Analysis Politics

The Western Pennsylvania Primary Battle That’s a Race for Women’s Health

Tara Murtha

One of the most exciting state house races in Pennsylvania this year is a primary race between two Democrats, Reps. Harry Readshaw and Erin Molchany, for House District 36 in Pittsburgh.

One of the most exciting state house races in Pennsylvania this year is a primary race between two Democrats in Pittsburgh.

The race between Reps. Harry Readshaw and Erin Molchany for House District 36 illustrates a split in the Democratic Party that tends to happen the farther west you go in Pennsylvania. Though of the same party, the candidates couldn’t be more distinct: Readshaw, 72, is a boy’s club conservative who has cast 31 votes against women’s health since 2002, according to advocates, while Molchany, 36, is a former Planned Parenthood employee who has spoken out about the importance of working women’s access to abortion services.

Advocates see the race leading up to the May 20 primary election as a referendum on women’s health—an issue so polarized in Pennsylvania that last year concerned lawmakers formed the Women’s Health Caucus, a group dedicated to combating legislative attacks on women’s health and introducing pro-active health initiatives.

The race is a result of redistricting plan approved last year. The new boundaries combined parts of Readshaw’s and Molchany’s districts into one new area. The newly combined House District 36 includes Pittsburgh’s South Side, the South Hills neighborhoods ranging from Mount Washington to Carrick, Mount Oliver, and some neighborhoods in Brentwood and Baldwin Borough.

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The redistricting plan favors Readshaw. As the Pittsburgh City Paper describes it:

That’s mostly Readshaw’s turf: More than 7 out of 10 voters in the new 36th were already Readshaw’s constituents, prompting Molchany to say, half-jokingly, “I feel like I’m a victim of cartography.”

Even Molchany’s home address was redistricted into Readshaw’s turf. The situation’s created an epic race: In addition to being seen as a referendum on women’s health, the race is also being framed as a fight for the soul of “a new Pittsburgh,” to borrow the campaign-winning slogan of Pittsburgh’s new mayor, Bill Peduto, who endorsed Molchany.

Molchany’s supporters hope that unlike the old Pittsburgh, the new Pittsburgh includes some female voices. Molchany is currently the only woman in Allegheny County’s house delegation. Overall, the state is hardly better: With less than 18 percent female representation in the general assembly, Pennsylvania is one of the worst states in the country when it comes female representation, and it shows in the state’s policy.

“I feel a certain responsibility as a woman legislator,” Molchany has said. “It changes the conversation when you have diversity in any body.”

To further set the stage, Republican Gov. Tom Corbett has been called the most endangered governor in the country, due in large part to a persistent gender gap, meaning less women support Corbett than men. In January, a Quinnipiac poll found that Pennsylvania women were giving Corbett a “big thumbs down,” which would likely hurt his chances at re-election this fall. From the poll: “There is a large gender gap in today’s results, as women disapprove 45-31 percent while men approve 41-37 percent.”

Another recent poll indicates that the 2014 elections are in the hands of “unmarried women, people of color and young people between the ages of 18 and 29.” Together, these groups are referred to as the RAE, as in “rising American electorate.” Single women are particularly significant this year.

“While we always see a reduction in voter turnout during mid-terms, the differences between 2010 and 2006 were dramatic in terms of who dropped off and the subsequent election results,” Celinda Lake, president of Lake Research Partners, is quoted as saying on the state politics blog PoliticsPA. “The candidates that addressed the issues of the RAE and unmarried women succeeded at higher rates than those that did not. In Pennsylvania, the effect of unmarried women turnout could determine the strength of the delegation in [the] state legislative body as well as control within the U.S. House and U.S. Senate.”

Allegheny County has, by far, the highest number of unregistered unmarried women in Pennsylvania. According to the U.S. Census and PA Voter File, 45,517 unregistered single female voters live in Allegheny County. (Second in line is Philadelphia County, with 26,505 potential single female voters.)

