News Abortion

Report: Total Abortion Coverage Ban Hurts Peace Corps Volunteers (Updated)

Emily Crockett

A new report released Monday, coordinated with a lobbying effort on Capitol Hill, says that returning Peace Corps volunteers see a policy denying them abortion coverage under any circumstances as “punitive and unfair” and think it needs to be changed.

UPDATE, May 6, 4:50 p.m.: The Peace Corps Equity Act was officially reintroduced in both the House and Senate on Monday, with 27 bipartisan co-sponsors in the Senate and four co-sponsors in the House so far.

Peace Corps volunteers receive no coverage for abortion care under any circumstance, including rape, incest, and life endangerment, which is a restriction that no other federal employees face. A new report released Monday, coordinated with a lobbying effort on Capitol Hill, says that returning volunteers see this policy as “punitive and unfair” and think it needs to be changed.

The report, No Exceptions: Documenting the Abortion Experiences of U.S. Peace Corps Volunteers, is a large-scale qualitative study drawing on interviews with 433 returned Peace Corps volunteers, conducted by researchers with the University of Ottawa, Cambridge Reproductive Health Consultants, and the Office of Population Research at Princeton University.

Eighteen of the 362 women interviewed for the study (5 percent of female respondents) had a personal experience with abortion while volunteering, and 32 women (9 percent) had been sexually assaulted during their time of service. The majority of women who had abortions only learned about the no-exceptions policy after they became pregnant, and 97 percent of respondents strongly disagreed with the policy as it currently stands.

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Christine Carcano shared her experience with becoming pregnant from rape during her Peace Corps service in Peru with Rewire via email. She didn’t want to tell her parents about the attack, she said, because “I did not want my service tarnished by this experience in anyone’s eyes.” So she turned to a fellow volunteer, who told his mother. The mother sent Carcano a $500 check with a note saying, “Money should be the last thing you have to worry about right now.”

Carcano, like many Peace Corps volunteers, subsisted on a meager stipend. She only made $300 per month, and the procedure would cost at least $500. The check from her friend’s mother allowed Carcano to have the procedure, she said, but it limited her options medically—she could only afford the smallest amount of anesthesia possible. Her doctors said it would be OK, but she said no injury she’s had in life compares to the “searing pain” of that procedure.

“I felt it in every part of my body,” she said. “What was already a traumatic experience was made all the more painful due directly to my financial limitations.” The entire ordeal was “blow after blow after blow,” she said, from being raped, to not wanting to tell anyone about it, to being forced to do so after testing positive for a sexually transmitted disease, to finding out she was pregnant, and finally being told that her medical coverage would include travel and other costs, but not an abortion itself.

“The current policy in the simplest terms is unjust,” Carcano said.

She said she doesn’t blame the Peace Corps because their hands were tied, but she urges the U.S. government to do the right thing by its volunteers. “By allowing a Peace Corps Volunteer’s employer to aid financially in these drastic and traumatizing experiences, the government would be proving how much they value our lives and our future.”

The problems Carcano had—not making enough to cover the abortion out of pocket, losing more confidentiality than she bargained for, compounding an existing trauma—are similar to those experienced by other returning volunteers who were interviewed for the new report. Women also reported being given no information other than a phone book when they asked about where they could obtain an abortion.

Because of the Peace Corps’ policy requiring women to be medically evacuated to Washington, D.C., after they are determined to be pregnant, many volunteers also reported concerns with confidentiality or with finishing their projects. Once evacuated to D.C., if the volunteer chooses to have an abortion, she has to pay for the procedure herself and remain in D.C. for about a month before being medically cleared to go back to her host country.

“If somebody leaves for, you know, a month or two, and goes to DC and comes back … it just doesn’t take much of a stretch of the imagination to kind of figure out what it was that happened to that Volunteer,” one participant noted in the study.

Given these hurdles, some volunteers seek an often-illegal abortion in their host country. Most volunteers who’d had an abortion also reported going through the procedure alone, either because they didn’t want to tell family members or because people in their support networks could not come to D.C.

Almost all of the study participants disagreed with the current policy, and a majority think it should be expanded to cover all abortions, not just those needed for dangerous or rape-induced pregnancies. The study includes a word cloud showing the most common responses volunteers had to the current policy; those words included “shocking,” “unfair,” “wrong,” “appalling,” and “bullshit.”

To make matters worse, according to the report, no other group that receives health care from the federal government—like Medicaid recipients, federal employees and their dependents, women in federal prisons, and even employees of the Peace Corps—faces the same restrictions on abortion coverage that Peace Corps volunteers do.

