Contraception 101: The Econ Course Our Politicians Need

Laurie Rubiner

Last week Congress ditched a family planning expansion from the stimulus, saying it didn't belong in an economic recovery package. But young, unintended parenting is a key indicator for poverty.

Last week, the Congress summarily
excised a provision from the stimulus package that would have expanded
family planning services for low-income women, claiming that the
provision didn’t belong in an economic recovery package. Led by
Republican Congressman John Boehner, the provision was mischaracterized
as costing the taxpayers money (though the nonpartisan Congressional
Budget Office determined that it actually saves the taxpayers $700 million over 10 years)
and was subsequently pilloried by talk show hosts and the media as an
example of how the stimulus bill had turned into one big package of
high priced bacon.  And – allow me to take a moment to put on my
I-have-no-sense-of-humor-feminista-hat – it provided wonderful
fodder for juvenile jokes by lots of male TV personalities, including
my own personal hero, Jon Stewart.

Now that the jokes have run their
course, and the stimulus bill is behind us, let’s consider whether
denying thousands of low-income women access to affordable
contraception is in fact a legitimate economic issue.  On August 20,
1964, in the White House Rose Garden, President Johnson signed the
Economic Opportunity Act, which established the Office of Economic
Opportunity to direct and coordinate a variety of educational,
employment, and training programs that were the foundation of President
Johnson’s War on Poverty. What we may have forgotten from our history
lessons is that the Office of Economic Opportunity granted the first
funds ever to support domestic family planning programs. President
Johnson’s calculation was simple: one key factor to individual economic
opportunity is the ability to plan and space the number of children you
have. Because the surest route to poverty is young, single
parenthood. 

But don’t take my word for it –
consider the statistics. According to an analysis of census data
conducted by the nonpartisan National Campaign to Prevent Teen
Pregnancy and Unplanned Pregnancy, two-thirds of families begun by a young, unmarried mother are poor
And a child is nine times more likely to grow up in poverty if the
mother gave birth as a teen, the parents were unmarried when the child
was born, and the mother did not receive a high school diploma or a
GED. It is a spiral we know all too well – a study by S.D. Hoffman
shows that only 40 percent of mothers who have children before age 18
graduate from high school, and only two percent complete college.  By
comparison, 75 percent of women who delay childbearing until they are
20 or 21 finish high school and nine percent complete a college degree.
The House Committee on Ways and Means in studying these numbers
determined that in the last 20 years, the median income for college
graduates has increased 19 percent while decreasing for high school
dropouts by 28 percent. I’m no financial wizard, but this income
disparity sure sounds like a pretty serious economic issue to me.

Sure, there are those who will say all
women have to do is abstain from sex until they are married and their
economic futures will be secure. But now that we have a president in
the White House who is actually interested in evidence, we can
acknowledge once and for all that the $1.5 billion the Bush
Administration spent on abstinence only programs didn’t work – 88
percent of teens who pledged virginity in middle and high school still
engaged in premarital sex, they are just less likely to use condoms or
any other form of contraception. This helps explain why the United
States has one of the highest rates of teen pregnancy in the developed
world and why at least one in four teen girls has a sexually
transmitted disease. And it’s why every reputable health organization,
including the American Medical Association, has denounced abstinence
only programs as ineffective. By contrast, we know that using
contraception does work – according to the Guttmacher Institute,
publicly funded family planning services help women avoid approximately
1.4 unintended pregnancies a year, pregnancies that would have resulted
in 640,000 unintended births and 600,000 abortions.

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I was thinking about Congressman
Boehner’s disdain for the idea that access to affordable contraception
could ever be considered an economic issue the other day when I was
visiting one of our clinics in North Carolina. A young patient was
gracious enough to allow me to sit in and observe her visit with one of
our clinicians. She was there to get long-acting contraception and
during the discussion the doctor asked her where she was going to
college. She named her targeted schools and said her goal was to double
major with the hope of one day being an occupational therapist. She was
excited for her future and taking responsibility for it at the same
time. As I sat there listening to her, I wished that Congressman
Boehner could pay attention to what she was saying. I think this young
woman could have taught him a thing or two about economics that he has
never had to learn.

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

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Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.

