Analysis Contraception

The Cost of Contraception in Insurance Plans: What the Data Say

Jodi Jacobson

In 2011, the Department of Health and Human Services examined the issue of just how much it costs insurance companies to cover contraception. Based on data from a wide range of peer-reviewed medical and public health data, the HHS analysis found that it costs more not to provide contraception than it does to provide it. Here's what the analysis said.

See all our coverage of the 2012 Contraceptive Mandate here.

In 2011, the Department of Health and Human Services examined the issue of just how much it costs insurance companies to cover contraception. Based on data from a wide range of peer-reviewed medical and public health data, evidence-based research and actuarial studies as well as prior experience with insurance policies in which contraception is covered without a co-pay, the HHS analysis found that it costs more not to provide contraception than it does to provide it.  HHS concluded:

While the costs of contraceptives for individual women can be substantial and can influence choice of contraceptive methods, available data indicate that providing contraceptive coverage as part of a health insurance benefit does not add to the cost of providing insurance coverage.

HHS guidelines for including contraceptive care and supplies as part of the essential package of primary health care for women were based on this analysis as well as on recommendations to HHS from the Institute of Medicine, which conducted an extensive study, relying on independent physicians, nurses, scientists, and other experts as well as evidence-based research to draw conclusions and formulate its recommendations.

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Here, in brief, is what the cost analysis said.

The Evidence

“Evidence from well-documented prior expansions of contraceptive coverage,” states the HHS issue brief, “indicates that the cost to issuers of including coverage for all FDA-approved contraceptive methods in insurance offered to an employed population is zero.”

In 1999, when Congress required the health plans in the Federal Employees Health Benefits (FEHB) program to cover the full range of FDA-approved contraceptive methods, premiums for 1999 had already been set when the legislation passed. The Office of Personnel Management (OPM), which administers the FEHB program, provided for a reconciliation process for insurers who found this requirement burdensome. But, HHS notes:

[T]here was no need to adjust premium levels because there was no cost increase as a result of providing coverage of contraceptive services.

In other words, no insurance company complained because they found it was to their advantage to provide the service.

This is critical because it is perhaps the best model for the nation in terms of what to expect. The FEHB program is the largest employer-sponsored health benefits program in the United States, and at the time, notes HHS, “it covered approximately 9 million Federal Employees, retirees and their family members and included approximately 300 health plans.”

Likewise a review of a similar mandate in Hawaii found no increase in insurance costs.  In 1999, Hawaii prohibited employer group health plans from excluding contraceptive services or supplies from coverage, requiring them to include FDA-approved contraceptive drugs or devices to prevent unintended pregnancy.

A report on this experience by the Insurance Commissioner of Hawaii concludes that the mandate did not appear to increase insurance costs in any of the four surveyed health plans in Hawaii servicing employer groups.

What do reviews of actuarial data show?

The direct costs of providing contraception as part of a health insurance plan are very low and do not add more than approximately 0.5 percent to the premium costs per adult enrollee, as per studies from three actuarial firms–Buck Consultants, PriceWaterhouseCoopers (PwC), and the Actuarial Research Corporation (ARC)–which estimated the direct costs of providing contraception coverage. 

More recent analysis of actuarial data conducted in July 2011 by the Actuarial Research Corporation and using data from 2010 estimated that contraceptive coverage without a co-pay costs roughly $26 per year per enrolled female.

However, notes HHS, “as indicated by the empirical evidence described above, these direct estimated costs overstate the total premium cost of providing contraceptive coverage.”

When medical costs associated with unintended pregnancies are taken into account, including costs of prenatal care, pregnancy complications, and deliveries, the net effect on premiums is close to zero. One study author concluded, “The message is simple: regardless of payment mechanism or contraceptive method, contraception saves money.

Counting indirect costs–such as time away from work and productivity losses–further reduces the total cost to an employer. 

A model developed by Global Health Outcomes that incorporates costs of contraception, costs of unintended pregnancy, and indirect costs found that covering contraception saves employers $97 per year per employee. Similarly, the PwC actuaries state that after all effects are taken into account, providing contraceptive services is “cost-saving.”

Does providing contraception through public programs also save costs?

Yes.

