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In Michigan, We’re Facing More Than Just a Class War

Hyde at 40 Physicians on Hyde

In Michigan, We’re Facing More Than Just a Class War

The state of Michigan has been receiving a fair bit of national attention lately, as newly-elected Governor Rick Snyder pushes forward shockingly anti-union, anti-working class legislation, some of which makes Governor Scott Walker’s bill in Wisconsin look tame by comparison. I’ve been on the front lines of the burgeoning movement here–particularly focused on building a more united left– while also working to organize this month’s upcoming Walk For Choice in Detroit. So it was surprising to me to learn that in spite of the degree to which I’ve been scrutinizing these issues, Michigan’s recent proposed anti-choice legislation almost flew  completely under my radar.

In the Lansing State Journal, Louise Knott Ahern offers descriptions of several of the anti-choice bills that have recently been introduced in Michigan. Among other bills not mentioned by Ahern, Senate Bill 13 would alter statutory law such that “The word ‘individual’ shall be construed to mean a natural person and to include a fetus.” House Bill 4433 would provide stricter guidelines for pre-abortion ultrasounds, mandating that an ultrasound be performed no fewer than two hours prior to the beginning of an abortion procedure, and requiring specifically that “The physician or qualified person assisting the physician shall ensure that the ultrasound screen is turned toward the patient to allow her to easily view the active ultrasound image of the fetus” (while still insisting that this constitutes giving women “an option” to view the ultrasound), as well as mandating that the most high-tech and visually accurate ultrasound possible be used. Particularly frightening when considering these proposals is the high level of support for anti-abortion measures in Michigan’s current state government: 76 percent of the Senate is anti-choice or mixed, and 71 percent of the House is anti-choice, mixed, or unknown. In Ahern’s words, “Michigan anti-abortion activists are taking advantage of what they consider the friendliest state government in decades,” proposing legislation with the potential to render Michigan one of the most restrictive states in the nation with regard to abortion rights.

I care deeply about the issues facing the working class both here in Michigan and around the country, and it is my hope that the people of Wisconsin inspire others to build strong movements to protest injustices across the nation. But as we mobilize to speak out in the name of social justice, we cannot become so singularly focused that we forget to include the basic rights and freedoms of women. Now is perhaps the perfect time to inject a more holistic analysis into working-class struggle—for those of us who are passionately defensive of reproductive rights to send the message that issues of class and reproductive politics in America are intricately interwoven. Working-class women are disproportionately likely to need access to abortion; the conservative leadership in Michigan is at once proposing to make working-class motherhood more financially challenging—by removing our Earned Income Credit for working families, placing limits on eligibility for cash assistance programs for families, and mandating paycuts and privitizations that will harm all public workers—while at the same time placing further restrictions on whether one is to become a mother in the first place. It is a perfect reflection of a right-wing agenda that calls itself “pro-life” while constantly slashing funding for any programs that strive to improve the lives of those most in need.

The hundreds of thousands of protesters in Madison have it right: we need to get angry, to stand up and unite and fight back. But in doing so, let’s not allow reproductive rights to fall by the wayside. Let’s take this opportunity—a climate of reinvigorated energy for protest and struggle—to fight for all of our rights.

Increasing Access to Health Insurance for Young Adults: An Unheralded Benefit of Health Reform

Originally published at MomsRising.org.

Young adulthood marks a period of life transition that impacts the availability of health insurance. College and university students often lose health insurance upon graduation, young adults are more likely to have low-wage and entry-level positions that do not offer health benefits, and many young adults lack the financial resources required to independently purchase health insurance. As a result of these dynamics, young adults ages 18 to 29 have long been disproportionately uninsured, and uninsured for longer periods of time, when compared to those in other age groups.