If all the single ladies do decide to vote this election, they have much more than identity politics to help them choose who to cast their vote for in House District 36. The candidates’ split on women’s health issues is so stark that Aleigha Cavalier, Western Pennsylvania project director for Planned Parenthood Pennsylvania Advocates and PAC—which officially endorsed Molchany—says she views this race as a referendum on women’s health.

“These are Democratic primary voters in an off-year election,” Cavalier told Rewire. “So there’s absolutely the opportunity to use women’s health as a referendum.”

Recent national attacks on women’s health compound the tension. As the state where the Casey decision was made—the ruling that opened the doors to the tidal wave of state-level restrictions on abortion all over the rest of the country—Pennsylvania has always been a battleground for women’s health policy. In the last four years, the Pennsylvania legislature has spent a significant amount of energy diminishing women’s reproductive rights.

Under Corbett, Pennsylvania lawmakers passed new abortion clinic regulations that shut down four abortion clinics that had been in good standing. They passed a law making it impossible for women to purchase private insurance abortion coverage through the state health insurance exchange, even when the mother’s health is at stake. They also introduced legislation requiring doctors who perform abortions to get admitting privileges at a nearby hospital, just as Texas did with HB 2, which has shut down roughly a third of the state’s abortion clinics. (It is expected that Pennsylvania lawmakers will sit on the admitting privileges legislation until after the primary election.)

Readshaw sponsored or voted affirmative on all of these initiatives. In fact, according to Planned Parenthood Pennsylvania Advocates, Readshaw has cast 31 votes against women’s health since 2002, making him one of a handful of Pennsylvania Democrats with voting records virtually indistinguishable from state Republicans.

He even co-sponsored Pennsylvania’s forced ultrasound bill, which was the most severe in the country. It would have required that doctors move ultrasound screens close to the face of a patient, and then document whether or not the patient “accepted” or “refused” to look at the screen as the transvaginal wand was pushed into her body. It also required that the patient pay separate fees to the doctor performing the ultrasound, with a refund available only if she did not obtain an abortion.

When a female constituent wrote Readshaw an email against the bill, he responded by sending her a handwritten letter that remarked on her voting record and her position in her household; the letter included the line “I do not choose to debate ‘intellect’ vs. morals, as I believe morals should overwhelmingly be the favorite.”

The overwhelming favorite, as it turned out, was neither intellect or morality: It was political survival. After similar legislation invited a huge backlash in Virginia, Readshaw (along with 12 Democrats and 19 Republicans) dropped support of the bill just ahead of the 2012 election, and it never passed.

Molchany’s record on women’s health care is short but clear. The first time she stood up on the floor to address the assembly was to advocate against the bill prohibiting private insurers from covering abortion in plans sold through the state exchange.

“I was hoping to talk about legislation that impacts the life of everyone in the Commonwealth,” she said. “Unfortunately, this house is focused on government restrictions on women’s health care. … I rise today because House Bill 818 is a bad bill. It is a dangerous bill, and it carries severe unintended consequences by creating barriers to legal and safe health-care options for women. So why are we doing this?”

What Readshaw has going for him is a history of personally assisting constituents and name recognition. His campaign recently commissioned a poll showing Readshaw in the significant lead, and noting 77 percent of Democrats in the district are familiar with him.

Planned Parenthood Pennsylvania Advocates’ Aleigha Cavalier says being familiar with Readshaw’s name and being aware of his voting record are two different things. “When you really talk to people on the South Side and … explain to them that [Readshaw] cast 31 votes against reproductive health care, that doesn’t align with the values of the district,” she said.

Planned Parenthood points to a recent poll indicating that most Pennsylvanians are pro-choice. But the general attacks on women’s health and access to health-care services and insurance have been much larger than abortion. The fact that these attacks don’t align with Pennsylvania voters is already evident by Corbett’s re-election struggle and the strategic political maneuvering around bills that endanger women’s health care—such as shelving the forced ultrasound bill before the 2012 election and keeping quiet on admitting privilege legislation until after this primary.