Roundups Politics

The House Freedom Fund Bankrolls Some of Congress’ Most Anti-Choice Candidates

Ally Boguhn

With the 2016 election cycle underway, the political action committee seems to be working tirelessly to ensure the House Freedom Caucus maintains a radical anti-choice legacy.

In its short existence, the House Freedom Caucus (HFC) has made a name for itself through endless efforts to push Congress further to the right, particularly when it comes to reproductive health. Now with the 2016 election cycle underway, the caucus’ political action committee, the House Freedom Fund, seems to be working just as tirelessly to ensure the caucus maintains a radical anti-choice legacy.

Since its founding by Rep. Jim Jordan (R-OH) in January 2015, the group of ultra-conservative lawmakers that make up the caucus has ballooned from just nine members to at least 36 members, as of October 2015, who have confirmed their own inclusion—though the group keeps its official roster secret. These numbers may seem small, but they pack a punch in the House, where they have enough votes to block major legislation pushed by other parts of the Republican party.

And now, the group is seeking to add to its ranks in order to wield even more power in Congress.

“The goal is to grow it by, and I think it’s realistic, to grow it by 20 to 30 members,” Rep. Matt Salmon (R-AZ), one of HFC’s founding members, told Politico in April. “All new members.”

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While the caucus itself reportedly does not endorse candidates, its unofficial PAC has already thrown money behind defending the seats of some of the group’s most notoriously anti-choice members, as well as a few new faces.

According to OpenSecrets.org, the Center for Responsive Politics’ campaign finance database, thus far in 2016, the House Freedom Fund has invested in seven congressional candidates currently vying to keep a seat in the House of Representatives: Rep. Rod Blum (R-IA), Rep. Dave Brat (R-VA), Rep. Tim Huelskamp (R-KS), Rep. Mark Meadows (R-NC), Rep. Scott Desjarlais (R-TN), Rep. Scott Garrett (R-NJ), and Rep. Paul Gosar (R-AZ). The PAC’s website also highlights two candidates hoping to move from their state legislatures to the House: Republican Indiana state senator Jim Banks and Georgia state Senator Mike Crane. The PAC is also backing the Republican candidate for Florida’s 2nd Congressional District, Mary Thomas; and Republican candidate for North Carolina’s 13th Congressional District, Ted Budd.

Rep. Warren Davidson (R-OH), who won a special election in early June to replace former House speaker John Boehner, also received funding from the PAC. He joined the House Freedom Caucus that same week.

The Republican Party actively works to deny access to virtually all forms of reproductive health care, so it is not surprising that the candidates supported by the House Freedom Fund, whose confirmed members are all members of the GOP, share similarly radical views on reproductive rights and health.

Here are some of the House Freedom Fund’s most alarming candidates:

Rep. Rod Blum

Rep. Blum, a freshman congressman from Iowa, considers his opposition to reproductive choice one of the “cornerstones” of his campaign. “It is unconscionable that government would aid in the taking of innocent life. I strongly oppose any federal funding for abortion and I will vote against any of our tax dollars flowing to groups who perform or advocate abortions on demand,” asserts Blum’s campaign site. The Hyde Amendment already bans most federal funding for abortion care.

Blum spent much of his first year in the House attempting to push through a series of anti-choice bills. The representative co-sponsored the medically unsupported Pain-Capable Unborn Child Protection Act, which would have enacted a federal ban on abortion at or beyond 20 weeks of pregnancy, in January 2015. He signed on as a co-sponsor for the failed Life at Conception Act, a so-called personhood measure that would have granted legal rights to fetuses and zygotes, thus potentially outlawing abortion and many forms of contraception, in March of that year. That July, Blum co-sponsored the Defund Planned Parenthood Act of 2015, which would have stripped the reproductive health organization of all federal funding for one year so that Congress could investigate it in the wake of the Center for Medical Progress’ (CMP) discredited videos smearing the provider. 

Blum’s co-sponsorship of anti-choice legislation was accompanied by a long series of like-minded votes throughout 2015, such as a January vote in favor of the No Taxpayer Funding for Abortion Act and Abortion Insurance Full Disclosure Act of 2015, which, among other things, would have made the Hyde Amendment’s annually renewed ban on most federal funding for abortion care permanent. He also voted to block Washington, D.C.’s Reproductive Health non-discrimination law, and in favor of a measure allowing states to exclude from Medicaid funding any health provider that provided abortions, as well as other anti-choice measures.