To remedy what is seen as a wrong-headed policy, returned volunteers and survivors of sexual assault are lobbying Congress this week to pass the Peace Corps Equity Act, slated to be introduced by Sen. Jeanne Shaheen (D-NH) and Rep. Nita Lowey (D-NY). President Obama has also included a fix to include coverage for cases of rape, incest, and life endangerment for Peace Corps volunteers in his annual budget proposal for the 2015 fiscal year.

The study’s authors also recommended better informing volunteers about the policy ahead of time and about available abortion providers; letting volunteers draw from their $7,500 readjustment allowance that they get upon return to the United States in order to pay for an abortion; finding ways to expand volunteers’ access to safe abortion care in their host countries, either with or without Peace Corps participation; and ensuring reliable access to contraceptive care.

“Extending basic reproductive health care services to female Peace Corps volunteers is long overdue,” said Sen. Shaheen in a statement. “Peace Corps Volunteers face inherent risks living and working abroad. There’s no reason they should be denied standard health care services offered to most women with federal health care coverage.”

Commentary Contraception

For Students at Religious Universities, Contraception Coverage Isn’t an Academic Debate

Alison Tanner

When the U.S. Supreme Court sent a case about faith-based objections to the Affordable Care Act's contraceptive mandate back to lower courts, it left students at religious colleges and universities with continuing uncertainty about getting essential health care. And that's not what religious freedom is about.

Read more of our articles on challenges to the Affordable Care Act’s birth control benefit here.

Students choose which university to attend for a variety of reasons: the programs offered, the proximity of campus to home, the institution’s reputation, the financial assistance available, and so on. But young people may need to ask whether their school is likely to discriminate in the provision of health insurance, including contraceptive coverage.

In Zubik v. Burwell, a group of cases sent back to the lower courts by the U.S. Supreme Court in May, a handful of religiously affiliated universities sought the right to deny their students, faculty, and staff access to health insurance coverage for contraception.

This isn’t just a legal debate for me. It’s personal. The private university where I attend law school, Georgetown University in Washington, D.C., currently complies with provisions in the Affordable Care Act that make it possible for a third-party insurer to provide contraceptive access to those who want it. But some hope that these legal challenges to the ACA’s birth control rule will reverse that.

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Georgetown University Law Center refused to provide insurance coverage for contraception before the accommodation was created in 2012. Without a real decision by the Supreme Court, my access to contraception insurance will continue to be at risk while I’m in school.

I’m not alone. Approximately 1.9 million students attend religiously affiliated universities in the United States, according to the Council for Christian Colleges and Universities. We students chose to attend these institutions for lots of reasons, many of which having nothing to do with religion. I decided to attend Georgetown University Law Center because I felt it was the right school for me to pursue my academic and professional goals, it’s in a great city, it has an excellent faculty, and it has a vibrant public-interest law community.

Like many of my fellow students, I am not Catholic and do not share my university’s views on contraception and abortion. Although I was aware of Georgetown’s history of denying students’ essential health-care benefits, I did not think I should have to sacrifice the opportunity to attend an elite law school because I am a woman of reproductive age.

That’s why, as a former law clerk for Americans United for Separation of Church and State, I helped to organize a brief before the high court on behalf of 240 students, faculty, and staff at religiously affiliated universities including Fordham, Georgetown, Loyola Marymount, and the University of Notre Dame.

Our brief defended the sensible accommodation crafted by the Obama administration. That compromise relieves religiously affiliated nonprofit organizations of any obligation to pay for or otherwise provide contraception coverage; in fact, they don’t have to pay a dime for it. Once the university informs the government that it does not want to pay for birth control, a third-party insurer steps in and provides coverage to the students, faculty, and staff who want it.

Remarkably, officials at the religious colleges still challenging the Affordable Care Act say this deal is not good enough. They’re arguing that the mere act of informing the government that they do not want to do something makes them “complicit” in the private decisions of others.

Such an argument stands religious freedom on its head in an attempt to impose one group’s theological beliefs on others by vetoing the third-party insurance providers’ distribution of essential health coverage to students, faculty, and staff.

This should not be viewed as some academic debate confined to legal textbooks and court chambers. It affects real people—most of them women. Studies by the Guttmacher Institute and other groups that study human sexuality have shown that use of artificial forms of birth control is nearly universal among sexually active women of childbearing years. That includes Catholic women, who use birth control at the same rate as non-Catholics.