News Law and Policy

Court Blocks North Carolina’s ‘Discriminatory’ Voter ID Law

Imani Gandy

“[T]he new provisions target African Americans with almost surgical precision," Circuit Judge Diana Gribbon Motz wrote for the court, describing the North Carolina GOP's voter ID law.

A unanimous panel of the Fourth Circuit Court of Appeals struck down North Carolina’s elections law, holding that the Republican-held legislature had enacted the law with discriminatory intent to burden Black voters and that it therefore violated the Voting Rights Act of 1965.

The ruling marks the latest defeat of voter ID laws passed by GOP-majority legislatures across the country.

“We can only conclude that the North Carolina General Assembly enacted the challenged provisions of the law with discriminatory intent,” Circuit Judge Diana Gribbon Motz wrote for the court.

HB 589 required in-person voters to show certain types of photo ID beginning in 2016, and either curtailed or reduced registration and voting access tools that Black voters disproportionately used, including an early voting period. Black voters also disproportionately lack photo IDs.

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Republicans claimed that the law was intended to protect against voter fraud, which has proven exceedingly rare in Republican-led investigations. But voting rights advocates argue that the law was intended to disenfranchise Black and Latino voters.

The ruling marks a dramatic reversal of fortune for the U.S. Justice Department, the North Carolina chapter of the NAACP, and the League of Women Voters, which had asked the Fourth Circuit to review a lower court ruling against them.

U.S. District Court Judge Thomas Schroeder in April ruled that plaintiffs had failed to demonstrate that the law hindered Black voters’ ability to exercise political power.

The Fourth Circuit disagreed.

“In holding that the legislature did not enact the challenged provisions with discriminatory intent, the court seems to have missed the forest in carefully surveying the many trees,” Motz wrote. “This failure of perspective led the court to ignore critical facts bearing on legislative intent, including the inextricable link between race and politics in North Carolina.”

The Fourth Circuit noted that the Republican-dominated legislature passed the law in 2013, immediately following the U.S. Supreme Court’s ruling in Shelby v. Holder, which struck a key provision in Section 4 of the Voting Rights Act.

Section 4 is the coverage formula used to determine which states must get pre-clearance from the Department of Justice or the District Court for the District of Columbia before making any changes to election laws.

The day after the Supreme Court issued its ruling in Shelby, the Republican chairman of the Senate Rules Committee announced the North Carolina legislature’s intention to enact an “omnibus” election law, the appeals court noted. Before enacting the law, however, the Republican-dominated legislature requested data on the use, by race, of a number of voting practices.

After receipt of the race data, the North Carolina General Assembly enacted legislation that restricted voting and registration, all of which disproportionately burdened Black voters.

“In response to claims that intentional racial discrimination animated its actions, the State offered only meager justifications,” Motz continued. “[T]he new provisions target African Americans with almost surgical precision.”

The ruling comes a day after the Rev. Dr. William J. Barber II, president of the North Carolina chapter of the NAACP and one of the primary organizers of Moral Mondays, gave a rousing speech at the Democratic National Convention that brought convention goers to their feet.

During a protest on the first day of the trial, Barber told a crowd of about 3,500 people, “this is our Selma.”

Analysis Law and Policy

After ‘Whole Woman’s Health’ Decision, Advocates Should Fight Ultrasound Laws With Science

Imani Gandy

A return to data should aid in dismantling other laws ungrounded in any real facts, such as Texas’s onerous "informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

Whole Woman’s Health v. Hellerstedt, the landmark U.S. Supreme Court ruling striking down two provisions of Texas’ omnibus anti-abortion law, has changed the reproductive rights landscape in ways that will reverberate in courts around the country for years to come. It is no longer acceptable—at least in theory—for a state to announce that a particular restriction advances an interest in women’s health and to expect courts and the public to take them at their word.

