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Monday, December 09, 2019 {{ new Date().getDay() }}

Guns On Campus: Not An Agenda For Women’s Safety

Allowing guns on campus won’t reduce sexual assault on campus — instead, it will increase the risk of homicide.

Two years ago, Republican leaders released a post-mortem analysis of the 2012 election in an effort to better understand how they lost the single women’s vote by 36 percent. The 100-page report recommended that GOP lawmakers do a better job listening to female voters, remind them of the party’s “historical role in advancing the women’s rights movement,” and fight against the “so-called War on Women.” Look no further than recent GOP-led efforts to expand gun rights on college campuses under the guise of preventing campus sexual assault for evidence that conservative lawmakers have failed to take their own advice.

Today, lawmakers in at least 14 states are pushing forward measures that would loosen gun regulations on college campuses. In the last few days, a number of them have seized upon the growing public outcry over campus sexual assault to argue that carrying a gun would prevent women from being raped. (So far they’ve been silent on how we might prevent young men – who, of course, would also be allowed to carry a gun – from attempting to rape women in the first place.)

Republican assemblywoman Michele Fiore of Nevada recently told The New York Times: “If these young, hot little girls on campus have a firearm, I wonder how many men will want to assault them? The sexual assaults that are occurring would go down once these sexual predators get a bullet in their head.” (Really? Hot little girls?) And as the Times highlighted, Florida representative Dennis Baxley jumped on the “stop campus rape” bandwagon recently when he successfully lobbied for a bill that would allow students to carry loaded, concealed weapons. “If you’ve got a person that’s raped because you wouldn’t let them carry a firearm to defend themselves, I think you’re responsible,” he said.

Let’s be clear. People aren’t raped because they aren’t carrying firearms. They are raped because someone rapes them. What a sinister new twist on victim blaming. As if anything positive could come from adding loaded weapons to the already toxic mix of drugs, alcohol, masculine groupthink, and the rape culture endemic in college sports and Greek life on campuses around the country.

These lawmakers have appropriated the battle cry of students who are demanding more accountability from academic institutions to prevent and respond to campus sexual assault. It’s a vain attempt to advance their own conservative agenda of liberalizing gun laws. This is an NRA agenda, not a women’s rights agenda. According to Everytown for Gun Safety, each of the lawmakers who have supported such legislation has received an “A” rating from the National Rifle Association (NRA). They have enjoyed endorsements from the NRA during election years and some – including Fiore and Baxley – received campaign contributions from the organization.

These lawmakers are pointing to the demands of a handful of women who have survived sexual assault and are advocating for liberalized campus gun laws. The experiences of these students are real and deserve to be heard and considered as we debate how to make campuses safer. We must also recognize that these students are outliers. Surveys have shown that nearly 80 percent of college students say they would not feel safe if guns were allowed on campus, and according to the Times, 86 percent of women said they were opposed to having weapons on campus. And for good reason.

Research shows that guns do not make women safer. In fact, just the opposite is true. Over the past 25 years, guns have accounted for more intimate partner homicides than all other weapons combined. In states that that require a background check for every handgun sale, 38 percent fewer women are shot to death by intimate partners. The presence of a gun in a domestic violence situation increases the risk of homicide for women by 500 percent. And women in the United States are 11 times more likely than women from other high-income countries to be murdered with a gun. Guns on college campuses would only make these statistics worse.

If the GOP wants to show they care about women – or at the very least care about their votes – this is just one of the realities they need to acknowledge. And they need to listen to the experiences of all women who have experienced sexual assault – like those who have created the powerful Know Your IX campaign – not just those who will help advance their NRA-sponsored agenda.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Keary O. via Flickr

 

 

Is Inequality Killing U.S. Mothers?

The United States’ embarrassing maternal mortality figures are closely tied to extreme economic inequality, and better understanding of one will help the other.

Imagine that each year six U.S. passenger jets crashed, killing all passengers on board. Imagine that every person who died on those planes was a woman who was pregnant or recently gave birth. Instead of offering interventions and regulations that might prevent more planes from falling from the sky, lawmakers attempted to defund and repeal the very programs meant to improve air safety. That, in a nutshell, is the maternal mortality crisis in the United States.

Today, more U.S. women die in childbirth and from pregnancy-related causes than at almost any point in the last 25 years. The United States is the one of only seven countries in the entire world that has experienced an increase in maternal mortality over the past decade (joining the likes of Afghanistan and South Sudan), and mothers in Iran, Turkey, the United Arab Emirates, Serbia, and Greece (among many other countries) have a better chance of surviving pregnancy than do women in the United States.

It should be no surprise that maternal mortality rates (MMRs) have risen in tandem with poverty rates. The two are inextricably linked. Women living in the lowest-income areas in the United States are twice as likely to suffer maternal death, and states with high rates of poverty have MMRs 77 percent higher than states with fewer residents living below the federal poverty level. Black women are three to four times as likely to die from pregnancy-related causes as white women, and in some U.S. cities the MMR among black women is higher than in some sub-Saharan African countries.

New research suggests that one of the many factors driving this crisis might be inequality. We may have just celebrated the dawn of 2015, but in terms of economic inequality it might as well be 1929, the last time the United States experienced such an extraordinary gulf between the rich and the, well, everyone else. Today nearly 1 in 3 blacks and 1 in 4 Hispanics (compared to 1 in 10 whites) live in poverty, and in certain states those percentages are even higher. Since the 2008 financial crisis, the net worth of the poorest Americans has decreased and stagnant wages and increased debt has driven more middle-class families into poverty. Meanwhile, the wealthiest Americans have enjoyed remarkable gains in wealth and income. Those in the top 1 percent have seen their incomes increase by as much as 200.5 percent over the past 30 years, while those in the bottom 99 percent have seen their incomes grow by only 18.9 percent during that same time.

As the financial well-being of the majority of Americans has eroded, so too has their health. A recent study conducted by Amani Nuru-Jeter from University of California, Berkeley shows that inequality has very different impacts on black and white Americans. The study found that each unit increase in income inequality results in an additional 27 to 37 deaths among African-Americans, and – interestingly – 417 to 480 fewer deaths among white Americans. Nuru-Jeter and her colleagues were surprised to discover the inverse relationship between inequality and death for whites, and suggested that more research is needed to better understand it. “We do know that the proportion of high-income people compared to low-income people is higher for whites than for African-Americans. It’s possible that the protective effects we are seeing represent the net effect of income inequality for high-income whites,” she said.

The research shows us that rising tides might lift some boats, but it sinks others. And it is unclear if the boats of poor whites actually rise, or if it just appears like they rise because of the higher concentration of people benefiting from inequality in white communities compared to black communities.

Either way, we know that the boats of women of color have certainly not been rising in recent years, and these recent findings beg us to ask how inequality is impacting U.S. mothers specifically. After all, we know that women of color have been disproportionately impacted by the economic downturn. Today the poverty rate for black women is 28.6 percent, compared with 10.8 percent for white women. A 2010 study found that the median wealth for single black and Hispanic women was only $100 and $120 respectively, while the median wealth for single white women was just over $41,000. And in the years following the recession black women represented 12.5 percent of all American workers but accounted for more than 42 percent of jobs lost by all women. Black women have an unemployment rate nearly double that of white women.

Given these grim statistics, it should be no surprise that inequality and maternal-related deaths have increased on parallel tracks over the last decade. But while inequality – and its threats to the economy and the wellbeing of average people – has recently gained long overdue attention, maternal mortality remains an invisible health crisis (unless, of course, you live in one of the communities where it’s all too common for women to die from pregnancy). The media rarely talks about it, foundations aren’t collaborating to invest in initiatives to help us understand – let alone improve – the situation, and policy makers aren’t even pretending to care about it. In fact, the Republican-dominated Congress seems eager to trim or prevent the very programs that help mothers have a healthy foundation for pregnancy: food stamps, reproductive health coverage and access, and wage increases, just to name a few.

The Affordable Care Act is providing much-needed health coverage to many poor women for whom it was previously out of reach, and if fully implemented could certainly help stem maternal deaths. But conservative members of Congress are doing their best to make it as ineffective as possible for the people who need it the most. Nearly 60 percent of uninsured black Americans who should qualify for Medicaid live in states that are not participating in Medicaid expansion. And a recent study found that as a result of conservative opposition to expansion, 40 percent of uninsured blacks who should have Medicaid coverage will not get it (compared to 24 percent of uninsured Hispanics and 29 percent of uninsured whites).

Nuru-Jeter’s research shows us that we will need a host of strategies to tackle deaths in the black community, and maternal deaths are certainly no exception. Better understanding how inequality might be driving unnecessary deaths among women of color would better enable us to identify exactly what those strategies should be and how they should be implemented. And perhaps we wouldn’t get all boats to rise immediately, but it just might get them all to float. It’s sad we aren’t even trying to accomplish that much.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Amnesty International via Flickr

A Crisis Turned Catastrophe In Texas

The Texas legislature created a crisis of women’s health care with House Bill 2, and the latest decision from the 5th Circuit Court of Appeals will bring Texan women to the brink.

Last night, a decision by the 5th Circuit Court of Appeals left Texas with no more than eight remaining abortion clinics. You would think by now the willingness of state lawmakers to deliberately create a health crisis among their constituents – and the willingness of the courts to allow it – would be no surprise. But I continue to be shocked.

“All Texas women have been relegated today to a second class of citizens whose constitutional rights are lesser than those in states less hostile to reproductive autonomy, and women facing difficult economic circumstances will be particularly hard hit by this devastating blow,” said the Center for Reproductive Rights’ Nancy Northrup.