As HHS notes:

Each year, public funding for family planning prevents about 1.94 million unintended pregnancies, including almost 400,000 teen pregnancies.  Preventing these pregnancies results in 860,000 fewer unintended births, 810,000 fewer abortions and 270,000 fewer miscarriages.  More than nine in 10 women receiving publicly-funded family planning services would be eligible for Medicaid-funded prenatal, delivery, and postpartum care services upon pregnancy.  Avoiding the significant costs associated with these unintended births saves taxpayers $4 for every $1 spent on family planning.

Evidence that expanding access to contraception through Medicaid is unequivocal: Increased access saves taxpayer money.

During the 1990s, HHS states:

…many states implemented Medicaid Section 1115 Family Planning Demonstrations.  An independent evaluation of the experience of six of these states found that all six Demonstrations yielded savings, with annual state savings ranging between $1.3 million in New Mexico and nearly $30 million in Arkansas.

As of August 1, 2010, 27 states, including States like Pennsylvania, Texas, Florida, and Virginia had expanded Medicaid eligibility for family planning services under waivers that stipulated that these expansions be budget neutral.  Based on this experience, the Congressional Budget Office has estimated that expanding family planning to all States would save $400 million over 10 years.

Why would insurance companies provide contraception without a co-pay to their female employees?  The answers are clear.

Culture & Conversation Law and Policy

The Modern Struggle Over Anti-Trans Bathroom Laws Has Its Roots in Decades of Title VII Fights

Jessica Mason Pieklo

Because of Sex: One Law, Ten Cases, and Fifty Years That Changed American Women’s Lives at Work, written by Gillian Thomas, senior staff attorney with the American Civil Liberties Union Women’s Rights Project, goes beyond cases that helped shape workplace anti-discrimination policies. Rather, it focuses on ten key women whose own lives changed the law.

In 1966, Ida Phillips, a single mother working as a waitress, sat down at her kitchen table and wrote a letter to then-President Lyndon B. Johnson. She told him her story: Despite her qualifications, Phillips had been told by a Martin Marietta employee not to apply for an assembly-line position at one of the construction-material company’s manufacturing plant. The job would have paid more than double what she was making as a waitress. It included a pension plan and insurance, benefits unavailable in most female-dominated industries at the time (and which since have only marginally improved.) The reason Phillips was turned away? She was a woman with a preschool child.

That letter, Phillips’ subsequent lawsuit, and her Supreme Court win would help spark a civil rights revolution in the workplace—one with consequences that reverberate today.

So opens Because of Sex: One Law, Ten Cases, and Fifty Years That Changed American Women’s Lives at Workwritten by Gillian Thomas, senior staff attorney with the American Civil Liberties Union (ACLU) Women’s Rights Project. Despite its full title, though, Because of Sex goes beyond cases that helped shape workplace anti-discrimination policies, focusing on ten key women whose own lives changed the law.

Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex, and national origin. And it was Phillips’ case, and the nine others profiled in the book, that would ultimately shape that law into one that, decades later, is an important tool in advancing gender and sex equality. As Thomas explained to Rewire in an interview, Title VII it is not just a foundational piece of civil rights legislation important for its historical effect on workplace equality. In the face of anti-transgender bathroom bills and statewide “religious liberties” legislation sweeping the country, it is a crucial tool for pushing equality forward.

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Thomas’ book is organized along three key themes in employment discrimination law: pregnancy-related workplace policies, gender stereotypes in the workplace, and sexual harassment. Those themes act as an inroad toward thinking more broadly about how, in Thomas’ words, we achieve “substantive equality” in the workplace. They illustrate how early fights over promotions and workplace policies that kept women out of certain jobs due to concerns of harming their potential fertility foreshadowed the legal showdowns over contraception coverage in employee health-care plans in cases like Burwell v. Hobby Lobby and Zubik v. Burwell.

“The subject matter areas that I saw [as a researcher and employment discrimination litigator] were, number one, women’s capacity for pregnancy, and then their subsequent roles as mothers, which, historically, has played a huge role in their second-class status legally,” Thomas told Rewire. “Women of color have always been seen as workers, irrespective of whether they had children, so that’s not an entirely universal stereotype. But I think it’s pretty safe to say that generally pregnancy and motherhood have proven to be enormous conflicts in terms of what equality looks like when you have these distinct differences” in how race and gender are perceived.