In an opinion driven by science and data, Justice Stephen Breyer, writing for the majority in Whole Woman’s Health, weighed the costs and benefits of the two provisions of HB 2 at issue—the admitting privileges and ambulatory surgical center (ASC) requirements—and found them wanting. Texas had breezed through the Fifth Circuit without facing any real pushback on its manufactured claims that the two provisions advanced women’s health. Finally, Justice Breyer whipped out his figurative calculator and determined that those claims didn’t add up. For starters, Texas admitted that it didn’t know of a single instance where the admitting privileges requirement would have helped a woman get better treatment. And as for Texas’ claim that abortion should be performed in an ASC, Breyer pointed out that the state did not require the same of its midwifery clinics, and that childbirth is 14 times more likely to result in death.

So now, as Justice Ruth Bader Ginsburg pointed out in the case’s concurring opinion, laws that “‘do little or nothing for health, but rather strew impediments to abortion’ cannot survive judicial inspection.” In other words, if a state says a restriction promotes women’s health and safety, that state will now have to prove it to the courts.

With this success under our belts, a similar return to science and data should aid in dismantling other laws ungrounded in any real facts, such as Texas’s onerous “informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

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In Planned Parenthood v. Casey, the U.S. Supreme Court upheld parts of Pennsylvania’s “informed consent” law requiring abortion patients to receive a pamphlet developed by the state department of health, finding that it did not constitute an “undue burden” on the constitutional right to abortion. The basis? Protecting women’s mental health: “[I]n an attempt to ensure that a woman apprehends the full consequences of her decision, the State furthers the legitimate purpose of reducing the risk that a woman may elect an abortion, only to discover later, with devastating psychological consequences, that her decision was not fully informed.”

Texas took up Casey’s informed consent mantle and ran with it. In 2011, the legislature passed a law that forces patients to undergo a medical exam, whether or not their doctor thinks they need it, and that forces them to listen to information that the state wants them to hear, whether or not their doctor thinks that they need to hear it. The purpose of this law—at least in theory—is, again, to protect patients’ “mental health” by dissuading those who may be unsure about procedure.

The ultra-conservative Fifth Circuit Court of Appeals upheld the law in 2012, in Texas Medical Providers v. Lakey.

And make no mistake: The exam the law requires is invasive, and in some cases, cruelly so. As Beverly McPhail pointed out in the Houston Chronicle in 2011, transvaginal probes will often be necessary to comply with the law up to 10 to 12 weeks of pregnancy—which is when, according to the Guttmacher Institute, 91 percent of abortions take place. “Because the fetus is so small at this stage, traditional ultrasounds performed through the abdominal wall, ‘jelly on the belly,’ often cannot produce a clear image,” McPhail noted.

Instead, a “probe is inserted into the vagina, sending sound waves to reflect off body structures to produce an image of the fetus. Under this new law, a woman’s vagina will be penetrated without an opportunity for her to refuse due to coercion from the so-called ‘public servants’ who passed and signed this bill into law,” McPhail concluded.

There’s a reason why abortion advocates began decrying these laws as “rape by the state.”

If Texas legislators are concerned about the mental health of their citizens, particularly those who may have been the victims of sexual assault—or any woman who does not want a wand forcibly shoved into her body for no medical reason—they have a funny way of showing it.

They don’t seem terribly concerned about the well-being of the woman who wants desperately to be a mother but who decides to terminate a pregnancy that doctors tell her is not viable. Certainly, forcing that woman to undergo the painful experience of having an ultrasound image described to her—which the law mandates for the vast majority of patients—could be psychologically devastating.

But maybe Texas legislators don’t care that forcing a foreign object into a person’s body is the ultimate undue burden.

After all, if foisting ultrasounds onto women who have decided to terminate a pregnancy saves even one woman from a lifetime of “devastating psychologically damaging consequences,” then it will all have been worth it, right? Liberty and bodily autonomy be damned.

But what if there’s very little risk that a woman who gets an abortion experiences those “devastating psychological consequences”?

What if the information often provided by states in connection with their “informed consent” protocol does not actually lead to consent that is more informed, either because the information offered is outdated, biased, false, or flatly unnecessary given a particular pregnant person’s circumstance? Texas’ latest edition of its “Woman’s Right to Know” pamphlet, for example, contains even more false information than prior versions, including the medically disproven claim that fetuses can feel pain at 20 weeks gestation.

