Historic Health Reform Bill Passes But At a Price: Women’s Groups Have Mixed Reaction

Jodi Jacobson

Last night, the House of Representatives passed "historic" legislation on health care reform, with a vote of 220 to 215.  Democrats were elated at passage of the bill after months of wrangling. Reactions from women's groups has been deeply mixed.

Last night, the House of Representatives passed "historic" legislation on health care reform, with a vote of 220 to 215. 

The one Republican voting in favor of the bill (and thereby making it a "bipartisan" bill, was Joseph Cao (R-LA), who was
immediately vilified by his Republican colleagues in the House and by
conservatives in the blogosphere who engaged in a Twitter campaign condemning him. Cao is
from a largely Democratic district. 

Democrats were elated at passage of the bill after months of wrangling.

The Huffington Post reports that:

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Cao’s vote was a mere bonus for Democrats, whose spontaneous floor
celebration radically outdid the reaction of the Yankees to winning the
World Series recently. The normally stoic Pelosi had tears streaming
down her cheek. Rep. Rosa DeLauro (D-Conn.) bent over and vigorously
pumped her fist. Arms were thrown in the air; hugs all around.

As the clock hit ten seconds, Democrats counted down the time,
finishing with an even louder cheer as Pelosi read out the tally:

Not even the extreme pro-life amendment could dampen enthusiasm.
"We’ll live to fight that battle," said Rep. Louise Slaughter (D-N.Y.),
a passionate supporter of reproductive freedom. "It took a hundred
years to do health care. Nothing can dim that."

Majority Whip Jim Clyburn (D-S.C.) said it was the hardest vote he’d
ever whipped. "We crossed a threshold tonight," he said. "This was a
tough deal."

Rep. Keith Ellison (D-Minn.), who’d fought for a stronger public
option, was fired up, too. "I’m ecstatic. I think it was great," he
said, before adding that he wasn’t happy with the Stupak amendment or
the weaker public option.


Reaction from women’s groups has been mixed.

Marcia Greenberger, Co-President of the National Women’s Law Center (NWLC) said:

NWLC is both gratified that the House passed this vitally important reform for women and their families, and outraged that anti-choice forces would use this major advance to subvert essential health care for women by taking away women’s ability to purchase coverage for abortion care with their own funds in the health insurance exchanges.

The NWLC will not rest until women have health care reform that meets their essential needs, including their reproductive health care needs. The Center calls on the Administration and the leadership in the House and the Senate to secure that result in the Senate and in Conference. Any other outcome is both dangerous to women’s health and unacceptable.

Page Gardner, founder and President of Women’s Voices Women Vote  (WVWV),  called passage of the House bill "a bold and historic step toward ensuring that all Americans will truly have access to quality, affordable health care.

The passage of the Affordable Health Care for America Act brings the American people one step closer to realizing the promise of a future where no one, including millions of unmarried women, is denied access to health insurance.

Unmarried women —
single, divorced, and widowed — face unique challenges in obtaining
and keeping health insurance.  With less income, jobs that often do not
offer health insurance plans, and without access to coverage provided
by the policy of a spouse, these women often face nearly insurmountable
challenges to obtaining health insurance.

Several statements focused on the cost to women of the Stupak Amendment:

Cecile Richards, President of Planned Parenthood Federation of America condemned " the adoption of the Stupak/Pitts amendment in HR 3962 this evening."

This amendment is an unacceptable addition to the health care reform bill that, if enacted, would result in women losing health benefits they have today. Simply put, the Stupak/Pitts amendment…restrict[s] women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977. 

Planned Parenthood serves three million women every year through its
more than 850 affiliate health centers across the country and has
worked tirelessly on behalf of those patients for affordable, quality
health care.

On behalf of the millions of women Planned Parenthood
health centers serve, the Planned Parenthood Federation of America has
no choice but to oppose HR 3962. The bill includes the Stupak/Pitts
amendment that would leave women worse off after health care reform
than they are today, violating President Obama’s promise to the
American people that no one would be forced to lose her or his present
coverage under health reform.

