News Contraception

Democrats Seek Permanent Repeal of Global Gag Rule; GOP Seeks to Enshrine it in Law

Jodi Jacobson

This week, Democrat Nita Lowey introduced the Global Democracy Promotion Act, intended to permanently repeal the Global Gag Rule, while the House GOP/Tea Party majority is using every means possible to enshrine it permanently into law.

Yesterday, Congresswoman Nita Lowey introduced the Global Democracy Promotion Act of 2011, a bill that would permanently repeal the Global Gag Rule (GGR), a policy that has been applied and revoked via executive order at each change in the White House, beginning with Ronald Reagan and leading most recently to repeal by President Obama in 2009. 

The GGR prohibits international health care providers from receiving U.S. international assistance for family planning if those organizations use other (non-US) funding to provide abortion counseling, referrals, or services, or seek to change laws regarding abortion care in countries in which abortion is a leading cause of death among women ages 15 to 49.  Access to contraception and to family planning counseling and information helps women and their partners to plan the number and spacing of children they want to have and to avoid unintended pregnancies that lead to abortion.  As such, by denying U.S. international assistance to groups that also provide safe, legal abortion, the GGR actually increases the number of abortions, rather than reducing them.

These facts notwithstanding, as we reported last week, House Republicans are seeking to enshrine the gag rule into law.  First, the included it in the 2012 State Department Authorization bill which passed out of committee last week. This week, apparently not wanting to leave any doubt about their desire and intentions to undermine women’s health and rights to self-determination, House leadership also included language in the House FY2012 appropriations bill that would make the GGR permanent law. And just to be sure, leadership also included in that bill a ban on U.S. support for the United Nations Population Fund (UNFPA) and cuts to international family planning assistance.  The bottom line of all these policies if passed would mean less support for family planning and more constraints on evidence-based programs, at a time when 215 million women worldwide want to plan their families but have no access to contraception, a set of conditions that again, will not reduce the number of abortions.  This bill is expected to be marked up in committee today.

The GDPA would do the opposite, by ensuring under U.S. law that U.S.-funded international family planning programs would be free to deliver services based on public health and medical evidence and in a manner that promotes the basic health and rights of women. In countries where complications of unsafe and illegal abortions are leading killers of women ages 15 to 49, it is irresponsible to say the least to force medical practitioners to remain silent about these issues.

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Lowey is the ranking Democrat on the House State and Foreign Operations Appropriations Subcommittee.  Her bill was introduced with 103 original co-sponsors. 

“A fundamental principle of medical ethics holds that health care providers must deal honestly and openly with patients,” said Lowey upon introducing the bill. 

“However in sixteen of the last twenty-six years, the Global Gag Rule has forced eligible health providers to choose between receiving U.S. aid or upholding their medical obligation to patients.  The Global Democracy Promotion Act would end this counter-productive requirement.”

Lowey’s bill seeks to ensure that “U.S. foreign aid policy promotes the American standards of freedom of speech and democratic participation in other countries, [and would] prevent foreign NGOs from being forced to sacrifice their right to free speech and their obligation to provide truthful, comprehensive information to patients in order to participate in U.S. supported programs,” noted Lowey.

Permanent repeal is critical to create a predictable policy climate for organizations that provide family planning and reproductive health services in poor communities overseas.  Some service providers in poor countries have had their U.S. program funding stopped then restored four times, leaving clinics, patients, doctors, and communities uncertain about prospects for U.S. support.

Organizations such as Planned Parenthood Federation of America, Population Action International and a range of others are supporting the bill and are asking citizens to call their members in support of the GDPA.

News Contraception

Funding Shortfall, Contraception Limits Mar GOP Zika Agreement

Christine Grimaldi

The Obama administration indicated that the latest House-passed Zika package is a non-starter for the president.

The $1.1 billion in Zika funding that Republicans railroaded through the U.S. House of Representatives around 3 a.m. Thursday underfunds the Obama administration’s request and limits access to contraceptive services, even though the disease can be sexually transmitted.

The largely party line 239-171 vote interrupted Democrats’ marathon, raucous sit-in demanding consideration of gun control proposals. House Speaker Paul Ryan (R-WI) called the House back into session shortly after 2:30 a.m. amid shouts of “No bill, no break!”

Rep. Jim McGovern (D-MA) attempted to request a final debate, otherwise known as a motion to recommit, on the conference report for Zika supplemental funding and fiscal year 2017 military construction and veterans affairs funding. The speaker pro tempore presiding over the House at the time instead spoke over McGovern and, in an unusual move, proceeded to a recorded vote without allowing debate on the measure, then adjourned the chamber early for its scheduled July 4 recess.