Take, for instance, the case of Peggy Young and the question whether an employer can refuse to make on-the-job accommodations for pregnant employees when it does so for nonpregnant employees. Young, another one of the women featured in Thomas’ book, was a United Parcel Service (UPS) “air driver” who became pregnant. When Young told her employer she was pregnant, UPS told her they couldn’t accommodate the light-lifting recommendation made by Young’s medical providers. Instead, UPS told Young, she would have to take unpaid medical leave for the remainder of her pregnancy.

In March 2015, the U.S. Supreme Court ruled against UPS, vacating the Fourth Circuit Court of Appeals ruling that had supported UPS’ policy. The decision produced a new test for assessing pregnancy discrimination claims and sent Young’s case back to the lower courts for another look. Not long after the Roberts Court’s decision, UPS and Young settled the lawsuit, bringing an end to Young’s case.

The decision was a qualified win for advocates. The Roberts Court had accepted Young’s argument that UPS had no legitimate business reason for failing to accommodate her particular request, but the decision went short of ruling businesses must accommodate any pregnancy request.

But Because of Sex doesn’t stop at unpacking overt discrimination like the kind detailed in Young’s 2015 case or Phillips’ one in 1966. The book also takes a look at what the law has described as more “benevolent” kinds of discrimination. These include employment policies designed to “protect” women from endangering possible future pregnancies, such as prohibiting women employees from working jobs where they may be exposed to hazardous chemicals.

“It really all boils down to two issues that we are talking about in all these things,” Thomas explained, when discussing workplace policies that, employers have argued, were put in place to protect their female employees from potentially endangering a pregnancy. “One is [employers] ignoring hazards that apply to men and making women into baby-making machines. And number two is [employers] treating health effects or health hazards on the job as reasons for diminishing women’s opportunities, instead of arming women with information and assuming that they will make the right choice for themselves.”

This disconnect is most apparent in the case of United Automobile Workers vJohnson Controls, Inc., another case Thomas highlights in her book. In 1982, the car battery manufacturer Johnson Controls sent a memorandum to all its employees that said “[w]omen who are pregnant or who are capable of bearing children will not be placed into jobs involving lead exposure or which would expose them to lead through the exercise of job bidding, bumping, transfer or promotion rights.”

The policy amounted to a demotion for many female employees and a closed door for others.

Title VII actually permits employers, in a limited context, to have employment policies that discriminate on their face, such as policies that permit churches to only hire members of the same faith. Johnson Controls argued its policy of keeping women out of certain positions due to employer concerns of health risks to future pregnancies fit within Title VII’s narrow window for permitting explicit discrimination.

The Supreme Court would eventually rule in 1991 that Johnson Controls’ policy violated Title VII because it forced female employees to have to choose “between having a child and having a job,” thereby rejecting the argument made by Johnson Control’s that a woman’s fertility—or infertility—can in most situations be considered a bona fide occupational qualification.

As Thomas noted in her book, “It was no coincidence that fetal protection politics were most prevalent in well-paid, unionized industries from which women historically had been excluded. Indeed they had been excluded precisely because they had been deemed physically unsuited for the dirty, sometimes strenuous work.”

But “in female-dominated fields, though, fetal protection policies made no business sense; they effectively would gut the workforce. That reality apparently trumped any hypothetical harm to employees’ future pregnancies,” Thomas wrote.

In other words, these policies didn’t exist in female-dominated fields.

Johnson Controls may have helped grant women the agency to determine how and when they earned a paycheck with regard to policies targeting their potential fertility, but it hardly ended the debate around when and how employers attempt to diminish women’s opportunities related to their roles as potential mothers. This has played out in the hundreds of lawsuits over the contraception benefit, for example.

In other words, if Johnson Controls had settled the question of whether a woman’s fertility was an appropriate grounds for discrimination, we would not have Hobby Lobby.

Because of Sex draws another connection between the historical fight over Title VII and the contemporary one: How do employers adjust workplace policies around shifting gender norms, and when is it discriminatory if they don’t?