House Bill 2 could be the grand finale in Texas’ efforts to completely dismantle its reproductive health infrastructure on which women – particularly poor women, women of color, young women, and immigrant women – have relied for decades. Pretty soon there won’t be any clinics left to close. Just three years ago, conservative lawmakers gutted the state’s family planning program, which closed approximately 80 family planning providers across the state, caused 55 more to reduce hours, and left hundreds of thousands of women without access to reproductive healthcare. Even before those programs were eviscerated, they provided care and services to only 20 percent of women in need.

And as if that wasn’t enough, lawmakers introduced HB2, a bill that imposes onerous restrictions on abortion providers and demands that all clinics meet costly – upwards of $1 million – building requirements to qualify them as ambulatory surgical centers (ASCs). Lawmakers claimed these regulations were critical to protecting the lives and health of Texas women, but that’s simply not the case. Currently more than three-quarters of the state’s ASCs have waivers that allow them to circumvent certain requirements: unsurprisingly, abortion providers are prohibited from obtaining those same waivers. HB2 quickly closed the majority of the state’s 41 clinics that offered abortion services – clinics that also provided birth control, pap smears, breast exams, pregnancy tests, and a host of other services. There are few, if any, providers to take their place.

These new restrictions add an unbearable weight to the burdens that too many of Texas’ women already shoulder. Texas has one of the nation’s highest unintended and teen birth rates. The nation’s lowest percentage of pregnant women receiving prenatal care in their first trimester. The highest percentage of uninsured children in the nation. High rates of poverty and unemployment and a woefully inadequate social safety net. And lawmakers who refuse to expand Medicaid, leaving nearly 700,000 women who would qualify for coverage without it.

Just a few weeks ago, Judge Lee Yeakel of the United States District Court in Austin gave health advocates an iota of hope when he ruled HB2 to be an undue burden on women’s constitutionally guaranteed right to an abortion. Yeakel’s decision wasn’t just significant because it delivered a win for humanity in Texas after countless losses, or because the concept of an undue burden was finally being used to protect – not erode – women’s right to chose, but because it was based on facts. Facts! Judge Yeakel relied on incontrovertible data to call BS on a law that purports to protect women, but has only ever been about abolishing abortion access.

He argued that for many women, HB2 might as well be an outright ban on abortion. He asked how the eight (at most) providers left could ever each serve between 7,500 and 10,000 patients. How would they cope with the more than 1,200 women per month who would be vying for limited appointments? “That the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity,” he said.

Yeakel acknowledged the complex intersections of women’s health and economic (in)security:

The record conclusively establishes that increased travel distances combine with practical concerns unique to every woman. These practical concerns include lack of availability of child care, unavailability of appointments at abortion facilities, unavailability of time off from work, immigration status and inability to pass border checkpoints, poverty level, the time and expense involved in traveling long distances, and other inarticulable psychological obstacles. These factors combine with increased travel distances to establish a de facto barrier to obtaining an abortion for a large number of Texas women of reproductive age who might choose seek a legal abortion.

Yeakel warned that the stated goal of improving women’s health would not come to pass. And it won’t. The increased delays in seeking early abortion care, risks associated with longer travel, the potential increases in self-induced abortions “almost certainly cancel out any potential health benefit associated with the requirement,” he said.

But Yeakel’s arguments were not compelling enough for the 5th Circuit, which finds it perfectly acceptable that more than one million women now need to travel more than 300 miles (and many women even further) to access health care that is constitutionally guaranteed to them.

This decision will have a ripple effect. Other anti-choice lawmakers across the country are following Texas’ lead, imposing similar restrictions on clinics and physicians who provide abortions. The vindication of Texas lawmakers who have used their legislative power to wreak havoc on the lives of women and families will only continue to embolden other states seeking the same goals.

Conservatives like to argue that they are not waging a war on women. Today there are a whole lot of us who find it impossible to argue otherwise.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Glenn~ via Flickr

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Fighting Bad Science In The Senate

The Senate hearing for the Women’s Health Protection Act shows just how important it is for women’s health advocates to push for the facts.

The propensity of anti-choice advocates to eulogize false science was on full display on Tuesday’s Senate hearing on the Women’s Health Protection Act (WHPA). That bill is a bold measure that would counter the relentless barrage of anti-choice legislation that has made abortion — a constitutionally protected medical procedure — altogether inaccessible for many U.S. women.

The bill was introduced last year by Senators Richard Blumenthal and Tammy Baldwin and Representatives Judy Chu, Lois Frankel and Marcia Fudge. It prohibits states from applying regulations to reproductive health care centers and providers that do not also apply to other low-risk medical procedures. It would, essentially, remove politicians from decisions that — for every other medical issue — remain between individuals and their providers.

The WHPA is long overdue. For the past three years, conservative lawmakers have used the guise of protecting women’s health to pass more than 200 state laws that have closed clinics, eliminated abortion services, and left women across the country without access to critical reproductive health care. The WHPA would reverse many of those policies and prevent others from being passed.

Tuesday’s hearing was representative of the broader debate over abortion rights. Those in favor of the bill argued that securing unfettered access to reproductive health care, including abortion, is critical to the health and lives of U.S. women and their families.

Those in opposition used familiar canards about abortion to argue that the law would be calamitous for U.S. women. Representative Diane Black of Tennessee had the gall to make the abortion-leads-to-breast cancer claim, one that has been disproven many times over. Others repeatedly cited the horrific cases of Kermit Gosnell, insinuating that all abortion providers (abortionists, in their lingo) are predatory and that late-term abortions are a common occurrence. In fact, if women had access to safe, comprehensive and intimidation-free care, Kermit Gosnell would have never been in business. Given the opposition’s testimony, you’d never know that late-term abortion is actually a rarity. According to the Centers for Disease Control, more than 90 percent of all abortions occur before 13 weeks gestation, with just over 1 percent taking place past 21 weeks.

At one point Representative Black argued that abortion is actually not health care. The one in three U.S. women who have undergone the procedure would surely argue otherwise.

Perhaps the most ironic testimony against the WHPA — and in favor of abortion restrictions — came from Senator Ted Cruz, who hails from Texas, a state with so many abortion restrictions that women are now risking their health and lives by self-inducing abortions or crossing the border to get care in Mexico. Senator Cruz attempted to validate U.S. abortion restrictions by referencing a handful of European countries with gestational restrictions on abortions. This was a popular argument during the hearing for Texas’ HB2 — the bill responsible for shuttering the majority of clinics in that state.

Cruz wins the prize for cherry picking facts to best support his argument. When citing our European counterparts, he conveniently ignored that such abortion restrictions are entrenched in progressive public health systems that enable all individuals to access quality, affordable (often free) health care, including comprehensive reproductive healthcare. Senator Cruz and his colleagues have adamantly opposed similar policies in the U.S., particularly the Affordable Care Act’s provisions for contraceptive coverage and Medicaid expansion. On the one hand conservatives lean on European policies to argue for stricter abortion restrictions at home, and on the other they claim those policies are antithetical to the moral fabric of the United States.

Would Cruz support France’s policies that enable women to be fully reimbursed for the cost of their abortion and that guarantees girls ages 15 to 18 free birth control? Or Belgium’s policy that enables young people to be reimbursed for the cost of emergency contraception? Or the broad exceptions that both countries make for cases of rape, incest, and fetal impairment, to preserve woman’s physical or mental health, and for social or economic reasons? He absolutely would not.

As the House of Representatives seems to be more motivated by suing the president than by voting on — let alone passing — laws that will actually improve the health and lives of their constituents, it’s highly unlikely that the WHPA will become law. But Tuesday’s debate — and the bill itself — is significant and shows a willingness among pro-choice advocates to go on offense after too many years of playing defense.

Bills such as the WHPA — even if they face a slim chance of being passed by a gridlocked Congress — provide an opportunity to call out conservatives’ use of bad science in their attempts to convince women that lawmakers know best when it comes to their personal medical decisions. And they allow us to remind lawmakers and citizens that despite all of the rhetoric to the contrary, abortion is a common, safe and constitutionally protected medical procedure, and that regulating it into extinction will only force women into back-alley practices like those run by Gosnell, costing them their health and their lives.

Those in support of the WHPA showed anti-choice lawmakers that the days of make a sport of trampling women’s health and rights are numbered.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Jbouie via Flickr

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The Supreme Court’s One-Two Punch Against Women’s Health: McCullen And Hobby Lobby

The Court’s rulings place more barriers, both physical and financial, between U.S. women and basic health care.

In the last week the Supreme Court announced two decisions that could dramatically change the landscape of women’s health access in the United States. It will be some time before we know the full impact of McCullen v. Coakley and Burwell v. Hobby Lobby, but in the short term two things are for sure. The decisions will make it more difficult and less safe for many women to get the care they need, and they will undoubtedly embolden a conservative movement that hardly needs fortification.

The last three years brought record setbacks to women’s health and rights. More abortion restrictions were enacted between 2011-2013 (205) than in the entire previous decade (189). Today nearly 90 percent of U.S. counties do not have an abortion provider and more than 56 percent of U.S. women live in a state hostile to abortion. In many states the procedure has essentially been regulated out of existence. But it’s not just abortion rights that are under attack. The days of conservatives being “anti-abortion” but pro-family planning are long behind us. Today’s conservatives view birth control as the gateway drug to abortion, and regulate it with the same zeal they once saved for abortion.

Restrictions to Title X funding are closing publicly funded clinics around the country. Those clinics serve to provide reproductive health services to low-income and young women, and the majority do not even provide abortions. There is reason to fear that other conservative states are following the lead of Texas, where thousands of women are dealing with the consequences of a complete lack of access to basic health care thanks to lawmakers who have closed a record number of clinics.

Making matters worse, today 24 states are not participating in the Medicaid expansion originally mandated by the Affordable Care Act (ACA), leaving two-thirds of poor blacks and single mothers and more than half of low-wage workers uninsured.

