U.S. Health and Human Services Secretary Kathleen Sebelius, who oversaw both a troubled initial rollout of the Affordable Care Act's website and a surge of higher-than-expected enrollment numbers after those troubles were resolved, is resigning on Friday.
U.S. Health and Human Services Secretary Kathleen Sebelius, who oversaw both a troubled initial rollout of the Affordable Care Act’s website and a surge of higher-than-expected enrollment numbers after those troubles were resolved, is resigning on Friday.
President Obama will nominate Sylvia Mathews Burwell, director of the Office of Management and Budget, to replace Sebelius. White House Chief of Staff Denis R. McDonough told the New York Timesthat Obama wanted “a proven manager and relentless implementer” for the health services job, and that Burwell fit the bill.
Obama stood by Sebelius amid intense public pressure and calls for her resignation after the HealthCare.gov website’s troubled launch. He told NBC News in November that Sebelius didn’t write code and “wasn’t our IT person.”
Shortly before news broke of her resignation, Sebelius was on Capitol Hill testifying that over seven million people have signed up for private insurance through the new exchanges. That’s not including an estimated five million or more people who are now covered through Medicaid or the Children’s Health Insurance Program (CHIP) expansion, and at least 9.5 million people who did not previously hold insurance are estimated to have gained coverage under Obamacare.
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McDonough told the Times that Sebelius is not being forced out, and that she saw the enrollment surge leading into the March 31 deadline as a good opportunity to bow out and let someone who was less of a political target take her place.
Sebelius told the Times on Thursday that she has never expected to “be here to turn out the lights in 2017,” and that her decision to leave was mostly a question of deciding the timing.
Republican Gov. John Kasich this week vowed to sign a measure to defund Planned Parenthood in Ohio, and Sen. Marco Rubio (R-FL) admitted that most people disagree with his anti-choice position on abortion exceptions.
Democratic moderators this week failed yet again to ask the candidates about abortion rights while the candidates couldn’t bring themselves to utter the word “abortion,” Republican Gov. John Kasich vowed to sign a measure to defund Planned Parenthood in Ohio, and Sen. Marco Rubio (R-FL) admitted that most people disagree with his anti-choice position on abortion exceptions.
Democratic Candidates Danced Around Abortion But Never Actually Said It
Yet another Democratic debate has come and gone without a single question about abortion rights—but that doesn’t mean it didn’t come up over the course of the night.
Both Clinton and Sanders made a point of bringing up the topic. The only issue: neither of the Democratic presidential candidates could bring themselves to say the word “abortion.” Instead, the two carefully stepped around the term, noting their pro-choice records and intent to stand up for “women’s issues.”
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CLINTON: And I appreciate greatly Senator Sanders’ voting record. And I was very proud to get the endorsement of the Planned Parenthood Action Fund, because I’ve been a leader on these issues. I have gone time and time again to take on the vested interests who would keep women’s health care decisions the province of the government instead of women ourselves.
I’m very proud that NARAL endorsed me because when it comes to it we need a leader on women’s issues. Somebody who, yes, votes right, but much more than that, leads the efforts to protect the hard-fought gains that women have made, that, make no mistake about it, are under tremendous attack, not just by the Republican presidential candidates but by a whole national effort to try to set back women’s rights.
Or Sanders discussing how Republicans want to interfere with “choice”:
SANDERS: Let me concur with the secretary, no question women’s rights are under fierce attack all over this country. And I’ll tell you something that really galls me. I will not shock anybody to suggest that in politics there is occasionally a little bit of hypocrisy. Just a little bit. All over this country we have Republican candidates for president saying we hate the government. Government is the enemy …. But, by the way, when it comes to a woman having to make a very personal choice, ah, in that case, my Republican colleagues love the government and want the government to make that choice for every woman in America. If that’s not hypocrisy, I don’t know what hypocrisy is.
As Fusion’s Katie McDonough noted, by the end of the exchange the candidates devoted 252 words to “make a statement that could have been made in 12 words: Abortion rights are under attack in this country. I will defend them.”
“Like I’ve said before, the Republican presidential contenders have had no problem saying ‘abortion’ in front of primetime audiences,” McDonough pointed out. “As state-level restrictions pile up, as the country’s most restrictive abortion ban is about to have its day in court, as the leading Republican candidates argue whether or not women should be allowed to terminate pregnancies in order to save their lives, Clinton’s and Sanders’ word-smithing about ‘choice’ rings increasingly hollow.”