Being able to stay on a parental health plan as a dependent provides young adults with an important mechanism to weather transitions and retain health insurance coverage. But before last September, when a young adult “aged out” of being able to stay on a parental plan varied by state and many states placed restrictions on which young adults could qualify as dependents. As a result of the Affordable Care Act (ACA), young adults across the country are now able to remain as a dependent on a parental plan, and therefore retain health insurance, until the age of 26.

But why is this important? After all, young adults are a relatively “healthy” population. Why should expanding health insurance options to this population be prioritized?

For many young women, the answer is contraception. Young adult women are at especially high risk for unintended pregnancy. Women in their twenties account for more than half (54 percent) of all unintended pregnancies in the US, and in 2001 there were more than 1.4 million unintended pregnancies among 18 to 24 year olds. Promoting access to and consistent and correct use of effective methods of contraception is critical for both reducing unintended pregnancy among this age cohort and fostering women’s reproductive autonomy.

And a woman’s health insurance status has a significant impact on her use of contraception. Studies have repeatedly shown that women with health insurance are more likely to use prescription contraceptives than uninsured women. That women who are uninsured often use less effective non-prescription methods (like condoms) or no contraception at all is hardly surprising; for many women paying out of pocket for the pill each month or incurring the upfront costs associated with getting an IUD is prohibitively expensive. A recent study by Ibis Reproductive Health in Massachusetts found that continued enrollment in a health plan that offered affordable contraceptive coverage was a key factor in shaping young women’s decisions about contraceptive use and method selection.

On September 23, 2010, a provision of the ACA quietly went into effect that offers young adults an important mechanism for obtaining or retaining health insurance. The ACA reformed the dependency statutes such that most young adults can now remain on a parent’s private health insurance plan until their 26th birthday. This includes young adults who are students as well as those who aren’t, young adults who are single or those who are married, and young adults who live with their parents and those who don’t. A young adult can be eligible as a dependent with respect to a parental health plan even if that same young adult isn’t considered a dependent for tax purposes. And the ACA only established a federal minimum; a number of individual states extend dependency coverage to young adults age 26 and older.

Of course, dependency statute reforms don’t affect or address the needs of all young adults and these reforms don’t necessarily translate into health insurance that is affordable or comprehensive. But the ACA marks an important step in meeting young adults’ health insurance needs in general and expanding access to contraception in particular. As a result of the ACA, as many as 2.12 million young adults will be newly covered by a parental plan by the end of 2011. However, in order for young adults to take full advantage of the dependency statute changes, we need to increase awareness among young adults and their parents about these reforms.

Increasing access to preventive health services is at the core of the ACA and young adults are among the many populations poised to benefit from reform. The one-year anniversary of the ACA represents an important moment, one that both allows us to recognize the gains we have made and inspires us to redouble our efforts to make affordable, high-quality, and comprehensive health care a reality for all.

Morning Roundup: Racist Anti-abortion Flyers at Princeton Theological Seminary

The WHO lists 30 essential drugs for maternal and child health, Montanans don’t want to ban abortion, Princeton Theological Seminarians upset by distribution of racist flyers, and health care reform turns one!

  • The World Health Organization has released a list of 30 medications that it deems essential for maternal and child health.
  • A recent poll in Montana shows that citizens there do not want to ban abortion. Fifty-six percent opposed a proposal to amend the state constitution banning the procedure, while 35 percent support such a measure.
  • Students at Princeton Theological Seminary are upset by the distribution of racist anti-abortion flyers at the school. CBS News reports that, “Among the fliers was one that displayed a noose and another with the words ‘in the new klan lynching is for amateurs.’”  The American Independent reports that Life Dynamics, based in Texas, is responsible for at least some of the flyers, which advertise a DVD linking abortion and slavery.
  • Happy Birthday Health Care Reform! You’re one-year-old today!

