comprehensive plan for insuring those 1 million Texans, and we need it yesterday,” said Ed Espinoza, the group’s executive director, in response to the candidate’s proposal.

Abbott’s Democratic rival, state Sen. Wendy Davis of Ft. Worth, has endorsed Medicaid expansion.

There’s nothing here that I find objectionable, but let’s be honest – it ain’t much, especially compared to Medicaid expansion and the million or so people it would help. The 2011 cuts to women’s health and family planning services has done such extensive and lasting damage to patients and providers in the state that anything short of a pledge to re-establish a clinic for every one that had to close is inadequate. Even that doesn’t make up for the inconvenience and hassle of finding new doctors and establishing new routines, but it at least makes the attempt. This is little more than a band-aid. Not a surprise, given Abbott’s known priorities, just nothing to write home about.

Where are the women’s health providers?

The Republican jihad against Planned Parenthood continues to have real consequences.

Right there with them

Right there with them

In 2011, under pressure from Republican leaders, state health officials began enforcing a provision lawmakers wrote to exclude Planned Parenthood and any clinics with organizational ties to abortion providers from the Women’s Health Program. At the time, Planned Parenthood clinics provided 40 percent of the program’s services and often subsidized services not expressly covered by it.

To replace Planned Parenthood, the state recruited new providers, the majority of which are physician groups, to participate in the reimagined program. But unlike many reproductive health clinics, which qualify for additional federal family planning grants, physician groups generally don’t have the public financing to pay for services that aren’t covered by the state program. While physician groups can absorb some of these additional costs, in most cases a patient must pay out of pocket for additional services or find an alternative provider that receives federal subsidies, which can delay care.

Emma Moreno, assistant manager at Valley Women’s Specialists, a physician group in Weslaco that participates in the Women’s Health Program, said the program covers Pap smears, for example, but if a patient tests positive for the human papillomavirus and needs further treatment, that care isn’t covered.

“If you’re going to provide a program or a service, provide the full service and not just half of it,” said Moreno, whose physician group still encourages women who may be eligible to apply for the state program.

[…]

To be eligible for the Women’s Health Program, a woman must have an income at or below 185 percent of the federal poverty threshold, or less than $1,800 a month for an individual. The original Women’s Health Program, which was jointly funded by the state and the federal government, was an offshoot of Medicaid. The federal government discontinued its $9-to-$1 match for the program in January 2012. That followed the state’s exclusion of Planned Parenthood clinics, despite the fact that those clinics were already prohibited from performing abortions because they accepted taxpayer dollars.

The Texas Women’s Health Program is nearly identical to the former Medicaid program in scope, though it now covers STD testing and some routine treatment, and is run entirely with state funding — $35.6 million a year.

In the first six months of the state-run program, enrollment and claims for services dropped significantly.

“While these numbers were collected before we added increased funding [for] women’s health in the last legislative session, they are exactly the type of data we will be carefully reviewing in the months ahead,” state Sen. Jane Nelson, R-Flower Mound, the chairwoman of the Senate Health and Human Services Committee, said in an email to The Texas Tribune last month. “It is important that we make sure the dollars we invested are providing meaningful preventive health services for the women of Texas.”

When I talk about how the likes of Rick Perry, David Dewhurst, and Greg Abbott just don’t want people to have access to health care, it’s about more than just their mulish resistance to expanding Medicaid or their petty harassment of ACA navigators. Their actions have had real world consequences. I’ve talked about this at length – browse through my Planned Parenthood archives, there’s too many entries to link to individually – and the bottom line remains that the state of Texas took something that was working and broke it for ideological reasons. They can try to put it back together again, at greater cost to Texas taxpayers, but even if they succeed they will still have disrupted the delivery of health care to hundreds of thousands of women, forcing many of them to find new doctors, for no good reason.

HBU wins contraception mandate lawsuit

This is very disappointing.

The federal government cannot force Houston Baptist University to pay for emergency contraception services as part of its employee health insurance plans, according to a ruling Friday by U.S. District Judge Lee Rosenthal.

The decision is a victory for HBU and East Texas Baptist University in their joint lawsuit against the government over the constitutionality of Affordable Care Act provisions about employer-paid birth control.

“The government doesn’t have the right to decide what religious beliefs are legitimate and which ones aren’t,” said Eric Rassbach, an attorney with the Becket Fund for Religious Liberty, a public interest law firm representing the two Texas colleges.

The universities said that obeying the Health and Human Services contraception mandate would violate their religious conscience. In a 46-page opinion, Rosenthal said they proved their positions.

“The belief need not be long-standing, central to (their) religious beliefs, internally consistent with any written scripture or reasonable from another’s perspective. They need only be sincerely held,” Rosenthal wrote.

The Obama administration exempted churches from the mandate, but not affiliated organizations like religious schools and hospitals.

The Obama administration is likely to appeal this ruling, but I wouldn’t hold out much hope. In the meantime, there’s a bigger case working its way towards the Supreme Court, involving secular companies such as Hobby Lobby, which want to establish the principle that corporations can have religious rights. If they win, then the employees of these institutions, who may not share the religious views of the owners of said corporations themselves or who may not even be religious, will have their health insurance options dictated to them.

You may be thinking to yourself “Wait, I thought it was the Catholics that opposed birth control. What’s up with Baptists opposing it?” You would not be the only one wondering about this.

I’m proud to be a part of a movement whose great concern is learning to love your neighbor as you love yourself. And as we move into the New Year, I hope those voices of justice will grow stronger and I wish for some other things as well.

I hope that the Religious Right will drop birth control as an issue. During the political season, the conservative Evangelical case against birth control was loud and clear. I spoke to Frank Schaeffer, one of the founders of the Religious Right, trying to remember my days growing up in a conservative Evangelical household. “I don’t remember birth control ever being an issue before. It wasn’t tied to the Evangelical pro-life movement, was it? Did I miss something?” I asked.

“No. Birth control wasn’t an issue at the beginning.” Schaeffer replied. “This is a case of the enemy of my enemy is my friend.”

In other words, the Religious Right took up the cause of birth control because the Roman Catholic Church is against birth control. Since the Religious Right Evangelicals and some Catholics could join forces and become more powerful in their shared quest to defeat Barack Obama, then they decided to add birth control as an issue. We began to hear the pill referred to more as an “abortifacient.”

I am now a Progressive Presbyterian, but growing up as a teen in a conservative Christian culture, I read Passion and Purity. I was advised to take the pill for medical reasons and refused because I thought it would make sex more tempting. I also thought that using a condom would be like premeditated sin, because you would have to have to buy them beforehand and plan on having sex. But there was no sense that birth control was somehow tied to abortion.

I’m hoping that since the Evangelical tie of birth control to the pro-life movement was a pragmatic political flop, it won’t affect conservative women who want to decide when they are ready to have a child. There is already a teen pregnancy problem in red states. We don’t need to exacerbate the issue, jeopardizing the lives and futures of young women by demonizing birth control.

I guess it’s a good thing for HBU and ETBU that their “belief” need not be “long-standing, central to (their) religious beliefs, internally consistent with any written scripture or reasonable from another’s perspective”, because as recently as last decade, this wasn’t part of their beliefs. In fact, one of their peer institutions that also sued the federal government over this mandate was providing emergency contraception coverage as part of its health insurance plan at the same time it was asking for injunctive relief against being required to provide emergency contraception coverage. Don’t make me do something I’m already doing, Your Honor!