It’s against this backdrop that we have McCullen and Hobby Lobby, two decisions that are effectively a one-two punch to U.S. women. They allow employers to erect financial barriers to contraceptive choice and embolden protesters to serve as physical and emotional barriers to women’s basic health care.

In McCullen, the Court struck down as a violation of free speech a Massachusetts law that provided a 35-foot “buffer zone” around clinics that provide abortion. The law was created to protect patients entering clinics, and many states have similar regulations in place. It’s unclear what will happen to those other buffer zones. It’s also more than slightly ironic that the Supreme Court, the very body responsible for upholding freedom of speech, has a 100-foot buffer zone that is still intact.

Protesters will feel vindicated in their attempt to persuade, intimidate, threaten, and terrorize women from accessing care to which they are constitutionally guaranteed. Last weekend the Boston clinic at the heart of the McCullen case saw a threefold increase in protesters. That’s just in Massachusetts. Clinics in more conservative states regularly see hundreds of protesters on a given day.

Hobby Lobby was just one of more than 50 companies (supported by organizations like the Beckett Fund for Religious Liberty) that took issue with the ACA’s “contraceptive mandate,” the requirement that all employer-based health plans fully cover, without cost sharing, all FDA-approved methods of contraception. These companies filed claims against the mandate, arguing that intra-uterine devices (IUDs) and emergency contraception (EC) constitute abortion and therefore being required to provide coverage for those methods was a violation of their religious liberty. Never mind that by all accepted medical standards those methods prevent, not terminate, pregnancy. The Court ruled in favor of Hobby Lobby, allowing “closely held” companies – generally understood to be those having more than 50 percent of the value of their stock owned by five or fewer individuals – to refuse coverage of certain contraceptive methods.

So, what happens now? Well, most women who work for Hobby Lobby and other such companies will no longer have access to the contraceptive method of their choice. They will have to decide if they want to pay for those methods out of pocket or go to a clinic where they can receive subsidized care, if they are lucky enough to have access to one. This will place additional and unnecessary pressure on an already embattled public health infrastructure.

The majority claimed the Hobby Lobby ruling was narrow and would not have the sweeping consequences suggested in Justice Ginsburg’s scathing and on-point dissent. I’m not convinced. According to Harvard Business Review, 90 percent of U.S. companies are considered closely held, and those companies employ more than 51 percent of U.S. workers. There are already at least 80 other cases waiting to follow in Hobby Lobby’s footsteps. Given conservatives’ strategic organizing and employers’ willingness to carry the anti-reproductive rights, anti-Obama, anti-ACA banner, others will surely join the cause.

For the time being, the ACA – and the mandate – remain intact, even if somewhat fractured. We should continue to fight for the full implementation of the ACA, a historic – and by all measures successful – piece of legislation that is advancing the vision FDR articulated more than 70 years ago when he called for a Second Bill of Rights. That vision included medical care to allow all Americans to achieve and enjoy good health.

In falsely pitting freedom of speech and religion against women’s rights – as if women don’t also have rights to those same freedoms – the Supreme Court has given momentum to an already fast-moving train. Conservatives will only have more resolve to continue tearing down the building blocks of women’s health and rights. It’s going to take a lot to stop them. A lot of outrage, a lot of action, and a lot of engaged voters committed to standing up for women’s rights. Here’s hoping we can make that happen.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: OZinOH via Flickr

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In Georgia, Lawmakers Taking Pride in Policies That Hurt the Poor

This post is the final installment in the Roosevelt Institute’s National Women’s Health Week series, which addresses pressing issues affecting the health and economic security of women and families in the United States. Today, a close look at the state of Georgia, where the legislature is taking active steps against the Affordable Care Act.

Georgia has taken the lead in the mad dash to thwart the Affordable Care Act (ACA) and prevent poor people from accessing health care. Last week, Governor Nathan Deal (R-GA) signed into law two bills that ensure the state won’t be expanding Medicaid any time soon, and that make it decidedly more difficult for people to gain coverage under the ACA. These laws – a notch in the belt of conservatives preparing for the fall election – compound the social and economic injustices already experienced by many low-income Georgians.

House Bill 990 moves the authority to expand Medicaid out of the governor’s office and over to lawmakers. In a state where conservative politics run deep, HB 990 is Governor Deal’s clever way of way of ensuring Medicaid expansion will never get passed, and abdicating all responsibility for the health and economic consequences that will surely result. The second bill, HB 943, restricts state and local agencies and their employees from advocating for Medicaid expansion, bans the creation of a state health insurance exchange, and prohibits the University of Georgia from continuing its navigator program once its original federal grant expires in August. The university’s navigators have been working throughout the state – especially in underserved rural areas – to help demystify the ACA, assist individuals in gaining coverage on the national exchange, and help those who already qualify for Medicaid to enroll.

“Someone else will now have to reinvent the wheel and figure out how to get resources to people in rural areas,” said Beth Stephens of Georgia Watch, a non-partisan consumer advocacy organization.

Like many other states that refuse to participate in Medicaid expansion, Georgia isn’t faring so well by most socioeconomic indicators. The poverty rate, which now hovers around 20 percent, is 50 percent higher than it was in 2000. Nearly two million Georgians do not have health coverage, ranking the state fifth nationally in numbers of uninsured. Close to half of those individuals between the ages 18 and 64 have incomes below 138 percent of the federal poverty level, many of whom would be covered under Medicaid expansion. Georgia has one of the nation’s highest unemployment rates (7 percent) and today the average family makes $6,000 less than it did 10 years ago, when inflation is factored in. Individuals living outside of major cities have few health care options. In recent years eight rural hospitals have closed, leaving residents with scarce health resources and hospital workers without jobs.

To make matters worse, lawmakers in Georgia have been systematically dismantling the state’s social safety net. Of the 300,000 Georgian families living below the poverty line, only 19,000 receive TANF and more than three-quarters of those cases involve children only. That means that fewer than 7 percent of low-income Georgians are able to get the welfare assistance they badly need. On the same day that Governor Deal signed the aforementioned bills, he also signed HB 772, requiring certain individuals to pass – and foot the bill for – a drug test before receiving welfare and food stamps. That bill is thought to be the nation’s most stringent when it comes to public assistance.

The environment is especially hostile for Georgia’s women, 21 percent of whom live in poverty (33 and 36 percent of black and Hispanic Georgian women, respectively). More women in Georgia die of pregnancy-related causes than women in all but two other states. The U.S. maternal mortality rate (MMR) is 18.5; that is the number of women who die for every 100,000 births. Georgia’s MMR has more than doubled since 2004 and is now 35.5 (a shocking 63.8 for black women and 24.6 for white women). Expanding Medicaid would extend health coverage to more than 500,000 uninsured Georgians, 342,000 of them women. That coverage would surely save women’s lives.

Expanding Medicaid is the right thing to do, and it makes good economic sense. It would support the development of 70,343 jobs statewide in the next decade. In that time it would bring $33 billion of new federal funding into the state, generating $1.8 billion in new state revenue. Despite all this, and despite the fact that poverty is increasing, access to health care is decreasing, and more women are dying because of pregnancy than in any time in the past 20 years, conservatives in Georgia proudly reject Medicaid expansion.

Grassroots groups in the state are working hard to counter anti-ACA sentiments. SPARK Reproductive Justice Now, an Atlanta-based non-profit that is educating and mobilizing Georgians on issues related to the ACA, released a statement in support of Medicaid expansion immediately after the Supreme Court determined states could opt out. In addition to hosting press conferences at the capital and participating in public education events, SPARK is empowering young people to collect and tell their own stories – and those of their families – to illustrate the need for improved health access in the state and clear up confusion about how the ACA would benefit various communities. The organization is also collaborating with health navigators, particularly those working in low-income, LGBT, and black communities, to get across the message that all Georgia citizens deserve health security. “We are telling them they shouldn’t have to worry about sacrificing gas, transportation, prescriptions, etc. We are putting it back on our state and our policymakers to make it right for everyone,” said Malika Redmond, SPARK’s executive director.

The majority of Georgians want lawmakers to make it right. Polls show that 59.6 percent disagree with the state’s refusal to participate in expansion. That sentiment is shared by 64.9 percent of women and by 82.9 percent of African-Americans.

Conservative lawmakers don’t seem to care. They are busy patting each other on the back for sticking it to Obama and undermining the ACA. But the ACA isn’t going away. It’s only getting stronger. And the only people conservatives are sticking it to are the poor families in their state that are already reeling from policies that are costing them their health, their happiness, and their lives.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Courtesy of the city of Marietta via Flickr

Why Are Courts Allowing Redefinitions Of Emergency Contraception?

This post is the third in the Roosevelt Institute’s National Women’s Health Week series, which will address pressing issues affecting the health and economic security of women and families in the United States. This post considers the problems created when judges accept misinformation about certain kinds of birth control as fact in the courtroom.

In courtrooms across the country the Affordable Care Act’s (ACA’s) “contraceptive mandate” is being hotly contested as a violation of religious liberty. The Supreme Court recently heard two such cases – Conestoga Wood and Hobby Lobby – and is expected to deliver a decision by the end of next month. While larger questions of the religious freedom of corporations loom, underlying claims about emergency contraception threaten to confuse the general population and stigmatize a contraceptive method many women rely on for their health and wellness.

More than 100 cases have been filed against the contraceptive mandate by non-profit organizations, for-profit companies, states, and lawmakers. Plaintiffs in each of the cases argue that the mandate is a violation of their religious liberty, many explicitly stating their opposition to IUDs and emergency contraception (EC), which they define as abortifacients (drugs that induce abortion).

According to the Center for Reproductive Rights, judges have responded differently to the varying definitions of EC. In extreme cases judges have agreed with the plaintiffs’ classification of EC as a method of abortion, and in others judges have clarified that the ACA requires coverage of contraception but not of abortifacients. Most commonly, judges are unaware of or unbothered by plaintiffs’ intentional misuse of the term, and end up relying on the plaintiff’s definition in their decision.