The law asks, “What are women supposed to want to do?” said Thomas in her interview with Rewire. “What work are they able to do? What work do they want to do? [Given] assumptions and stereotypes that are about their abilities, their preferences, their interests and how [they are] conforming to [those] in terms of stereotypes about what femininity is—what [are] women … supposed to look and act like?”

Gender nonconforming behavior, and the manner in which employees experience discrimination as a result of that behavior, is a key component over the debate around transgender rights. But it would take a “shrill” woman and the birth of the notion of “workplace harassment” to get us and the law there first.

By every measure, Ann Hopkins should have been made a partner in the global accounting firm Price Waterhouse. She was smart. Ambitious. Worked hard and constantly outperformed her peers. But it was those very attributes that her male partners deemed “too aggressive” or as evidence that she needed “charm school,” and ultimately used to deny her a partnership that by every objective measure she had earned.

The Supreme Court would ultimately disagree. In 1989, it ruled Hopkins should have been made a partner and that the comments relating to her demeanor amounted to improper gender stereotyping, a violation of Title VII’s sex discrimination provisions.

If Hopkins was initially shut out of workplace advancement due to her defiance of feminine stereotypes, so too are women subjected to on-the-job harassment, as Thomas draws out in Because of Sex. “Sexual harassment didn’t even have a name in 1974, but was such a prevalent force driving women out of the work force, driving them into different jobs [and] subjugating them just generally in terms of the identity as sexual objects on the job,” Thomas further explained in her interview.

1974 was the year Mechelle Vinson first hired a lawyer to represent her in a case against her boss, who was chronically sexually abusing her on the job. But at the time, courts largely wrote off those kinds of complaints as a kind of chasing-around-the-office, and not sexual harassment, or in Vinson’s case, on-the-job rape. As described by Thomas in her book, “throughout the 1970s, many courts responded to complaints about abusive bosses with a collective shrug that conveyed, ‘You can’t blame a guy for trying.'”

“Sexual harassment was such a prevalent force driving women out of the workforce, driving them into different jobs, and subjugating them just generally in terms of the identity as sexual objects on the job,” Thomas told Rewire.

That “you can’t blame a guy for trying” attitude hasn’t completely gone away as far as the federal courts are concerned. After all, in 2013 the Roberts Court in Vance v. Ball State made it even harder for employees to bring workplace harassment suits, and employees still face losing jobs for “being too cute” or having their sexuality be a perceived threat to their employer’s ability to remain professional in the workplace.

Which is why, in the fight over transgender bathroom access in 2016, Title VII should be a powerful force in defeating these latest attempts to stymie social progress. The idea that “you can’t blame a guy for trying” has morphed into “how the hell can we police gender roles if we don’t know where you pee.” That’s thanks almost entirely to the manner in which the law has wrestled with gender stereotypes under Title VII, Thomas explained.

In 2012, the Equal Employment Opportunity Commission (EEOC), the federal agency charged with enforcing workplace anti-discrimination laws, issued the landmark decision Macy v. Holder, which held that employment discrimination based on transgender status was a form of unlawful sex discrimination under Title VII. Then in 2015, it issued a ruling stating that denying employees access to restrooms consistent with their gender identity is also a violation of Title VII. Meanwhile several federal courts of appeals have ruled that Title VII protects against gender identity discrimination.

But the Roberts Court has yet to weigh in.

“I think sexual orientation in a way is the sort of a final frontier” in Title VII litigation, said Thomas. “The court seems really fixated on this idea of analogizing very precisely from Hopkins. In other words, if you look or act in a way that doesn’t conform to gender stereotypes then, OK, [the courts] can understand that’s sex discrimination,” said Thomas. “But if your identity is not conforming to stereotypes in that you, you know, are romantically attracted to someone of your sex, that is harder for [the courts] to get, even though it’s obviously the most obvious manifestation of stereotype.”

This is, in many ways, a fight that started in the workplace—one that eventually got the backing of the Obama administration before becoming a flashpoint of conservative election-cycle politics. Thomas’ book doesn’t close on a prediction of what the next big Title VII fight will be per se, but it is impossible to finish it and not see the narrative threads of the historical fight for workplace equality woven throughout the the contemporary one. Sex. Gender. How the law understands and navigates the two. All this is what makes Thomas’ Because of Sex the closest thing to an assigned reading I can make.

