RJ100: Reproductive Justice and Obama’s First 100 Days

Emily Douglas

Are your reproductive rights more secure today than they were 100 days ago? How about the human rights of women around the world? Are we making progress toward universal access to basic sexual and reproductive health services, comprehensive sex education and HIV/AIDS prevention and treatment here and abroad? Rewire evaluates whether Obama is making the grade.

Are your
reproductive rights more secure today than they were 100 days ago?  How
about the human rights of women around the world?  Are we making
progress toward universal access to basic sexual and reproductive
health services, comprehensive sex education and HIV/AIDS prevention
and treatment here and abroad?



On the 100th day of the Obama Administration, Rewire
evaluates whether the Administration makes the grade on these and many
other critical sexual and reproductive health issues. After 8 long
years of attacks on sexual and reproductive health and rights here and
abroad, it is clear that the Obama Administration intends to – and indeed
already has begun – to take women’s rights and sexual and reproductive
health seriously.  Even in the first 100 days, progress has already
been made in several critical areas.  We recognize that this period
represents only one-tenth of the entire first term of the Obama
Administration and many changes are in process. For that reason, this scorecard should not be viewed as definitive either in regard to the ultimate outcomes on some of the issues in progress, nor on the issues covered here overall.  We also recognize that
Congress plays a critical role – whether positive or negative – in changing
policy and funding streams.  Nonetheless, we feel it is critical to
measure whether campaign and Administration rhetoric on these issues is
backed up with concrete actions, and how effectively the administration pushes Congress to make good in these same areas.

Toward that end, this scorecard is
the first in a series being launched by Rewire.  We will
continue to evaluate these same issues in coming months and throughout
the course of the Administration.

Access to Contraception: Grade = A-

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We are looking for progress on…

  • Access to
    EC
    for women in the military.
    Military health care facilities are not required to stock EC, even on
    remote bases.  Obama should direct Secretary of Defense Robert
    Gates to make EC available to servicewomen immediately.
  • Full funding of Title X.  Planned Parenthood Federation of America cites a $400 million gap in
    Title X funding, arguing that the for this program budget needs to be increased from
    $300 million to $700 million. In 2006, only about half (54 percent) of those in need of publicly funded birth control actually had access to services provided by Medicaid, Title X and other sources of government funding.
  • The FDA needs to make Plan B available over the counter to all women at risk of unintended pregnancy, irrespective of age.
  • The Administration needs to fully rescind the HHS health care denial regulation, an issue we will monitor closely.

Sexuality Education and Teen Pregnancy Prevention: Grade = C

We are looking for progress on…

  • Zeroing out abstinence-only funding.  There is no reason to continue funding these programs, which have been
    shown to be wasteful, ineffective, propagate harmful gender stereotypes
    and marginalize LGBT youth.  Obama’s 2010 budget should zero
    out abstinence-only funding and create line-item funding of
    comprehensive sexuality education.
  • Passing the Real Act.  The Obama administration must put some muscle
    behind the REAL Act
    ,
    which would for the first time allocate federal money to comprehensive
    sexuality education.
  • Clarification on the role of the White House Advisory Council on Faith-Based and Neighborhood Partnerships. The US has the highest
    teen pregnancy rate of all industrialized countries – it’s a public
    health issue that needs the White House’s attention. But is
    the White
    House Advisory Council on Faith-Based Initiatives really the best place
    to formulate solutions? Without more information, we remain skeptical.

Women’s Economic Equity: Grade = A+

  • The Lily Ledbetter
    Fair Pay Act was the very first bill Obama signed into law.  The Act, which restores women’s rights to
    bring pay discrimination complaints up to 180 days after each discriminatory paycheck, undoes the Supreme Court’s earlier harmful
    ruling that women could only file up to 180 days after the first
    instance of pay discrimination.
  • On March 11, Obama established
    the White House Council on Women and Girls
    .  The Council will assess
    how programs of various government agencies will affect women and girls. It will also focus on pay equity and challenges faced by working
    parents.
  • On February 4, Obama provided crucial support to low-income children and families when he signed into law the expansion of SCHIP, the federal children’s
    health insurance program, to extend coverage to 11 million children.
  • At least 42% of
    jobs created by the stimulus should go to women.

We are looking for progress on…

  • Pay equity.  While Ledbetter
    is an admirable achievement, it only restores pay discrimination law
    to where it was prior to the Supreme Court’s 2007 ruling.  Even
    before Ledbetter vs. Goodyear was decided, women earned only
    $0.77 on the dollar that men earned and needed better pay discrimination
    protections.  The White House should urge Congress to pass the Paycheck Fairness and Fair Pay Acts, which close loopholes and stiffen penalties for wage discrimination.

Global Reproductive
Health:
Grade = A+

  • Shortly after taking
    office, Obama overturned
    the global gag rule
    ,
    which prevented US foreign aid recipients from counseling women about
    the availability of safe abortion services and from advocating for the
    liberalization of abortion laws.
  • The Obama administration restored US contributions to the United Nations Population Fund,
    providing $50 million to the UN agency that funds family planning
    assistance internationally. 
  • Obama’s 2009 budget
    allocates $150
    million over 2008 levels

    for international family planning.

