Using Pseudoscience at HHS

Kathleen Barry

The extremists are coming out of the closet with their real agenda: the assault on birth control.

I thought the battle for women’s rights had largely been won. But the
extremists are coming out of the closet with their real agenda, the
assault on birth control. This fringe has won converts for its warped
pseudo-science at the Department of Health and Human Services, where a
proposed rule would codify that anyone receiving federal funding could
not be required to provide birth control under the basis that it might
violate their religious views.

The new rules would mean that all
health care providers — including pharmacists and medical staff at
hospitals and clinics, medical schools and even family planning centers
— could refuse to provide all forms of contraception. Women’s rights
are being put at the whim of their providers who could now claim a
"conscience" clause to refuse to cover birth control in medical plans
or provide pregnancy prevention to rape victims.

It seems the
debate over women’s reproductive rights has come full circle, so that
women are once again forced to argue for their right of
self-determination. Every day, Americans face important life decisions,
with outcomes that will reverberate for years: how to afford health
care; how to die with dignity, how to talk to teenagers about sex; when
and what kind of contraceptives to use; when to have a baby and whether
it is safe to have more than one child. This debate is really about
more than contraception, it’s about life decisions and whether women
get to make them for themselves.

How did this happen? With nine
out of every ten American women using contraceptives, you’d think we
were out of the Dark Ages. It’s a small minority of activists who are
pushing for these extreme measures. The Women Donors Network, together
with Communications Consortium Media Center, conducted research and
found that 91 percent of voters agreed that couples should have access
to birth control. Voters believe, by 83 percent, that we should respect
people’s ability to make their own life decisions, including when to
have a child — and not impose our values and views on them.

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The
extremists’ agenda is designed to strip woman of self-determination. We
cannot allow the intractable debate on pregnancy termination to
overshadow our right to prevent a pregnancy. Under the proposed HHS
rule anyone — the doctor, the pharmacist, the receptionist — could
deny a woman the right to contraception.

Given that
contraceptives prevent unintended pregnancies, you would think that the
anti-abortion crowd would be the biggest promoter of birth control. Not
so, because their real target is to end family planning. It’s time to
move on to the critical issues about reproductive health and sexuality
that face all of us every day — issues such as access to contraception
and cervical cancer prevention. Let’s agree to disagree about abortion,
but certainly prevention of unwanted pregnancy can be a common ground
goal most Americans can agree upon.

The public has only until September 25th to send comments to HHS about the proposed rule. Send your comments to consciencecomment@hhs.gov.
The proposed HHS rule should die a swift death and the anti-women
activists should back off, allowing the rest of us to move on.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

News Law and Policy

Wisconsin GOP’s Voter Restriction Law Suffers Another Legal Blow

Imani Gandy

In blocking many of Wisconsin's elections restrictions, the lower court ruled that the state must reform how it deals with voters who have difficulty obtaining the required photo ID to vote.

A federal appeals court yesterday refused to stay a lower court order blocking several Wisconsin voting restrictions, allowing election officials to move forward with early voting in the state next month.

Attorneys on behalf of the state of Wisconsin filed the request for a stay with the Seventh Circuit Court of Appeals after a lower court judge last month issued an injunction that blocked parts of Wisconsin’s sweepings elections laws.

The lower court ruled that the justification for the laws did not justify the burden on voting rights that they impose. And this week a three-judge panel of the Seventh Circuit declined to stay that ruling, without explaining.

The ruling comes days after elections officials in Madison and Milwaukee announced their intention to kick off early voting in late September, a month earlier than would have been allowed had the lower court not struck down the restrictions on early voting, according to the Milwaukee-Wisconsin Journal Sentinel.

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The Republican-backed elections law created state-imposed limitations on the time and location for in-person absentee voting, a provision requiring absentee ballots be sent by mail instead of fax or email, the requirement that dorm lists—a certified list provided by the university of the students living in college housing, which student voters may use as proof of residence—must include citizenship information, a ban on using expired but otherwise qualifying student IDs to establish proof of residency, and a 28-day durational residency requirement.

In blocking many of Wisconsin’s elections restrictions, the lower court ruled that the state must reform how it deals with voters who have difficulty obtaining the required photo ID to vote. Gov. Scott Walker (R) and the GOP-controlled Wisconsin legislature had implemented a system under which people who don’t have birth certificates or who have problems with gathering documentation needed to obtain the proper identification would still be able to vote.

The lower court noted that the Walker administration’s system did not provide a viable long-term solution for those voters who could not obtain their birth certificates because they were destroyed in fires or misplaced by bureaucrats.

The court later stayed that portion of the ruling, stating that the system created by Walker’s administration—which provides people with temporary voting credentials while they await a decision about whether they qualify for an ID—was sufficient to allow people to vote during the upcoming November election and therefore does not need to be immediately reformed.

The ruling comes on the heels of a ruling in another voting rights case in Wisconsin, Frank v. Walker, about the state’s voter ID law. In that case, a three-judge panel of the Seventh Circuit stayed a ruling that would have permitted anyone eligible to vote in Wisconsin to an accommodation that would permit that voter to cast a ballot after signing an affidavit stating that they could not easily obtain an ID.

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