President’s 2010 Budget Overview Includes Medicaid Family Planning Expansion

Emily Douglas

While the 2010 budget overview is generally non-specific, it does make clear that the Medicaid family planning expansion is included.

President Obama’s 2010 "Budget Overview Document" it out, and there’s "great news" for in it for reproductive health advocates, says Tait Sye of Planned Parenthood.

While the overview is generally non-specific, it does make clear that
the Medicaid family planning expansion — which would extend Medicaid
coverage for family planning services to non-pregnant women — is
included (see page 127).  The expansion, which would enable states to extend coverage to non-pregnant women without first seeking a waiver from the federal government, was first included in the economic stimulus package.  When widely decried by Republicans, it was quickly abandoned by President Obama, who asked congressional Democrats to drop the provision.

"The inclusion of a provision to expand eligibility for Medicaid
funded family planning services is a tremendous step forward in meeting
the need for access to family planning services. Federal funding for
family planning is a common sense, common ground solution that enables
people to act responsibly, stay healthy and plan for strong families,"
Mary Jane Gallagher, president of the National Family Planning &
Reproductive Health Association, said in a statement. 
Gallagher also called for the budget to fund Title X at $700 million.

The overview is promising on a number of other sexual and reproductive health priorities, including committing to "fund[ing] models that stress the importance of abstinence while providing
medically accurate and age-appropriate information to youth who have
become sexually active."  But the outline does not reveal whether funding for abstinence-only programming will be eliminated.  "We are cautiously optimistic about the language in
the President’s overview," says Jen Heitel Yakush, Assistant Director for Public Policy at SIECUS. "We are concerned that youth who may become
sexually active are not included in the language but we do believe that this
language reflects an end to funding for ineffective
abstinence-only-until-marriage programs."
The 2009 budget cuts funding for the Community-Based Abstinence Education program by $14 million, but sex ed advocates hope for a total zeroing-out of all abstinence-only funding streams in the 2010 budget.

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Advocates expect the budget itself to be released in April.

Analysis Politics

Experts: Trump’s Proposal on Child Care Is Not a ‘Solution That Deals With the Problem’

Ally Boguhn

“A simple tax deduction is not going to deal with the larger affordability problem in child care for low- and moderate-income individuals," Hunter Blair, a tax and budget analyst at the Economic Policy Institute told Rewire.

In a recent speech, GOP presidential nominee Donald Trump suggested he now supports policies to made child care more affordable, a policy position more regularly associated with the Democratic Party. The costs of child care, which have almost doubled in the last 25 years, are a growing burden on low- and middle-income families, and quality options are often scarce.

“No one will gain more from these proposals than low- and middle-income Americans,” claimed Trump in a speech outlining his economic platform before the Detroit Economic Club on Monday. He continued, “My plan will also help reduce the cost of childcare by allowing parents to fully deduct the average cost of childcare spending from their taxes.” But economic experts question whether Trump’s proposed solution would truly help alleviate the financial burdens faced by low- and middleincome earners.

Details of most of Trump’s plan are still unclear, but seemingly rest on addressing child care costs by allowing families to make a tax deduction based on the “average cost” of care. He failed to clarify further how this might work, simply asserting that his proposal would “reduce cost in child care” and offer “much-needed relief to American families,” vowing to tell the public more with time. “I will unveil my plan on this in the coming weeks that I have been working on with my daughter Ivanka … and an incredible team of experts,” promised Trump.

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An adviser to the Trump campaign noted during an interview with the Associated Press Monday that the candidate had yet to nail down the details of his proposal, such as what the income caps would be, but said that the deductions would only amount to the average cost of child care in the state a taxpayer resided in:

Stephen Moore, a conservative economist advising Trump, said the candidate is still working out specifics and hasn’t yet settled on the details of the plan. But he said households reporting between $30,000 and $100,000, or perhaps $150,000 a year in income, would qualify for the deduction.