We are looking for progress on…

  • The international
    family planning community has
    asked for $1 billion in family planning funding
    ,
    arguing that that amount is necessary to fulfill unmet need for contraceptives.  Five former directors of the USAID Office for Population
    and Reproductive Health have argued that the USAID population budget be
    increased from $457 million in 2008 to $1.2 billion in 2010, growing
    further to $1.5 billion in 2014 because of the "enormous pent-up and
    unmet growing need."

Domestic AIDS Response: Grade = B

  • The White House has
    unveiled Act Against AIDS
    ,
    a plan to "put the HIV crisis back on the national radar screen,"
    says Domestic Policy Council director Melody Barnes.  The five-year
    communications campaign will partner with African-American community-based
    organizations to promote education, prevention and treatment.
  • The White House named longtime HIV/AIDS health care advocate Jeff Crowley to head the Office of National AIDS Policy, which is charged with developing a National AIDS Strategy.  Crowley’s appointment was widely praised by HIV/AIDS advocates.

We are looking for progress on…

  • A National AIDS Strategy.  Despite campaign
    promises to do so, Obama has not yet articulated a National AIDS Strategy,
    even though 1) the US requires that each PEFPAR focus country have one
    and 2) HIV continues to spread among vulnerable populations lacking
    access to prevention information and services, and many
    of those infected still lack access to treatment.
  • Evidence-based prevention for intravenous drug users.  Obama must work to ensure that effective needle exchange programs receive federal funding.
  • Universal access to prevention education and methods, including for prison inmates.

Global AIDS Policy: Grade = Incomplete

We are looking for progress on…

  • Effective prevention strategies.  Both the White House and Secretary of State Hillary Clinton must instruct the Global AIDS Coordinator to overhaul prevention strategies.  Under the Bush Administration,
    a large share of funding for prevention of sexual transmission went
    to abstinence-only-until-marriage programs which are just as ineffective
    internationally as they are here at home.  These and other restrictions – such
    as the so-called prostitution pledge – have left women, youth, and marginalized
    populations at higher risk of new infections.  Moreover, PEPFAR
    programs are not effectively integrated with broader reproductive and
    sexual health strategies, a mistake in an epidemic that is largely driven
    by sexual transmission.  These and other aspects of PEPFAR policy
    and funding need to be changed as soon as possible.
  • The administration has sent mixed signals on needle exchange, an area in which it promised evidence-based programming.
  • Increased attention to long-term sustainability of the health-care work force, access to affordable drugs and other essential components of effective prevention, treatment and care strategies.

Global Women’s
Rights: Grade = A+

  • Under the Obama
    administration, global women’s rights issues are getting attention
    like never before.  On March 6, Obama
    created the post of ambassador-at-large for global women’s issues
    , naming Melanne Verveer to the position. 
  • Secretary
    of State Hillary Clinton spoke forcefully

    for the role of safe, legal abortion services in comprehensive reproductive
    health care and in women’s equality when testifying before the House
    Foreign Relations Committee.
  • At the UN Commission
    on Population and Development, US State Department Acting Assistant
    Secretary for Population, Refugees, and Migration, Margaret Pollack, told delegates that
    the US
    once again
    supported "universal access to sexual and reproductive health."
    Pollack also affirmed that the US is committed to ratifying CEDAW.
  • U.S. anti-trafficking
    policy is headed in the right direction under Luis deBaca, newly named
    head of the State Department Office of Trafficking in Persons.  DeBaca recognizes that sex trafficking is only one aspect
    of human trafficking, that raids don’t work and that harm reduction
    does.

We are looking for progress on…

  • Integration of women’s rights within and across all areas of development policy and funding.
  • Strong attention to gender equity, women’s rights, and reproductive and sexual health concerns within foreign aid reform legislation.
  • Efforts to respond to and reduce violence against women, and to secure women’s social and economic rights.

Analysis Abortion

Legislators Have Introduced 445 Provisions to Restrict Abortion So Far This Year

Elizabeth Nash & Rachel Benson Gold

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

Mid year state restrictions

 

Signs of Progress

The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedt struck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear. 

Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.

More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.

As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.

071midyearstatecoveragetable

But the Assault Continues

Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:

  • Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
  • Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
  • Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.

071midyearstateeligibilitytable

The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:

  • By the end of June, four states enacted legislation to ban the most common method used to perform abortions during the second trimester. The Mississippi and West Virginia laws are in effect; the other two have been challenged in court. (Similar provisions enacted last year in Kansas and Oklahoma are also blocked pending legal action.)
  • South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
  • Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
  • Oklahoma Gov. Mary Fallin (R) vetoed a sweeping measure that would have banned all abortions except those necessary to protect the woman’s life.

071midyearstateabortionstable

In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.

Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.

News Abortion

Reproductive Justice Groups Hit Back at RNC’s Anti-Choice Platform

Michelle D. Anderson

Reproductive rights and justice groups are greeting the Republican National Convention with billboards and media campaigns that challenge anti-choice policies.