Roundups Politics

The House Freedom Fund Bankrolls Some of Congress’ Most Anti-Choice Candidates

Ally Boguhn

With the 2016 election cycle underway, the political action committee seems to be working tirelessly to ensure the House Freedom Caucus maintains a radical anti-choice legacy.

In its short existence, the House Freedom Caucus (HFC) has made a name for itself through endless efforts to push Congress further to the right, particularly when it comes to reproductive health. Now with the 2016 election cycle underway, the caucus’ political action committee, the House Freedom Fund, seems to be working just as tirelessly to ensure the caucus maintains a radical anti-choice legacy.

Since its founding by Rep. Jim Jordan (R-OH) in January 2015, the group of ultra-conservative lawmakers that make up the caucus has ballooned from just nine members to at least 36 members, as of October 2015, who have confirmed their own inclusion—though the group keeps its official roster secret. These numbers may seem small, but they pack a punch in the House, where they have enough votes to block major legislation pushed by other parts of the Republican party.

And now, the group is seeking to add to its ranks in order to wield even more power in Congress.

“The goal is to grow it by, and I think it’s realistic, to grow it by 20 to 30 members,” Rep. Matt Salmon (R-AZ), one of HFC’s founding members, told Politico in April. “All new members.”

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While the caucus itself reportedly does not endorse candidates, its unofficial PAC has already thrown money behind defending the seats of some of the group’s most notoriously anti-choice members, as well as a few new faces.

According to OpenSecrets.org, the Center for Responsive Politics’ campaign finance database, thus far in 2016, the House Freedom Fund has invested in seven congressional candidates currently vying to keep a seat in the House of Representatives: Rep. Rod Blum (R-IA), Rep. Dave Brat (R-VA), Rep. Tim Huelskamp (R-KS), Rep. Mark Meadows (R-NC), Rep. Scott Desjarlais (R-TN), Rep. Scott Garrett (R-NJ), and Rep. Paul Gosar (R-AZ). The PAC’s website also highlights two candidates hoping to move from their state legislatures to the House: Republican Indiana state senator Jim Banks and Georgia state Senator Mike Crane. The PAC is also backing the Republican candidate for Florida’s 2nd Congressional District, Mary Thomas; and Republican candidate for North Carolina’s 13th Congressional District, Ted Budd.

Rep. Warren Davidson (R-OH), who won a special election in early June to replace former House speaker John Boehner, also received funding from the PAC. He joined the House Freedom Caucus that same week.

The Republican Party actively works to deny access to virtually all forms of reproductive health care, so it is not surprising that the candidates supported by the House Freedom Fund, whose confirmed members are all members of the GOP, share similarly radical views on reproductive rights and health.

Here are some of the House Freedom Fund’s most alarming candidates:

Rep. Rod Blum

Rep. Blum, a freshman congressman from Iowa, considers his opposition to reproductive choice one of the “cornerstones” of his campaign. “It is unconscionable that government would aid in the taking of innocent life. I strongly oppose any federal funding for abortion and I will vote against any of our tax dollars flowing to groups who perform or advocate abortions on demand,” asserts Blum’s campaign site. The Hyde Amendment already bans most federal funding for abortion care.

Blum spent much of his first year in the House attempting to push through a series of anti-choice bills. The representative co-sponsored the medically unsupported Pain-Capable Unborn Child Protection Act, which would have enacted a federal ban on abortion at or beyond 20 weeks of pregnancy, in January 2015. He signed on as a co-sponsor for the failed Life at Conception Act, a so-called personhood measure that would have granted legal rights to fetuses and zygotes, thus potentially outlawing abortion and many forms of contraception, in March of that year. That July, Blum co-sponsored the Defund Planned Parenthood Act of 2015, which would have stripped the reproductive health organization of all federal funding for one year so that Congress could investigate it in the wake of the Center for Medical Progress’ (CMP) discredited videos smearing the provider. 

Blum’s co-sponsorship of anti-choice legislation was accompanied by a long series of like-minded votes throughout 2015, such as a January vote in favor of the No Taxpayer Funding for Abortion Act and Abortion Insurance Full Disclosure Act of 2015, which, among other things, would have made the Hyde Amendment’s annually renewed ban on most federal funding for abortion care permanent. He also voted to block Washington, D.C.’s Reproductive Health non-discrimination law, and in favor of a measure allowing states to exclude from Medicaid funding any health provider that provided abortions, as well as other anti-choice measures.