“I don’t think that Britney Spears needs a child care credit,” Moore said. “What we want to do is to help financially stressed middle-class families have some relief from child-care expenses.”

The deduction would also likely apply to expensive care like live-in nannies. But exemptions would be limited to the average cost of child care in a taxpayer’s state, so parents wouldn’t be able to claim the full cost of such a high-price child care option.

Experts immediately pointed out that while the details of Trump’s plan are sparse, his promise to make average child care costs fully tax deductible wouldn’t do much for the people who need access to affordable child care most.

Trump’s plan “would actually be pretty poorly targeted for middle-class and low-income families,” Hunter Blair, a tax and budget analyst at the Economic Policy Institute (EPI), told Rewire on Monday.

That’s because his tax breaks would presumably not benefit those who don’t make enough money to owe the federal government income taxes—about 44 percent of households, according to Blair. “They won’t get any benefit from this.”

As the Associated Press further explained, for those who don’t owe taxes to the government, “No matter how much they reduce their income for tax purposes by deducting expenses, they still owe nothing.”

Many people still may not benefit from such a deduction because they file standard instead of itemized deductions—meaning they accept a fixed amount instead of listing out each qualifying deduction. “Most [lower-income households] don’t choose to file a tax return with itemized deductions,” Helen Blank, director of child care and early learning at the National Women’s Law Center (NWLC), told Rewire Tuesday. That means the deduction proposed by Trump “favors higher income families because it’s related to your tax bracket, so the higher your tax bracket the more you benefit from [it],” added Blank.

A 2014 analysis conducted by the Congressional Research Service confirms this. According to its study, just 32 percent of tax filers itemized their deductions instead of claiming the standard deduction in 2011. While 94 to 98 percent of those with incomes above $200,000 chose to itemize their deductions, just 6 percent of tax filers with an adjusted gross income below $20,000 per year did so.

“Trump’s plan is also not really a solution that deals with the problem,” said Blair. “A simple tax deduction is not going to deal with the larger affordability problem in child care for low- and moderate-income individuals.”

Those costs are increasingly an issue for many in the United States. A report released last year by Child Care Aware® of America, which advocates for “high quality, affordable child care,” found that child care for an infant can cost up to an average $17,062 annually, while care for a 4-year-old can cost up to an average of $12,781.

“The cost of child care is especially difficult for families living at or below the federal poverty level,” the organization explained in a press release announcing those findings. “For these families, full-time, center-based care for an infant ranges from 24 percent of family income in Mississippi, to 85 percent of family income in Massachusetts. For single parents the costs can be overwhelming—in every state annual costs of center-based infant care averaged over 40 percent of the state median income for single mothers.”

“Child care now costs more than college in most states in our nation, and it is an actual true national emergency,” Kristin Rowe-Finkbeiner, CEO and executive director of MomsRising, told Rewire in a Tuesday interview. “Donald Trump’s new proposed child care tax deduction plan falls far short of a solution because it’s great for the wealthy but it doesn’t fix the child care crisis for the majority of parents in America.”

Rowe-Finkbeiner, whose organization advocates for family economic security, said that in addition to the tax deduction being inaccessible to those who do not itemize their taxes and those with low incomes who may not pay federal income taxes, Trump’s proposal could also force those least able to afford it “to pay up-front child care costs beyond their family budget.”

“We have a crisis … and Donald Trump’s proposal doesn’t improve access, doesn’t improve quality, doesn’t lift child care workers, and only improves affordability for the wealthy,” she continued.

Trump’s campaign, however, further claimed in a statement to CNN Tuesday that “the plan also allows parents to exclude child care expenses from half of their payroll taxes—increasing their paycheck income each week.”

“The working poor do face payroll taxes for Social Security and Medicare, so a payroll tax break could help them out,” reported CNN. “But experts say it would be hard to administer.”

Meanwhile, Democratic presidential nominee Hillary Clinton released her own child care agenda in May, promising to use the federal government to cap child care costs at 10 percent of a family’s income. 