In Domino’s Farms Corp v. Sebelius, the judge included the following statement in his opinion granting the company a preliminary injunction against the mandate: “FDA-approved contraceptive medicines and devices include barrier methods, implanted devices, hormonal methods, and emergency contraceptive ‘abortifacients’…” Other cases and opinions include variations on this same theme.

There are two important things to know. First, the ACA does not mandate or provide coverage for abortions. Second, EC and the IUD do not cause abortions. A quick recap: The most common forms of EC – Plan B and Ella – can be taken after sex and prevent pregnancy primarily by delaying or inhibiting ovulation. (For those who are more visually inclined, here’s a great video). The copper IUD, which is most often used as a long-acting birth control method, can also be used as a form of emergency contraception and can prevent sperm from fertilizing an egg. Conservatives have seized on research that has shown that it might be possible for Ella and the IUD to prevent the implantation of a fertilized egg. That research, however, is not conclusive.

The onslaught of legal challenges – and some of the judicial opinions that are emerging from them – is problematic for a number of reasons. First, the language used in these cases, often quoted by the media and advocates, adds to the drumbeat of misinformation that confuses the general public. These cases reinforce the common misperception that EC is really just a different form of mifepristone and causes early abortions. This contributes to the stigma and shaming that women experience when they, for a number of reasons, need to access EC.

Second, singling out EC and IUDs suggests that these methods are not part of the socially and medically accepted continuum of family planning – methods that women rely on every day to make informed decisions about their health. The cases conflate the IUD and EC and ignore the fact that many women choose IUDs as their preferred method of family planning. Indeed, recent studies have shown that when cost is not a factor, 75 percent of women prefer a long-acting birth control method, such as the IUD. As Solicitor General Verrilli stated during the recent Supreme Court oral arguments: “We’ve got about two million women who rely on the IUD as a method of birth control in this country. I don’t think they think are engaged in abortion in doing that.”

As the contraceptive mandate challenges are litigated, and as medically inaccurate language about EC is incorporated into complaints, news coverage, and even into judicial opinions, EC risks becoming pushed further to the margins. We should be especially concerned when judges accept at face value plaintiff’s characterizations of EC. Their opinions carry weight and authority and become truth in many people’s minds.

The value of and right to EC should not be debated. It is a standard component of reproductive health care, approved and regulated by the FDA, and all women should have access to it regardless of their employer’s religious beliefs.

At the heart of all of the challenges to the contraceptive mandate are questions of religious liberty, and the rulings on those issues will reverberate far beyond birth control. But central to these challenges are also fundamental concerns about women’s rights and ability to take care of themselves and their families. Judges should be mindful of how their decisions impact not only women’s legal access to contraceptive methods, but also how the language they use shapes public knowledge about reproductive health care. The public debate about reproductive health care is already rife with misinformation. Women don’t need more.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: WeNews via Flickr

For U.S. Mothers, Conservative Policies Can Be Deadly

This post is the first in the Roosevelt Institute’s National Women’s Health Week series, which will address pressing issues affecting the health and economic security of women and families in the United States. Today, a look at why conservative policies at the state level are leading to increased maternal mortality rates.

For much of the last decade, maternal mortality rates (MMRs) have declined globally. But in the United States, they have consistently increased and are now at one of the highest points in the last 25 years. If conservatives have their way with social and economic policy, it’s unlikely the U.S. will make significant strides to improve the health of mothers in the near future.

According to a report released last week in the The Lancet, the U.S. now ranks 60th out of 180 countries for maternal deaths. China is number 57. Only seven other countries experienced an increase in MMR over the past 10 years. They include Greece, Afghanistan, and South Sudan. The report estimates that for every 100,000 births, 18.5 mothers die in the U.S. By comparison, 13.5 women die in Iran, 6.1 in the United Kingdom, and only 2.4 in Iceland.

It is no coincidence that the U.S. MMR has increased as poverty rates have steadily climbed. In 2010, Amnesty International released a report that showed women living in the lowest-income areas were twice as likely to suffer a maternal death. States with high rates of poverty were found to have MMRs 77 percent higher than states with fewer residents living below the federal poverty level. Women of color have poverty rates more than double those of white women, and black women are 3-4 times as likely to die from pregnancy-related causes.

The numerous factors that contribute to the high U.S. MMR are complex, as are the solutions required to effectively address the problem. However, one solution is already in place and is working. The Affordable Care Act (ACA) will significantly improve maternal health by mandating coverage of pre-natal, maternity, and post-partum care in all insurance plans. But some of the women in greatest need will remain uninsured and at increased risk because of the refusal of 21 states to expand Medicaid. Many of those states have among the nation’s highest rates of poverty and maternal mortality.

Expanding Medicaid would save women’s lives. A 2010 study conducted in New York City showed that the MMR for women with no insurance was approximately four times higher than for insured women, and that the rate for women insured by Medicaid was comparable to that of women with private insurance.

Many states have higher Medicaid eligibility limits that enable pregnant women with incomes above the standard Medicaid threshold to receive coverage. However, that coverage does not begin until women are already pregnant, and it is often terminated soon after their babies are born. This short coverage period leaves women uninsured for much of their lives and places them at higher risk for health problems that can lead to complications during and after pregnancy. Following implementation of the ACA, some states reduced eligibility limits for pregnant women, and loopholes in other states will leave many women without coverage during this critical time. Expanding Medicaid would provide continuous coverage for women whose incomes exclude them from the program and who do not qualify for subsidized insurance through the exchanges.

Despite the maternal health crisis unfolding in many states, conservative state lawmakers stand firm in their refusal to expand Medicaid, even though the federal government will cover 100 percent of the cost for the first three years and a minimum of 90 percent thereafter. Some states, like Georgia, are so intent on undermining the ACA that they have passed laws to prevent state employees from advocating for expansion and have made it more difficult for people who already qualify for Medicaid to enroll.

Conservatives do not have plans to solve this crisis. In fact, their plans will only make it worse. Family planning cuts and abortion restrictions in places like Texas have shuttered women’s health clinics and obliterated the health infrastructure on which poor women relied for their basic needs. And while many women and their families are still reeling from the recession, cuts to safety net programs like food stamps have led to greater insecurity in health, income, and food than ever before.

Last week’s Lancet report is a stark reminder that women suffer heavy casualties in the partisan battles raging in states across the country. But what we are witnessing today is more than a nasty game of politics: it is a violation of women’s human rights. We should be ashamed and outrage.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: SEIU International via Flickr

Cliven Bundy’s Window Into The War On The Poor

Republicans were quick to distance themselves from the Nevada rancher after his remarks about slavery, but he points to a deeper issue with conservative policy.

It’s tempting dismiss Cliven Bundy – the Nevada rancher who last week suggested that blacks were better off under slavery – as a fringe conservative unworthy of any more airtime. But his remarks provide a window into the underbelly of today’s conservative movement and are worth a closer look.

Bundy was a little known entity until earlier this month when his two-decade long refusal to pay cattle grazing fees escalated into a face off between his own armed militia and agents from the Bureau of Land Management. The episode launched him into the national spotlight and endeared him to conservatives like Senators Rand Paul and Dean Heller, and Texas Governor Rick Perry, among others.

Bundy capitalized on his moment in the spotlight to expound on the grazing rights of his cattle, abortion, and slavery.  He suggested that government subsidies have caused “negroes” to abort their “young children” and “put their young men in jail, because they never learned how to pick cotton.” He went on: “And I’ve often wondered, are they better off as slaves, picking cotton and having a family life and doing things, or are they better off under government subsidy? They didn’t get no more freedom. They got less freedom.”

Conservatives scrambled to distance themselves from Bundy by denouncing his comments as offensive and racist. But they were rather quiet on Bundy’s characterization of the safety net as a modern form of slavery. Their silence reflects a common ideology uniting conservative politicians to the likes of Bundy, one that lays the blame for poverty squarely on the shoulders of poor people – particularly poor people of color – and the government programs meant to support them.

And it’s hard to argue that the GOP’s recent social policy proposals aren’t fueled by the same fire that propelled Bundy’s diatribe. Rand Paul has equated universal health care and government programs such as food stamps to slavery. Congressional candidates from North Carolina to Arizona have argued that entitlement programs are simply a way for government to assert power over the people. Paul Ryan, whose latest budget slashes spending for Medicaid and food stamps, has warned that the safety net is on the brink of becoming “a hammock that lulls able-bodied people to lives of dependency and complacency, that drains them of their will and their incentive to make the most of their lives.” Mike Huckabee suggested that by supporting mandated contraceptive coverage, Democrats were suggesting women needed “Uncle Sugar” to control their “libidos or reproductive system.”

These notions have motivated conservatives’ strategic dismantling of the social safety net. Cuts to food stamps, with more to come should Paul Ryan have his way. Refusal to participate in Medicaid expansion, leaving more than 3 million low-income people uninsured. Rejection of the minimum wage increase. Opposition to extending federal unemployment benefits. Repudiation of equal pay measures. The imposition of funding cuts and regulations that have shuttered women’s health clinics across the country. And a government shutdown spurred by opposition to the ACA, specifically the law’s contraceptive mandate.

Who bears the greatest burden of these actions? Poor women, particularly women of color, who have long been blamed for perpetuating the cycle of poverty. Bundy and conservative politicians alike rely on historic notions of poor women being lulled to complacency by government subsidies. Those notions – in addition to being racist and classist – are simply incorrect. The majority of subsidy recipients work, but don’t make enough to support themselves or their families. As of 2011, 70 percent of low-income families and half of all poor families were working, but research suggests that nearly one-third of all working families do not make enough money to meet basic needs.