The key to understanding all this is in the quoted bit above. Take a look at the reason the lawsuit was filed in the first place.

Dub Oliver, president of East Texas Baptist University, told KLTV 7 that he opposes the provision because he believes that “life begins at conception” and that contraception drugs cause abortions.

But the statement that “contraception drugs cause abortions” is not a matter of faith, it’s a matter of testable, provable fact. And the facts as we now know them show that this belief is mistaken.

Several scientists and doctors said in interviews that this view did not reflect the way the birth control methods actually work. “There’s so much evidence for how these things work prior to fertilization,” said Diana L. Blithe, director of contraceptive development for the National Institute of Child Health and Human Development. “And there’s no evidence that they work beyond fertilization.”

She and other experts said these methods are so effective in preventing fertilization that the chance of an egg and sperm uniting is slim. If fertilization does occur, the embryo runs a high risk of not implanting for natural reasons. While several medical Web sites, including some from government agencies, raise the possibility that the morning-after pill could affect implantation, Dr. Blithe and others said it had not been scientifically verified that the drugs work that way.

One morning-after pill, Plan B, contains a synthetic progesterone that blocks ovulation, said Dr. Anita Nelson, a professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. Recent studies have indicated that women who take Plan B after ovulation have a normal chance of becoming pregnant, and that Plan B does not prevent their fertilized eggs from implanting, Dr. Nelson said. Ella, the other morning-after pill, delays ovulation by blocking the body’s progesterone, she said.

She said that Ella was a hormonal cousin of the drug used in an acknowledged abortifacient, RU-486, which is given to women who are up to about seven weeks pregnant and stops the development of an already-implanted embryo. But the RU-486 hormone is a very high dose, between 200 to 600 milligrams, whereas the Ella hormone is 30 milligrams, Dr. Nelson said. She said that Ella had not been tested to see if it prevented implantation. But she added that the RU-486 hormone at low doses acts only to prevent ovulation.

See also this NPR story on the same subject. The evidence at hand was sufficient to convince Catholic bishops in Germany that emergency contraception was acceptable, at least in some cases. But that’s what this is about, conflating birth control with abortion, and teaming up with the Catholic Chuch – the “enemy of my enemy” – against the Obama Administration by conflating birth control with abortion. That says to me that this is much more about politics than it is about faith. To the extent that faith is involved, it’s a matter of convenience. I don’t think that’s worth trumping the rights of the employees of these institutions, and I’m disappointed that Judge Rosenthal bought into it. BOR has more.

It’s about much more than abortion

Yet another reminder that even if the Legislature had taken no action on abortion since 2011, it still grievously damaged women’s access to healthcare.

The closure of nine of 32 family planning clinics in the Rio Grande Valley — a result of the state Legislature’s decision to cut family planning financing in 2011 — has compounded the struggles of low-income, Latina women trying to access reproductive health services, according to a report released Tuesday by the Center for Reproductive Rights and the National Latina Institute for Reproductive Health.

“Profound barriers to reproductive health, including cost, lack of transportation, immigration status and lack of accessible clinics, mean that Latinas in Texas are systemically barred from the care they need to live with health and dignity,” Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health, said in a statement. “These conditions are dangerous to the health of Latinas and immigrant women.”

The Legislature’s decision in 2011 to cut two-thirds of the state’s two-year family planning budget — to $37.9 million from $111 million for 2012-13 — has caused 76 medical facilities across the state to close or stop providing family planning services as a result of lost public financing, according to the Texas Policy Evaluation Project (TxPEP), a three-year study at the University of Texas evaluating the impact of the cuts to family planning services.

The enactment of stricter abortion regulation in November — the constitutionality of which is currently being debated in federal courts — has also caused a third of state’s nearly 40 licensed abortion facilities, including the only two abortion clinics in the Valley, to stop performing abortions. The Center has provided legal assistance to the abortion providers involved in that lawsuit.

Although the report released Tuesday focuses on the Valley, TxPEP researchers have found women across Texas have lost access to trusted providers, experienced longer wait times for services and paid higher rates for contraception and other health services, as a result of the 2011 cuts to family planning services.

In its 2013 session, the Legislature sought to mitigate the impact of the 2011 cuts with the largest financial package for women’s health services in state history, increasing spending to $214 million in the 2014-15 budget from $109 million. Texas’ 2014-15 budget includes a $100 million expansion of a primary care program to provide services for an additional 170,000 women; $71 million to operate the Texas Women’s Health Program; and $43 million to replace family planning grants that the federal government awarded to another organization to distribute.

The efforts to rebuild access to reproductive health care is slow moving, as the state is still in the process of contracting providers to participate in the expanded primary care program. Texas Women’s Health Program, which replaced the federally-financed Medicaid Women’s Health Program in January after the state violated federal rules by ousting Planned Parenthood clinics, has fewer women enrolled and has processed fewer claims so far this year than during the same time period last year.

See here for some background. As I said before, even if a sufficient number of new clinics eventually opens and the state’s replacement Women’s Health Program matches the reach and breadth of the Planned Parenthood-anchored network that the Lege and Rick Perry killed off, you can’t undo the damage and disruption that the original cuts caused. Tens of thousands of women were left in the lurch, often to the detriment of their health, and most if not all of them will wind up with a different doctor than who they had before. All of this was done in the service of ideology. When we talk about a war on women, when Wendy Davis talks about truly being “pro-life”, this is what we’re talking about.

Remember how concern for women’s health was supposed to be a thing?

Now that the omnibus anti-abortion bill has been passed and signed, the Republicans can quit pretending to care about the state of health care access for women in Texas as before.

Right there with them

Right there with them

Three Planned Parenthood family planning clinics in Southeast Texas announced plans Thursday to close at the end of August. The closures result from reduced family planning funds and the removal of Planned Parenthood from the state Women’s Health Program, said Melaney Linton, CEO of Planned Parenthood Gulf Coast.

While the closures were announced the same day as Gov. Rick Perry’s signing of omnibus abortion legislation, House Bill 2, the closures are “a completely separate issue” from that new law, Linton said.

Linton said many patients who visit the three clinics cannot afford to pay for services and therefore would “go without the care they need.” She said the decision by the state not to expand Medicaid under the Affordable Care Act was “the final straw” that rendered the clinics unable to serve patients.

“This has been a long time coming,” she said.

But John Seago, legislative director for Texas Right to Life, said he believes women in that region will still have access to health programs, noting the recent legislative move to restore funds to participants in the Women’s Health Program.

In the 2013 session, the Legislature voted to add $71 million to the program.

“The Legislature has more than restored the funding that was effective last session,” Seago said.

It’s certainly good that the Legislature restored funding for the WHP after it was decimated in 2011, but the damage has already been done. Some sixty clinics closed their doors statewide after the 2011 budget cuts. and the number of clinics funded by the Texas Department of State Health Services dropped from 300 to 136 in the year following those cuts. If you burn my house down, then build me another two years later, you can claim you’ve made me whole but I was still homeless in the interim. Even if you could credibly claim that there are now as many clinics that provide health care and family planning services for women as there were in 2011 – I have no idea if this is true, and neither does John Seago; what’s more, I’m sure he doesn’t care – the fact remains that hundreds of thousands of Texas women had their health care disrupted. Even if every single one of these women now has a clinic that’s as close to them and as convenient for them and as affordable for them that they’re aware of and comfortable visiting, it still wasn’t their choice to make that change. It was done to them by Rick Perry, David Dewhurst, Greg Abbott, and the Republican friends of people like John Seago in the Texas Legislature. What was done can be ameliorated but it can never be undone. PDiddie has more.