Congressional negotiators attempted to reconcile the differences between the House’s $622.1 million and the U.S. Senate’s $1.1 billion in Zika funding levels. Senate Appropriations Committee Vice Chair Barbara Mikulski (D-MD) in May called her chamber’s $1.1 billion “a bottom line, not a starting point for negotiations with the House.”

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Mikulski and other Democrats involved in the bicameral Zika negotiations ultimately refused to sign the final conference report (H. Rept. 114-640), slamming the Republican agreement for falling short of the $1.9 billion the Obama administration requested to combat Zika.

Democrats objected to the Zika package’s $750 million in offsets derived from leftover Ebola reserves, unspent Affordable Care Act funding for territories to establish health-care exchanges, and the U.S. Department of Health and Human Service’s administrative fund. “Offsetting emergency spending would set a precedent that will hinder our ability to respond to the next public health crisis, natural disaster, or national security event requiring emergency funding,” House Appropriations Committee Democrats, led by Rep. Nita Lowey (D-NY), said in a statement.

The latest stalemate comes as Zika infections are on the rise in the United States, according to Centers for Disease Control and Prevention (CDC) tracking. The CDC concluded that Zika causes microcephaly, an incurable neurological disorder that impairs brain and skull growth in utero, as well as other severe fetal brain defects.

Online requests for abortion medications have spiked in Latin American countries that issued warnings to pregnant people about Zika-related complications yet outlaw or restrict the procedure, according to a study published Wednesday in the New England Journal of Medicine.

Contraception Restrictions Anger Democrats

Democrats also decried language that they said would restrict access to contraceptive services for women in the United States and Puerto Rico.

Page 118 of the full conference report routes $95 million in Zika funds through the federal Social Services Block Grant program toward public health departments, hospitals, and Medicaid Managed Care clinics. This move “limits access to health care” in a sprawling territory with only 13 Medicaid Managed Care clinics, according to a Democratic summary obtained by Rewire.

“Of the 78 municipalities in Puerto Rico, only 12 include a Medicaid clinic. Twenty-six of the municipalities are not even adjacent to another municipality with a Medicaid clinic, and geographical conditions on the island (e.g., mountains) make travel between certain municipalities difficult,” the summary said. “For many women in Puerto Rico, this bill would make access to contraceptive services more difficult.”

The language also precludes awarding subgrants to outside groups “that could provide important services to hard-to-reach populations, especially hard-to-reach populations of women that want to access contraceptive services.”

Democrats alleged the Zika package takes similar restrictive actions on the international front.

“The Republican conference report does not explicitly prohibit funding for contraceptives or family planning activities in global health activities, but takes away the money, limits the use of funds, and forces USAID to rely on reprogramming which is a mechanism to slow the access to funds,” the summary said.

Specifically, Page 125 of the full conference report directs $145.5 million toward global health programs—nearly 60 percent below the administration’s request, according to the summary. The shortfall, along with a mandate to prioritize funds for mosquito control and vaccines, in effect leaves nothing for contraceptives or family planning programs to prevent sexual transmission of Zika.

Senate Minority Leader Harry Reid (D-NV) called the Republican agreement “more of the same anti-woman” tactics, including repeated votes to defund Planned Parenthood.

“Instead of responding to this emergency that is threatening American women, Republicans are using this awful virus as an excuse for another attack on women’s health,” Reid said on the Senate floor Thursday morning.

Response Indicates Rocky Path Forward

The Obama administration indicated that the latest House-passed Zika package is a non-starter for the president.

“This plan from Congressional Republicans is four months late and nearly a billion dollars short of what our public health experts have said is necessary to do everything possible to fight the Zika virus and steals funding from other health priorities,” White House Spokesperson Josh Earnest said in a statement.

“The fact that the Republican plan limits needed birth control services for women in the United States and Puerto Rico as we seek to stop the spread of a sexually transmitted disease is a clear indication they don’t take seriously the threat from the Zika virus or their responsibility to protect Americans.”

A Senate Democratic aide told Rewire it’s “extremely unlikely this gets through the Senate.”

Although the motion to proceed on the conference report will be privileged and not subject to debate, Republicans still need 60 votes for cloture to end debate on the underlying measure itself, the aide said.

“By preventing the funding from going to Planned Parenthood, suspending environmental safety regs, underfunding veterans, and making cuts from public health programs, Republicans have decided to go their own way and hold Zika funding hostage to their own extreme agenda,” the aide said.