A cap like this, Blank said, “would provide more help to low- and middle-income families.” She continued, “For example, if you had a family with two children earning $70,000, if you capped child care at 10 percent they could probably save … $10,000 a year.”

Clinton’s plan includes a promise to implement a program to address the low wages many who work in the child care industry face, which she calls the “Respect And Increased Salaries for Early Childhood Educators” program, or the RAISE Initiative. The program would raise pay and provide training for child-care workers.

Such policies could make a major difference to child-care workers—the overwhelming majority of which are women and workers of color—who often make poverty-level wages. A 2015 study by the EPI found that the median wage for these workers is just $10.31 an hour, and few receive employer benefits. Those poor conditions make it difficult to attract and retain workers, and improve the quality of care for children around the country. 

Addressing the low wages of workers in the field may be expensive, but according to Rowe-Finkbeiner, it is an investment worth making. “Real investments in child care bring for an average child an eight-to-one return on investment,” she explained. “And that’s because when we invest in quality access and affordability, but particularly a focus on quality … which means paying child-care workers fairly and giving child-care workers professional development opportunities …. When that happens, then we have lower later grade repetition, we have less future interactions with the criminal justice system, and we also have a lower need for government programs in the future for those children and families.

Affordable child care has also been a component of other aspects of Clinton’s campaign platform. The “Military Families Agenda,” for example, released by the Clinton campaign in June to support military personnel and their families, also included a child care component. The former secretary of state’s plan proposed offering these services “both on- and off-base, including options for drop-in services, part-time child care, and the provision of extended-hours care, especially at Child Development Centers, while streamlining the process for re-registering children following a permanent change of station (PCS).” 

“Service members should be able to focus on critical jobs without worrying about the availability and cost of childcare,” said Clinton’s proposal.

Though it may be tempting to laud the simple fact that both major party candidates have proposed a child care plan at all, to Rowe-Finkbeiner, having both nominees take up the cause is a “no-brainer.”

“Any candidate who wants to win needs to take up family economic security policies, including child care,” she said. “Democrats and Republicans alike know that there is a child care crisis in America. Having a baby right now costs over $200,000 to raise from zero to age 18, not including college …. Parents of all political persuasions are talking about this.”

Coming up with the right way to address those issues, however, may take some work.

“We need a bold plan because child care is so important, because it helps families work, and it helps them support their children,” the NWLC’s Blank said. “We don’t have a safety net for families to fall back on anymore. It’s really critical to help families earn the income their children need and child care gives children a strong start.” She pointed to the need for programs that offer families aid “on a regular basis, not at the end of the year, because families don’t have the extra cash to pay for child care during the year,” as well as updates to the current child care tax credits offered by the government.

“There is absolutely a solution, but the comprehensive package needs to look at making sure that children have high-quality child care and early education, and that there’s also access to that high-quality care,” Rowe-Finkbeiner told Rewire. 

“It’s a complicated problem, but it’s not out of our grasp to fix,” she said. “It’s going to take an investment in order to make sure that our littlest learners can thrive and that parents can go to work.”

Investigations Media

The ‘HUSH’ Documentary: Another Secret Recording Inside an Abortion Clinic

Sharona Coutts

HUSH relies almost exclusively on interviews with renowned anti-choice “experts” whose work has been discredited. They trot out many of the worn theories that have been rejected by medical and public health experts. The innovation of HUSH, however, is that it has reframed these discredited ideas within the construct of a conspiracy theory.

Another day, another secret recording made in an abortion clinic.

At least, that’s the very strong impression given by some of the scenes contained within the documentary film HUSH, which premiered late last year and is currently making the rounds of film festivals and anti-choice conferences in the United States and internationally, including the National Right to Life Convention that took place in Virginia last month.