Blum’s brief time in Congress has been marked by such extremism that Emily’s List, an organization that works to elect pro-choice women, put Blum on their “On Notice” list in July 2015, signaling their intention to prioritize unseating the Iowa Representative. “In less than five months into the 114th Congress, we have seen Representative Blum lead the crusade to restrict women’s access to healthcare, most notably when he cosponsored a national abortion ban,” explained the organization in a press release on its decision to target Blum. “It’s clear that Congressman Blum is more focused on prioritizing an extreme ideological agenda over enacting policies that benefit more women and families in Iowa’s First Congressional District.”

Rep. Dave Brat

Rep. Dave Brat gained notoriety for his win against incumbent representative and then-House Majority Leader Eric Cantor in 2014, a victory considered one of “the biggest political upset[s] in recent memory.” Like many of his HFC colleagues, Brat has co-sponsored several pieces of anti-choice legislation, including the Pain-Capable Unborn Child Protection Act in 2015 and the Conscience Protection Act of 2016, which claimed to “protect” against “governmental discrimination against providers of health services” who refuse to provide abortion care. Brat’s voting record in Congress earned him a 100 percent rating from the National Right to Life Committee.

In April of this year, the Virginia representative signed on to a letter with Senator Ted Cruz (R-TX) and other anti-choice legislators, such as House Freedom Fund candidate Rep. Meadows expressing “serious concerns” about the Food and Drug Administration’s decision to update the label of abortion drug mifepristone to bring it in line with scientific research and evidence-based medicine. Though medication abortions are safe and result in complications in fewer than 0.4 percent of patients, the lawmakers nonetheless claimed that the regulation change could be dangerous, noting that the drug was originally approved during the Clinton administration and demanding a list of information about it.

In the wake of the deadly shooting at a Colorado Springs Planned Parenthood facility in November, when the alleged shooter parroted the same violent rhetoric about the reproductive health organization popularized by the CMP’s discredited videos, many in Congress called for the panel investigating Planned Parenthood to be disbanded and for lawmakers to distance themselves from the videos. Brat, however, saw no reason the anti-choice violence should affect the conservative crusade to shut down access to reproductive health care. “Principles are principles,” Brat said at the time according to the Huffington Post. “They don’t change on a news cycle.”

Rep. Tim Huelskamp

Kansas Rep. Tim Huelskamp has been an anti-choice advocate since graduate school, when, according to the biography provided on his website, he was “active in assisting women in crisis pregnancies” while working toward a doctoral degree at American University. His advocacy continued as he made his way to Congress, eventually leading him to become the congressional “Pro-Life Caucus” whip.

Though he has cast plenty of anti-choice votes, the congressman’s most notable moment when it comes to reproductive rights may be a 2012 speech on the House floor, in when he compared abortion to slavery and accused Planned Parenthood and the Obama administration of being racist. “Perhaps the biggest war against our liberties is the war that is being waged against those that are not here today, the unborn,” claimed Huelskamp. “Besides slavery, abortion is the other darkest stain on our nation’s character and this president is looking for every way possible to make abortion more available and more frequent. And he wants you to pay for it. Even if you disagree with it.”

Huelskamp went on to falsely accuse Planned Parenthood of targeting people of color. “I am the adoptive father of four children, each of them either Black, Hispanic, Native American, and I am incensed that this president pays money to an entity that was created for the sole purpose of killing children that look like mine; a racist organization and it continues to target minorities for abortion destruction,” said the congressman. “Shame on this president and shame on that party.”

It wouldn’t be the last time Huelskamp exploited race in order to promote his anti-choice agenda. In 2015, the Kansas Representative lashed out at those who accepted awards from Planned Parenthood, tweeting that they were supporting a “racist” agenda.