Mar 22

One Year Later: Protecting the Gains, Correcting the Flaws of Health Care Reform

The Patient Protection and Affordable Care Act (ACA) became law in March 2010, bringing with it onerous abortion restrictions but also the promise—and in some instances already the reality—of substantial improvements in insurance coverage for various reproductive health services. Still, reproductive health advocates will face three main tasks as they seek to hold on to these gains: fending off repeated attacks from health care reform opponents, working with federal and state policymakers to implement key provisions of the law, and fixing the things that health reform got wrong.

Among the most important early provisions of health care reform that went into effect in September 2010 is one requiring all new private health plans to cover a range of preventive health services without any out-of-pocket costs to consumers. The initial list of protected services includes many related to reproductive health, including breast and cervical cancer screening, screening and counseling for HIV and other STIs, and HPV vaccination.

This list will expand later this year, when the Department of Health and Human Services issues a set of new guidelines for women’s preventive health care that may include contraceptive counseling, services and supplies. Supported by a strong body of evidence, contraceptive services have long been recognized by government bodies and private-sector experts as a vital and effective component of preventive care. Contraceptive use helps women avoid unintended pregnancy and space their births, which in turn helps improve maternal and child health. And insurance coverage without cost-sharing is an inexpensive—or even cost-saving—way of helping women overcome obstacles to effective contraceptive use.

Another notable new feature allows states to expand Medicaid coverage specifically for family planning services to women and men otherwise ineligible for the program. This provision builds on the experiences of the 22 states that have already expanded coverage via a burdensome “waiver” process—which the legislation now allows states to avoid. The potential gains for women, families and society are enormous.

Even more significant gains are yet to be realized. Starting in 2014, the health reform law will expand insurance coverage and patient protections to tens of millions of Americans through a historic expansion of Medicaid and the establishment of new health insurance “exchanges” that will help individuals and small businesses purchase private insurance with federal subsidies. All of this should make family planning, maternity and STI services more affordable and accessible. In fact, the law has already expanded coverage for young adults by requiring private plans to extend dependent coverage to adult children younger than age 26. This provision should improve coverage and access to sexual and reproductive health care among young adults, the group most at risk for unintended pregnancy and STIs.

Yet, implementation of the overhaul faces several major, intertwined challenges. These include a historic budget crisis affecting Medicaid—which would see an influx of new participants under health care reform—and other health programs. Another major challenge is the shift in political power following the November 2010 elections, which swept into office opponents of health care reform at both the federal and state level. They have already launched a number of attacks on the legislation generally and the gains for reproductive health services specifically.

While fending off these attacks, reproductive health advocates will need to work with federal and state policymakers to promote the optimal implementation of key provisions of health care reform. This includes setting up the major infrastructures of health care reform—including the structure and authority of the upcoming health insurance exchanges, the scope of the benefits package to be required under plans for individuals and small businesses, and the expansion of Medicaid—so that it works for both individuals and safety-net providers seeking to meet the expected surge in demand.

Finally, reproductive health advocates face an uphill struggle in convincing Congress to fix problems in health care reform. In particular, extending Medicaid coverage brings with it an unprecedented expansion in the reach of the decades-old Hyde amendment, which prevents federal Medicaid dollars from going toward abortion coverage (except in the most extreme circumstances). More than two-thirds of new Medicaid enrollees are projected to be residents of states that have not countered this ban by using state revenues. Further, while private insurance plans on the exchanges may include abortion coverage, the law includes so many administrative hurdles that—combined with attacks on abortion coverage by state policymakers—it may end up dissuading insurers from offering the coverage at all.

Other shortcomings severely limit coverage options for millions of immigrants. Despite the major expansion to Medicaid under health reform, Congress refused to eliminate the long-standing policy that bars federal support for undocumented immigrants and recent legal immigrants under that program. In fact, undocumented immigrants are even barred from using their own funds to purchase private insurance plans in the new insurance exchanges.

In short, while some tangible gains for reproductive health have already been made under health care reform—and many important ones are still in the offing—these positive developments should not be taken for granted.