The film is the creation of Mighty Motion Pictures and Canadian reporter Punam Kumar Gill, who says in the film that she is pro-choice, a “product of feminism.” It purports to tell the story of “one woman,” Gill, who “investigates the untold effects of abortion on women’s health.”

HUSH—which claims in the film’s credits to have received support from the Canadian government—attempts to cast itself as neither pro-choice nor “pro-life,” but simply “pro-information.” The producers insist throughout the film, in their publicity materials, and in private emails seen by Rewire that their film is objective and balanced.

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That’s how they pitched it to Dr. David Grimes, a highly respected OB-GYN and a clinical professor in the Department of Obstetrics and Gynecology at the University of North Carolina School of Medicine, who agreed to do on-camera interviews for the film. Grimes now says the producers and reporter misled him about their intentions.

“There was no balance,” Grimes told Rewire. “It’s a hatchet job. It’s obvious.”

Indeed, HUSH relies almost exclusively on interviews with renowned anti-choice “experts” whose work has been discredited, many of whom are featured in Rewire‘s gallery of False Witnesses. They trot out many of the worn theories that have been rejected by medical and public health experts—namely, that abortion is linked to a host of grave physical and mental health threats, “like breast cancer, premature birth, and psychological damage.”

The innovation of HUSH, however, is that it has reframed these discredited ideas within the construct of a conspiracy theory.

When Anti-Choice “Science” Goes Conspiracy Theory

As a piece of propaganda, the use of the conspiracy theory has the advantage of removing the debate over abortion’s safety from the realm of logic. In HUSH‘s topsy-turvy world, the medical establishment becomes the scare-quoted “Medical Establishment,” and the more distinguished or authoritative a person or organization, the more suspect they become.

For reasons that remain murky, the film’s thesis is that the world’s leading reproductive and health organizations—including the National Cancer Institute, the American Cancer Society, the American Congress of Obstetricians and Gynecologists, and the World Health Organization, along with all of their staff, contractors, and affiliated experts—have been hiding information about the risks of abortion.

This is most apparent when the reporter, Gill, tells the viewers that “if women have the right to abortion, they should also have the right to know” about the risks she believes she has identified.

Later, the film shows graphics highlighting the states that have various informed consent laws—some of which are literally called “A Woman’s Right to Know” acts—that force providers to give patients false information about the safety of abortion. Rather than concluding that the authority of the state has been used to mandate that doctors provide medically unsound “counseling” using the very junk science that Gill presents throughout the film, she hews to the back-to-front logic of all conspiracy theories. In her view, the existence of these laws shows that the risks are real, but that the faceless, nameless “they” still won’t let women in on the their deadly secrets.

In Gill’s world, the unwillingness of organizations to speak with her becomes evidence that they are hiding something.

The American Congress of Obstetricians and Gynecologists tells Gill that it won’t fulfill her requests by giving her an interview because the science is settled; Gill sees this as a sign of conspiracy.

“This is where I started to feel equally suspicious of those denying any link,” Gill tells the viewer, her voice floating over inky footage of the U.S. Capitol at night. Lights from the Capitol dance on the velvety surface of the Lincoln Memorial Reflecting Pool, and Gill confides: “I felt like I was digging into something much deeper and darker.”

A comical scene ensues where Gill is astonished to find that turning up with a film crew on the grounds of the National Cancer Institute does not suddenly persuade it to grant her an interview with one of its experts.

“What was going on here?” says Gill in her voiceover. “It was like they really didn’t want any questions being asked.”

In fact, the National Cancer Institute had replied to Gill’s multiple requests with links to its website, which contains the conclusive studies that have long since dispelled the notion that any link exists between abortion and breast cancer. The film shows footage of those emails.

Furthermore, Grimes provided Rewire with copies of emails he had exchanged with the film’s producers during its production, in which he gave them citations to relevant studies and warned them that the work of the anti-choice “experts” they had approached had been thoroughly debunked.

After seeing the film, Grimes emailed the producers inquiring why they hadn’t simply asked him to connect them with additional experts.

