Will Washington Be First to Hold CPCs Accountable?

Amie Newman

Washington may become first in the nation to establish statewide regulation of "Limited Service Pregnancy Centers," ensuring women know exactly what they will - and won't - get when seeking care.

Late last week two bills with the potential to change the way “crisis pregnancy centers” are regulated were introduced in the Washington State Legislature. The Limited Service Pregnancy Center Accountability Act (SB 5274/HB 1366) targets “Limited Service Pregnancy Centers (LSPCs)” (also known as crisis pregnancy centers) for their historically deceitful practices in the state. Cities from Baltimore, MD to Austin, TX have passed laws regulating crisis pregnancy centers but with these bills Washington could become the first state in the country to regulate the centers statewide.

According to Legal Voice, a Washington State group which provides legal advocacy for women, and a key backer of the legislation, there are 46 such centers in 21 counties operating around the state. The centers pop up to offer “pregnancy care” to mostly lower-income women, with no health insurance. The centers target younger women seeking low-cost or free pregnancy testing, and unbiased pregnancy options or counseling. What women receive from the centers, however, is what the legislation aims to regulate.

The legislation, among other efforts, requires that LSPCs provide accurate information about the services offered. LSPCs generally provide pregnancy testing or, notes Legal Voice, “sometimes ultrasound imaging or sexually transmitted infection testing.”  Still, it hasn’t prevented the centers from positioning themselves as health care providers, luring women in under the guise of “pregnancy care” and then providing false or misleading information about reproductive health care in an effort to steer women away from choosing abortion as an option. To combat these efforts, the bills require centers to disclose that they do not “provide services or referrals for abortion or comprehensive birth control” or “medical care for pregnant women.” The legislation would further require the centers to provide pregnancy test results immediately; many such centers delay delivery of pregnancy test results in an effort to delay a decision to have an abortion, or to deny women the option of a safe, legal abortion completely. 

“A woman facing an unintended pregnancy needs to be able to count on some standards for any care she receives, no matter what reproductive choice she ultimately makes,” said Representative Judy Clibborn, the Prime House Sponsor of the bill.  “Delaying access to pregnancy test results and other personal health information only puts women’s health in jeopardy.”

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The bills also address the disturbing lack of assured medical privacy or access to medical records for the women who utilize the centers, by mandating that the centers may not share health information about women seeking care with any other person, entity or organization without express written permission from the patient first. Currently, LSPCs are under no obligation or mandate to keep women’s health and medical information private.

These are basic guidelines which, for centers hoping to offer care and services to women in need of pregnancy testing and pregnancy options counseling, should be easy to follow. State anti-choice groups, like Human Life of Washington, are claiming that the legislation stomps on the rights of women and girls, “Women and girls are smart, resourceful and capable of making their own decisions about what agencies they want to go to for help with their unplanned pregnancies,” their web site notes. Yet crisis pregnancy centers are notorious for fraudulent practices; setting up shop, for example, right next to a Planned Parenthood health center, attempting to “trick” young women into visiting their center by making the space look similar. In fact, LSPCs have arisen precisely because groups like Human Life of Washington and others believe the opposite – that women are not in fact capable of making their own decisions when faced with an unintended pregnancy but rather need groups to offer a more limited range of options. 

In the face of indecision and vulnerability, LSPCs create an environment which feeds off of young women’s uncertainty, fear and lack of access to affordable, high-quality health care. The centers hone in on younger women and women without adequate resources because they are the easiest to target. Offering free pregnancy testing under the pretense that these centers are medical clinics brings young women in the door; feeding women a steady diet of scare tactics and false “facts” about pregnancy, childbirth, abortion care, and even adoption and parenting keeps them there.

In a report released yesterday, Deceptive Practices of Limited Service Pregnancy Centers, by Legal Voice and Planned Parenthood Votes! Washington, the authors note:

Their primary audience is women facing an unintended pregnancy, and, in particular, vulnerable women who are in their teens or early twenties, or who are receiving public assistance. The services they advertise include free pregnancy tests, “pregnancy options” counseling, and assistance in the form of free packages of diapers and baby clothes.

What these centers do not advertise is that they are not medical clinics; that they are staffed primarily by volunteers who lack medical training; and that they are expressly opposed to abortion and any form of contraception other than abstinence and will not make referrals for these services. In some cases, they will withhold a woman’s private records generated during her visit if they believe the woman will later seek an abortion.