Republican cuts to government subsidies will only further erode the economic security of American families. Instead of laying blame – indeed, punishment – on poor women, we should bolster the foundation on which they stand. The Roosevelt Institute recently released a report that made the case for economic policies that would support working families: raising the minimum wage; expanding the earned income tax credit; instituting paid sick and family leave; and strengthening the right to organize; among others.

As my colleague Ellen Chesler and I recently argued, all of these recommendations are necessary but will be meaningless if women are not able to make free and fully informed decisions about their reproductive health, including planning the timing and size of their families. As such we must expand the nation’s family planning program, push for all states to expand Medicaid, and tear down the other policy barriers that prevent low-income women from accessing care.

Conservative leaders are desperate to convince the poor that social safety net programs are the chains binding them to poverty, thereby legitimizing the destruction of the very system built to lift up America’s poor families. Perhaps we should thank Bundy for using such ugly terms to shed light on the conservative substitute for the war on poverty: a war against the poor.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: John M. Glionna/Los Angeles Times/MCT

Memo To Congress: Family Planning Needs More Funding

On Thursday, March 20, Roosevelt Institute Fellow Andrea Flynn joined the National Family Planning and Reproductive Health Association for a briefing on “The Publicly Funded Family Planning Network: An Essential Partner in the New Health Care Environment.” Her prepared remarks are below.

The Affordable Care Act represents an historic investment in the health of American women and girls. It has already improved the lives of millions of Americans and will make health care accessible for many more as rollout continues. Fulfilling the promise of the ACA, however, depends on the continued support of existing programs, such as Title X, which must remain as pillars of the country’s public health infrastructure.

For more than 40 years, Title X has provided critical medical care to low-income women, immigrant women, and young women across the country.  Some have suggested that the ACA’s expanded coverage of women’s health care will obviate the need for Title X. In fact, the opposite is true. Title X will play a number of important functions in the coming years.

First, Title X will support a network of qualified family planning and reproductive health care providers who will deliver care and services to the growing ranks of insured. Clinics funded by Title X will become an even more critical building block of our nation’s health system. Even when individuals obtain coverage, many will continue to choose publicly funded clinics as their main source of care. As one of my colleagues here will further explain, during the four years following the implementation of Massachusetts’ health care reform patients continued to rely on Title X centers even after they gained insurance coverage.

Women who are already fully insured will also continue to rely on Title X clinics because they can access care with complete confidence. Issues such as intimate partner violence and religious beliefs of employers, family members, and partners, cause many women to circumvent their insurance plans when accessing family-planning services. Sadly, these concerns will persist regardless of the coverage status of American women.

Second, Title X will guarantee family-planning access to those still uninsured. The ACA was intended to provide a path to health insurance for most Americans. However, because of the Supreme Court’s decision to allow states to opt out of Medicaid expansion, fewer uninsured Americans will gain coverage than originally planned. Today, 22 states are still refusing to expand Medicaid, leaving more than 3.5 million low-income women without coverage. As a result, two-thirds of poor black and single mothers, and more than half of uninsured, low-wage workers, remain without coverage. Title X clinics will continue to be a trusted place of care for these women.

Moreover, even in states that participate in Medicaid expansion, many low-income individuals may still remain uninsured. Estimates suggest that between 25 and 35 percent of those eligible for Medicaid still do not know it, and are failing to enroll.  Many immigrants will also remain uninsured, given the federal 5-year eligibility requirement for Medicaid. And millions of others will churn among coverage plans. One study estimates that up to 29 million people under age 65 will be forced to change coverage systems from one year to the next. Individuals who fall into these categories will rely on the Title X network for quality, affordable, and confidential care.

Third, and equally important, Title X will continue to set a comprehensive standard of care for family planning and reproductive health services.

Finally, Title X clinics are a primary and trusted point of entry into the health system. Six in 10 women who receive services at a publicly funded family-planning center consider it their primary source of medical care. As such, the Title X network will continue to play an important role in ACA outreach and enrollment efforts to ensure that health coverage is realized by as many Americans as possible.

Title X is particularly important given the health challenges facing many women in the United States. However, current funding for U.S. public family-planning programs extends care and services to just over half of the women in need. Per capita, the United States spends two and a half times more on health care than other developed countries, yet Americans overall have less access to services and experience worse health outcomes. The United States reports among the highest rates of teen birth, unintended pregnancy, and maternal and infant mortality of any industrialized country. Almost half of all U.S. pregnancies – approximately 3.2 million annually – are unintended. Poor women, women of color, and immigrant women bear a disproportionate burden in this regard. They are also more likely to experience chronic disease, maternal mortality and have a lower life expectancy than women with higher incomes.

Unintended pregnancy and teen pregnancy remain persistent issues in the United States, ones that Title X has been tackling for decades. Unintended pregnancies have a number of larger health implications. Women who have unintended pregnancies are more likely to develop complications and face worse outcomes themselves and for their infants. They often receive inadequate prenatal care, and the care they do receive begins later in pregnancy. Research has shown that pregnancies that occur in rapid succession pose additional risks for both mother and child.

The U.S. teen pregnancy rate has declined dramatically over the last decade, thanks to services offered by programs like Title X. However, it is still considerably higher than in any other developed country, where rates are generally 5 to 10 births per 1,000, compared to the current U.S. rate of 29.4 per 1,000. Racial disparities are especially pronounced in relation to teen pregnancy, with teen birth rates for white women hovering around 21.8 per 1,000, while the rates for Hispanic, Black, and American Indian teens are at least twice that. Research has shown that increased access to comprehensive reproductive health information, care, and services, including a broad range of contraceptive methods, reduces rates of unplanned pregnancy among teens.

Title X has prevented these various health disparities from becoming even more troubling. With an increased investment the program could replicate its incredible results many times over, leading to significant health improvements for American women.

In times of economic uncertainty the demand for publicly funded family-planning services increases. Since the 2008 financial crisis and the ensuing recession, the need for Title X has grown dramatically, while funding levels have declined or remained flat. Over the past few years the Title X budget has been cut by $40 million. To make matters worse, the anti-family-planning and overall austerity sentiments that have since prevailed reduced and restricted family-planning budgets in many states. There have been fewer state and federal funds for women’s health during the very time that women have also lost jobs and insurance coverage.

When Title X centers lose funding, they are forced to make cuts in three places: services and supplies, hours, and staff. As a result of funding challenges, 6 in 10 Title X clinics have been unable to stock the most costly contraceptives, particularly long-acting reversible contraceptives (LARCs) such as the IUD and implants, methods considered highly effective and most desirable among women wanting to avoid pregnancy.

Family planning is first and foremost a matter of women’s health and rights. But it is also central to women’s economic security. The continued fragility of the U.S. economy and the recession’s devastating impact on low-income families requires an increased investment in family planning. American families, many of them now headed by single women, face enormous challenges. Access to affordable contraception enables women to pursue educational and professional opportunities that strengthen their families and their communities. The majority of women who participated in a recent Guttmacher Institute study report that birth control enables them to support themselves financially, complete their education, and get or keep a job.

Given the tenuous state of the U.S. economy, the vulnerability of women’s health programs in the face of unrelenting political attacks, and the fraying social safety net more broadly, public funding for family planning is more critical than ever. Continued — indeed, increased — funding of Title X will maximize the impact and reach of the ACA and ensure continued quality care for those who remain uninsured.

Thank you.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: WeNews via Flickr

AOL’s CEO Proves Women And Children Make Easy Scapegoats In The Workplace

The law has put maternity care on an equal footing with other health benefits for decades — but some executives still haven’t caught up.

AOL CEO Tim Armstrong recently ignited a firestorm of criticism when he announced the company would be restructuring its retirement benefits. Armstrong explained that the financial burden of Obamacare and the deliveries of two “distressed babies,” which cost the company $1 million each, had forced the company to reduce 401(k) matching contributions:

We had to decide, do we pass the $7.1 million of Obamacare costs to our employees? Or do we try to eat as much of that as possible and cut other benefits? …Two things that happened in 2012. We had two AOL-ers that had distressed babies that were born that we paid a million dollars each to make sure those babies were OK in general. And those are the things that add up into our benefits cost.

Sorry, AOL employees: You can either get your expensive babies or your retirement benefits, but you can’t get both.

Armstrong has since issued a public apology and, amidst uproar from his employees, reversed the benefits decision. But his remarks remain significant, illustrating the readiness of employers to use maternity costs and the new health law as scapegoats for other business decisions that affect company profits. His comments also reflect the extent to which pregnancy, childbirth, and childcare are considered lower priorities in the workplace than other health benefits.

In an era of ever-rising health costs, it is certainly reasonable for AOL to seek ways to reduce health spending. But why single out premature births instead of, say, cancer or diabetes cases? Apparently in American corporate culture maternity coverage is still considered a “bonus” benefit that employees should feel lucky to have. You’d think this wouldn’t be the case at AOL, whose decade-old Well Baby program provides education and support for employees throughout the pre-natal and post-partum stages. Armstrong’s comments run counter to AOL’s public persona of being a company truly invested in the health and wellness of its parents and their families.

Maternity coverage should be considered a routine component of employee benefits, especially since they have been mandated in employer health plans for more than three decades. In 1978, Congress passed the Pregnancy Discrimination Act (PDA) – an amendment to the 1964 Civil Rights Act – in an effort to end pregnancy-based discrimination in the workplace. Benefits required by the PDA are both ethically sound and financially prudent. Research has shown that every dollar spent on prenatal care saves employers $3.33 in postnatal care expenses and $4.63 in long-term morbidity costs.

