Fighting the Myths on Contraception and the Stimulus

Mary Jane Gallagher

Conservatives, pundits, and Democrats alike perpetuated myths about contraception, Medicaid and family planning this week. Here, we set the record straight.

Much hay has been made about contraception
this week, some good, most of it bad.  If you have not heard by
now, there was a provision in the House version of the economic stimulus
package that would have expanded eligibility for Medicaid-funded family
planning services, which was stripped out after House Republicans threw
a fit about spending "hundreds of millions of dollars on contraceptives." 
They claimed that their outrage was over the connection – or lack
thereof – between funding for contraceptives and stimulating the economy,
but the truth is far less complicated.  Minority Leader Boehner
and his friends simply do not like contraception, and they really, REALLY
do not want you to be able to access it. 

Before we delve too deeply into the
misguided hatred of all things contraceptive, let’s take a moment
to clear up some of the myths they have perpetuated this week about
the provision they lobbied so hard to destroy. 

What does
"expanded eligibility for Medicaid-funded family planning services"
mean, anyway?

Right now, Medicaid – the government’s
way of paying for health care for low-income women and men – provides
funding for pregnancy-related care for women whose incomes are up to
a certain percentage of the federal poverty level (roughly $17,600
for a family of three).  The provision that was stripped out of
the House bill would have allowed states to provide family planning
services to anyone who, based on their income, would be eligible for
pregnancy-related care under Medicaid.  In other words, if you
would qualify for pregnancy-related care under Medicaid, you would also
qualify to access family planning services, including contraceptives,
if you do not wish to become pregnant. 

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Why is family planning important?

Family planning services – counseling,
contraception, sex education and preventive health services – are
a critical element of basic health care that helps women and men make
socially responsible decisions and build strong families.  Contraception
is basic health care for women throughout much of their lives – an
average woman who wants two children will spend five years pregnant
or trying to get pregnant and roughly 30 years trying to prevent pregnancy.  Publicly supported family planning
services help to prevent at least 1.4 million unintended pregnancies
every year, thus reducing
the need for abortion
.  

Why is Medicaid coverage of family
planning a good thing?

Bottom line: Medicaid coverage of family
planning is good health care policy that saves the government money. 
That’s right, SAVES money.  According to the Guttmacher Institute,
every $1 spent on publicly funded family planning saves more than $4 in state
and federal dollars
. The
Congressional Budget Office (CBO) evaluation of the House stimulus bill
found that the Medicaid family planning expansion provision would have
saved the federal government $200 million over 5 years and an astonishing $700 million over 10 years.  These numbers do not even include the
substantial savings state governments also realize, all while providing
essential health care to millions who would otherwise have no access
to care. 

Why is
legislation necessary?

Right now, 27 states have obtained
a waiver from the federal government to expand eligibility for family
planning services; 20 of those states have obtained a waiver that allows
them to do the kind of income-based expansion that the stimulus provision
would have allowed.  The problem with waivers, however, is that
obtaining one requires states to navigate a burdensome bureaucratic
process which lasts an average of 15 months, and that is just from the
point of submitting their paperwork.  It can often take years for
a state to collect the information needed and put together the waiver
application, all at a significant investment of staff time and resources.    

Why
now?

As the economic crisis worsens, employers
are being forced to lay off staff and slash benefits for remaining employees,
leaving more and more Americans reliant on the health care safety net
for basic health care services, including family planning and reproductive
health care.  Federal investments in family planning pay huge dividends,
both in improved health and in cost savings, at a time when America
is in desperate need of both.  Furthermore, many states with family
planning waivers have found that the additional resources made available
to providers has allowed them to hire new staff and expand clinic hours
– creating jobs and serving additional patients in need at the same
time. 

So why all the controversy?

That really is the question of the
hour, especially when this provision has already passed in the House,
back in 2007 as part of the CHAMP Act.  Why would Mr. Boehner and
his like-minded colleagues be so opposed to including this important
provision in the stimulus package?  The vehement opposition to
a provision that would enable states to provide quality, essential health
care to millions of women, all the while creating jobs AND saving the
government precious tax dollars is beyond the limits of reason… until
you realize that reason has nothing to do with it. 

This attack on contraception is just
the latest in a long line of attacks on family planning.  Let there
be no doubt that the War on Contraception is alive and well in America,
and there are no signs of it easing up any time soon.  So what
should our next step be?  Should we continue to try and placate
a small yet vocal minority who refuses to understand that family planning
saves money, reduces unintended pregnancies and is critical health care
for women?  Or should we chart a new and bolder course, one that
places the needs of women above the rhetoric and the attempts at compromise. 