After receiving numerous reports from women who visited these centers over the years, more than ten reports in 2009 alone, the two organizations undertook an investigation. Their primary aim was to uncover whether, in fact, there was a systematic effort, on the part of LSPCs, to prevent women from accessing reproductive health services by using deceptive means. What they found became the basis for the legislation currently before the Washington State Legislature.

Employing trained, volunteer testers, the investigation covered 20 limited service pregnancy centers around the state. The range and depth of misinformation or outright lies offered to the testers would shock even the most hardened health advocate; from providing misleading information to women in order to delay a woman’s decision, to feeding them blatant fabrications about birth control and sexually transmitted infections. The report is a catalogue of dishonesty. But it is the lack of information which the authors acknowledge first and foremost. The majority of the centers, the report notes, “did not inform the tester that the center did not provide abortion or abortion referrals unless explicitly asked. Even when explicitly asked, two centers failed to disclose that they would not provide or refer for abortions.”

One tester told a staff member of Pregnancy Services in Mt. Vernon, WA, outright, that she wanted an abortion. She was not told that the center did not provide abortions but was rather urged to come to the center where they’d provide her with pregnancy results immediately. If there is a reason for lying by omission, aside from an obvious desire to bury legal abortion as an option for women, and not providing potential clients with information upfront that abortion care will not be discussed, information about legal abortion options will not be offered and, foremost, that abortion is not a service provided by the center, it’s hard to see what that is.

According to the report, every single center provided false or distorted information about abortion and pregnancy. Some offered written material which included statements like “abortion causes breast cancer” as well as pamphlets warning women of the distinctly non-diagnostic “post-abortion syndrome” – a condition which does not exist and for which there is no credible evidence to support. Others told young women that if they were already pregnant, Plan B (emergency contraception) would harm the baby.

A teenage girl told the authors of the report that she informed a staff member at a center that she was pregnant and planning on keeping the baby. Sara Ainsworth, Senior Legal & Legislative Counsel for Legal Voice and a lead author of the report, told Rewire that the young girl was told she was “too poor” and “wouldn’t be a good parent;” she told the authors that adoption was pushed because, the center told her, “a lot of teenagers have unhealthy babies…and complicated pregnancies.”

Others did so in order to place barriers between the young women and their legal right to access abortion, purposefully providing incomplete information. A staff member with Care Net in Tacoma told one woman that an abortion could be performed up to the ninth month of pregnancy and another that she could have an abortion anytime “until she went into labor.” Other centers, in fact, claimed legal cover as an excuse for withholding pregnancy test results — telling women that it was illegal for the centers to release the patient’s own results if said woman was planning on “using” the results to then obtain an abortion – a blatant lie, notes Legal Voice. 

Another woman (though Ainsworth points out she’s far from the only one with whom the authors spoke who had this experience) talked about a center which refused to release her own medical records because the woman told the center she’d be using the pregnancy test to access Medicaid coupons (in Washington State, with a positive pregnancy test, a woman can access Medicaid for insurance coverage of abortion care). A staff person at the center who performed an ultrasound on the woman, told her she should wait until she was 12 weeks along, to see if she’d miscarry first.

Let it not be said, however, that limited service pregnancy centers are simply anti-abortion. In fact, the subterfuge extends to contraception and birth control as well.

Staff members at local centers like Care Net and Life Choices also told testers that condoms were ineffective at preventing against AIDS – that the AIDS virus is “so small it goes right through condoms like a grain of rice through a tennis racquet; condoms do not do anything to protect against STDs.”

There are many things the legislation will not do. It will not put LSPCs out of business or force them to provide any services they do not want to provide, or to which they are opposed for any reason.

Ainsworth says, “This will simply require the centers to disclose what they do and don’t offer, in terms of services. At least women will understand what they will get when visiting a limited service pregnancy center.”

It’s a tough year in Washington State for legislation unrelated to the state’s current budget crisis. The state faces a shortfall of $6.5 billion over the next two years so much of the current session is being swallowed up by extraordinarily difficult economic decisions, on the part of the legislators. Does Ainsworth think this legislation has a chance of passing, then?

“The great thing about this legislation is that it’s a chance to effect good policy without costing the state anything. And in the end, it helps ensure people’s heatlh – besides being the morally correct thing to do.”

With 32 co-sponsors so far, the bills seem to have a good chance of passing. Increasingly, regions around the country are reacting to the disastrous consequences of the thousands of unregulated pregnancy centers providing services to unsuspecting and — often times — vulnerable young women. As well, the funneling of abstinence-only money into these centers has provided a federal funding foundation for these centers to keep operating; although Texas has proposed to zero out all funding for its crisis pregnancy centers this legislative session. Holding those centers accountable for providing women with accurate, truthful information about the services provided – and the underlying belief system which fuels those services – is critical to ensuring the health and well-being of women of all ages in Washington State.