“Had you truly wanted more pro-choice researchers to speak to these issues, I could have named scores of colleagues from the membership of the Society for Family Planning and Physicians for Reproductive Health who would have been happy to help,” Grimes wrote in a note he shared with Rewire. “You did not ask. That some organizations like the National Cancer Institute did not want to take part in your film in no way implies a reluctance on the part of the broader medical community to speak about abortion research.”

It seems that Gill—whose online biographies give no indication that she is a scientist—would not have been satisfied in hearing about existing research. She tells the viewers that, in her view, “more study is needed to determine the extent of the abortion-breast cancer link,” and concludes that “to entirely deny the connection is ludicrous.”

In an interview with Rewire, Grimes noted that doing such research would be viewed as unethical by reputable scientists.

“That issue is settled, and we should not waste limited resources that should be directed to urgent, unanswered questions, such as the cause of endometriosis and racial disparities in gynecologic cancers,” he said.

Grimes made his dissatisfaction clear to the producers. He wrote to them: “My inference after viewing the film is that you are suggesting a large international conspiracy of silence on the part of major medical and public health organizations, the motivation for which is not specified.”

The corollary to the suspicion cast over the most reputable research and representative bodies is that the film transforms the marginal status of the anti-choice “experts” into a boon.

Seen through HUSH‘s conspiracy theory lens, the fact that the work of people like Priscilla Coleman, David Reardon, and Angela Lanfranchi is rejected by the medical establishment becomes proof not of the unsoundness of their ideas, but rather that a conspiracy is afoot to silence them.

Instead of presenting this small but vociferous group of discredited activists as outliers—shunned because their theories have no scientific basis, or because they lack any credentials relevant to reproductive or mental health, or because they have repeatedly mischaracterized data—HUSH paints them as whistle-blowing renegades determined to set the truth free.

A tearful Lanfranchi recounts the story of patients who came to her with aggressive breast cancer in their 30s. Lanfranchi says she strove to understand “why this was happening,” and realized that each of these young women had had abortions, which she then concluded had caused their cancer. Lanfranchi said her hopes that the public would learn of this risk were dashed over time.

“Over the years I’ve realized that, no, it didn’t matter how many studies there were,” she tells viewers. “That information was not going to get out.”

Joel Brind says that he has worked with a colleague whom he says he later discovered was pro-choice, but that their views on abortion never came up. “This is about science,” he tells Gill. “This is about the effect on women and whether or not abortion increases the risk of breast cancer. Period.”

Gill asks both Lanfranchi and Brind whether they are trying to “stop abortion,” or whether they “want abortion to go away.” Both answer that all they want is for women to be informed when they exercise their choice.

The film makes no mention of the fact that both have been anti-choice activists for decades; they have each testified in support of anti-choice laws in both legislative and judicial proceedings, and both have participated in the extreme right-wing, anti-choice, anti-LGBTQ World Congress of Families.

To the extent that HUSH acknowledges these activists’ bias, it is couched in a softer light that is linked, implicitly, to their religious views—a reality raised by Grimes in his on-camera interview, in which he notes, accurately, that the anti-choice “intellectuals” often lack the relevant medical or scientific qualifications to do the type of work they purport to do, but that they do tend to share religious convictions that lead them to oppose abortion and contraception.

That allows the producers to imply that the False Witnesses are perhaps victims of discrimination; to suggest that their work is being discounted because of the activists’ religious beliefs, and not because the work itself has been thoroughly debunked. Play the ball, not the man, appears to be the producers’ plea.

It’s a conspiracy theory twilight zone: where medical groups withhold information for reasons so cloudy that they cannot be articulated, but where people who have for years worn their beliefs on their sleeves cannot be evaluated with those political views in mind.