Blum’s brief time in Congress has been marked by such extremism that Emily’s List, an organization that works to elect pro-choice women, put Blum on their “On Notice” list in July 2015, signaling their intention to prioritize unseating the Iowa Representative. “In less than five months into the 114th Congress, we have seen Representative Blum lead the crusade to restrict women’s access to healthcare, most notably when he cosponsored a national abortion ban,” explained the organization in a press release on its decision to target Blum. “It’s clear that Congressman Blum is more focused on prioritizing an extreme ideological agenda over enacting policies that benefit more women and families in Iowa’s First Congressional District.”

Rep. Dave Brat

Rep. Dave Brat gained notoriety for his win against incumbent representative and then-House Majority Leader Eric Cantor in 2014, a victory considered one of “the biggest political upset[s] in recent memory.” Like many of his HFC colleagues, Brat has co-sponsored several pieces of anti-choice legislation, including the Pain-Capable Unborn Child Protection Act in 2015 and the Conscience Protection Act of 2016, which claimed to “protect” against “governmental discrimination against providers of health services” who refuse to provide abortion care. Brat’s voting record in Congress earned him a 100 percent rating from the National Right to Life Committee.

In April of this year, the Virginia representative signed on to a letter with Senator Ted Cruz (R-TX) and other anti-choice legislators, such as House Freedom Fund candidate Rep. Meadows expressing “serious concerns” about the Food and Drug Administration’s decision to update the label of abortion drug mifepristone to bring it in line with scientific research and evidence-based medicine. Though medication abortions are safe and result in complications in fewer than 0.4 percent of patients, the lawmakers nonetheless claimed that the regulation change could be dangerous, noting that the drug was originally approved during the Clinton administration and demanding a list of information about it.

In the wake of the deadly shooting at a Colorado Springs Planned Parenthood facility in November, when the alleged shooter parroted the same violent rhetoric about the reproductive health organization popularized by the CMP’s discredited videos, many in Congress called for the panel investigating Planned Parenthood to be disbanded and for lawmakers to distance themselves from the videos. Brat, however, saw no reason the anti-choice violence should affect the conservative crusade to shut down access to reproductive health care. “Principles are principles,” Brat said at the time according to the Huffington Post. “They don’t change on a news cycle.”

Rep. Tim Huelskamp

Kansas Rep. Tim Huelskamp has been an anti-choice advocate since graduate school, when, according to the biography provided on his website, he was “active in assisting women in crisis pregnancies” while working toward a doctoral degree at American University. His advocacy continued as he made his way to Congress, eventually leading him to become the congressional “Pro-Life Caucus” whip.

Though he has cast plenty of anti-choice votes, the congressman’s most notable moment when it comes to reproductive rights may be a 2012 speech on the House floor, in when he compared abortion to slavery and accused Planned Parenthood and the Obama administration of being racist. “Perhaps the biggest war against our liberties is the war that is being waged against those that are not here today, the unborn,” claimed Huelskamp. “Besides slavery, abortion is the other darkest stain on our nation’s character and this president is looking for every way possible to make abortion more available and more frequent. And he wants you to pay for it. Even if you disagree with it.”

Huelskamp went on to falsely accuse Planned Parenthood of targeting people of color. “I am the adoptive father of four children, each of them either Black, Hispanic, Native American, and I am incensed that this president pays money to an entity that was created for the sole purpose of killing children that look like mine; a racist organization and it continues to target minorities for abortion destruction,” said the congressman. “Shame on this president and shame on that party.”

It wouldn’t be the last time Huelskamp exploited race in order to promote his anti-choice agenda. In 2015, the Kansas Representative lashed out at those who accepted awards from Planned Parenthood, tweeting that they were supporting a “racist” agenda.