Commentary Politics

Democrats’ Latest Platform Silent on Discriminatory Welfare System

Lauren Rankin

The current draft of the 2016 Democratic Party platform contains some of the most progressive positions that the party has taken in decades. But there is a critical issue—one that affects millions in the United States—that is missing entirely from the draft: fixing our broken and discriminatory welfare system.

While the Republican Party has adopted one of the most regressive, punitive, and bigoted platforms in recent memory, the Democratic Party seems to be moving decisively in the opposite direction. The current draft of the 2016 Democratic Party platform contains some of the most progressive positions that the party has taken in decades. It calls for a federal minimum wage of $15; a full repeal of the Hyde Amendment, which prohibits the use of federal Medicaid funding for abortion care; and a federal nondiscrimination policy to protect the rights of LGBTQ people.

All three of these are in direct response to the work of grassroots activists and coalitions that have been shifting the conversation and pushing the party to the left.

But there is a critical issue—one that affects millions in the United States—that is missing entirely from the party platform draft: fixing our broken and discriminatory welfare system.

It’s been 20 years since President Bill Clinton proudly declared that “we are ending welfare as we know it” when he signed into law a sweeping overhaul of the U.S. welfare system. The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 implemented dramatic changes to welfare payments and eligibility, putting in place the Temporary Assistance for Needy Families (TANF) program. In the two decades since its enactment, TANF has not only proved to be blatantly discriminatory, but it has done lasting damage.

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In one fell swoop, TANF ended the federal guarantee of support to low-income single mothers that existed under the now-defunct Aid to Families with Dependent Children (AFDC) program. AFDC had become markedly unpopular and an easy target by the time President Clinton signed welfare reform legislation into law, with the racist, mythic trope of the “welfare queen” becoming pervasive in the years leading up to AFDC’s demise.

Ronald Reagan popularized this phrase while running for president in 1976 and it caught fire, churning up public resentment against AFDC and welfare recipients, particularly Black women, who were painted as lazy and mooching off the government. This trope underwrote much of conservative opposition to AFDC; among other things, House Republican’s 1994 “Contract with America,” co-authored by Newt Gingrich, demanded an end to AFDC and vilified teen mothers and low-income mothers with multiple children.

TANF radically restructured qualifications for welfare assistance, required that recipients sustain a job in order to receive benefits, and ultimately eliminated the role of the federal state in assisting poor citizens. The promise of AFDC and welfare assistance more broadly, including SNAP (the Supplemental Nutrition Assistance Program, commonly known as food stamps) benefits, is that the federal government has an inherent role of caring for and providing for its most vulnerable citizens. With the implementation of TANF, that promise was deliberately broken.

At the time of its passage, Republicans and many Democrats, including President Bill Clinton, touted TANF as a means of motivating those receiving assistance to lift themselves up by their proverbial bootstraps, meaning they would now have to work while receiving benefits. But the idea that those in poverty can escape poverty simply by working harder and longer evades the fact that poverty is cyclical and systemic. Yet, that is what TANF did: It put the onus for ending poverty on the individual, rather than dealing with the structural issues that perpetuate the state of being in poverty.

TANF also eliminated any federal standard of assistance, leaving it up to individual states to determine not only the amount of financial aid that they provide, but what further restrictions state lawmakers wish to place on recipients. Not only that, but the federal TANF program instituted a strict, lifetime limit of five years for families to receive aid and a two-year consecutive limit, which only allows an individual to receive two years of consecutive aid at a time. If after five total years they still require assistance to care for their family and themself, no matter their circumstances, they are simply out of luck.

That alone is an egregious violation of our inalienable constitutional rights to life, liberty, and the pursuit of happiness. Still, TANF went a step further: It also allowed states to institute more pernicious, discriminatory policies. In order to receive public assistance benefits through TANF, low-income single mothers are subjected to intense personal scrutiny, sexual and reproductive policing, and punitive retribution that does not exist for public assistance recipients in programs like Social Security and Supplemental Security Income disability programs, programs that Democrats not only continue to support, but use as a rallying cry. And yet, few if any Democrats are crying out for a more just welfare system.

There are so many aspects of TANF that should motivate progressives, but perhaps none more than the family cap and forced paternity identification policies.

Welfare benefits through the TANF program are most usually determined by individual states based on household size, and family caps allow a state to deny welfare recipients’ additional financial assistance after the birth of another child. At least 19 states currently have family cap laws on the books, which in some cases allow the state to deny additional assistance to recipients who give birth to another child. 