Bill to Defund Planned Parenthood in Ohio Moves to Kasich’s Desk, Where He Promises to Sign It
Fresh off of his distant second-place victory in the New Hampshire GOP primaries thanks in part to positioning himself as a “moderate” alternative, Ohio Gov. John Kasich has vowed to sign anti-choice legislation that would defund Planned Parenthood in the state.
The bill will redirect public funds away from organizations that promote or provide abortion, but will not affect Medicaid funding, as Rewirereported. The legislation, which passed through the GOP-controlled Ohio state legislature Wednesday, would redirect $1.3 million in grants from Ohio’s Department of Health away from Planned Parenthood.
Although many states have pushed for similar bans on funding for Planned Parenthood, Ohio’s is unique in that it targets funding for programs unrelated to abortion instead of blocking Medicaid funding to the organization, according to the Washington Post:
The Ohio bill is different in that it targets state and federal programs addressing HIV/AIDS, domestic violence, infant mortality and other problems. Planned Parenthood receives a large percentage of that money every year to administer the programs across the state. Under the new bill, the organization would be barred from administering those programs because of its role as an abortion provider.
Planned Parenthood Advocates of Ohio, a political arm of the reproductive health provider, has mobilized against Kasich and his promise to move ahead with the legislation, targeting the Republican presidential candidate with a five-figure ad buy.
The ad notes that the funding cuts would affect a domestic violence prevention program and breast and cervical cancer screenings.
Rubio: “I Know That the Majority of Americans Don’t Agree With Me” on Abortion Exceptions
Sen. Marco Rubio (R-FL) admitted Sunday that most voters don’t agree with his stringent opposition to abortion rights, even in cases of rape or incest.
During an appearance on ABC’s This Week, Rubio reasserted that should he be elected, he would sign anti-abortion measures that included exceptions for cases of rape and incest, but that he did not personally agree with them. Rubio, speaking with host George Stephanopoulos, explained that he supports anti-choice legislation that included exceptions for life endangerment and other measures he claimed would ultimately “save lives.”
“I do require an exception for life of the mother because I’m pro-life,” Rubio said. “The broader point I’ve made, however, is I believe all human life is worthy of the protection of our laws. That’s what I deeply and personally believe. And I’m not going to change my position on something that is so deep in me in order to win an election.”
When Stephanopoulos pushed Rubio to address what he would say to a rape victim who needed an abortion, the senator dismissed the circumstances, claiming that the fetus was more important.
“It’s a terrible situation. I mean, a crisis pregnancy, especially as a result of something as horrifying as that, I’m not telling you it’s easy. I’m not here saying it’s an easy choice. It’s a horrifying thing what you’ve just described,” said Rubio. “I get it, I really do. And that’s why this issue is so difficult. But I believe a human being, an unborn child, has a right to live, irrespective of the circumstances of which they were conceived. And I know that the majority of Americans don’t agree with me on that.”
Most Americans support exemptions to abortion bans in cases of rape or incest. Seventy-five percent of Americans believe abortion should be legal under these circumstances, according to Gallup.
Today, the entire nation is aware of the disaster. But for well over a year, residents in this city of some 100,000 people fought a lonely battle to convince the authorities that they were drinking, bathing, and cooking with poisoned water.
At first the signs were subtle—a slight discoloration of the tap water, a strange smell lingering in the shower stall or bathtub. Then the symptoms became more severe. Adults started to lose clumps of their hair and children broke out in rashes. Suspicions grew into fears, which were subsequently confirmed by studies. Families waited anxiously for test results to trickle in.
It all began in April 2014 when the city of Flint, under a state official, switched its water source from Lake Huron to the highly corrosive Flint River in a cost-cutting scheme aimed at saving $5 million in a two-year period. The chloride-heavy water quickly ate away at Flint’s aging infrastructure, leaching lead from the pipes into the water supply. Today, the entire nation is aware of the disaster. But for well over a year, residents in this city of some 100,000 people fought a lonely battle to convince the authorities that they were drinking, bathing, and cooking with poisoned water.
As households continued to consume the murky, toxic water, mothers started noticing changes in their kids’ behavior, including slower cognitive capabilities, according to reports. Elderly people were developing lesions in their skin. Before long, local, women-led groups like Water You Fighting For and the Flint Democracy Defense League had begun to mobilize their communities to raise the issue as a public health crisis. Families came out to demonstrations holding samples of the discolored water and signs that said, “Stop Poisoning Our Children.”