The state begins preparing its excuses for its WHP screwup

The fail is strong in this one.

Right there with them

State health officials continue to insist that they have signed up more than enough providers to replace Planned Parenthood across most of Texas. Areas of limited coverage — including San Angelo, Corsicana and Paris — are being scoured to find health care providers willing to join the Women’s Health Project, they said.

In the meantime, the provider information that was pulled from the Health and Human Services Commission’s website is undergoing a belated check for accuracy to remove doctors and clinics that were mistakenly listed as participants in the Women’s Health Program or that provided only limited services, such as surgical contraception.

New information will not be posted online until a state contractor verifies that every listed health care provider is a participant in the Women’s Health Program — and state health agency employees double-check the revised list, said Stephanie Goodman, a spokeswoman for the state Health and Human Services Commission.

What went wrong?

Originally, the list was generated by the contractor, the Texas Medicaid and Healthcare Partnership, by using provider numbers for practices that had joined the health program, Goodman said. That shortcut, however, captured all locations of a provider group, even those that were not participating — including pediatric clinics, labs and surgeons.

“Obviously, on something this high-profile, that’s going to be this scrutinized, this is an area where we should have done a better job,” she said.

“Our mistake, honestly, was not calling on our own” to verify the contractor’s work, Goodman said. “On paper, picking up all those providers that could legitimately bill under the program made sense. We should have realized that pulling from billing records would make it difficult for women to use” the list.

Goodman said she expects the revised list to be published online this week.

That’s what you said last week, Stephanie. I guess one of these weeks you’ll be correct about that.

The mistakes were unfortunate, Goodman said, because they overshadowed a lot of hard work that has been done to launch the state program, particularly in signing up enough new providers to meet the need left by Planned Parenthood’s ouster.

“That’s one of the sad parts of this. I’d hate for women to see these stories and think, ‘There’s no help for me,’ ” she said. “There are clinics all over the state that said they have the ability to serve more women.”

The real mistake, of course, was believing that in Rick Perry’s Texas, where the 2011 Legislature slashed spending on family planning by two-thirds, there would be any incentive for this to be done right. Forget the scapegoating of the contractor, whose work was apparently never supervised or verified by anyone at the HHSC – we don’t need no stinkin’ project management! – and focus for a minute on the statement above on how “areas of limited coverage” – that is, places where only Planned Parenthood had done this kind of work before – are still “being scoured” to find providers more than three weeks after the state WHP was supposed to go live. No one could have seen this coming, because the Perry administration has such an admirable record of caring about women and children, especially poor women and children. If these women have received a message that there’s no help for them, there’s a good reason for it.

Where are the doctors?

The Morning News tries to verify that the Dallas-area providers listed for the new Texas Women’s Health Program are in fact providing health care services to the women in this program as advertised. It goes about as well as you’d expect.

Right there with them

A Dallas Morning News survey of 336 contacts listed online for the program showed that 18 percent of the 55 unrepeated physicians and offices surveyed knew they were a part of the program and are accepting new patients. Two listings point people to businesses with no connection to the program — a sports medicine clinic and a title company.

A spokeswoman for the Health and Human Services Commission, which operates the new program, acknowledged that the list has problems.

“It’s not that it’s a list that they shouldn’t be using, it’s that there are addresses on that list that shouldn’t be there, so we’re going to have to do some work to clean that list up,” said Linda Edwards Gockel.

Gockel said the list, which has been available on the program website for more than three months, is not the same list of 3,500 approved providers the state has touted. It represents all the locations a potential provider billed from in the past.

She said the commission hopes to have the list corrected by next week. Gockel could not say why it was not removed sooner, but that women can always call the 1-800 number listed on the website. After The News pointed out the list’s failings, subsequent press releases from the commission avoided mention of the website.

In fact, if you go to the Texas Women’s Health Program website now and click the Find A Doctor link, you will not see any providers listed at all:

According to Trail Blazers, the site “will be fixed sometime this week”, though it looks now like that has been pushed out a few more days. Reps. Donna Howard and Lon Burnam had previously found the same problems that the DMN reports on here in Austin and Fort Worth. Now other Democrats are getting in on the action.

“It is unacceptable that thousands of Texas women may be cut off from access to the program due to the program’s inability to meet demand,” said Rep. Jessica Farrar, D-Houston, the House Democratic Caucus chairwoman, in a prepared statement. “My main concern is to ensure that women may be given the opportunity to affordable and accessible health care.”

Using the Texas Public Information Act, Farrar requested that the agency release a list of the available providers enrolled in the Texas Women’s Health Program along with the number of patients they anticipate serving, the number of patients served by the former Medicaid Women’s Health Program and the geographical areas in the state where provider enrollment does not meet demand.

Good on you, Rep. Farrar. What all this says to me is that the list that had been given on the website was complete and unadulterated junk and that they have taken it down in a desperate attempt to fix it. Remember that the state has been bragging for months about how they’re all fired up and ready to go without Planned Parenthood and with a list of 3,000 providers all set to step in. Is there any reason now to believe that was anything but a lie? Further, given the obvious problems and the complete disconnect between what the state has been saying and what everyone who has bothered to check has discovered, is there any reason to think the state will get this fixed any time soon? I say no and no.

I also say it’s time to get the people primarily responsible for this mess on the record about it. That includes State Sen. Bob Deuell, who requested the AG opinion that declared the state could sever ties with Planned Parenthood while still receiving federal money for the WHP (and how has that turned out so far?); Kyle Janek, the chair of the Health and Human Services Commission; and of course Rick Perry himself. Good on the DMN and Reps. Howard, Burnam, and Farrar for uncovering this lie, but it’s time for everyone else to get in the game as well. Rick Perry isn’t going to care about this until he’s forced to care about it.

No injunction in state lawsuit for Planned Parenthood

Bummer.

Right there with them

Travis County District Judge Stephen Yelenosky on Friday refused to grant Planned Parenthood’s request for a temporary injunction to be included in the Texas Women’s Health Program.

“Probable injury is not really sufficient,” said Yelenosky, who ruled in favor of Planned Parenthood at a hearing in December, “… because it is unlikely that the plaintiffs will succeed at trial, I will deny the temporary injunction.”

Although Yelenosky agreed with Planned Parenthood’s arguments that the organization’s exclusion from the Texas WHP could endanger access to health services, his ruling indicated he did not believe their legal arguments would be successful at trial. Yelenosky also cited a “poison pill” rule that would cause the Texas WHP to self-destruct if a court overturned the Affiliate Ban Rule in the reasoning for his ruling.

“This allows us to continue to provide important family planning and preventive care to low-income women and fully enforce state law,” Dr. Kyle Janek, the state’s executive commissioner of health and human services, said in a statement on the ruling. “We’ve got the Texas Women’s Health Program up and running, and we’ll continue to provide help to any woman who needs to find a new doctor or clinic.”

