This article appears in partnership with The Media Consortium, of which Rewire is a member organization.
It was a roller coaster week
for proponents of the public option. While the Senate Finance Committee
rejected two proposed public option amendments, four of the five
health bills produced by congressional committees include a public
option. The next stage is to put those bills together in a process
called conference, that results in a final piece of legislation that
the House and the Senate will vote on. In this video clip, Marcy
Wheeler tells VideoNation that progressives can continue the fight
for a public option by emulating a tried and true Blue Dog strategy:
Focus on building a bloc of votes, not on flipping the opposition.
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This strategy is working pretty well in the House where dozens of
progressive members have pledged to vote against any bill that doesn’t
include a public option.
In an exclusive audio interview with Tristam Korten, whose two-partseries on
anti-health reform crusader Rick Scott ran in Salon this week, Korten
and I discuss how Scott is personally bankrolling a multimillion dollar
campaign against health care reform.
Who is this man? Scott used to run the largest hospital chain in the
country, until the firm was found to have defrauded Medicare out of $2
billion. Scott was never charged, but he was sent packing in the wake
of the scandal. He has since founded Solantic, a Florida chain of
bare-bones walk-in clinics that profit by offering the uninsured lower
rates than they’d get at the ER. Why are their rates lower? Because
hospitals currently jack up the price of ER visits to compensate for
the fact that so many uninsured patients don’t pay their bills at all.
If we had universal health insurance, everyone would pay the same price
and Solantic wouldn’t seem like such a good deal.
As Korten and I discuss in our interview, Scott has been accused of
discriminating against employees who don’t meet his marketing-driven
image of an attractive, “clean cut,” young staff. Solantic recently
settled out of court with several staffers who said they were fired for
refusing to enforce the company’s biased hiring policies.
Korten’s research was supported by a grant from the Investigative Fund of the Nation Institute.
State legislatures came into session in January and quickly focused on a range of sexual and reproductive health and rights issues. By the end of the first quarter, legislators in 45 states had introduced 1,021 provisions. Of the 411 abortion restrictions that have been introduced so far this year, 17 have passed at least one chamber, and 21 have been enacted in five states (Florida, Indiana, Kentucky, South Dakota, and Utah).
This year’s legislative sessions are playing out on a crowded stage. The U.S. Supreme Court is considering a case involving a package of abortion restrictions in Texas; that decision, when handed down in June, could reshape the legal landscape for abortion at the state level. Moreover, just as state legislatures were hitting their stride in late March, the U.S. Food and Drug Administration revised the labeling for mifepristone, one of the two drugs used for medication abortion. That decision immediately put the issue back on the front burner by effectively counteracting policies restricting access to medication abortion in a handful of states. (Notably, the Arizona legislature moved within days to enact a measure limiting the impact of the FDA decision in the state.)
Progress on Several Fronts
Despite the ongoing attention to restricting abortion, legislators in several states are looking to expand access to sexual and reproductive health services and education. By the end of the first quarter, legislators in 32 states had introduced 214 proactive measures; of these, 16 passed at least one legislative body, and two have been enacted. (This is nearly the same amount introduced in the year 2015, when 233 provisions were introduced.)
Although the proactive measures introduced this year span a wide range of sexual and reproductive health and rights issues, three approaches have received particular legislative attention:
Allowing a 12-month contraceptive supply. Legislators in 16 states have introduced measures to allow pharmacists to dispense a year’s supply of contraceptives at one time; these bills would also require health plans to reimburse for a year’s supply provided at once. (In addition, a bill pending in Maryland would cover a six-month supply.) Legislative chambers in three states (Hawaii, New York, and Washington) have approved measures. Similar measures are in effect in Oregon and the District of Columbia.
Easing contraceptive access through pharmacies. Legislators in 12 states have introduced measures to allow pharmacists to prescribe and dispense hormonal contraceptives. As of March 31, bills have been approved by at least one legislative chamber in Hawaii and Iowa and enacted in Washington. The measures in Hawaii and Iowa would require pharmacist training, patient counseling, and coverage by insurance; the Hawaii measure would apply only to adults, while the Iowa measure would apply to both minors and adults. The new Washington law directs the state’s Pharmacy Quality Assurance Commission to develop a notice that will be displayed at a pharmacy that prescribes and dispenses self-administered hormonal contraception. Under current state law, a pharmacy may prescribe and dispense these contraceptives under a collaborative practice agreement with an authorized prescriber. Oregon has a similar measure in effect. (California, the only other state with such a law, issued regulations in early April.)