“I remember one woman who would come out to some of the earliest protests—she was a senior citizen and each time she would show up with a bigger and bigger ball of her own hair,” Sylvia Orduño, an organizer with the Michigan Welfare Rights Organization, said in an interview with Rewire. “She had this really long hair but pretty soon, I was able to see her scalp because she was losing so much of it.”
She said other women were panicking about rashes breaking out in their children’s genital areas. “And one mother even told me her 4-year-old was having trouble speaking: Like, there were words he knew but he was struggling to communicate them.”
Health-care providers, too, began noticing how their patients became particularly anxious about what the water situation meant for their family’s health and well-being.
“Soon after the switch we started noticing a difference in the communities we serve and the patients who were seeking care,” Sabrina Boston, manager of the Planned Parenthood Health Center in Flint, told Rewire in a phone interview.
In June 2015, a full year after Flint residents had first begun to consume lead-contaminated water, the Michigan chapter of the American Civil Liberties Union released a mini-documentary titled Hard to Swallow: Toxic Water Under a Toxic System in Flint. It featured several Flint residents, including LeeAnne Walters, whose five children started falling ill shortly after the switch in 2014. Anxious about her kids’ “scaly skin,” rashes, and rapid hair loss, Walters summoned city officials to test her tap water. The test returned results that showed lead levels at 397 parts per billion (ppb). By comparison, the Environmental Protection Agency warns that anything over 15 ppb can cause “irreversible” damage to a child’s brain.
Subsequent testing by volunteer researchers from Virginia Tech University showed Walters’ tap water to contain lead levels of over 13,000 ppb. According to this ACLU video, a lead-to-water ratio of 5,000 ppb is considered hazardous waste. Walters has since moved away from Flint, but her attempts to get to the bottom of her family’s sudden health problems have been widely recognized as instrumental in galvanizing national attention for the situation on the ground, which state and city officials had long sought to conceal.
Serious Consequences for Maternal and Child Health
Today, much of that cover-up is a matter of public record, with Michigan Gov. Rick Snyder (R) last week releasing official emails revealing his administration’s knowledge of the problem for well over a year.
On January 16 President Obama declared a federal state of emergency in the majority-Black city, days after Gov. Snyder had deployed the National Guard to assist in relief efforts, including distributing bottled water and filters to tens of thousands of households. Federal aid totaling $5 million—the maximum allocation possible under federal emergency laws—was recently made available to help mitigate the crisis. In addition, according to the New York Times, President Obama announced last Thursday Michigan could have immediate access to $80 million that had previously been earmarked for federal water infrastructure development. It is still unclear how this funding will be allocated.
Even as help pours in from around the nation, with big-name celebrities pledging tens of thousands of dollars in financial support, residents in Flint continue to suffer the health impacts of consuming and being in contact with lead-poisoned water, which has particularly serious consequences for maternal and child health.
According to the World Health Organization, there is no known “safe” blood-lead concentration, although the severity of symptoms and likelihood of longer-term impacts increase along with exposure. These include behavioral issues and reduced cognitive functioning in young children, as well as anemia, hypertension, and toxicity to their reproductive organs. WHO research also shows that high levels of lead exposure over a prolonged time period can severely damage a child’s brain and central nervous system, causing comas, convulsions, and in some cases death.
Data from the Centers for Disease Control and Prevention show that pregnant women and lactating mothers who are exposed to lead are at heightened risk of gestational hypertension. And since lead can persist in bones for decades, especially in pregnant and lactating women, mothers and their babies remain exposed to lead long after external sources of contamination have been eliminated.
“This is a reproductive health crisis of monumental proportions that you would not expect to see in a developed country and certainly not in a state …like Michigan, which ironically is surrounded by one of the largest bodies of fresh water in the world,” Dr. John Hebert, director of the Obstetrics and Gynecology Residency Program at the Hurley Medical Center, told Rewire.
By his estimates, based on his department’s observations of the unfolding crisis, between 9,000 and 10,000 children, and at least “a couple of thousand pregnant women” have likely been exposed to lead-contaminated water. For pregnant women this means “a heightened risk of pre-term delivery, increased rates of miscarriage, and low birth weight in infants,” he said.
In fact, one of the earliest notices warning residents to refrain from drinking Flint water, back in September of 2015, was directed at “senior citizens, children, and pregnant women,” after an independent study by the Hurley Medical Center found double the acceptable levels of lead in Flint water.
