Updated: The State of Choice in Ohio: Lots of Roadblocks, But Also Some Victories Ahead

Robin Marty

What is the state of reproductive health in Ohio? It's on shaky ground, but every anti-choice cloud has a silver lining.

Ohio has been through a lot in recent
years.  The state has been hard hit economically by the recession, and
unemployment skyrocketed into double digits in 2009.  Ohio is beginning to recover
financially, but one thing it may take longer to recover from is the profusion
of anti-choice laws passed within the last year.  Women and families
already suffering due to the economic downturn are finding themselves in even
more difficult circumstances once anti-choice politicians put cutting off
access to basic reproductive health care ahead of caring for the needy.

Access to reproductive health is an important public health issue. According to
NARAL Pro-Choice Ohio, in 2009 half
of all pregnancies in the state were unplanned, and 40 percent of unplanned
pregnancies ended in abortion. Twenty-five percent of all adolescent girls
had a sexually transmitted disease and 16,000 teenage girls gave birth last
year.  Ohio ranks 25th in the country in teen pregnancy rates, a rate that
has increased by 3 percent every year since 2005.

Of course, it’s hard to reduce the number of unintended pregnancies when the
state ranks 48th in the nation for access to contraception. Should a woman have unprotected sex and wish
to avoid pregnancy, she won’t find easy access to emergency contraception as
one-third of pharmacies in the state do not stock  it.  If she then decides she wants an abortion, she had
better hope she lives in or near one of the six cities that have abortion
providers, since she will have to come in, receive legislatively-mandated "consent" information, then leave and return again 24 hours later.

One thing that has kept the anti-choice activists from gaining even more ground
is the state’s governor, Ted Strickland.  As the first pro-choice governor
in Ohio since 1991, Gov. Strickland has been vetoing
anti-choice legislation
, such as the
law passed in 2007 to limit the use of RU 486.  He also eliminated
$500,000 in abstinence-only education funds from the budget that same
year.  This year, Strickland did a line item veto on a provision
prohibiting the funding of stem cell research, much to the chagrin of anti-choice activists.

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Perhaps the biggest victory for those who
support women’s access to reproductive health care is the introduction of the
Ohio Prevention First Act. This legislation requires insurance companies to
cover contraception at the same rate as it would other prescriptions, requires
that sex education taught in schools be medically accurate and contain
information on both contraception and sexually transmitted diseases, creates a
task force focused on the high rate of teen pregnancy, forces hospitals to
provide victims of rape and sexual assault with emergency contraception, and
rules that pharmacists must stock and fill orders for contraceptives without
opting out due to "conscience" issues.

"Prevention-First legislation enabled us to be in a proactive stand, which
was both exciting and quite unusual," said Wendy Leatherberry, a
non-profit consultant active in the pro-choice movement in Ohio.

Other victories include shooting down some more outrageous roadblock bills such
as the "paternal consent" bill introduced by State Rep. John Adams,
R-Sidney.  The bill, which gained little traction in the legislature,
would have required women to obtain permission from the biological father
before having an abortion, and, in cases of more than one partner, the woman
must provide a full list of men with whom she had sex.  Women who lied
about the identify of the potential father or doctors who aborted without
permission from the father would be prosecuted.

"People are very comfortable in the anti-choice world, bolder and more
comfortable with their position of preventing women from getting
abortions," stated Leatherberry.

Ironically, the fate of reproductive health services in Ohio is unclear, but
not because of well-funded anti-choice groups in the state.  The 2010
election will determine who is in charge of realigning the legislative
districts.  Although a vast majority of Ohioans believe in sex ed in
school and more access to contraception, and a small amount more identify as
strongly/somewhat pro choice than strongly/somewhat pro-life, nearly two-thirds
of Ohio’s state senate and over half of its state house is anti or mixed
choice, regardless of party.