I say yes, the time has come for Congress
and the Administration to do what they know to be right.  We must
increase federal funding for family planning, starting with passing
legislation expanding eligibility for Medicaid-funded family planning
services, and we must do it today. 

News Politics

Missouri ‘Witch Hunt Hearings’ Modeled on Anti-Choice Congressional Crusade

Christine Grimaldi

Missouri state Rep. Stacey Newman (D) said the Missouri General Assembly's "witch hunt hearings" were "closely modeled" on those in the U.S. Congress. Specifically, she drew parallels between Republicans' special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life.

Congressional Republicans are responsible for perpetuating widely discredited and often inflammatory allegations about fetal tissue and abortion care practices for a year and counting. Their actions may have charted the course for at least one Republican-controlled state legislature to advance an anti-choice agenda based on a fabricated market in aborted “baby body parts.”

“They say that a lot in Missouri,” state Rep. Stacey Newman (D) told Rewire in an interview at the Democratic National Convention last month.

Newman is a longtime abortion rights advocate who proposed legislation that would subject firearms purchases to the same types of restrictions, including mandatory waiting periods, as abortion care.

Newman said the Missouri General Assembly’s “witch hunt hearings” were “closely modeled” on those in the U.S. Congress. Specifically, she drew parallels between Republicans’ special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life. Both formed last year in response to videos from the anti-choice front group the Center for Medical Progress (CMP) accusing Planned Parenthood of profiting from fetal tissue donations. Both released reports last month condemning the reproductive health-care provider even though Missouri’s attorney general, among officials in 13 states to date, and three congressional investigations all previously found no evidence of wrongdoing.

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Missouri state Sen. Kurt Schaefer (R), the chair of the committee, and his colleagues alleged that the report potentially contradicted the attorney general’s findings. Schaefer’s district includes the University of Missouri, which ended a 26-year relationship with Planned Parenthood as anti-choice state lawmakers ramped up their inquiries in the legislature. Schaefer’s refusal to confront evidence to the contrary aligned with how Newman described his leadership of the committee.

“It was based on what was going on in Congress, but then Kurt Schaefer took it a step further,” Newman said.

As Schaefer waged an ultimately unsuccessful campaign in the Missouri Republican attorney general primary, the once moderate Republican “felt he needed to jump on the extreme [anti-choice] bandwagon,” she said.

Schaefer in April sought to punish the head of Planned Parenthood’s St. Louis affiliate with fines and jail time for protecting patient documents he had subpoenaed. The state senate suspended contempt proceedings against Mary Kogut, the CEO of Planned Parenthood of St. Louis Region and Southwest Missouri, reaching an agreement before the end of the month, according to news reports.

Newman speculated that Schaefer’s threats thwarted an omnibus abortion bill (HB 1953, SB 644) from proceeding before the end of the 2016 legislative session in May, despite Republican majorities in the Missouri house and senate.

“I think it was part of the compromise that they came up with Planned Parenthood, when they realized their backs [were] against the wall, because she was not, obviously, going to illegally turn over medical records.” Newman said of her Republican colleagues.

Republicans on the select panel in Washington have frequently made similar complaints, and threats, in their pursuit of subpoenas.

Rep. Marsha Blackburn (R-TN), the chair of the select panel, in May pledged “to pursue all means necessary” to obtain documents from the tissue procurement company targeted in the CMP videos. In June, she told a conservative crowd at the faith-based Road to Majority conference that she planned to start contempt of Congress proceedings after little cooperation from “middle men” and their suppliers—“big abortion.” By July, Blackburn seemingly walked back that pledge in front of reporters at a press conference where she unveiled the select panel’s interim report.

The investigations share another common denominator: a lack of transparency about how much money they have cost taxpayers.

“The excuse that’s come back from leadership, both [in the] House and the Senate, is that not everybody has turned in their expense reports,” Newman said. Republicans have used “every stalling tactic” to rebuff inquiries from her and reporters in the state, she said.

Congressional Republicans with varying degrees of oversight over the select panel—Blackburn, House Speaker Paul Ryan (WI), and House Energy and Commerce Committee Chair Fred Upton (MI)—all declined to answer Rewire’s funding questions. Rewire confirmed with a high-ranking GOP aide that Republicans budgeted $1.2 million for the investigation through the end of the year.

Blackburn is expected to resume the panel’s activities after Congress returns from recess in early September. Schaeffer and his fellow Republicans on the committee indicated in their report that an investigation could continue in the 2017 legislative session, which begins in January.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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