Republican efforts to prevent Planned Parenthood of Tennessee from participating in HIV- and syphilis-prevention programs hit a wall recently as a federal judge in Nashville issued a permanent injunction, blocking the defunding law.
The Tennessee law is similar to many other efforts by conservatives around the country to defund Planned Parenthood. Though Planned Parenthood has participated in HIV and syphilis programs for years, successfully and without issue, in December 2011 Tennessee legislators singled out and refused to approve Planned Parenthood’s contracts for those programs moving forward. They did so based on the claim that any money going to Planned Parenthood for any reason funds abortion care in some fashion. Planned Parenthood challenged the action, and in February 2012 a federal district court issued a preliminary injunction that allowed Planned Parenthood to continue its sexually transmitted disease prevention work, ruling that terminating the contracts because of Planned Parenthood’s association with abortion services was likely unconstitutional.
This new ruling, which came last week, affirms the earlier injunction and permanently bars Tennessee officials from disqualifying Planned Parenthood from receiving funding on the basis that the funding goes indirectly to abortion care.
Cecile Richards, president of Planned Parenthood Action Fund, praised the decision in an email statement: “This court ruling means politicians will not be allowed to interfere with people’s access to the critical preventive care that Planned Parenthood health centers provide. This is a victory for the Tennesseans who count on Planned Parenthood for preventive health services and education and should be a warning to legislators in Arkansas and beyond: cutting public funding for Planned Parenthood’s services will not stand. Politicians have no business dictating where women, men, or teens can go for their health care. They should have access to the providers they trust for lifesaving disease testing and education.”
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The fight for comprehensive sexual health programs is far from over, but this latest decision should send a message that ideology cannot trump common sense public-health policy. Too bad the individuals who need to hear that message most clearly aren’t listening.
So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.
So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.
Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.
Signs of Progress
The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedtstruck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear.
Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.
More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.
As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.
But the Assault Continues
Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:
Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.
The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:
South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.
Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.
A coalition of leaders from reproductive rights, LGBTQ, labor, and Latino organizations joined together Friday to speak on the political and legislative records of presumptive Republican nominee Donald Trump and his newly announced running mate, Gov. Mike Pence (R-IN).
“Today Donald Trump doubled down on his hateful anti-LGBTQ agenda by choosing [as] a running mate … a man who has made attacking the rights and dignity of LGBT people a cornerstone of his political career,” said Chad Griffin, president of the Human Rights Campaign, during a press call hosted by the Hillary Clinton campaign. Speaking after news broke that Pence would join Trump’s ticket, Griffin outlined the many ways Pence had previously threatened the well-being of LGBTQ Americans, including voting against nondiscrimination efforts, signing a so-called religious freedom bill in the state, and opposing marriage equality.
“Let’s be clear, the Trump-Pence ticket is the gravest threat the LGBTQ community has ever faced in a presidential election,” said Griffin.
Ilyse Hogue, president of NARAL Pro-Choice America, said that Pence’s selection was “proof positive” that the presumptive Republican nominee was moving to surround himself with “extreme ideologues,” adding that Pence had a track record of enforcing much of the anti-choice rhetoric Trump has wielded during his run for president.
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“Donald Trump has promised to defund Planned Parenthood. Mike Pence actually led multiple efforts to shut down the government just so he could defund Planned Parenthood,” said Hogue. “As governor, he slashed funding for reproductive health-care clinics like Planned Parenthood to such a degree that it resulted in a public health crisis, with an uptick in HIV infections in rural areas of Indiana.”
“Donald Trump said … that he would punish women who had abortions. Under Mike Pence’s watch as governor, Purvi Patel … has been sentenced to 20 years in prison for attempting a home abortion,” continued Hogue.
“We now have two men in the race who don’t seem to get that women are half the workforce, and breadwinners in their families” said Liz Shuler, the secretary-treasurer of workers’ rights organization the AFL-CIO, in response to Pence’s selection. Shuler explained that Pence had voted against equal pay efforts such as the Paycheck Fairness Act and the Lilly Ledbetter Fair Pay Act while in the U.S. House.
Pence also repealed Indiana’s construction wage law, which set a minimum wage for workers on public construction projects, “taking money directly out of the pockets of construction workers,” said Shuler. She compared Pence’s stance on labor issues to similar positions taken by Trump, who has previously claimed wages are “too high” and supports right-to-work laws, which as Rewire has previously reported, “have had negative effects on wages, income, and access to health care for people who work in states that have seen legislators attack collective bargaining.”
Martín Garcia, director of campaigns for the Latino Victory Project, worried about a Trump-Pence ticket’s impact on “Latinos across the country.” Garcia warned that Trump’s plan to deport 11 million people would “tear families and communities apart” and that his proposed border wall could “cost taxpayers millions of dollars.” He added that such policies would be in line with Pence’s rhetoric and policymaking.
During his time in Congress, Pence co-sponsored a measure which would have changed the rules on birthright citizenship, limiting it “to children born to at least one parent who is a citizen, immigrants living permanently in the U.S., or non-citizens performing active service in the U.S. Armed Forces,” according to ABC’s Indianapolis affiliateRTV6.