Ultimately, this means that if a woman on welfare becomes pregnant, she is essentially left with deciding between terminating her pregnancy or potentially losing her welfare benefits, depending on which state she lives in. This is not a free and valid choice, but is a forced state intervention into the private reproductive practices of the women on welfare that should appall and enrage progressive Democrats.

TANF’s “paternafare,” or forced paternity identification policy, is just as egregious. Single mothers receiving TANF benefits are forced to identify the father of their children so that the state may contact and demand financial payment from them. This differs from nonwelfare child support payments, in which the father provides assistance directly to the single mother of his child; this policy forces the fathers of low-income single women on welfare to give their money directly to the state rather than the mother of their child. For instance, Indiana requires TANF recipients to cooperate with their local county prosecutor’s child support program to establish paternity. Some states, like Utah, lack an exemption for survivors of domestic violence as well as children born of rape and incest, as Anna Marie Smith notes in her seminal work Welfare Reform and Sexual Regulation. This means that survivors of domestic violence may be forced to identify and maintain a relationship with their abusers, simply because they are enrolled in TANF.

The reproductive and sexual policing of women enrolled in TANF is a deeply discriminatory and unconstitutional intrusion. And what’s also disconcerting is that the program has failed those enrolled in it.

TANF was created to keep single mothers from remaining on welfare rolls for an indeterminate amount of time, but also with the express goal of ensuring that these young women end up in the labor force. It was touted by President Bill Clinton and congressional Republicans as a realistic, work-based solution that could lift single mothers up out of poverty and provide opportunities for prosperity. In reality, it’s been a failure, with anywhere from 42 to 74 percent of those who exited the program remaining poor.

As Jordan Weissmann detailed over at Slate, while the number of women on welfare decreased significantly since 1996, TANF left in its wake a new reality: “As the rolls shrank, a new generation of so-called disconnected mothers emerged: single parents who weren’t working, in school, or receiving welfare to support themselves or their children. According to [the Urban Institute’s Pamela] Loprest, the number of these women rose from 800,000 in 1996 to 1.2 million in 2008.” Weissmann also noted that researchers have found an uptick in “deep or extreme poverty” since TANF went into effect.

Instead of a system that enables low-income single mothers a chance to escape the cycle of poverty, what we have is a racist system that denies aid to those who need it most, many of whom are people of color who have been and remain systemically impoverished.

The Democratic Party platform draft has an entire plank focused on how to “Raise Incomes and Restore Economic Security for the Middle Class,” but what about those in poverty? What about the discriminatory and broken welfare system we have in place that ensures not only that low-income single mothers feel stigmatized and demoralized, but that they lack the supportive structure to even get to the middle class at all? While the Democratic Party is developing strategies and potential policies to support the middle class, it is neglecting those who are in need the most, and who are suffering the most as a result of President Bill Clinton’s signature legislation.

While the national party has not budged on welfare reform since President Bill Clinton signed the landmark legislation in 1996, there has been some state-based movement. Just this month, New Jersey lawmakers, led by Democrats, passed a repeal of the state’s family cap law, which was ultimately vetoed by Republican Gov. Chris Christie. California was more successful, though: The state recently repealed its Maximum Family Grant rule, which barred individuals on welfare from receiving additional aid when they had more children.

It’s time for the national Democratic Party to do the same. For starters, the 2016 platform should include a specific provision calling for an end to family cap laws and forced paternity identification. If the Democratic Party is going to be the party of reproductive freedom—demonstrated by its call to repeal both the federal Hyde and Helms amendments—that must include women who receive welfare assistance. But the Democrats should go even further: They must embrace and advance a comprehensive overhaul of our welfare system, reinstating the federal guarantee of financial support. The state-based patchwork welfare system must be replaced with a federal welfare assistance program, one that provides educational incentives as well as a base living wage.

Even President Bill Clinton and presumptive Democratic presidential nominee Hillary Clinton both acknowledge that the original welfare reform bill had serious issues. Today, this bill and its discriminatory legacy remain a progressive thorn in the side of the Democratic Party—but it doesn’t have to be. It’s time for the party to admit that welfare reform was a failure, and a discriminatory one at that. It’s time to move from punishment and stigma to support and dignity for low-income single mothers and for all people living in poverty. It’s time to end TANF.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (D-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

CORRECTION: A previous version of this article included a typo that misidentified Sen. Tim Kaine as a Republican. We regret this error.