Rep. Mark Meadows

Rep. Mark Meadows, who has a 100 percent rating from the National Right to Life Committee, co-sponsored anti-choice measures such as the House’s 2015 fetal pain bill, the 2015 Life at Conception Act, and the Prenatal Nondiscrimination Act of 2016 (PRENDA). He also once badgered a pregnant doctor testifying during a House committee hearing about the importance of offering maternity coverage through the Affordable Care Act. However, the congressman’s recent vendetta against Planned Parenthood stands out the most.

In July 2015, in the wake of CMP’s deceptively edited videos, Meadows latched onto the discredited films in order to justify defunding Planned Parenthood. “In addition to cutting funding for abortion providers, I strongly urge Congress to investigate the legality of the practices engaged in by Planned Parenthood,” said Meadows at the time.

In September, as Congress faced the looming threat of a possible government shutdown if they didn’t pass a budget bill, Meadows exploited the opportunity to push for Planned Parenthood to be defunded, no matter the cost. With the South Carolina congressman leading the charge, pressure from conservatives to pull funding for the reproductive health-care provider played a role in prompting then-House Speaker John Boehner to resign his position. Meadows was a co-sponsor of the Defund Planned Parenthood Act of 2015, which passed in the House as part of a compromise to narrowly escape the shutdown. 

But Meadows’ quest to attack Planned Parenthood didn’t end there. In September, the congressman also participated in the House Oversight and Government Reform Committee’s hearing to “examine the use of taxpayer funding” by Planned Parenthood and its affiliates, a sham hearing used by the GOP to repeatedly push misinformation about the organization.

Rep. Scott Desjarlais

Rep. Scott Desjarlais, a medical doctor, is perhaps best known for his attempt to pressure his patient, with whom he was having an affair, into having an abortion when she became pregnant. While the congressman has repeatedly run on his anti-abortion credentials, his divorce papers also revealed he had supported his wife in having two abortions. Politico‘s Chas Sisk labeled DeJarlais  “the biggest hypocrite in Congress.”

Desjarlais made headlines again in 2015 for voting for a later abortion ban. A spokesperson for the Tennessee Republican told the Times Free Press that the vote was in accordance with the congressman’s record:

“Congressman DesJarlais was proud to vote in favor of this legislation,” said his spokesman Robert Jameson, who added that DesJarlais has maintained a “100 percent pro-life voting record” during his five years in Congress and “has always advocated for pro-life values.”

Indiana State Sen. Jim Banks

Indiana state Sen. Jim Banks (R-Columbia City) is one of the few candidates backed by the House Freedom Fund that has yet to win federal office, but his time in the state legislature has given him more than ample opportunity to demonstrate his opposition to reproductive health and rights.

Banks’ campaign website highlights the candidate’s “pro-life” position as a key issue for his race for the House, providing an extensive record of his anti-choice credentials and claiming that he is “running for Congress so that northeast Indiana continues to have a strong voice for innocent lives in Washington, D.C.” That page includes a laundry list of campaign promises, including amending the U.S. Constitution to give a fetus legal human rights, which could outlaw abortion and many forms of contraception; banning federal funding for abortion, though such a ban already exists; eliminating federal funding for any organization that performs abortions domestically or abroad; and opposing any change to the Republican platform on abortion.

The state senator’s site goes on to suggest that “it has been far too long since the Supreme Court discovered that women have a ‘right’ to have an abortion,” lamenting that much of the anti-choice movement’s work to shutter access to abortion in state legislatures hasn’t been replicated on a federal level and promising to address the issue if elected.

Included in his anti-choice resumé is a note that both Banks and his wife have been working in the movement to oppose choice since graduating college, when the two joined Focus on the Family, an organization that has spent millions of dollars promoting its extreme agenda, even devoting $2.5 million to run an anti-abortion ad during the 2010 Super Bowl. The two also worked together on the Allen County Right to Life Board of Directors, and Banks’ wife, Amanda, remains the board’s vice president.

But most extreme of all was the legislation Banks spearheaded while in the state legislature, which included several targeted regulation of abortion providers (TRAP) measures. Most recently the state senator sponsored Indiana’s SB 144, a bill that would modify the state’s 20-week abortion ban to outlaw the procedure once a fetal heartbeat could be detected, typically around six weeks’ gestation. In a statement on the bill, Banks claimed the law was needed because it “would protect unborn Hoosiers’ right to life and also includes important women’s health protections.”