Pete Schenkkan, a lawyer representing Planned Parenthood, said the organization is “confident in the merits of our case,” and will still consider taking the case to trial.

See here and here for the background. It’s not looking too good for Planned Parenthood at this point, though of course it’s the women who depend on their services that are the real losers. I suppose they could still win at trial, but as I said before it’s ultimately at the ballot box where the fight really matters.

As for the state’s claims that everything is peachy keen with their replacement WHP, Rep. Lon Burnam joined his colleague Rep. Donna Howard in checking with the providers that are listed on the Texas WHP website. You will I’m sure be shocked to hear that most of the providers listed are not in fact participating in the program. See his release beneath the fold and his much more accurate list of providers in Tarrant County here.

On top of this, the Better Texas blog reminds us that the problems run deeper than just the WHP:

Over the last year much attention has been paid to the fate of the 130,000 women in WHP, and especially the 40,000+ who choose Planned Parenthood as their provider. While this is certainly worthy of attention (and even outrage), comparatively little attention has been paid to the DSHS family planning cuts that took effect in 2011 and have already resulted in 147,000 women losing access and 53 safety net family planning clinics closing.

It seems the media followed WHP more closely, because of the attention-grabbing dispute between Texas and the federal government, and lawsuits between the state and Planned Parenthood. By comparison the 2011 Legislature’s votes to cut DSHS family planning by two-thirds ($73 million over the biennium) provided less drama, even though they’ve harmed more women and slashed or eliminated funding from more safety net providers. And the DSHS cuts didn’t just hurt that program. Clinics that closed in the wake of the DSHS cuts also provided care in WHP and had staff on site that helped women through the WHP enrollment process. Since the DSHS cuts took effect, client enrollment in WHP has declined.

On the bright side, the Lege is reconsidering that decision to slash family planning funds since someone explained to them that less birth control means more babies. So they have going for them.

(more…)

A family planning end run?

This is interesting.

Texas lawmakers have spent the past two years attacking family planning services in the state, cutting funds for programs that provide women with birth control and wellness exams. Now family planning advocates are fighting back.

A coalition of providers plans to bypass Gov. Rick Perry and the Texas Legislature and apply directly to the federal government for family planning funds. If the coalition wins the federal grant—called Title X (Title 10)—a slice of Texas’ family planning money would no longer go to the state health department—and would no longer be subject to the whims of the Legislature. Instead, the coalition, organized by Fran Hagerty of the Women’s Health and Family Planning Association of Texas, would distribute the money to family planning providers statewide, including perhaps Planned Parenthood, and restore services to tens of thousands of Texans.

Since 1982, the Department of State Health Services has received Title X grants in Texas, though any group can apply to the federal government for the money. The department then distributes the money, alongside cash from other federal and state grants, to providers delivering family planning and preventive care. The Title X grant is worth $14.5 million per year, part of the $111.5 million pot of money the state had to spend on family planning.

[…]

At $14.5 million per year, the Title X grant comprises only a small slice of Texas’ annual family planning budget. But it’s worth much more than its dollar value. That’s because Title X money comes with a confidentiality clause not always attached to other funding streams. This means that providers need only $1 from Title X to cast privacy protection over all their clients, especially teens who would otherwise need parental consent to access birth control.

Similarly, Title X recipients get a discount on pharmaceuticals. With this discount, clinics can buy drugs at half the wholesale cost. Again, just $1 of Title X casts this discounted rate over every drug purchased by the clinic. That often helps clinics prescribe the more effective, yet more expensive, types of birth control.

The protections afforded by Title X demonstrate how complex and delicate clinic funding arrangements are. Having it means that some providers, whose clinics teeter on the edge of financial viability, could continue operations. “When providers lost Title X funding, they lost much more than just the money,” Hagerty said. They also lost their patient confidentiality, discounted drugs and the more discretionary spending that Title X allows. Restoring those protections to providers is what Hagerty said gave her the impetus to take the project on.

There’s more, so go read it and when you’re done go back and read the earlier story about the devastating effect of the family planning cuts on Texas health providers. This isn’t a panacea, nor is it a guaranteed funding source going forward – among other things, as with any other government program it is subject to the whims of the prevailing political sentiments; I for one have a hard time believing this would have survived four years of Romney/Ryan budgeting intact – but if it can help the clinics that need it, it’s a good effort. We’ll see how it goes.

Draft Cecile?

Nonsequiteuse looks ahead.

Cecile Richards

I hereby kick-off (or join, because maybe others have beat me to it since I’ve been in a deep wormhole this summer) THE DRAFT CECILE RICHARDS TO RUN FOR GOVERNOR OF TEXAS MOVEMENT.

She’s going to be speaking at the DNC, and we all know that spot at the podium sets people up for a pretty sweet trajectory. She’s tough, smart, and must be at least a full foot taller than Goodhair. She could send him into hiding with a single side-eye.

More than that, she’s a clear win on the compassion front. She understands what it takes to take care of the least among us. She gets that strong, healthy women mean strong, healthy families, and that translates directly into a strong, healthy economy and community.

And, in this time of legitimate rape and vaginal probes and kamikaze Komen, she knows how to capitalize on the zeitgeist and rake in the big bucks. I’m nothing if not practical: serious green is what it will take to turn Texas blue.

Planned Parenthood might not be ready to let her go, but consider what it would mean to accelerate the demographic shift in Texas politics. I know great women are standing in the wings who could carry on the proud tradition Cecile has become a part of, leading that institution.

I believe federal law now mandates that all such movements begin with a Facebook page. I personally have hopped on the Draft Henry bandwagon so I’ll leave that task to someone else, but I’ll be happy to give the page a Like once it’s up.

That said, I’d be delighted to see this happen. I’d suggest that the second thing to do, after the Facebook page, is to convince Ms. Richards and her family to move back to Texas, since she currently resides in New York, according to her Wikipedia page. Her roots are deep enough here to overcome that, but better sooner than later, you know?

One more thing I’d point out is this: In addition to the “serious green” that Nonsequiteuse mentions will be needed to run and win a gubernatorial campaign, the other thing that we really ought to be looking for is a candidate with some personality. The last Democratic candidate for Governor for whom the word “charismatic” would be on the short list of accurate adjectives was Cecile’s mother, Ann Richards, in 1994. That’s a long time to go without pizzazz. Henry Cisneros has it, Cecile Richards has it, Julian Castro has it if he ever decides to move up his time frame (2018 is such a long way off), maybe someone else besides them who could mount a campaign will have it. I’m hardly the first person to suggest such a quality – McBlogger, call your office – but after so many elections without it, it’s hard to see why we’d not want to be looking for it this time around. Surely having a bit of Elvis in our candidate would help with the green-raising as well. That’s the argument, now it’s time for some drafting. Who’s on board with this? See Sarah Killf’s well-timed post for more on Ms. Richards.

Who cares about women, anyway?

The state of Texas certainly doesn’t.

If there was any hope that the state was seeking a compromise with the federal government over Texas’ Women’s Health Program, it’s fading fast. At the direction of lawmakers and Texas Attorney General Greg Abbott, the Texas Health and Human Services commissioner signed a rule on Thursday that formally bans Planned Parenthood clinics and other “affiliates of abortion providers” from participating in the program — something the Obama administration has said is a deal-breaker for the nearly $40 million-per-year state-federal Medicaid program.