But simply issuing such an advisory in a city with a staggering poverty rate could not ensure compliance. In its Geography of Poverty article series, MSNBC reported that between 2009 and 2013, nearly half (41.5 percent) of Flint’s residents lived below the poverty line, far higher than the state’s 16.8 percent poverty rate. During the same period, about a quarter of Flint’s families lived on less than $15,000 per year, while the child poverty rate was 66.5 percent—nearly 10 percentage points higher than Detroit’s, which sits about 70 miles south.
“When you live in the affected zip codes you don’t have a choice,” Dr. Hebert explained. “You can’t simply stop drinking the water. Mothers have used this water to prepare formula for their infants; they may have been forced to drink contaminated water and then breastfeed their children. This crisis is absolutely not to be taken lightly.”
“The Damage Has Already Been Done”
Reproductive justice advocates say the situation in Flint not only represents a local public health emergency but also mirrors a larger crisis of reproductive justice for low-income women of color around the country.
“We are seeing so many intersecting issues—from economic justice to environmental justice to health-care access—meeting right in the middle, and landing in a community that is overwhelmingly Black and where low-income communities of color are bearing the brunt of this collision in the most horrific ways,” Monica Simpson, executive director of SisterSong Women of Color Reproductive Justice Collective, told Rewire. A majority of Flint’s residents—about 52 percent—are Black.
Simpson stated, “This is a severe reproductive justice crisis that cannot be ignored.”
Referring to the fact that Michigan’s Republican-led legislature, which was complicit in the water crisis, has a long history of pushing a so-called pro-life agenda, Simpson said, “This is our opportunity to reclaim our language. For too long many of us within the reproductive justice movement have been forced into the ‘pro-choice’ category by default, because we support abortion access. In fact, I consider myself pro-life: I support every woman’s right to live her best and most healthy life possible. But I haven’t been able to embrace that label, which has been hijacked by people who call themselves pro-life but are really pro-privilege and pro-white supremacy. If they cared about life, they would not be hand-picking who gets access to water, they would be ensuring that every woman and child has that right and that access.”
For reproductive health-care providers, the decision to respond to calls from the community was an obvious one. Planned Parenthood’s Boston told Rewire that the Flint Health Center, which sees about 3,200 patients annually, amounting to close to 7,000 visits each year, initially distributed water filters in partnership with the Flint Health Department, and later began to hand out free bottled water.
Flint resident Tunde Olaniran, the outreach manager for Planned Parenthood of Mid and South Michigan, who first brought the crisis to the organization’s attention, said he took his cue from local organizers who’ve been mobilizing since the switch happened back in April 2014.
“I was listening to the voices of women of color and organizations like the Genesee County Healthy Sexuality Coalition and the Coalition for Clean Water, who were talking about the toxicity of water long before any reports were released,” he told Rewire. “There is a lesson here on the need to listen … to grassroots organizers and impacted community members on how to solve very serious issues.”
Boston said that many patients and visitors to the center are “still expressing fears, confusion, and anger.”
“They are looking for guidance on what this means for their children, their families, and their own health,” she explained, adding that the clinic continues to educate patients about possible health risks and steps they can take to mitigate the impacts of lead contamination. Staff at the Flint center are urging women to “pump and dump” their breast milk, especially if they haven’t been tested; advising men on the possibility of lead contamination reducing their sperm count; and handing out resources, including lists of where testing is being done.
As residents fret over their health, the city is continuing to issue bills and past-due notices for water that residents say is good for nothing but flushing the toilet. The Detroit Free Pressreported Monday that some 100 residents protested outside the Flint city hall, ripping up their bills—as high as $100—and holding signs reading, “Why Pay for Poison?” According to some sources, Flint residents are saddled with some of the highest water bills in the country, often touching $150 per month.
While the political machine continues to grind on—with groups like the ACLU now pushing for several reforms including the immediate repeal of Public Act 436, which enabled a string of politically appointed emergency managers to override public concerns about the water—health-care providers are preparing for the long haul.
“A lot of the damage has already been done,” Dr. Hebert told Rewire. “There is no magic anecdote that can reverse it. Cognitive deficits and other neurological impacts on infants and unborn children will not become apparent for a long time. We are not talking about weeks or months here—these children are going to have to be monitored closely for several years.”
He said there is an urgent need for thorough follow-through and early childhood intervention programs to give a boost to those kids that wind up with developmental difficulties.
And even these steps, some say, will not be enough. “I think the families and the women who have come forward and put this issue on the map are very brave,” Michigan Welfare Rights Organization’s Orduño said. “But I don’t see how there can ever really be adequate solutions, or recourse, or reparations for any of this.”