After asserting that she is, herself, pro-choice, Gill says she “finds validity” in the claims of the anti-choice advocates, and that she finds it “sickening” that the “media and health organizations have spent their energies closing the case and vilifying those who advocate in favor of the link, instead of investigating any and all reasons why breast cancer rates among young women have increased and women are dying.”

The producer, Joses Martin, did not answer Rewire’s questions about the experts he and his team had selected, other than to say, “We are very proud of the balanced approach that we’ve taken in this documentary that is neither anti-abortion nor pro-abortion.”

Another Instance of Secret Recordings Made in Abortion Clinics

What troubles Grimes most about the film is not so much that he was cast as the face of an international conspiracy by virtue of being the sole pro-choice physician to appear on camera, but that he may be associated with people who appear to have made secret recordings in at least one abortion clinic.

The footage and audio in question have been heavily edited, and it is difficult to discern what is real from what has been staged or spliced to give certain effects.

Early in the film, Gill is shown standing in the entry path to what the producers identify as a “Seattle abortion clinic.” As she makes her way inside, the footage swaps to guerilla-style, hidden camera shots, which capture wall artwork that appears in some Planned Parenthood clinics. Viewers see Gill’s face in the waiting room, as well as blurs of other people there. The film then swaps to audio recordings without any video footage. Gill can be heard posing as a patient, receiving counseling from a woman who is identified as a “health center manager.” This audio is used twice more during the film.

In Washington state, it is a crime to make audio or video recordings of people without their consent. Similar laws are in place in California, Florida, and Maryland, states where David Daleiden and his co-defendants from the Center for Medical Progress made their surreptitious videos of Planned Parenthood employees and members of the National Abortion Federation.

Grimes asked the producers whether they had obtained permission to make any of those recordings; Rewire asked the producers whether the recordings were in fact made in Seattle.

The producer, Joses Martin, replied to Grimes that he would “not be disclosing the name or location of the clinic or the name of the individual recorded to yourself or anyone else.”

“We have kept this information undisclosed and private both in the film and out of the film to not bring any undue burden on them. We’re certainly not implicating anyone involved of wrong doings, as was the goal in the Center For Medical Progress case,” Martin wrote in an email shared with Rewire.

In an email to Rewire, Martin did not answer our specific questions about the recordings, but asserted, “We did not break any laws in the gathering of our footage.”

Planned Parenthood had no comment on whether the crew had obtained consent to film inside its clinics, or whether Gill had misrepresented herself throughout her conversation with the counselor. Nor did the organization comment on the increasing use of secret recordings by anti-choice activists within its clinics. In a federal suit, Planned Parenthood has sued Daleiden for breaches of similar laws in California, Florida, and Maryland.

The branch of the Canadian government that the producers credited with supporting the film was less sanguine when informed about the apparent use of secret recordings made in American abortion clinics.

The film’s credits say that it was produced “with the assistance of the Government of Alberta, Alberta Media Fund,” but when Rewire contacted that Canadian province to learn why it had funded a piece of anti-choice propaganda, a spokesperson distanced the fund from the film.

“We have entered into conversations with the production company but we do not at this point have a formal agreement in place, and we were not aware that the production had been completed,” the spokesperson said. “We’re not able to comment on any funding because to date we have not funded the project. Thank you for bringing the use of our logo to our attention and we’ll be in touch with the producers to discuss.” The producers did not reply to Rewire’s question about their use of the logo.

Ironically, while the producer, Martin, did reply to emails from both Grimes and Rewire (albeit without answering specific questions), the reporter, Gill, remained silent. She never answered questions about what she knew about the backgrounds of the False Witnesses to whose work she lent such credence. She didn’t respond to our questions about whether she obtained permission to record video or audio within abortion clinics, or where those clinics were located. And she didn’t reply to our questions about the nature of her relationship with the extreme anti-choice group Live Action, who also received a credit at the end of the film.

To a reporter such as Gill, such silence would surely have been deeply suspicious.

Rewire Investigative Reporter, Amy Littlefield, contributed to this report. 

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