“The Obama administration is trying to force Texas to violate our own state laws or they will end a program that provides preventative health care to more than 100,000 Texas women,” said Allison Castle, a spokeswoman for Gov. Rick Perry. “This boils down to the rule of law — which the state of Texas respects and the Obama administration does not.

The rule, signed by Commissioner Tom Suehs on Thursday, takes effect March 14. Unless some last-minute agreement is brokered, the program, which receives $9 in federal funds for every $1 in state funds, will be either phased out or cut off by the end of March. At least 130,000 poor Texas women will lose access to cancer screenings, well-woman exams and contraception.

“No one’s politics should interfere with a woman’s access to health care,” said Planned Parenthood Gulf Coast President and CEO Peter J. Durkin. “It is shameful that Governor Perry and Commissioner Suehs continue to politicize lifesaving breast cancer screenings and birth control access for low-income women.”

Republican lawmakers worked overtime last legislative session to design language that would keep any Planned Parenthood-affiliated clinics from receiving state family planning and women’s health dollars, despite the fact that taxpayer-funded clinics may not perform abortions. They got the backing of Abbott, who said their efforts were legal, and gave the state’s health commissioner the go-ahead to implement the new language.

But when Texas was faced with renewing the Women’s Health Program this year, officials with the U.S. Department of Health and Human Services said the state’s plans violated the Social Security Act. They gave the program a three-month extension, but said they had no intention of renewing if Planned Parenthood, which provides 44 percent of the program’s services, was blacklisted.

The stalemate appears unbreakable — Republican lawmakers have made clear they’d rather forgo the program and the federal money than allow Planned Parenthood to participate.

I don’t know how much more evidence you need to conclude that the state’s jihad against Planned Parenthood is about much more than abortion. It’s rich to see Perry and Abbott try to direct what the feds can do with their money, since they get their noses so far out of joint when it’s the other way around. Ironically, this happened on the same day that the state joined a lawsuit challenging the rule that would require all employers to include coverage for contraceptives in employees’ health care benefits. That charge is being led by the Catholic bishops, all of whom as far as I could tell were silent on the prospect of 130,000 women losing access to health care in Texas. As State Rep. Garnet Coleman points out, nearly half of all births in Texas are paid for with Medicaid. What will happen to these women and their babies? The state of Texas and the Catholic bishops don’t care. They have an ideology to pursue.

In related news, a number of people suddenly noticed last week that Texas’ sonogram law is pretty much the same as the one in Virginia that got derailed after drawing national attention. Texas’ law, on the other hand, got little to no national notice despite fierce resistance here from those who saw this law as the degradation and humiliation of women that it is. We can stare at our navels all day trying to figure out why that is, but it’s really not so hard to understand. It’s about winning elections. Until Democrats start winning more of them, and in particular until they win a high profile one because of an issue like this, this is what we’re going to get. As with every other issue we talk about here, nothing changes until the people we elect to our government change. Neil, Rachel, and Burka have more. Be sure to read through the comments for a pained defense of his legislation by Sen. Dan Patrick and some good responses to him.

Pinterest

Rachel brings up a topic that I admit had not occurred to me.

Raise your hand if you’ve heard of Pinterest.

Chances are, if you’re a woman, your hand is up right now.

Chances are, if you’re a man, you are either rolling your eyes because you’ve heard of it and are sick of hearing about it or you are a little confused.

Pinterest has exploded onto the scene as the new up-and-comer, particularly after it was announced that Pinterest is driving more traffic to websites than Google Plus, You Tube and LinkedIn combined. I’ve been watching the Pinterest frenzy with some interest, as it’s one of the first self-expression networks that women dominated before men even knew what was happening.

Naturally, that has caused some (male) pundits to discount Pinterest’s staying power.

Regardless of where you stand on whether or not Pinterest is the Next Big Thing, there’s no doubt that it’s A Big Thing Right Now which means it’s time for all you politicians to climb on the bandwagon, rosin up your social skills and start putting it to use. Here are a few tips to get you started.

I admit, I knew nothing about Pinterest beyond knowing that it exists and noticing that the only people I knew who seemed to be using it were women. But like Rachel, I’m intrigued by the possibilities of a platform like this for political purposes. Seems to me that in an election year that has been and will be about denying access to birth control, denying access to health care for women by de-funding Planned Parenthood, and generally treating women and their doctors as being incapable of making their own decisions, and given that the voting bloc Democrats need to be bringing to their side are “disproportionately young, female and secular”, it doesn’t take a social media guru to see the possibilities in a female-oriented community whose goal is to “connect everyone in the world through the ‘things’ they find interesting”. Annie’s List, I’m especially looking at you. Here’s one way of doing it, if you can’t think of anything offhand. You’re smart, you can figure it out from there. Everyone knows how to use the tools from the last election. The first people to figure out how to use the tools for the next election will have a huge advantage in it.

On free speech and reproductive rights

I must say, I was a bit flummoxed by this story.

The City of Austin might repeal a 2-year-old ordinance requiring some facilities that counsel women with unplanned pregnancies to post signs saying they don’t offer abortions or contraceptive services.

The four Austin facilities affected by the ordinance sued the city last fall, saying the ordinance violates their constitutional rights.

City attorneys are urging the City Council to repeal the ordinance at Thursday’s council meeting “to avoid further litigation costs” and because similar laws have been struck down in other cities, according to a written summary of their recommendation.

Bill Spelman, the council member who led the charge to enact the ordinance, is proposing that the council revise, not repeal, it.

“This is a consumer awareness issue,” Spelman said in an email. “I still believe that it is important for women to have as much information about these businesses as possible, and I believe the changes I’m proposing will provide women information as well as satisfying the legal issues that have come up since (the council) passed the original ordinance” in April 2010 .

The ordinance requires pregnancy resource centers that don’t offer or refer clients to abortions or birth control to display entrance signs in English and Spanish noting the lack of those services.

So, it’s perfectly constitutional for the state to compel doctors to show a sonogram they don’t want to show to a patient who doesn’t want them to show it to them, but it’s a violation of free speech for the state to require a “clinic” that performs no medical services to clearly state that they perform no medical services? How is that even remotely consistent? I’ve been trying to come up with a righteous rant about this, but in the end I decided it was better just to point you to what Katherine Haenschen said; see also her report on Council’s actions. Now if you’ll excuse me, I need to go put a helmet on so my head doesn’t explode.

It’s always been about controlling women

Sadly, there’s nothing new about this.

Senate Finance Committee Chair Steve Ogden, R-Bryan, said Monday afternoon that budget negotiators will likely adopt a 2012-13 family planning budget that is “pretty close” to the House’s proposal — $37 million for low-income women under the Department of State Health Services — compared to the $100 million proposed by the Senate.

Meanwhile, Sen. Bob Deuell, R-Greenville, and Rep. Garnet Coleman, D-Houston, agree that the Medicaid Women’s Health Program, operated under the Health and Human Services Commission with a 9 to 1 federal match, is likely dead.

Both pots of money are a casualty of GOP lawmakers’ efforts to keep Planned Parenthood or any other clinic that provides abortions in some of its affiliate branches from getting state dollars for family planning. (No clinic that provides abortions may receive state or federal funds.) But Coleman and Deuell said it’s something more: lawmakers’ increasing desire to link contraception to abortion.