Expanding education on sexual coercion. Measures are pending in 17 states to incorporate education on dating violence or sexual assault into the sex or health education provided in the state. A bill has been approved by one legislative chamber in both New Hampshire and New York. The measure approved by the New Hampshire Senate would require age-appropriate education on child sexual abuse and healthy relationships for students from kindergarten through grade 12. The measure approved by the New York Senate would mandate education on child sexual abuse for students from kindergarten through grade 8. And finally, in March, Virginia enacted a comprehensive new law requiring medically accurate and age-appropriate education on dating violence, sexual assault, healthy relationships, and the importance of consensual sexual activity for students from kindergarten through grade 12. Virginia will join 21 other states that require instruction on healthy relationships.
Ongoing Assault on Access to Sexual and Reproductive Health Services
Even as many legislators are working to expand access to services, others are continuing their now years-long assault on sexual and reproductive health services and rights. Restricting access to abortion continues to garner significant attention. However, last year’s release of a series of deceptively edited sting videos targeting Planned Parenthood has swept both the family planning safety net and biomedical research involving fetal tissue into the fray.
Abortion bans. Legislative attempts to ban abortion fall along a broad continuum, from measures that seek to ban all or most abortions to those aimed at abortions performed after the first trimester of pregnancy or those performed for specific reasons.
Banning all or most abortions. Legislators in nine states have introduced measures to ban all or most abortions in the state, generally by either granting legal “personhood” to a fetus at the moment of conception or prohibiting abortions at or after six weeks of pregnancy. Only one of these measures, a bill in Oklahoma that would put performing an abortion outside the bounds of professional conduct by a physician, has been approved by a legislative chamber.
Banning D&E abortions. Legislators in 13 states have introduced measures to ban the most common technique used in second-trimester abortions. Of these, a bill in West Virginia was enacted in March over the veto of Gov. Earl Ray Tomblin (D). A similar measure was approved by both houses of the Mississippi legislature and is being considered by a conference committee. (Kansas and Oklahoma enacted similar laws last year, but enforcement of both has been blocked by court action.)
Banning abortion at 20 weeks post-fertilization. South Dakota and Utah both enacted measures seeking to block abortions at 20 weeks during the first quarter of the year. The new South Dakota law explicitly bans abortions at 20 weeks post-fertilization (which is equivalent to 22 weeks after the woman’s last menstrual period). The Utah measure requires the use of anesthesia for the fetus when an abortion is performed at or after that point, something that providers would be extremely unlikely to do because of the increased risk to the woman’s health. In addition to these new measures, 12 other states ban abortion at 20 weeks post-fertilization.
Banning abortion for specific reasons. In March, Indiana enacted a sweeping measure banning abortions performed because of gender, race, national origin, ancestry, or fetal anomaly; no other state has adopted such a broad measure. The Oklahoma House approved a measure to ban abortion in the case of a fetal genetic anomaly; the state already bans abortion for purposes of sex selection. Currently, seven states ban abortion for the purpose of gender selection, including one state that also bans abortion based on race selection and one that also bans abortion due to fetal genetic anomaly.
Family planning funding restrictions. In the wake of the Planned Parenthood videos, several states have sought to limit funding to family planning health centers that provide or refer for abortion or that are affiliated with abortion providers. These efforts are taking different forms across states.
Medicaid. Measures to exclude abortion providers (e.g., Planned Parenthood affiliates) from participating in Medicaid have been introduced in five states, despite the clear position of the federal Centers for Medicare and Medicaid Services that such exclusions are not permitted under federal law. In March, Florida Gov. Rick Scott (R) signed a Medicaid restriction into law. By the end of the first quarter, measures had passed one chamber of the legislature in Arizona, Mississippi, and Missouri; a measure introduced in Washington has not been considered. (A related measure enacted in Wisconsin in February limits reimbursement for contraceptive drugs for Medicaid recipients.)