Based on Armstrong’s comments one might assume $1 million births a commonplace occurrence, but they aren’t. It’s true that one in every eight infants in the United States is born pre-term, but the average cost of care for the majority of those babies doesn’t come close to seven figures. Approximately 70 percent of infants admitted to the NICU stay for longer than 20 days, which typically costs between $40,000 and $80,000. The high costs associated with the two pre-term births to which Anderson refers are not the norm.

Why should the economic security of employees be first on the chopping block? Armstrong might have been a bit more introspective before publicly pointing his finger at his employees’ pre-term babies. After all, shortly before his gaffe went viral, he was in the harsh glare of the media spotlight for the overwhelming failure of Patch, a media venture he championed that lost AOL $300 million (last month the company cut its losses and sold its majority stakes in the site).  Two million dollars in NICU expenses seems quite reasonable by comparison.

AOL, like many large companies, is self-insured. As such, it directly pays employee health costs and assumes that the risk of catastrophic health events is worth the expanded choices in health benefits and the increased savings that results when income from premiums exceeds health costs. It’s unfair for companies to sacrifice the economic security of their employees when those bets don’t pay off.

It is simply dishonest to lay the blame for such losses of maternity care and Obamacare expenses. After all, the new law will improve the health of employees and generally lower employer costs in the long run by mandating the full coverage of family planning, women’s preventive health care, and extended coverage for children of employees. These measures will reduce unplanned and mistimed pregnancies (which still account for nearly half of all U.S. pregnancies) and enable women and their families to prevent and treat health conditions long before they become emergencies.

We must not regard maternity coverage as a bonus benefit. It is indeed a benefit central to employee health coverage and essential to the economic security and overall well-being of American workers and their families. The inherent value in such coverage was enshrined in laws passed more than 30 years ago, and has been reaffirmed by Obamacare. It’s long past time for executives like Armstrong to live and speak those same values when making decisions that affect the health and security of their employees.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: TechCruch via Flickr

In ‘Nuestro Texas,’ A Call For Human Rights In Reproductive Health Care

A new report on access to reproductive health care in the Rio Grande Valley highlights the human rights violations happening right in the U.S.

During the past three years, more than 150,000 women in Texas have lost access to reproductive health services, thanks to a relentless barrage of laws and policies that have shuttered 76 family planning clinics across the state. A disproportionate number of those women live in the Rio Grande Valley, a region with extreme health disparities and some of the nation’s highest levels of poverty and unemployment.

A recent report – Nuestra Voz, Nuestra Salud, Nuestro Texas – co-authored by the Center for Reproductive Rights (CRR) and the National Latina Institute for Reproductive Health (NLIRH) illustrates the dire impact that three years of draconian policies have had on women in the valley. During a briefing at the Roosevelt Institute last week, Katrina Anderson, Human Rights Counsel at CRR, and Jessica González-Rojas and Diana Lugo-Martinez, NLIRH’s Executive Director and Senior Director of Community Engagement, shared the report’s findings and conveyed the stories and experiences of the more than 180 local women they have interviewed.

Nuestro Texas stands out because it illustrates the deeply personal impact of the state’s restrictions and regulations, but it is also unique because it frames Texas women’s rights as fundamental human rights issues, using international standards – a framing infrequently used when addressing women’s health in the United States.

Communities across Texas are feeling the acute pain of the rapid destruction of a once-robust public health infrastructure, and the most harm has been done along the state’s Southeast border with Mexico. Nine of the Valley’s 32 health clinics have closed, and those remaining open have curtailed hours, reduced staff, increased fees, and eliminated some services. Before the cuts, public clinics in the valley served nearly 20,000 patients. Today they serve just over 5,000.

Nuestro Texas tells the stories of women who now seek care in Mexico, or purchase black-market medications, or forgo family planning and medical care altogether because the barriers of cost, travel, and immigration status are simply too great. Women live with the anxiety of undiagnosed and untreated breast lumps, cervical pain, sexually transmitted diseases, and a host of other adverse health issues.

Beyond declining access to family planning and a full range of women’s health care services, abortion services have all but disappeared in the Valley thanks to the sweeping anti-choice legislation passed last year by the state legislature in Texas. As a result, reports of incidents of self-abortion are becoming commonplace, because without other options women will take the termination of unplanned pregnancies into their own hands, as they did for decades before abortion was legalized in 1973. Even before the 2011 budget cuts and recent abortion restrictions, the estimated rate of self-induced abortion in Texas was more than twice that of the nation overall, and the rate along the border was more than five times greater than the national rate. Recent articles by Andrea Grimes (RH Reality Check) and by Lindsay Bayerstein (The New Republic) illustrate the dire consequences of regulating reproductive health care into obscurity.

Despite the profound stresses women in the valley now endure, at the Roosevelt Institute briefing González-Rojas maintained that they are not simply “victims of systemic barriers.” They are using their voices to advocate for the health and rights of women and families. Outreach workers help navigate immigration and transportation barriers so that women can access needed care in Mexico, if necessary. They host community meetings where women can share their frustrations, fears, and experiences. They teach self-breast exams and educate about the warning signs of sexually transmitted diseases, even though there are few clinics to see women who may need care.

González-Rojas explained that framing women’s rights as human rights has positioned reproductive health as a family and community issue, one that requires multiple voices and solutions to address. Focusing on human rights has empowered women in the valley to organize and mobilize for policy change. They teach communities about immigration, health, and economic policies and encourage them to fight back by protesting, petitioning lawmakers, and – when possible – by voting. Lugo-Martinez said Valley residents have become engaged and excited about human rights and are routinely sharing copies of the landmark 1948 Universal Declaration of Human Rights at community meetings.

“Women in the Valley will not rest until they can get care when and where they need it,” González-Rojas said. Nor should we remain complacent, for it would be wrong to assume that what is happening in Texas will stay there. “Texas is the epicenter of bad reproductive health policy, but it is also the incubator of those policies. What happens in Texas really matters,” said Anderson.

States across the nation are now following Texas’s lead in significantly restricting women’s access to reproductive health care. Nuestro Texas demonstrates the urgency of accelerating legal and policy trends across the country, as conservative legislators pursue an unrelenting anti-choice, anti-women’s-health agenda.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: Bill & Heather Jones via Flickr

In Contraceptive Mandate Challenges, Women’s Health And Much More Is On The Line

Despite significant existing accommodations for religious organizations, the current challenges to the contraceptive mandate could severely limit access to reproductive care.

On New Year’s Eve, Supreme Court Justice Sonia Sotomayor temporarily blocked enforcement of the Affordable Care Act’s (ACA) contraceptive mandate on a Colorado-based religious organization – Little Sisters for the Poor and Aged – paving the way for the heated debates on women’s health that will ensue in the year ahead.

The contraceptive mandate, which requires employers to provide full coverage of all FDA-approved contraceptive methods, has been a lightning rod since it was first introduced. Religious groups argued it violated their religious liberty, given their religious-based opposition to contraception. In response, President Obama modified the mandate by creating an “exception” that exempts houses of worship altogether, and an “accommodation” that enables organizations that identify as religious (such as Little Sisters) to opt out. Their employees can receive contraceptive coverage from a third-party insurer. These provisions should have put a quick end to the religious objections, but they didn’t.

In order to opt out of the contraceptive mandate, organizations must sign a form that certifies they identify as religious and acknowledges that either their insurance company or a third-party administrator will contact employees directly to provide coverage. Effectively, this provision removes the non-profit from coverage of birth control all together. However, Little Sisters argues that the simple act of signing that form constitutes a substantial burden on their religious liberty.

Here’s the kicker: All of this is moot because Little Sisters’ insurance company is run by the Christian Brothers, which is considered a church and is therefore exempt from adhering to the mandate. So while Little Sisters does have to sign the form for procedural reasons (and to prevent them from being fined for not complying with the mandate), the insurance company can – and likely would – legally refuse to provide the coverage.

While this specific case will have little impact on the employees of Little Sisters (who are out of luck either way), an ultimate ruling in the organization’s favor would provide more fuel to the anti-contraceptive mandate fire already raging across the country.

It also lays the groundwork for two cases already on the Supreme Court docket that will determine the future of contraceptive coverage. In those cases – Hobby Lobby and Conestoga Wood, to be heard on March 25 – the owners of private companies have asserted that providing contraceptive coverage for their employees is a violation of their religious liberty.  The Court will determine if for-profit groups actually have religious liberty, and – if yes – if the contraceptive mandate infringes on that liberty.  That decision will either guarantee contraceptive coverage to millions of women for the foreseeable future, or set a precedent where employers can use their personal religious beliefs as a basis for refusing coverage of a host of health services.

The 91 cases filed against the contraceptive mandate (46 from for-profit companies and 45 from non-profit organizations) reflect conservatives’ deep discomfort with women’s sexuality and their staunch opposition to facilitating – even in the slightest way – women’s sexual autonomy. The overwhelming acceptance and use of birth control among all American women means nothing. Indeed, 99 percent of sexually active women in America have used contraception, including nearly 90 percent of Protestants and Catholics.

All women should have access to comprehensive health services, including the full range of contraceptive options. For the majority of American women, access means affordability. For women in low- and minimum-wage jobs, dishing out $40 or more a month for birth control is simply not an option. Research has shown that in difficult economic times and when forced to pay out of pocket for birth control, women are more likely to use it intermittently or forgo it altogether, increasing their chances of unintended pregnancy. A 2009 study by the Guttmacher Institute showed that as a result of the 2008 economic downturn, 8 percent of women dispensed with birth control altogether and 18 percent used it inconsistently in order to save money.

These cases raise various legal questions to be answered by the courts, as well as serious ethical questions that we must consider. Do we want our bosses interfering in our personal medical decisions? Must we continue to allow reproductive health to be the one area of medicine to be adjudicated by the courts instead of our doctors?  If employers can use their position of power to infringe on access to birth control, what’s stopping them from denying access to other services that don’t suit their fancy? Could Scientologist employers deny access to psychiatric drugs? Could Catholic employers deny coverage for treatment of sexually transmitted diseases? It’s quite a slippery slope.