“Apparently the anti-abortion movement has morphed into the anti-contraception movement,” Deuell said.

Added Coleman: “The objective to end contraception funded by the state is another religious intrusion into the lives of individuals.”

With all due respect to Sen. Deuell, there’s been no metamorphosis. The anti-abortion movement has always been about controlling women’s sexuality. This has nothing to do with the motives of sincere individuals who oppose abortion on principle, it has to do with a reactionary and radical political ideology that unfortunately got a huge boost last November despite being at best a stealth item on the political agenda. It’s also unfortunate that Sen. Deuell, who recognizes this movement for what it is, however belatedly, has nonetheless played right into it with his own legislative attacks on Planned Parenthood. Perhaps he and others like him who do distinguish between opposing abortion and promoting a fanatically misogynistic worldview through legislation might learn something from this. If so, that would at least be a tiny sliver of daylight to emerge from this terribly dark session. It’s up to those of us who have seen this coming for years to make sure they realize it.

http://www.chron.com/disp/story.mpl/metropolitan/falkenberg/7574416.html

How little do the Republicans care about women’s health?

They don’t care at all.

An innovative women’s health initiative is heading toward oblivion over a legislative impasse between abortion rights opponents and supporters even though the program has nothing to do with abortions.

Unless renewed by law, the 5-year-old Medicaid Women’s Health Program will expire in December, ending contraceptive care and disease screening for 120,000 low-income women.

Sen. Bob Deuell , sponsor of the renewal bill, said Monday that he does not have enough support to bring the measure to the floor for a vote.

The sticking point is a provision designed to ensure that Planned Parenthood never participates in the program, which is intended to provide birth control to women who would qualify for taxpayer-supported Medicaid coverage if they were to become pregnant.

Deuell’s bill not only bans Planned Parenthood’s participation, it would also cancel the Women’s Health Program if the organization successfully sued to overturn the ban.

“It won’t pass the House without that in there,” said Deuell, R-Greenville.

But the so-called poison pill has also killed the bill’s chances in the Senate, Deuell added. “The Democrats here just can’t vote for it,” he said.

[…]

More than 120,000 low-income women participate in the health program, and state health officials say the effort saves state money — $21.4 million in 2008 — by reducing the number of Medicaid-financed births.

In addition to contraceptive care, participants are screened for cancer, diabetes, hypertension, anemia, sexually transmitted diseases and other conditions that could shorten their lives.

“I think it is a sad lack of leadership from the Texas Legislature that there’s no way to renew a program that is incredibly successful,” said Sarah Wheat with Planned Parenthood of the Texas Capital Region.

You might think $21.4 million is a lot to waste on spite, but the Republicans in the legislature clearly don’t. I don’t even know what else to say. Perhaps now that a budget deal has been reached, there will be some resolution for this, though I don’t know what I’d root for. Lisa Falkenberg has more.

Planned Parenthood roundup

As you know, it’s been a truly crappy year for women’s health, family planning, and Planned Parenthood. All over the country there has been a relentless assault on reproductive freedom, which has spilled over into health care and access to health care, mostly for women. We’ve certainly seen it here in Texas between the House budget and its zeroing out of family planning funds and the Medicaid Women’s Health Program. It’s shameful and harmful and in the end will cost the state more money than they could possibly cut from the already meager budget, but none of that matters to this misogynistic crowd.

I’m glad to see that Planned Parenthood is fighting back, but let’s be honest, the legislative battle is pretty much over save perhaps for a point of order or some other rulebook jujitsu. What matters now is winning the next election and sweeping as many of these troglodytes out of office. I had the good fortune last week to attend the Planned Parenthood Action Fund annual luncheon with a number of my blogging colleagues, and we were heartened to hear featured speaker and nationally known pollster Celinda Lake talk about how out of touch with the mainstream these radical actions are. But none of that means anything if those of us who care about it don’t show up and vote accordingly. So if you sat it out last November, or if you voted Republican but without intending to send a “defund Planned Parenthood and cripple family planning and women’s health” message, it’s on you this time to not do that again. We can’t afford any more of it.

With that, let me present a roundup of what was written about that luncheon. Lots of good stuff here from:

Nonsequiteuse, and Nonsequiteuse again.
Texas Liberal
Brains and Eggs
Hair Balls
Katrina Esco
Bay Area Houston

You should also read this AusChron story about what’s been going on in the Lege with family planning and reproductive freedom. If you’re not mad after reading all this, you need to get your blood pressure checked.

Finally, today is Texas Stands with Planned Parenthood Day of Action. It’s probably a little late to get in on some of the action, but click on to see what you can do today and going forward. We need everyone to be involved.

(more…)

Fight over family planning funds coming

It’s a small piece of the difference between the House and Senate budgets, but it will surely be a big part of the fight over how the two are reconciled.

The Senate budget approved by the Finance Committee would spend $11 billion more than the House version, and members of the upper chamber seem unwilling to leave family planning drastically underfunded. The Senate is expected to vote on a final version of the bill this week and clear up the details.

The money that the House slashed helps needy women get physical exams, birth control pills and tests for sexually transmitted infections, as well as other health disorders.

Republican Sen. Bob Deuell of Greenville , an open opponent of abortion and a practicing physician, sees the wisdom in finding money for low-income women who need the services. “These programs prevent unwanted pregnancies and prevent abortions by allowing women to plan their pregnancies,” he said. “I would dare say (the Senate) is willing to put more into family planning.”

[…]

In a show of power, the House’s Republican supermajority used a series of amendments to strip the budget of more than $60 million in family planning services and shift it to other programs for poor and disabled children. Some of the money was moved into anti-abortion-rights programs and crisis pregnancy centers.

The conservatives were relentless in their efforts, which some see as part of a nationwide attack on Planned Parenthood, the most widely known family planning program. This larger conservative movement to defund Planned Parenthood, and groups like it, is intended to reduce access to abortion nationwide.

Houston Rep. Jessica Farrar , leader of the House Democrats, said the fight is about ideology, not fiscal prudence. “It’s not about policy; it’s not about women’s health — everything is about abortion for them,” she said.

Farrar and others say that gutting services that help women and children stay healthy and avoid unintended pregnancies will yield skyrocketing long-term Medicaid costs. Women who can’t get birth control are more likely to stay trapped in poverty at the cost of the taxpayer, family planning advocates contend.

There’s no question that Rep. Farrar is right. The question is which side will blink first. There’s a middle ground between spending X dollars and spending Y dollars. There isn’t between believing something is good and believing it’s evil. The anti-family planning zealots do have an ace in the hole, and that’s Rick Perry’s line item veto power. They can give if they need to and still win.

What Planned Parenthood actually does

Since the only thing apparently holding up a deal to prevent a government shutdown is the GOP’s mulish insistence on de-funding Planned Parenthood, perhaps it’s time we all understood what Planned Parenthood actually does. Ezra Klein gives the explanation, with a chart.

[A]bortion services account for about 3 percent of Planned Parenthood’s activities. That’s less than cancer screening and prevention (16 percent), STD testing for both men and women (35 percent), and contraception (also 35 percent). About 80 percent of Planned Parenthood’s users are over age 20, and 75 percent have incomes below 150 percent of the poverty line. Planned Parenthood itself estimates it prevents more than 620,000 unintended pregnancies each year, and 220,000 abortions. It’s also worth noting that federal law already forbids Planned Parenthood from using the funds it receives from the government for abortions.