Reproductive advocacy groups have moved to counter negative images that will be displayed this week during the Republican National Convention (RNC) in Cleveland, while educating the public about anti-choice legislation that has eroded abortion care access nationwide.

Donald Trump, the presumptive GOP nominee for president, along with Indiana Gov. Mike Pence (R), Trump’s choice for vice president, have supported a slew of anti-choice policies.

The National Institute for Reproductive Health is among the many groups bringing attention to the Republican Party’s anti-abortion platform. The New York City-based nonprofit organization this month erected six billboards near RNC headquarters and around downtown Cleveland hotels with the message, “If abortion is made illegal, how much time will a person serve?”

The institute’s campaign comes as Created Equal, an anti-abortion organization based in Columbus, Ohio, released its plans to use aerial advertising. The group’s plan was first reported by The Stream, a conservative Christian website.

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The site reported that the anti-choice banners would span 50 feet by 100 feet and seek to “pressure congressional Republicans into defunding Planned Parenthood.” Those plans were scrapped after the Federal Aviation Administration created a no-fly zone around both parties’ conventions.

Created Equal, which was banned from using similar messages on a large public monitor near the popular Alamo historic site in San Antonio, Texas, in 2014, did not respond to a request for comment on Thursday.

Andrea Miller, president of the National Institute for Reproductive Health, said in an interview with Rewire that Created Equal’s stance and tactics on abortion show how “dramatically out of touch” its leaders compared to where most of the public stands on reproductive rights. Last year, a Gallup poll suggested half of Americans supported a person’s right to have an abortion, while 44 percent considered themselves “pro-life.”

About 56 percent of U.S. adults believe abortion care should be legal all or most of the time, according to the Pew Research Center’s FactTank.

“It’s important to raise awareness about what the RNC platform has historically endorsed and what they have continued to endorse,” Miller told Rewire.

Miller noted that more than a dozen women, like Purvi Patel of Indiana, have been arrested or convicted of alleged self-induced abortion since 2004. The billboards, she said, help convey what might happen if the Republican Party platform becomes law across the country.

Miller said the National Institute for Reproductive Health’s campaign had been in the works for several months before Created Equal announced its now-cancelled aerial advertising plans. Although the group was not aware of Created Equal’s plans, staff anticipated that intimidating messages seeking to shame and stigmatize people would be used during the GOP convention, Miller said.

The institute, in a statement about its billboard campaign, noted that many are unaware of “both the number of anti-choice laws that have passed and their real-life consequences.” The group unveiled an in-depth analysis looking at how the RNC platform “has consistently sought to make abortion both illegal and inaccessible” over the last 30 years.

NARAL Pro-Choice Ohio last week began an online newspaper campaign that placed messages in the Cleveland Plain Dealer via Cleveland.com, the Columbus Dispatch, and the Dayton Daily News, NARAL Pro-Choice Ohio spokesman Gabriel Mann told Rewire.

The ads address actions carried out by Created Equal by asking, “When Did The Right To Life Become The Right To Terrorize Ohio Abortion Providers?”

“We’re looking to expose how bad [Created Equal has] been in these specific media markets in Ohio. Created Equal has targeted doctors outside their homes,” Mann said. “It’s been a very aggressive campaign.”

The NARAL ads direct readers to OhioAbortionFacts.org, an educational website created by NARAL; Planned Parenthood of Greater Ohio; the human rights and reproductive justice group, New Voices Cleveland; and Preterm, the only abortion provider located within Cleveland city limits.

The website provides visitors with a chronological look at anti-abortion restrictions that have been passed in Ohio since the landmark decision in Roe v. Wade in 1973.

In 2015, for example, Ohio’s Republican-held legislature passed a law requiring all abortion facilities to have a transfer agreement with a non-public hospital within 30 miles of their location. 

Like NARAL and the National Institute for Reproductive Health, Preterm has erected a communications campaign against the RNC platform. In Cleveland, that includes a billboard bearing the message, “End The Silence. End the Shame,” along a major highway near the airport, Miller said.

New Voices has focused its advocacy on combatting anti-choice policies and violence against Black women, especially on social media sites like Twitter.

After the police killing of Tamir Rice, a 12-year-old Black boy, New Voices collaborated with the Repeal Hyde Art Project to erect billboard signage showing that reproductive justice includes the right to raise children who are protected from police brutality.

Abortion is not the only issue that has become the subject of billboard advertising at the GOP convention.

Kansas-based environmental and LGBTQ rights group Planting Peace erected a billboard depicting Donald Trump kissing his former challenger Sen. Ted Cruz (R-Texas) just minutes from the RNC site, according to the Plain Dealer.

The billboard, which features the message, “Love Trumps Hate. End Homophobia,” calls for an “immediate change in the Republican Party platform with regard to our LGBT family and LGBT rights,” according to news reports.

CORRECTION: A version of this article incorrectly stated the percentage of Americans in favor of abortion rights.