As it was originally written, the ACA treats family planning as the critical pillar of women’s health that it is. The Obama administration has gone above and beyond to accommodate the beliefs of religious organizations, and the court should now uphold this mandate that helps to make the ACA so transformative for the health of American women.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States and globally.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

AFP Photo/Saul Loeb

Abortion Restrictions Are Harming Women’s Health And Human Rights In Texas

Abortion restrictions in Texas are hurting low-income women in the Rio Grande Valley, which is proof positive that the U.S. needs to think about human rights locally, not just internationally.

Last week the Supreme Court decided to leave in place a Texas law that has essentially closed a third of the abortion providers in that state. On their own, the abortion restrictions are devastating. But in the context of three long years’ worth of family planning and women’s health cuts that violate the human rights of women in that state, they are catastrophic.

Over the summer Wendy Davis launched Texas into the national spotlight when she filibustered the same sweeping anti-abortion laws that were upheld by the Supreme Court. But long before that, women’s health advocates were sounding the alarm bells about the impact of massive family planning cuts that dismantled the state’s health infrastructure, on which millions of low-income women relied.

In order to understand the full implications of this week’s ruling, one must consider the current state of women’s health care – particularly for low-income women – in Texas. The Center for Reproductive Rights (CRR) and the National Latina Institute for Reproductive Health (NLIRH) recently released a must-read report that illustrates the devastating human toll of family planning and reproductive health cuts on women living in Texas’s Rio Grande Valley.

The Valley is a marginalized region inside a state with some of the worst health disparities and the highest percentage of uninsured adults in the country. Many women in the Valley live in colonias, unincorporated communities along the U.S.-Mexico border, which often lack clean water, plumbing, electricity, and public transportation.

The report profiles women whose health and lives have changed along with the landscape of health infrastructures and systems in their communities. Women who detected lumps in their breasts four years ago but cannot afford the mammogram to determine if they are cancerous. Women who received mammograms months ago but cannot get results because of exorbitant doctor’s fees. Women with ovarian cysts and cervical pain who risk their lives swimming across the river and traveling through towns rife with violence to access care in Mexico.

These women – and the thousands more they represent – must decide between paying rent, giving their children food and a roof over their heads, or having a mammogram, a Pap test, or contraceptives. “It’s one or the other, but not both,” they say. They live with a constant din of anxiety and fear, not knowing what disease is or might be growing in their bodies, where they will get care in emergency situations, or what will happen to their children if they become sick (or worse).

These women are living the consequences of calculated decisions made by conservative lawmakers to dismantle the state’s health safety net. Over the last two years, they cut the state’s family planning budget by two-thirds, from $111 million to $37.9 million. They established a tiered system and forfeited $30 million in federal funds so they could exclude Planned Parenthood and other organizations affiliated with abortion providers from receiving state or federal resources.

The 2011 policies shuttered 76 family planning clinics across the state (including 9 out of the Valley’s 32) and caused 55 more to reduce hours. Publicly funded clinics served 77 percent fewer patients in 2013 compared to 2011 (202,968 and 47,322, respectively). In the Valley, public clinics went from serving 19,595 in 2011 to 5,470 in 2013. These trends are particularly troubling when you consider that even before the cuts, publicly funded family planning programs were providing care to less than 20 percent of the population in need.

As the CRR/NLIRH report describes, women in the Valley – particularly Latina women – experience the grave consequences of living at the intersections of race, class, gender, and immigration in the United States. They are 31 percent more likely to die of cervical cancer than women in non-border communities. In the rest of the country, rates of cervical cancer have been plummeting thanks to early detection and treatment, but among Latinas in the Valley the rate is increasing and cervical cancer deaths among Latinas is nearly twice that of non-Latina white women.

The report exposes the lesser-known consequences of the cuts and regulations on clinics that are still open. Remaining providers have reduced hours, laid off staff, increased fees, and stopped providing the most effective family planning methods all while managing a rapidly growing demand for their services. The average cost of a one-month supply of contraception and the fee for an annual exam has increased three- to four-fold since 2010. Ultrasounds and mammograms, once accessible thanks to subsidized rates, are no longer in reach of most women. Wait times often exceed several months.

For women living in areas where clinics have closed, reaching neighboring providers is often impossible due to transportation barriers. Buses are nonexistent, infrequent, or unreliable. Gas is too expensive. Childcare is hard to find. Taking time off work is not an option. For undocumented immigrants, traveling to other communities requires passing through internal checkpoints and risking deportation.

So what happens? Women purchase unregulated contraceptives off the black market, without consulting a doctor about which form of family planning is best for their bodies. They seek care in Mexico, taking the risk that they will not make it back across the border safely. Or, like many of the women described in the report, they forgo contraception and medical care because they simply cannot afford it.

This is the background upon which the most recent abortion restrictions have occurred. There is not a single abortion provider left in the Valley. At a minimum, women must travel three to five hours each way to access an abortion (and must make that trip multiple times thanks to ultrasound and counseling requirements). For most women, it might as well be outlawed.

Many of the women in the Valley do not reap the benefits of federal programs and policies meant to support low-income women. Undocumented immigrants are not eligible for public insurance programs. New immigrants must wait five years before becoming eligible for Medicaid. Texas is not expanding Medicaid under the Affordable Care Act, leaving those who aren’t poor enough for Medicaid but are too poor to qualify for subsidies out of luck.

Title X, the nation’s only program dedicated to family planning – which once provided effective and far reaching family planning care for the state’s low-income women – was seriously weakened by the above-mentioned regulations. (Luckily, the Obama administration recently took Title X out of the hands of the state government and endowed it to the Women’s Health and Family Planning Association of Texas, which has directed funding back to family planning clinics and even enabled a previously closed facility in the Valley to reopen.)

As the CRR/NLIRH report argues, the state of Texas has done more than just grievously neglect an underserved and marginalized community of women. It has violated the human rights of women in Texas, a duty it is legally obligated to respect, protect, and fulfill. American exceptionalism has relegated human rights to the international development sphere and deemed them unnecessary within our own borders. But for the health and lives of women in Texas and around the country, it is time we think about how we can use human rights to make America exceptional in ways we can be proud of.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: George Olcott via Flickr

Richard Nixon Knew Family Planning Saves Taxpayer Dollars, But Today’s GOP Doesn’t Care

As the Affordable Care Act helps more Americans get health insurance, it’s time to increase funding for Title X, because the need for family planning services is only going up.

For more than 40 years, Title X has provided family planning and reproductive health services to millions of American women. More recently, conservative lawmakers have targeted Title X as part of their obsession with shrinking the social safety net and restricting access to women’s health care. Those same opponents are now likely to argue that the Affordable Care Act’s (ACA) focus on women’s health renders Title X unnecessary.  But as I argue in my new paper published by the Roosevelt Institute, that is simply not the case. In reality, the success of the ACA and the health of women across the country are dependent on even greater support for existing family planning programs.

Title X is the nation’s only program solely dedicated to family planning. It was passed into law in 1970 with overwhelming bipartisan support and can in fact be credited to two Republican presidents: Richard Nixon, who signed the bill into law, and then-congressman George H.W. Bush, who led the legislative effort. It provides critical medical care to low-income, immigrant, and young women and enables clinics to pay for and maintain facilities, train and hire staff, and purchase equipment and supplies.

Despite being perennially underfunded, the program delivers incredible health results. Last year it served 4.76 million women, preventing an estimated 996,000 unintended pregnancies, 200,000 of which were among teens. Research has shown that services provided at Title X clinics save federal and state governments more than $3 billion every year.

As millions of Americans gain health coverage for the first time thanks to the ACA, clinics funded by Title X will become an even more critical building block of our nation’s health system. Even when individuals obtain coverage, many will continue to choose publicly funded clinics as their main source of care. In the four years following the implementation of Massachusetts’ health care reform, which served as the model for the ACA, publicly funded health centers experienced a 31 percent increase in patients, even though the number of uninsured visiting those facilities fell by more than 15 percent.

Even women who are already fully insured will continue to rely on Title X clinics for family planning because they can do so in complete confidence. Issues like intimate partner violence and religious beliefs of employers, family, and partners, cause many women to circumvent their insurance plans when accessing family planning services and instead rely on public providers.

The fact is, despite the GOP’s relentless strategic misinformation campaigns and the technology problems that bedeviled the rollout this month, the ACA is good for women. It mandates that insurance plans fully cover all methods of contraception, prohibits gender discrimination and denial of care based on pre-existing conditions, and enables young people to stay on their parents’ plans until they are 26. It requires plans to cover pap tests, STD screening, preconception and prenatal care visits, postpartum counseling and breastfeeding support, and one well visit a year. Make no mistake: this is groundbreaking.

Despite these historic advancements, many women will remain uninsured in the years to come. There are lots of reasons for this, not the least of which is the refusal of many states to accept federal funding for the expansion of Medicaid.

The ACA was intended to be a path to health care for all Americans, and a major pillar of the law was the expansion of Medicaid to all individuals who fall below 138 percent of the federal poverty level ($15,415 for an individual or $26,344 for a family of three), with subsidies for individuals above that level to buy insurance in the marketplaces. But last year the Supreme Court ruled that the federal government could not constitutionally require states to expand Medicaid, and conservative lawmakers pounced on the opportunity to block a major component of the ACA.

Today, 22 states refuse to expand Medicaid even though the federal government will foot 100 percent of the bill for the first three years and cover at least 90 percent of the cost after that. These states are denying care to more than 3.5 million low-income women who badly need it. The New York Times reported that as a result, two-thirds of poor black and single mothers and more than half of uninsured, low-wage workers will remain without coverage.