So though the fight over Planned Parenthood might be about abortion, Planned Parenthood itself isn’t about abortion. It’s primarily about contraception and reproductive health. And if Planned Parenthood loses funding, what will mainly happen is that cancer screenings and contraception and STD testing will become less available to poorer people. Folks with more money, of course, have many other ways to receive all these services, and tend to get them elsewhere already.

The fight also isn’t about cutting spending. The services Planned Parenthood provides save the federal government a lot of money. It’s somewhat cold to put it in these terms, but taxpayers end up bearing a lot of the expense for unintended pregnancies among people without the means to care for their children. The same goes for preventable cancers and sexually transmitted diseases such as HIV/AIDS.

That saves the state of Texas money, too. Not that any of the misogynists who are making these demands yet call themselves “fiscally conservative” care about that, of course. Over this wingnut wish list item they are willing to shut down the government – which, by the way, will also cost a ton of money. Among them are freshman CD27 Congressman Blake Farenthold. Makes you proud, doesn’t it? For more on what Planned Parenthood does, read this. A statement from Peter J. Durkin, President and CEO of Planned Parenthood Gulf Coast, on the subject of the shutdown is beneath the fold. Steve Benen, Matt Yglesias, RH Reality Check, and Feministing have more.

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Senate pushes back on House efforts to redirect family planning funds

A little sanity is always nice to see.

State budget cuts taking aim at Planned Parenthood may limit the availability of family planning services for many poor Texans and have the unintended consequence of increasing unwanted pregnancies, two key lawmakers said Monday.

State Sens. Robert Deuell, R-Greenville, and Jane Nelson, R-Flower Mound, said they hope a conference committee will restore funding to the State Department of Health Services Family Planning program. Both are members of the Senate Finance Committee and focus on health issues.

“I don’t care for Planned Parenthood, (but) I don’t want to cut access to family planning. I don’t want to decrease access,” said Deuell. “One way to stop abortions is to prevent unwanted pregnancies.”

Nelson agreed, saying, “We need to help women who need our assistance with family planning or contraceptives to not have a baby when they can’t care for it.”

Sure seems obvious, right? Women who aren’t pregnant don’t get abortions. But the so-called “pro-life” crowd has always been more about controlling women than about sound public policy, so here we are.

Fran Hagerty, the chief executive officer of the Women’s Health and Family Planning Association of Texas, predicted the family planning cuts ultimately would cost taxpayers.

“The rule of thumb is, it costs $180 a year” for a woman to receive a physical exam and receive a year’s supply of birth control, Hagerty said, while a baby born on Medicaid will cost taxpayers $10,000 in its first year.

“When you compare that, it’s a no brainer,” Hagerty said. “The number-one factor for low-income women becoming welfare dependent is an unwanted pregnancy. If birth control is not available, they are more likely to stay in poverty and become dependent on the state.”

As long as they can’t get an abortion, the “pro-lifers” don’t care. They can always cut the funding for programs that would help these women so the budget balances in the end. See how easy it is?

Sonogram bill delayed in the House

Delayed for a day, at least.

House lawmakers today launched into debate over their version of an abortion sonogram bill — one that is more stringent than the measure that passed the Senate last month. But after hours of delays over technicalities, lawmakers voted to send the bill back to committee, with the goal of bringing it back to the floor tomorrow.

HB 15, authored by Rep. Sid Miller, R-Stephenville, would require a doctor performing an abortion to conduct a sonogram on the woman at least 24 hours ahead of the procedure. (The Senate version sets a two-hour mandate.)

The doctor would also show the woman the sonogram image, play the audible heartbeat for her and describe what appears on the sonogram, including the dimensions of the embryo or fetus and the presence of arms or legs. (In the Senate version, the woman would be able to opt out of viewing the sonogram or hearing the heartbeat, though she’d still have to hear the description. In the House version, there’s no penalty if the woman opts out of viewing the sonogram or hearing the heartbeat.)

While the House bill excepts women experiencing a medical emergency, it makes no exception for women who have been the victim of rape or incest, which the Senate version does.

The “technicality” in question was related to a point of order.

The point of order was raised on House Bill 15 because the Committee Chair took testimony on the issue, but not on the actual bill. Those who testified on the bill testified on the topic, or “matter” of the bill, and once their testimony was over, the bills were laid out. This goes against years of House precedent, where a bill is laid out and then testimony is taken on the specific legislation. Additionally, the initial ruling on the Chair, which is currently being revisited, suggested that House Chairs would no longer have to follow the five-day posting requirement in order to hear testimony on a “matter” the Committee has jurisdiction over.

By rewriting the rules, House Republicans are side-stepping the established and essential witness process for bills. Removing the public testimony on all legislation would be a grave and dangerous precedent for House Republicans to establish, and would seriously undermine the open government process Democrats have fought for years to protect.

That point of order, raised by Reps. Yvonne Davis and Trey Martinez-Fischer, was upheld, so back to committee it goes. I don’t know if this means that there will be further testimony – you would have to think so, or else the underlying issue would seem to be unresolved. We’ll see. In the meantime, kudos to State Rep. Carol Alvarado for clearly demonstrating just how literally intrusive this abominable bill will be, and remember that if people like Rep. Sid Miller really cared about saving lives, he’d support more spending on contraception, which would also save money in the long run on health care and reduce the number of abortions, too. But that’s not what this is all about, so never mind.

UPDATE: Christy Hoppe has a good explanation of what happened with the point of order.

Sonogram bill passes out of committee

As expected.

One of Gov. Rick Perry’s designated “emergency” pieces of legislation cleared an early hurdle on Wednesday when the Senate State Affairs Committee voted in favor of a bill that would require a physician to perform a sonogram on a pregnant woman at least 24 hours before performing an abortion.

The bill passed on a 7-2 vote, with Sen. Rodney Ellis, D-Houston, and Leticia Van de Putte, D-San Antonio, dissenting. It is likely to be heard by the full Senate as early as next week.

And barring anything unusual, it will be passed. I had wondered if there were enough Democratic votes to prevent it from coming to the floor, but with Sens. Lucio and Zaffirini in favor of it, the answer is no. I don’t see anything stopping it.

In its original form, doctors would be required to perform a sonogram, explain the procedure as it is performed and require a woman see the image and hear the heartbeat of the fetus. That version contained language that allowed a woman to “avert her eyes” if she chose.

A committee substitute introduced Wednesday would not compel the doctor to perform the sonogram or detect a heartbeat if a woman’s pregnancy was the result of sexual assault or incest or if the fetus has an “irreversible medical condition or abnormality.”

In any circumstance, the doctor and the woman cannot be prosecuted for the woman’s decision not to see the sonogram or hear the heartbeat.

“This is an issue about empowering women,” said [bill sponsor Sen. Dan] Patrick, an outspoken abortion opponent. “What this bill does is remove the barrier that is placed in front of women now from getting information they’re entitled to.”