Similar attempts by six other states have been blocked by court action since 2010. These measures include laws adopted by Indiana and Arizona as well as administrative actions taken in Alabama, Arkansas, Louisiana, and Texas.
Other family planning funds. Legislators in 13 states have introduced measures to prevent state or federal funds that flow through state agencies from being distributed to organizations that provide, counsel, or refer for abortions; the measures would also deny funds to any organization affiliated with an entity engaging in these activities. Measures in three of these states have received significant legislative attention. In February, Wisconsin enacted a measure directing the state to apply for Title X funds (the state is not currently a grantee under the program); if the state’s application were approved, the measure would ban this funding from going to organizations that engage in abortion care-related activity. A measure that would deny funds to organizations engaged in abortion care-related activity passed the Kentucky Senate in February. A similar measure in Virginia, which would both prohibit an abortion provider from receiving funding and give priority to public entities (such as health centers operated by health departments) in the allocation of state family planning funds was vetoed by Gov. Terry McAuliffe (D) in March.
Related funds. In February, Ohio Gov. John Kasich (R) signed a measure barring abortion providers or their affiliates from receiving federal funds passing through the state treasury to support breast and cervical cancer screening; sex education; and efforts to prevent infertility, HIV in minority communities, violence against women, and infant mortality.
Fetal tissue research. The Planned Parenthood videos have also led to legislation in 28 states aimed at research involving fetal tissue. Measures have passed one legislative chamber in four states (Alabama, Iowa, Idaho, and Kentucky), and new laws have been enacted in four states (Arizona, Florida, Indiana, and South Dakota) in the first quarter alone. All four laws ban the donation of fetal tissue for purposes of research. These new laws are the first to ever ban the donation of fetal tissue. The Arizona law also bans research using fetal tissue, and the new South Dakota law strengthens the state’s existing ban by now considering fetal tissue research as a felony; four other states (Indiana, North Dakota, Ohio and Oklahoma) have similar provisions in effect.
Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.
Senator and presidential candidate Rand Paul (R-KY) announced Tuesday that the Department of Health and Human Services (HHS) would be launching an investigation into "Planned Parenthood’s unconscionable" fetal tissue donation practices.
Senator and presidential candidate Rand Paul (R-KY) announced Tuesday that the Department of Health and Human Services (HHS) would be launching an investigation into “Planned Parenthood’s unconscionable” fetal tissue donation practices.
The letter from HHS on which Paul based his comments makes no such promise.
On Tuesday, the senator released a statement touting a response from HHS Inspector General Daniel Levinson agreeing to an earlier request initiated by Paul and 49 other senators for the department to audit “all fetal tissue research support by HHS, specifically examining the Department’s oversight of contractor and grantee compliance with the laws governing fetal tissue research.”
Speaking of what he deemed to be an “HHS investigation of Planned Parenthood tissue practices,” Paul lauded the department for taking up his cause. “I am encouraged to see the Inspector General take action to investigate Planned Parenthood’s unconscionable practices,” the senator claimed, rehashing discredited claims about the organization.
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Rehashing discredited claims about the organization, Paul wrote that it “deserves not one penny more of our taxpayer dollars, and I am confident this investigation will give further proof of that.”
However, the actual response from Levinson on behalf of HHS did not promise to investigate Planned Parenthood or its practices specifically, instead affirming that the department would undertake an internal audit of all fetal tissue research supported by the department and the National Institutes of Health (NIH)—an agency of HHS—as Paul’s letter had originally requested.
Referring to a past discussion on the topic, Levinson explained that HHS would conduct an internal probe and “interview HHS and National Institutes of Health (NIH) officials” with a “focus on gathering relevant documentation related to policies and procedures for monitoring fetal tissue research activities.”
“Our goal is to obtain information related to fetal tissue research grants, NIH’s monitoring procedures over third-party certifications and those related to the Department’s internal fetal tissue research, and any known violations of Federal requirements,” Levinson continued.
It appears Paul engaged in a bit of wordplay in his rush to promote HHS’ response, suggesting the investigation would be into Planned Parenthood by repeatedly asserting that the probe was into their “practices” and implying the organization was somehow tied to the review. But in truth, Paul’s initial letter simply asked the department for an internal probe of its fetal tissue policies and a review of whether the third-party entities it works with are in compliance with the law—not an inquiry specifically into Planned Parenthood.