Debra Ness, President of the National Partnership for Women and Families stated:

Tonight’s vote in the House of Representatives in favor of the
Stupak-Pitts amendment betrays the promise of health care reform. It is
a reckless and unnecessary amendment that would endanger women’s health
and lives. It must not stand.

In voting to block private insurers from using privately paid
premiums and co-pays to cover a legal health procedure that women need,
opponents of choice are trying to use health reform to take away
coverage Americans now have. This amendment breaks the fundamental
promise of reform: that Americans will be able to keep the coverage
they have. And it ignores women’s basic reproductive health needs.

A fair compromise — worked out by Congresswoman Lois Capps —
was in place. It prohibited federal funds from being used to pay for
abortion services, but allowed plans to segregate public and private
funds so they could pay for these services with private premiums and
co-pays. There was no reason for this amendment, except to advance an
extreme ideological anti-choice agenda.

We will work tirelessly to convince lawmakers to remove this
language, and call on President Obama and leaders in both houses to
ensure that it is not in the final bill. Although the legislation
contains measures that can improve women’s health, reform that includes
this amendment would be a broken promise for women and a tainted
victory for the country.

Nancy Keenan, president of NARAL Pro-Choice America, called House
passage of a stunning last-minute anti-choice amendment to health
reform an outrageous blow to women’s freedom and privacy — and she
vowed to fight to remove this provision as the process goes to the

The Stupak-Pitts amendment makes it virtually impossible for private
insurance companies that participate in the new system to offer
abortion coverage to women. This would have the effect of denying women
the right to use their own personal private funds to purchase an
insurance plan with abortion coverage in the new health system — a
radical departure from the status quo. Presently, more than 85 percent
of private-insurance plans cover abortion services.

The Service Employees International Union, which ran a campaign calling on Congress not to treat women as a "preexisting condition," gave an unequivocal thumbs up to the legislation and did not mention the Stupak amendment.

Commentary Contraception

For Students at Religious Universities, Contraception Coverage Isn’t an Academic Debate

Alison Tanner

When the U.S. Supreme Court sent a case about faith-based objections to the Affordable Care Act's contraceptive mandate back to lower courts, it left students at religious colleges and universities with continuing uncertainty about getting essential health care. And that's not what religious freedom is about.

Read more of our articles on challenges to the Affordable Care Act’s birth control benefit here.

Students choose which university to attend for a variety of reasons: the programs offered, the proximity of campus to home, the institution’s reputation, the financial assistance available, and so on. But young people may need to ask whether their school is likely to discriminate in the provision of health insurance, including contraceptive coverage.

In Zubik v. Burwell, a group of cases sent back to the lower courts by the U.S. Supreme Court in May, a handful of religiously affiliated universities sought the right to deny their students, faculty, and staff access to health insurance coverage for contraception.

This isn’t just a legal debate for me. It’s personal. The private university where I attend law school, Georgetown University in Washington, D.C., currently complies with provisions in the Affordable Care Act that make it possible for a third-party insurer to provide contraceptive access to those who want it. But some hope that these legal challenges to the ACA’s birth control rule will reverse that.

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Georgetown University Law Center refused to provide insurance coverage for contraception before the accommodation was created in 2012. Without a real decision by the Supreme Court, my access to contraception insurance will continue to be at risk while I’m in school.

I’m not alone. Approximately 1.9 million students attend religiously affiliated universities in the United States, according to the Council for Christian Colleges and Universities. We students chose to attend these institutions for lots of reasons, many of which having nothing to do with religion. I decided to attend Georgetown University Law Center because I felt it was the right school for me to pursue my academic and professional goals, it’s in a great city, it has an excellent faculty, and it has a vibrant public-interest law community.

Like many of my fellow students, I am not Catholic and do not share my university’s views on contraception and abortion. Although I was aware of Georgetown’s history of denying students’ essential health-care benefits, I did not think I should have to sacrifice the opportunity to attend an elite law school because I am a woman of reproductive age.