No, it’s about shaming them, which Patrick hopes will lead to fewer abortions. If he could have passed a bill requiring women seeking abortions to write 100 times on a blackboard “I am a bad person and I should be ashamed of myself”, he’d do it. This was the next best thing. Patrick and his ilk think these women are ignorant victims who are being duped by unscrupulous doctors. This is why anti-abortion legislation never holds the women responsible for getting an abortion they’re trying to make illegal even though they say it’s murder. In the case of this bill, the only penalty provided is that the doctor could be subject to losing his or her license if they fail to show the sonogram. Shouldn’t “empowerment” imply some kind of responsibility? It would if that’s what this were really about, but it’s not.

I’ve no doubt that Sen. Patrick is sincere in his desire to reduce the number of abortions in Texas. It may surprise him to know that I share that goal. It’s just that I would go about it by trying to reduce the number of unintended and unwanted pregnancies. That means a greater investment in making contraception more accessible and affordable, better and more comprehensive sex education, ensuring prenatal care is more available and affordable, and ensuring the social safety net is strong, since people do take financial factors into account when they consider their options. (It’s expensive to be pregnant, birth a child, and rear it, in case you hadn’t heard.) That would require spending some money, which outside of making other people spend theirs on unnecessary sonograms, the Senator is not inclined to do. It’s true that my method would not eliminate the need for abortions. But then, neither will Sen. Patrick’s. Even if he someday succeeds in his goal of outlawing them completely, women will still get them, one way or another, just as they did before Roe v. Wade. At least my way would have the ancillary benefit of improving women’s health overall. Other than maybe sonogram machine manufacturers, I don’t know who will benefit from SB16. Katherine Hanschen has more.

It’s going to be a misogynistic year

It already has been, unfortunately. Here’s Gail Collins on the recent efforts by some right wing activists who are targeting Planned Parenthood:

The people trying to put Planned Parenthood out of business do not seem concerned about what would happen to the 1.85 million low-income women who get family-planning help and medical care at the clinics each year. It just doesn’t come up. There’s not even a vague contingency plan.

“I haven’t seen that they want to propose an alternative,” said [Planned Parenthood president Cecile] Richards.

There are tens of millions Americans who oppose abortion because of deeply held moral principles. But they’re attached to a political movement that sometimes seems to have come unmoored from any concern for life after birth.

There is no comparable organization to Planned Parenthood, providing the same kind of services on a national basis. If there were, most of the women eligible for Medicaid-financed family-planning assistance wouldn’t have to go without it.

That’s because the people doing this and the legislators who enable them don’t care about that. The hostility they have towards women is shocking. Kaili Joy Grey summarizes some of that hostility:

[A]s Republicans have gained greater control of elected offices at the federal and state levels, we are witnessing the concerted effort to undo the very legislation intended to protect women’s health, lives, and livelihood. Even as Republicans offer empty platitudes about equality and feminism, their agenda to legislate women into second-class citizenship has never been clearer.

One of the major battles for Republicans is equal pay. Last year, Senate Republicans voted to blockthe Paycheck Fairness Act, which would have expanded and improved the protections of the 45-year-old Equal Pay Act. Republicans made clear at the time that they were far more concerned with protecting employers from costly litigation than with ensuring that employers are not allowed to discriminate against women.

Now, Republicans in Minnesota are taking this argument one step further, by proposing legislation to repeal existing laws to enforce equal pay for women because it’s just too expensive for small businesses and local governments to ensure that women are paid equally. And besides, they argue, such enforcement is no longer necessary because the pay gap has been all but eradicated.

It’s a lie, of course. The pay gap still exists. In Minnesota, for example, in both the private and public sectors, the gap between men and women’s pay ranges from 24 to 49 percent.

Critics of equity laws argue that the pay gap isn’t real because women choose lower-paying jobs. That too is a lie. Even within the same professions, the pay gap between men and women is real and significant. An extensive new study found that in the medical field, female doctors earn nearly $17,000 less than their male counterparts. To compare, the pay gap for doctors in 1999 was $3,600. That pay gap is real, and it is getting worse.

[…]

What has received far less attention this week is a new bill introduced by State Representative Bobby Franklin in the Georgia State Legislature:

To amend Titles 16 and 17 of the Official Code of Georgia Annotated, relating to criminal law and criminal procedure, respectively, so as to change the term “victim” to the term “accuser” in the context of a number of statutes making reference to circumstances where there has not yet been a criminal conviction; to provide for related matters; to repeal conflicting laws; and for other purposes.

The law would apply to victims of stalking, rape, and domestic violence, crimes in which the vast majority of victims are women and the perpetrators are men. As the Democratic Legislative Campaign Committee explained:

Burglary victims are still victims. Assault victims are still victims. Fraud victims are still victims. But if you have the misfortune to suffer a rape, or if you are beaten by a domestic partner, or if you are stalked, Rep. Franklin doesn’t think you’ve been victimized. He says you’re an accuser until the courts have determined otherwise.

To diminish a victim’s ordeal by branding him/her an accuser essentially questions whether the crime committed against the victim is a crime at all. Robbery, assault, and fraud are all real crimes with real victims, the Republican asserts with this bill.

Republicans have, for years, attempted to redefine what constitutes “real” rape and not-really rape, or as Kristen Schall on the Daily Show called it, rape-ish. In 2006, South Dakota State Senator Bill Napoli made news when he described what he considered a legitimate exception to the sweeping new abortion bill that would not permit exceptions even for rape or incest:

A real-life description to me would be a rape victim, brutally raped, savaged. The girl was a virgin. She was religious. She planned on saving her virginity until she was married. She was brutalized and raped, sodomized as bad as you can possibly make it, and is impregnated. I mean, that girl could be so messed up, physically and psychologically, that carrying that child could very well threaten her life.

Brutal rape. Forcible rape. Rape of a religious virgin who intends to save herself for marriage. These are the rape victims accusers deemed valid by the Republican ideology that presumes rape victims are guilty until proven innocent. While such proposed legislation has not yet become the law of the land, the idea that rape victims accusers are responsible for their own assault has taken firm root in our discourse about violence against women.

This is in addition to another bill, HR 358, which would allow hospitals to refuse treatment to a woman who might need a pregnancy terminated, even if doing so could result in the woman’s death. Think it could never come to that? The state of Idaho has already refused to sanction a pharmacist who refused to fill an emergency prescription because the requester didn’t give in to his demand to know if the woman who needed the prescription had had an abortion.

I have always found stuff like this to be shocking, repugnant, and deeply puzzling, but it takes on a new urgency for me these days as a father of two little girls. How am I supposed to protect them from that? I can’t, of course. But I can teach them to fight back against it, and that’s very much what I intend to do.

By the way, those jokers who did that undercover videotaping of the Planned Parenthood employees? They altered the audio on their tape to make the employee look worse. This is not the first time these folks have done that, either. Why is it that they are granted any credibility by mainstream news outlets?

And finally, the Senate this week takes up the Governor’s “emergency” sonogram legislation, which is designed primarily to make women who are having an abortion feel bad about it. The thing to watch is whether the Senate Democrats refuse to vote to suspend the rules to let the bill come to the floor. There are nine sure votes against bringing it up; the Senators I’m uncertain about are Carlos Uresti, Eddie Lucio, and Judith Zaffirini. If two of them vote against suspending the rules, the bill will be stopped. That doesn’t mean it couldn’t be attached to some other bill later as an amendment, of course. But keep an eye on the voting for this one, it’s by no means guaranteed to pass.