Click here for more information on:

Holding on to health care reform and gains for reproductive health

http://www.guttmacher.org/pubs/journals/j.contraception.2010.12.008.pdf

Florida Files 18 Anti-Abortion Bills This Session

The Florida legislature may not have been making the kind of anti-abortion bill headlines that Ohio or South Dakota has been recently.  But that doesn’t mean they haven’t been one of the busiest states in trying to restrict abortion access.

Via the Miami Herald:

Between a conservative Legislature and a more conservative governor, there’s a concentrated effort this year to tighten Florida’s abortion laws.

From reviving a measure to require a woman to receive an ultrasound before undergoing an abortion to a blanket ban that would pose a legal challenge to Roe v. Wade, at least 18 bills are filed.

“It’s an unprecedented year,” said Stephanie Kunkel, executive director of the Florida Alliance of Planned Parenthood Affiliates.

Some of the bills are mainly for show, like an all out ban in the state, which isn’t expected to make it through the senate, while others are the now sadly standard pushes for ultrasounds before an abortion or banning abortion coverage from insurance policies.

The insurance ban, the bill sponsor claims, isn’t about abortion, but simply how people buy insurance.  Yet the committee discussing the ban refused to allow any exceptions for health of the mother or fetus, claiming that could allow too many women to claim whatever they want.  St. Augustine.com reports:

Committee members shot down an amendment filed by Sen. Eleanor Sobel, D-Hollywood, that tried to expand exemptions in the bill from cases when rape or incest is involved to cases where “fetal impairment” could occur.

Republicans on the committee said the term could justify an abortion in almost any case. Opponents said it needs to be there to protect the mother in other instances, but the term should not wear a concrete label because it deals with issues that are very personal.

“That is a condition that needs to be addressed with those physicians and the patient,” said Suzie Prabhakaran, an OB/GYN and medical director at Planned Parenthood in Sarasota. “It’s kind of a case that you know it when you see it.”

Still, even with their 18 bills, Florida isn’t the state proposing the most bills. According to the Miami Herald, that honor belongs to West Virginia, with over 30 bills to restrict abortion.

Murkowski, Brown, Collins Against Eliminating Title X

Although the Republican dominated House has already made its move to eliminate Title X funding from the federal budget, Republicans in the senate are already signalling a willingness to break with their party should there be a vote.

Via UPI.com:

Scott Brown Tuesday became the second Republican in the U.S. Senate to criticize a GOP proposal that would cut funding for Planned Parenthood.

“I support family planning and health services for women,” Brown, R-Mass., said in a statement. “Given our severe budget problems, I don’t believe any area of the budget is completely immune from cuts. However, the proposal to eliminate all funding for family planning goes too far. As we continue with our budget negotiations, I hope we can find a compromise that is reasonable and appropriate.”

Brown joins Sen. Lisa Murkowski, R-Alaska, in opposing a House GOP proposal to slash $300 million in federal grants and aid to Planned Parenthood, The Hill reported. Sen. Susan Collins, R-Maine, also has criticized proposals that would cut funding for other family planning programs.

NARAL Pro-Choice America has already come out thanking Brown for his words:

“Today’s report that Senator Scott Brown has said he will oppose efforts to defund Planned Parenthood and other family-planning centers is a positive first step, and we look forward to seeing his name appear in the ‘no’ column when this vote comes to the Senate floor,” said Nancy Keenan, president of NARAL Pro-Choice America and Andrea Miller, executive director of NARAL Pro-Choice Massachusetts, in a joint statement. “We also call on Senator Brown to stand up for the Commonwealth’s women and oppose other far-reaching and intrusive anti-choice policies as they move from the House to the Senate.”

The House plans to attempt to defund Planned Parenthood and hurt other family planning programs is believed to likely receive little traction in the Democratically held senate, but having a few Republicans also on record as opposing the idea will definitely make those who value reproductive health care breathe a little easier.