That’s why, as a former law clerk for Americans United for Separation of Church and State, I helped to organize a brief before the high court on behalf of 240 students, faculty, and staff at religiously affiliated universities including Fordham, Georgetown, Loyola Marymount, and the University of Notre Dame.

Our brief defended the sensible accommodation crafted by the Obama administration. That compromise relieves religiously affiliated nonprofit organizations of any obligation to pay for or otherwise provide contraception coverage; in fact, they don’t have to pay a dime for it. Once the university informs the government that it does not want to pay for birth control, a third-party insurer steps in and provides coverage to the students, faculty, and staff who want it.

Remarkably, officials at the religious colleges still challenging the Affordable Care Act say this deal is not good enough. They’re arguing that the mere act of informing the government that they do not want to do something makes them “complicit” in the private decisions of others.

Such an argument stands religious freedom on its head in an attempt to impose one group’s theological beliefs on others by vetoing the third-party insurance providers’ distribution of essential health coverage to students, faculty, and staff.

This should not be viewed as some academic debate confined to legal textbooks and court chambers. It affects real people—most of them women. Studies by the Guttmacher Institute and other groups that study human sexuality have shown that use of artificial forms of birth control is nearly universal among sexually active women of childbearing years. That includes Catholic women, who use birth control at the same rate as non-Catholics.

Indeed, contraception is essential health care, especially for students. An overwhelming number of young people’s pregnancies are unplanned, and having children while in college or a graduate program typically delays graduation, increases the likelihood that the parent will drop out, and may affect their future professional paths.

Additionally, many menstrual disorders make it difficult to focus in class; contraception alleviates the symptoms of a variety of illnesses, and it can help women actually preserve their long-term fertility. For example, one of the students who signed our brief told the Court that, “Without birth control, I experience menstrual cycles that make it hard to function in everyday life and do things like attend class.” Another woman who signed the brief told the Court, “I have a history of ovarian cysts and twice have required surgery, at ages 8 and 14. After my second surgery, the doctor informed me that I should take contraceptives, because if it happened again, I might be infertile.”

For these and many other reasons, women want and need convenient access to safe, affordable contraceptives. It is time for religiously affiliated institutions—and the Supreme Court—to acknowledge this reality.

Because we still don’t have an ultimate decision from the Supreme Court, incoming students cannot consider ease of access to contraception in deciding where to attend college, and they may risk committing to attend an university that will be legally allowed to discriminate against them. A religiously affiliated university may be in all other regards a perfect fit for a young woman. It’s unfair that she should face have to risk access to essential health care to pursue academic opportunity.

Religious liberty is an important right—and that’s why it should not be misinterpreted. Historically, religious freedom has been defined as the right to make decisions for yourself, not others. Religious freedom gives you have the right to determine where, how, and if you will engage in religious activities.

It does not, nor should it ever, give one person or institution the power to meddle in the personal medical decisions of others.

Analysis Politics

Paul Ryan Uses Falsehoods Behind Texas HB 2 to Push Yet Another Abortion Restriction

Ally Boguhn

In a CNN town hall Tuesday night, Paul Ryan agreed with an audience member's baseless sentiment that the Supreme Court had struck down “commonsense health and safety standards at abortion clinics" in its Whole Woman's Health v. Hellerstedt ruling.

During a CNN town hall on Tuesday night, House Speaker Paul Ryan (R-WI) pushed falsehoods about the anti-abortion provisions at the center of the recent U.S. Supreme Court decision in Whole Woman’s Health v. Hellerstedt being necessary for patient health and safety. Ryan nonsensically then used the decision as a launch point to promote House Republicans’ Conscience Protection Act, which passed in the House Wednesday evening and supposedly shields those who object to abortion from discrimination. The only things Texas’ provisions and the legislation have in common, however, is that they’re all about blocking access to abortion care.

Town hall audience member and executive director of New Jersey Right to Life Marie Tasy claimed during the event Tuesday that the Supreme Court had struck down “commonsense health and safety standards at abortion clinics,” in its landmark ruling against two provisions—the admitting privileges and surgical center requirements—of Texas’ HB 2.