What if studies show—as they have since the American Psychological Association first conducted one to that effect in 1989—that abortion doesn’t increase the risk of mental health issues?

If the purpose of informed consent laws is to weed out women who have been coerced or who haven’t thought it through, then that purpose collapses if women who get abortions are, by and large, perfectly happy with their decision.

And that’s exactly what research has shown.

Scientific studies indicate that the vast majority of women don’t regret their abortions, and therefore are not devastated psychologically. They don’t fall into drug and alcohol addiction or attempt to kill themselves. But that hasn’t kept anti-choice activists from claiming otherwise.

It’s simply not true that abortion sends mentally healthy patients over the edge. In a study report released in 2008, the APA found that the strongest predictor of post-abortion mental health was prior mental health. In other words, if you’re already suffering from mental health issues before getting an abortion, you’re likely to suffer mental health issues afterward. But the studies most frequently cited in courts around the country prove, at best, an association between mental illness and abortion. When the studies controlled for “prior mental health and violence experience,” “no significant relation was found between abortion history and anxiety disorders.”

But what about forced ultrasound laws, specifically?

Science has its part to play in dismantling those, too.

If Whole Woman’s Health requires the weighing of costs and benefits to ensure that there’s a connection between the claimed purpose of an abortion restriction and the law’s effect, then laws that require a woman to get an ultrasound and to hear a description of it certainly fail that cost-benefit analysis. Science tells us forcing patients to view ultrasound images (as opposed to simply offering the opportunity for a woman to view ultrasound images) in order to give them “information” doesn’t dissuade them from having abortions.

Dr. Jen Gunter made this point in a blog post years ago: One 2009 study found that when given the option to view an ultrasound, nearly 73 percent of women chose to view the ultrasound image, and of those who chose to view it, 85 percent of women felt that it was a positive experience. And here’s the kicker: Not a single woman changed her mind about having an abortion.

Again, if women who choose to see ultrasounds don’t change their minds about getting an abortion, a law mandating that ultrasound in order to dissuade at least some women is, at best, useless. At worst, it’s yet another hurdle patients must leap to get care.

And what of the mandatory waiting period? Texas law requires a 24-hour waiting period—and the Court in Casey upheld a 24-hour waiting period—but states like Louisiana and Florida are increasing the waiting period to 72 hours.

There’s no evidence that forcing women into longer waiting periods has a measurable effect on a woman’s decision to get an abortion. One study conducted in Utah found that 86 percent of women had chosen to get the abortion after the waiting period was over. Eight percent of women chose not to get the abortion, but the most common reason given was that they were already conflicted about abortion in the first place. The author of that study recommended that clinics explore options with women seeking abortion and offer additional counseling to the small percentage of women who are conflicted about it, rather than states imposing a burdensome waiting period.

The bottom line is that the majority of women who choose abortion make up their minds and go through with it, irrespective of the many roadblocks placed in their way by overzealous state governments. And we know that those who cannot overcome those roadblocks—for financial or other reasons—are the ones who experience actual negative effects. As we saw in Whole Woman’s Health, those kinds of studies, when admitted as evidence in the court record, can be critical in striking restrictions down.

Of course, the Supreme Court has not always expressed an affinity for scientific data, as Justice Anthony Kennedy demonstrated in Gonzales v. Carhart, when he announced that “some women come to regret their choice to abort the infant life they once created and sustained,” even though he admitted there was “no reliable data to measure the phenomenon.” It was under Gonzales that so many legislators felt equipped to pass laws backed up by no legitimate scientific evidence in the first place.

Whole Woman’s Health offers reproductive rights advocates an opportunity to revisit a host of anti-choice restrictions that states claim are intended to advance one interest or another—whether it’s the state’s interest in fetal life or the state’s purported interest in the psychological well-being of its citizens. But if the laws don’t have their intended effects, and if they simply throw up obstacles in front of people seeking abortion, then perhaps, Whole Woman’s Health and its focus on scientific data will be the death knell of these laws too.