Rep. Mark Meadows

Rep. Mark Meadows, who has a 100 percent rating from the National Right to Life Committee, co-sponsored anti-choice measures such as the House’s 2015 fetal pain bill, the 2015 Life at Conception Act, and the Prenatal Nondiscrimination Act of 2016 (PRENDA). He also once badgered a pregnant doctor testifying during a House committee hearing about the importance of offering maternity coverage through the Affordable Care Act. However, the congressman’s recent vendetta against Planned Parenthood stands out the most.

In July 2015, in the wake of CMP’s deceptively edited videos, Meadows latched onto the discredited films in order to justify defunding Planned Parenthood. “In addition to cutting funding for abortion providers, I strongly urge Congress to investigate the legality of the practices engaged in by Planned Parenthood,” said Meadows at the time.

In September, as Congress faced the looming threat of a possible government shutdown if they didn’t pass a budget bill, Meadows exploited the opportunity to push for Planned Parenthood to be defunded, no matter the cost. With the South Carolina congressman leading the charge, pressure from conservatives to pull funding for the reproductive health-care provider played a role in prompting then-House Speaker John Boehner to resign his position. Meadows was a co-sponsor of the Defund Planned Parenthood Act of 2015, which passed in the House as part of a compromise to narrowly escape the shutdown. 

But Meadows’ quest to attack Planned Parenthood didn’t end there. In September, the congressman also participated in the House Oversight and Government Reform Committee’s hearing to “examine the use of taxpayer funding” by Planned Parenthood and its affiliates, a sham hearing used by the GOP to repeatedly push misinformation about the organization.

Rep. Scott Desjarlais

Rep. Scott Desjarlais, a medical doctor, is perhaps best known for his attempt to pressure his patient, with whom he was having an affair, into having an abortion when she became pregnant. While the congressman has repeatedly run on his anti-abortion credentials, his divorce papers also revealed he had supported his wife in having two abortions. Politico‘s Chas Sisk labeled DeJarlais  “the biggest hypocrite in Congress.”

Desjarlais made headlines again in 2015 for voting for a later abortion ban. A spokesperson for the Tennessee Republican told the Times Free Press that the vote was in accordance with the congressman’s record:

“Congressman DesJarlais was proud to vote in favor of this legislation,” said his spokesman Robert Jameson, who added that DesJarlais has maintained a “100 percent pro-life voting record” during his five years in Congress and “has always advocated for pro-life values.”

Indiana State Sen. Jim Banks

Indiana state Sen. Jim Banks (R-Columbia City) is one of the few candidates backed by the House Freedom Fund that has yet to win federal office, but his time in the state legislature has given him more than ample opportunity to demonstrate his opposition to reproductive health and rights.

Banks’ campaign website highlights the candidate’s “pro-life” position as a key issue for his race for the House, providing an extensive record of his anti-choice credentials and claiming that he is “running for Congress so that northeast Indiana continues to have a strong voice for innocent lives in Washington, D.C.” That page includes a laundry list of campaign promises, including amending the U.S. Constitution to give a fetus legal human rights, which could outlaw abortion and many forms of contraception; banning federal funding for abortion, though such a ban already exists; eliminating federal funding for any organization that performs abortions domestically or abroad; and opposing any change to the Republican platform on abortion.

The state senator’s site goes on to suggest that “it has been far too long since the Supreme Court discovered that women have a ‘right’ to have an abortion,” lamenting that much of the anti-choice movement’s work to shutter access to abortion in state legislatures hasn’t been replicated on a federal level and promising to address the issue if elected.

Included in his anti-choice resumé is a note that both Banks and his wife have been working in the movement to oppose choice since graduating college, when the two joined Focus on the Family, an organization that has spent millions of dollars promoting its extreme agenda, even devoting $2.5 million to run an anti-abortion ad during the 2010 Super Bowl. The two also worked together on the Allen County Right to Life Board of Directors, and Banks’ wife, Amanda, remains the board’s vice president.

But most extreme of all was the legislation Banks spearheaded while in the state legislature, which included several targeted regulation of abortion providers (TRAP) measures. Most recently the state senator sponsored Indiana’s SB 144, a bill that would modify the state’s 20-week abortion ban to outlaw the procedure once a fetal heartbeat could be detected, typically around six weeks’ gestation. In a statement on the bill, Banks claimed the law was needed because it “would protect unborn Hoosiers’ right to life and also includes important women’s health protections.”