“Absolutely,” Ryan said in response to Tasy’s remarks. “I agree with that.”

But the provisions of the law in question were not about keeping anybody safe. As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

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Despite this, Ryan then used the falsehood at the center of HB 2 as a call to action for yet another anti-choice restriction: the Conscience Protection Act. After fielding the question from Tasy about how anti-choice issues could be advanced in Congress in the wake of the Court’s decision, Ryan pivoted to claim that the government is “forcing people to conduct [abortion] procedures”:

Actually, tomorrow we are bringing a bill that I’ve been working on called the Conscience Protection Act. I’m pro-life. I think you probably know that. And I would like to think we could at least get consensus in this country that taxpayers shouldn’t be funding abortions. That the government shouldn’t be forcing people to conduct procedures, especially health-care workers, against their own conscience.

Our First Amendment is the right of conscience, religious freedom. Yet our own government today, particularly in California, is violating that right and not allowing people to protect their conscience rights, whether they’re Catholic hospitals or doctors or nurses. Tomorrow we’re bringing the Conscience Protection Act to the floor and passing it. It’s Diane Black’s bill. And it is to give those citizens in America who want to protect their conscience rights their ability to defend those rights. That is one thing we’re doing tomorrow to protect the conscience, because I believe we need to cultivate a culture of life. And at the very least, stop the government from violating our conscience rights.

Ryan would go on to make similar remarks the next day while speaking on behalf of the bill on the House floor, though this time he added that the “bill does not ban or restrict abortion in any way …. All it does is protect a person’s conscience.” 

As Rewire‘s Christine Grimaldi previously reported, the Conscience Protection Act would codify and expand on the Weldon Amendment. According to the Department of Health and Human Services (HHS), the amendment prohibits states that receive federal family planning funding from discriminating against any health care entity-including physicians, health-care professionals, hospitals, and insurance plans, “on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”

The Weldon Amendment currently must be passed each year as part of annual appropriations bills.

Grimaldi noted that the act “would give health-care providers a private right of action to seek civil damages in court, should they face alleged coercion or discrimination stemming from their refusal to assist in abortion care.”

Ryan proposed similar conscience protections as part of his recently released health-care plan, though, as Grimaldi wrote, “the Conscience Protection Act goes a step further, allowing providers to sue not only for threats, but also for perceived threats.”

But those whom Ryan and his colleagues are claiming to defend already have protections that impede access to abortion care, according to critics of the measure.

Ryan, for example, suggested in both his CNN appearance and his House floor speech the next day that California’s requirement that insurance plans must cover elective abortions under “basic health services” violates “religious freedom.” But a June investigation by the HHS Office for Civil Rights into whether California’s requirement violated the Weldon Amendment rejected similar complaints by anti-choice group Alliance Defending Freedom.

“Let’s be very clear—right now, current law says that hospitals, insurers, and doctors may refuse to perform an abortion or provide coverage for abortion, which already greatly limits women’s access to legal procedures,” said Rep. Jan Schakowsky (D-IL) Wednesday, speaking after Ryan on the House floor during remarks before the Conscience Protection Act passed.

“More importantly, when a woman’s health is in danger, providers would not be required to act to protect the health of that mother. This bill would allow them to refuse to … facilitate or make arrangements for abortion if they have a moral objection to it,” continued Schakowsky. “They could also refuse to provide transportation to another hospital if a woman is in distress if that hospital provides abortions.”

Debra L. Ness, president of the National Partnership for Women & Families, explained in a statement following the passage of the legislation in the House that the measure is about blocking access to abortion. “The Conscience Protection Act is dangerous, discriminatory legislation designed to block women’s access to abortion care,” said Ness.

“For example, a hospital could rely on the Conscience Protection Act to turn away a woman in an emergency situation who needs an abortion or refuse to provide a woman information about her treatment options. This legislation is a license for providers to discriminate against women and undermine their access to essential, constitutionally protected health care,” Ness said.