News Law and Policy

House GOP Blocks Troops’ Abortion Care Access

Christine Grimaldi

“This issue is important because so many of our service members who get pregnant, who need an abortion, are finding themselves in really dangerous situations,” said Rep. Jackie Speier (D-CA).

An effort to lift the ban prohibiting military facilities from providing on-site abortion care failed Wednesday in the U.S. House of Representatives.

Reps. Jackie Speier (D-CA) and Marc Veasey (D-TX) sought to enable service members and their dependents to pay out of pocket for abortion care at defense medical facilities (MTFs). Under federal law enacted in 1996, the U.S. Department of Defense cannot provide abortion care at such facilities, even if a pregnant person shoulders the cost, except in cases of rape, incest, and danger to the pregnant person’s life.

Speier during a marathon markup introduced the amendment in the House Armed Services Committee, which considered legislation (HR 4909) setting the fiscal year 2017 parameters for national defense. The National Abortion Federation (NAF), a professional association of abortion providers, sent the committee a provider letter and coalition letter in support of lifting the ban on abortion care in MTFs. NARAL Pro-Choice America offered support via a fact sheet.

The amendment failed by a vote of 37 to 25.

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Speier, prior to the House Armed Services Committee’s vote on her amendment, faulted federal law for preventing service members from exercising the same constitutional right to an abortion as the civilians they protect.

“This issue is important because so many of our service members who get pregnant, who need an abortion, are finding themselves in really dangerous situations,” Speier said.

Service members stationed across the United States face significant hurdles in obtaining abortion care. Ellsworth Air Force Base in South Dakota restricts service members to travel boundaries, but the nearest abortion provider falls outside of that range, Speier said.

“Additionally, challenges both domestically and internationally include disclosing personal health information to their commanding officer in order to travel off base; approval by the unit commander, which might take days or weeks; the need to seek approval of mileage pass; limited or no access to a car; and local facilities abroad that are substandard, unsafe, or have language barriers,” she said. “Members, this is just the right thing to do for our service members.”

Republicans on the committee disagreed. Rep. Trent Franks (R-AZ), the lawmaker behind the anti-choice misinformation campaign to ban so-called sex-selective and race-selective abortions, was among those who condemned the amendment.

Rep. John Fleming (R-LA) touted the exceptions to abortion access codified in federal law. He claimed that many active duty health-care providers would opt out of performing the abortions, forcing the military to hire civilian providers and invest in equipment at the expense of taxpayers. “This will, in effect, create a government-run Planned Parenthood on all of the military bases,” he said.

Fleming said no one is preventing a service member from going off base and using the “great transportation” available to access the abortion facilities that exist in every state. But a recent investigation found that abortion clinics nationwide are shuttering at a dramatic rate.

As a result of state-level targeted regulation of abortion providers laws and, in some instances, anti-choice violence, a Bloomberg report found that at least 162 clinics that provided abortion services have either closed or stopped offering abortion since 2011, with 21 clinics opening during that time. The clinics have closed in 35 states home to a combined population of 30 million women of reproductive age. Missouri is one of five states with only one abortion clinic, as anti-choice state laws have closed all but the Planned Parenthood St. Louis clinic.

Veasey rebutted Fleming by citing the hurdles he has witnessed firsthand after the Texas state legislature passed the “draconian” HB 2. The law has left the state with one legal abortion provider for every one million Texans who could become pregnant. “This burden would be huge on the military women in the state of Texas,” Veasey said.

Speier is a vocal pro-choice advocate in the House. She serves on the GOP-led House select panel targeting fetal tissue research and consistently criticizes the panel’s tactics, as her Republican colleagues continue to rely on the widely discredited smear videos alleging that Planned Parenthood profited from fetal tissue donations.

“You know, this hearing belongs in a bad episode of House of Cards,” Speier said during last week’s inquiry into fetal tissue “pricing.” Republican lawmakers during the hearing repeatedly referred to the sale of “baby body parts” even though an independent third party disproved the heavily edited Center for Medical Progress videos.

NAF officials slammed the anti-choice lawmakers who blocked the amendment.

“This ban on abortion care in MTFs will continue to harm service women and their families until anti-abortion lawmakers allow a women and her doctor, not politicians and JAG Officers [the legal branch concerned with military justice and law], to decide when and where she will be able to obtain the medical care she needs,” NAF President and Chief Executive Officer Vicki Saporta said in a statement. “The House Armed Services Committee should be working to expand access to health care for our service women and their families, not continuing to restrict it.”