Planned Parenthood, for its part, welcomed HHS’ probe of federal fetal tissue research oversight. “We applaud the HHS for this timely review of practices around fetal tissue donation,” Executive Vice President Dawn Laguens said in a statement on the matter. “This work is often critical to lifesaving medical research, and has helped with important breakthroughs, such as the polio vaccine and research into a cure for Alzheimer’s disease.”
The organization’s president, Cecile Richards, also noted the organization would only benefit from the “updated guidance” such a review would grant. “A new review by a blue ribbon panel could help ensure the entire medical community is meeting the highest possible standards for this practice,” Richards said in a statement, according to the Washington Post. “In addition to Planned Parenthood, other health care providers that make tissue donations could benefit from updated guidance.”
Richards also noted that Planned Parenthood had formally asked NIH to conduct a similar review of their policies in June. Pointing to general public confusion over fetal tissue research in the wake of deceptively edited videos released by the anti-choice front group Center for Medical Progress (CMP), Richard’s letter on behalf of Planned Parenthood asked for a “review of the research and the procedures surrounding it by an independent expert panel.”
HHS has already told congressional Republicans, chomping at the bit to indict Planned Parenthood after the CMP’s video release, that the department has no evidence of any violations of fetal tissue laws.
An August letter from Jim Esquea, assistant secretary for legislation at HHS, to Sens. Joni Ernst (R-IA) and Roy Blunt (R-MO) explained that the department knew of no wrongdoing by Planned Parenthood in facilitating the donation of fetal tissue for patients who requested it. The senators had earlier co-sponsored a failed bid to defund Planned Parenthood over CMP’s videos.
“Currently, we know of no violation of these laws in connection with the research done at our agencies,” wrote Esquea to Ernst and Blunt, according toPolitico. “Furthermore … we have confirmed that HHS researchers working with fetal tissue obtained the tissue from non-profit organizations that provided assurances to us that they are in compliance with all applicable legal requirements.”
As Politicofurther reported at the time, although HHS is involved with an extremely small share of fetal tissue research, all of it appears to be in accordance with federal law:
HHS has gotten re-affirmations from government researchers and government-funded researchers that their tissue procurement is done in accordance with the tissue laws. And it got assurances from the companies that provide that fetal tissue to researchers at NIH and FDA that they are obtaining the fetal tissue and organs in compliance with federal laws, the letter says.
HHS also said that research with fetal tissue conducted by NIH accounts for less than 0.1 percent of its total research budget. It didn’t provide whole numbers.
Other investigations led by states and Congress into alleged wrongdoing on behalf of Planned Parenthood and fetal tissue donations have consistently turned up no evidence that the reproductive health provider has broken any law.
Paul’s unwillingness to accept mounting evidence that fetal tissue laws are not being broken may be due in part to his relentless campaign to politicize CMP’s videos in order to push his stringently anti-choice agenda ahead of the 2016 presidential elections. In July, Paul vowed to use the discredited videos in order to defund Planned Parenthood, and in September he implied he would oppose any measure to fund the government that also funded Planned Parenthood.
“I don’t know about the rest of Congress, but I plan on taking a stand and saying, ‘Not one penny more for Planned Parenthood,’” Paul said at a September anti-abortion rally. “I have never voted for any funds for Planned Parenthood, and I never will.”
Planned Parenthood provides basic reproductive health services to an estimated 2.7 million people in the United States who may not otherwise have access to care. Despite making up just 10 percent of all publicly supported safety-net family planning centers, the organization provides contraception for 36 percent of all low-income women who seek these services at such centers, according to analysis from the Guttmacher Institute.
Although politicians often point to the presence of other health-care organizations and clinics to fill the gap should Planned Parenthood be defunded, the organization’s absence would be difficult to fill. Investigations conducted by Rewirerevealed that many of the health-care centers conservatives claim could make up the difference are actually elementary, middle, and high schools; clinics that provide care for homeless people; nursing homes; and other locations ill-equipped to appropriately handle a sudden influx of patients seeking reproductive health services.