Basically, women who fall into the coverage gap are not considered poor enough for Medicaid by their states, but because the ACA originally intended for them to be covered by the expansion, they also don’t qualify for subsidies. And even if they did, the cost of subsidized insurance would likely still be prohibitive given their income level. These individuals will have no choice but to rely on the social safety net – in this case, Title X-funded clinics – for care.

The very critics who have staked their political careers on sinking the ACA and preventing scores of women from accessing family planning services – and who shut down the government in an attempt to do so – would love nothing more than to do away with Title X. They have tried unsuccessfully in recent years, and the program will certainly be in their crosshairs as they continue to chip away at the host of social programs on which low-income women rely.

The ACA, while an enormous advancement for women’s health, does not eliminate the need for the Title X program. Rather, Title X will maximize the impact and reach of the ACA and ensure quality care for those who will remain uninsured.

In the forthcoming budget battles, women’s health advocates will have to fight tooth and nail to maintain Title X’s current funding level, which has already been diminished by sequestration. The program is as critical today as it was when it was created. Today’s very different breed of GOP lawmakers could use a reminder that it was their own party four decades ago that realized investing in family planning was a critical way to improve the health of women, communities, and the entire nation. Who ever thought we’d be longing for Nixon?

Read Andrea’s paper, “The Title X Factor: Why the Health of America’s Women Depends on More Funding for Family Planning,” here.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: SEIU International via Flickr

The Shutdown Shows The GOP Can’t Accept Defeat In The War On Women

When the GOP attempts to deny women access to contraception in the lead-up to a government shutdown, it’s hard to see how the party hopes to regain women’s support.

Yesterday the federal government shut down for the first time in two decades due, in part, to the GOP’s growing opposition to contraception. Republicans are intent on rolling back women’s rights, and this time they are holding the federal government hostage in an attempt to advance their agenda.

With less than a day until the government would shut it doors, House Republicans put forth a spending bill that would enable employers, universities, and health insurance companies to deny coverage for contraception based on moral or religious beliefs. The bill would delay the “contraceptive mandate” – an Affordable Care Act provision that requires coverage of contraceptive and reproductive health services without co-pays – until January 2015. More broadly, the bill would delay the implementation of most ACA provisions for another year and would repeal a tax central to the law’s financing. Of course, delaying the law by a year is simply an attempt to overturn it altogether. Even Mitt Romney, who as governor of Massachusetts implemented the very health overhaul on which the ACA is modeled, said a delay is the most strategic path to repeal.

The past few years have been an exercise in Republican tenacity as the party attempts to sink President Obama’s landmark domestic policy achievement. The fact that Obama won a second term in a decisive victory, the U.S. Congress passed Obamacare into law, and the U.S. Supreme Court deemed it constitutional are all apparently meaningless.

The GOP, hijacked by the right wing of its party, is redefining what it means to lose. Elizabeth Warren said it best on Sunday:

In a democracy, hostage tactics are the last resort for those who can’t win fights through elections, can’t win fights in Congress, can’t win fights for the presidency, and can’t win their fights in the courts. For this right-wing minority, hostage-taking is all they have left: a last gasp for those who cannot cope with the realities of our democracy.

Since 2010, Republicans have voted 43 times to overturn the ACA. They have challenged the contraceptive mandate ad nauseam, have protested the employer mandate, and at the state level have refused to participate in the Medicaid expansion that would extend benefits to millions of uninsured, low-income individuals.

And President Obama, to the consternation of some on the left, has made concessions in hopes of advancing his overall agenda. Earlier this year, he compromised on the contraceptive mandate by enabling a broader group of self-defined faith-based organizations to qualify for a religious exemption, creating an accommodation where employees of those organizations can obtain full family planning coverage directly from insurance companies. He has responded to complaints from business lobbyists by agreeing to delay the employer mandate until 2015. (That provision requires employers with more than 50 full-time employees to offer affordable coverage for their workers, including children and young adults up to age 26.)

Republicans emphatically insist they are acting in the best interest of the American people. They aren’t. The ACA is good for women and for the entire nation. It has already expanded contraceptive coverage to millions of women, and within the next three years, approximately 13 million more uninsured women will be able to access affordable family planning and reproductive health services. The law will enable the majority of American women to access annual well-woman visits, screenings for cancer and STDs, maternal health care, emergency contraception, and pregnancy testing and counseling. Because of the ACA, individuals with pre-existing conditions will be able to get coverage and gender discrimination by insurance providers will be illegal. This law represents the most significant advancement in women’s reproductive health in nearly a century.

The unfolding debacle goes hand in hand with the reasons the GOP lost the women’s vote in 2012 and is partly why they will not seize it back any time in the near future. Earlier this year, I wrote about the party’s self-reflective autopsy examining why and how Democrats carried the women’s vote by 36 points in the presidential election. They blamed their loss on a failed communications strategy but found little to be objectionable in the substance of their arguments. This week’s shutdown starkly illustrates the GOP’s inability to accept that the majority of Americans do not share their vision for the nation.

It’s becoming increasingly impossible for the GOP to argue that they care much at all about the women’s vote. Afterall, 69 percent of Republican women reported being opposed to a government shutdown, and 67 percent of registered voters believe that all workers should be allowed to access health care services regardless of their employer’s beliefs. And it turns out the only place contraception is controversial is in the halls of Congress; it is nearly universally accepted and used by Americans.

The GOP likes to say the “war on women” is a Democratic canard used to manipulate women at the voting booth. If only that were the case.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: WeNews via Flickr.com

Why The Right Doesn’t Really Want European-Style Reproductive Health Care

U.S. conservatives want Europe’s abortion restrictions, but they oppose the generous systems and legal exceptions that support women’s health.

Earlier this month, Texas lawmakers witnessed and participated in passionate debates about one of the nation’s most sweeping pieces of anti-choice legislation. That legislation, known as SB1, was initially delayed by Wendy Davis’s now-famous filibuster before Governor Rick Perry signed it into law last week during a second special legislative session. It bans abortions after 20 weeks, places cumbersome restrictions on abortion clinics and physicians, and threatens to close all but five of the state’s 42 abortion clinics. Throughout the many days of hearings, anti-choice activists relied on religious, scientific, and political evidence to argue that the new Texas law is just and sensible.

Many of those arguments are tenuous at best, but it is the continued reference to European abortion laws that most represent a convenient cherry-picking of facts to support the rollback of women’s rights. Many European countries do indeed regulate abortion with gestational limits, but what SB1 supporters conveniently ignore is that those laws are entrenched in progressive public health systems that provide quality, affordable (sometimes free) health care to all individuals and prioritize the sexual and reproductive health of their citizens. Most SB1 advocates would scoff at the very programs and policies that are credited with Europe’s low unintended pregnancy and abortion rates.

Members of the media have also seized on European policies to argue that Texas lawmakers are acting in the best interests of women. Soon after the passage of SB1, Bill O’Reilly argued that “most countries in the world have a 20-week threshold,” and Rich Lowry, editor of the National Reviewwrote, “It’s not just that Wendy Davis is out of step in Texas; she would be out of step in Belgium and France, where abortion is banned after 12 weeks.”

It’s hard to imagine any other scenario in which O’Reilly and Lowry, and most conservative politicians and activists, would hold up European social policies as a beacon for U.S. policy. After all, the cornerstones of Europe’s women’s health programs are the very programs that conservatives have long threatened would destroy the moral fabric of American society. One cannot compare the abortion policies of Europe and the United States without looking at the broader social policies that shape women’s health.

Both Belgium and France have mandatory sexuality education beginning in elementary school (in France parents are prohibited from removing their children from the program). France passed a bill earlier this year that allows women to be fully reimbursed for the cost of their abortion and guarantees girls ages 15 to 18 free birth control. Emergency contraception in both countries is easily accessible over the counter, and in Belgium the cost of the drug is reimbursed for young people and those with a prescription. Both countries limit abortion to the first trimester but also make exceptions for cases of rape, incest, and fetal impairment, to preserve woman’s physical or mental health, and for social or economic reasons. None of these exceptions are included in the new Texas law, and I’d guess it would be a cold day in hell before the likes of O’Reilly and Lowry advocate for more expansive health policies or for including such exceptions in abortion laws.

But it would be wise if they did. This availability of preventative care contributes to the overall health and wellness of women in Europe and enables them to make free and fully informed decisions about their bodies over the course of their lifetimes. The demonization and lack of progressive sexual health policies in Texas, and in the United States more broadly, drives high rates of unintended pregnancy, teen pregnancy, maternal mortality, sexually transmitted infections, and abortion.

Unfortunately, Texas couldn’t be further from France or Belgium when it comes to the care it provides to women and families before, during, and after delivery, as I’ve written about before. The Texas teen birth rate is nearly nine times higher than that of France and nearly 10 times higher than that of Belgium. Nearly 90 percent of all teens in France and Belgium reported using birth control at their last sexual intercourse, compared with only 53 percent in Texas. The infant mortality rate in Texas is twice that of Belgium and France. The poverty rate among women in Texas is a third higher than that of women in Belgium and France, and the poverty rate among Texas children is 1.5 times higher. Less than 60 percent of Texas women receive prenatal care, while quality care before, during, and after pregnancy is available to nearly all women throughout Europe.

None of those hard facts were compelling enough to amend – let alone negate – the new law. It seems impossible these days to find a common ground between anti- and pro-choice individuals, but if conservatives wanted to have a conversation about enacting European-style sexual and reproductive health policies in the United States, that just might be something that could bring everyone to the same table. The more likely scenario is that once conservatives have plucked out the facts that help advance their anti-choice cause, they will promptly return to tarring and feathering Europe’s socialized health system.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States and globally.

Cross-posted from the Roosevelt Institute’s Next New Deal blog

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: European Parliament via Flickr.com