Ohio pro-choice advocates underscore that gerrymandering is responsible for the
large number of anti-choice elected officials, a factor they hope can be
changed during the next redistricting.  However, Jennifer Garrison, the state Democratic
Party’s leading candidate
for Secretary of State, who, if elected would be highly influential in the
redistricting process, was also anti-choice, believing abortion should only be
allowed in cases of rape or due to threats to a mother’s health.
Garrison has now left the race, citing too much focus on her anti-choice stance.  Instead, county clerk Maryellen O’Shaughnessy will be filing to run for the party nomination, with the support of Gov. Strickland. Current
Secretary of State Jennifer Brunner, who is pro-choice, is leaving
the position to run for Ohio’s open senate seat
.  Anti-choice forces in the state have
made it clear that they are focusing on even more races, recently
releasing their slate of 2010 pro-life endorsed candidates
.

So with a surge of anti-choice activists from both parties hoping to strengthen
their hold on the legislature and with numerous state-based anti-choice groups
beginning to fight among themselves for donations, Ohio will continue to be a
hotbed of activity throughout the year.

UPDATED to reflect the recent changes in the race for the office of Secretary of State.

Analysis Law and Policy

State-Level Attacks on Sexual and Reproductive Health and Rights Continue, But There’s Also Some Good News

Rachel Benson Gold & Elizabeth Nash

Despite the ongoing attention to restricting abortion, legislators in several states are looking to expand access to sexual and reproductive health services and education.

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.

News Politics

Kasich’s Anti-Choice Policy Blitz Forcing Ohio Women to Seek Abortion Care in Michigan

Ally Boguhn

Since Kasich, a 2016 presidential candidate, took office in 2011, he has quietly led his state to an almost unprecedented number of abortion clinic closures.

Michigan, Ohio’s neighboring state, has seen an influx of nonresidents seeking abortion care in the wake of Republican Gov. John Kasich’s relentless campaign to roll back abortion access, FiveThirtyEight reports.

Since Kasich, a 2016 presidential candidate, took office in 2011, he has quietly led his state to an almost unprecedented number of abortion clinic closures. Analysis of data released by the Michigan Department of Health and Human Services has revealed that many Ohio residents may in fact be turning to the neighboring state for abortion care.

Although Michigan has seen an overall decrease in abortions since 1987, that number has steadily begun to riseand so have the number of nonresidents visiting the state for abortions.

“From 2012 to 2013 abortions rose by 11.6 percent, and from 2013 to 2014 they increased 5.8 percent,” explained FiveThirtyEight in a report profiling Kasich’s anti-abortion legacy in Ohio. “Data from Michigan’s health department shows that the number of abortions performed on nonresidents jumped from 708 in 2013 to 1,318 in 2014, an increase of 86 percent.”

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Ohio was home to 14 clinics two years into Kasich’s first term in 2013, but as they were forced to comply with medically unnecessary licensing regulations, all but eight closed or were forced to stop providing abortion services, as RH Reality Check has reported.

The Associated Press in November uncovered evidence that Kasich’s aides had played a key role in helping craft the same measure that forced the clinic closures, an anti-abortion restriction inserted into the 2014 state budget that was previously attributed solely to the state’s Republican-majority legislature. Emails obtained by the news organization and verified by the governor’s office detailed how members of Kasich’s team had helped write language for the abortion restriction 18 months prior to the state’s budget being released to the public.

Despite often being labeled as a “moderate” Republican presidential candidate, Kasich has overseen the implementation of 16 anti-choice measures, such as a 2011 later abortion ban, and appointed Ohio Right to Life President Michael Gonidakis to the state medical board.

“The slew of new provisions has meant not only fewer options but also more obstacles for women looking to terminate a pregnancy, and in turn it has affected who is able to get an abortion in the state,” FiveThirtyEight reported.

Sheva Guy, a 23-year-old Cincinnati doctoral student, shared her own struggle with obtaining an abortion in Ohio after a second-trimester ultrasound showed that her fetus had a fatal spinal abnormality. In the absence of reliable access to abortion in her home state, where no doctors were willing to do the procedure, Guy was forced to travel more than 300 miles to Chicago and spend $3,000 to receive the care she needed.

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