Indeed, contraception is essential health care, especially for students. An overwhelming number of young people’s pregnancies are unplanned, and having children while in college or a graduate program typically delays graduation, increases the likelihood that the parent will drop out, and may affect their future professional paths.

Additionally, many menstrual disorders make it difficult to focus in class; contraception alleviates the symptoms of a variety of illnesses, and it can help women actually preserve their long-term fertility. For example, one of the students who signed our brief told the Court that, “Without birth control, I experience menstrual cycles that make it hard to function in everyday life and do things like attend class.” Another woman who signed the brief told the Court, “I have a history of ovarian cysts and twice have required surgery, at ages 8 and 14. After my second surgery, the doctor informed me that I should take contraceptives, because if it happened again, I might be infertile.”

For these and many other reasons, women want and need convenient access to safe, affordable contraceptives. It is time for religiously affiliated institutions—and the Supreme Court—to acknowledge this reality.

Because we still don’t have an ultimate decision from the Supreme Court, incoming students cannot consider ease of access to contraception in deciding where to attend college, and they may risk committing to attend an university that will be legally allowed to discriminate against them. A religiously affiliated university may be in all other regards a perfect fit for a young woman. It’s unfair that she should face have to risk access to essential health care to pursue academic opportunity.

Religious liberty is an important right—and that’s why it should not be misinterpreted. Historically, religious freedom has been defined as the right to make decisions for yourself, not others. Religious freedom gives you have the right to determine where, how, and if you will engage in religious activities.

It does not, nor should it ever, give one person or institution the power to meddle in the personal medical decisions of others.

News Law and Policy

AmeriCorps Health Program Loses Funding Amid Abortion Controversy

Nicole Knight Shine & Christine Grimaldi

A spokesperson for the Corporation for National and Community Service said in an email to Rewire that the grantee "was unsuccessful in a highly competitive year, and they were not the only longtime grantee to not receive funding."

AmeriCorps, the federal government’s public service arm, is ending its oldest neighborhood health program amid reports that a few members broke the law by offering emotional support, or doula care, to abortion patients.

Although Samantha Jo Warfield, a spokesperson for the federal agency that oversees AmeriCorps, on Thursday described the Community HealthCorps funding cut as a routine decision in competitive grant process, powerful Republicans in Congress had been gunning for the program following a critical report in April by the inspector general’s office.

The timing of the report, issued by the Office of Inspector General for the Corporation for National and Community Service, which oversees AmeriCorps, came just as the agency was reviewing grantees for funding.

The report said that a few AmeriCorps members were authorized by the former director of the National Association of Community Health Centers (NACHC), a nonprofit grantee that runs Community HealthCorps, to offer emotional support to abortion patients at three New York City clinics between 2013 and 2015.

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The report also included allegations of waste, fraud, and abuse by NACHC senior management.

A federal statue, the report goes on to say, expressly prohibits the use of AmeriCorps resources to “provid[e] abortion services or referrals for receipt of such services.” The report fails to make clear whether the emotional support, described parenthetically in the report as “doula care,” happened during work or non-work hours.

In April, Republicans were swift to blast NACHC, which has been until now AmeriCorps’ largest grantee, taking in $30 million over the last five years.

The head of the Republican-controlled House Appropriations Subcommittee, Rep. Tom Cole (R-OK), demanded the “immediate termination and nonrenewal” of NACHC’s grant in a letter on April 26 to Wendy Spencer, CEO of the Corporation for National and Community Service, which oversees AmeriCorps. Cole described NACHC’s “blatant disregard for federal law” as “outrageous.”

The anti-choice group the Family Research Council suggested that “AmeriCorpse” was promoting the “abortion industry.”

Warfield, spokesperson for Corporation for National and Community Service, didn’t respond to Rewire‘s emailed questions about a possible political motivation for eliminating the grantee’s funding after a 20-plus year relationship.

Rather, Warfield did reply that the grantee “was unsuccessful in a highly competitive year, and they were not the only longtime grantee to not receive funding.” She also dismissed news reports that Community HealthCorps was AmeriCorps’ sole health-care program.

In a statement Thursday, the National Association of Community Health Centers said it was “disappointed” at the funding cut. It noted that the health-care program had helped 240,000 Americans on average annually, and produced “solid results for the country for over two decades.”

Warfield told BuzzFeed, which broke the news, that more than 400 AmeriCorps clinic volunteers, who earn a small stipend and student loan forgiveness for their participation, will be able to finish their term in Community HealthCorps.

As Jessica Mason Pieklo, Rewire vice president of law and courts, noted in an April analysis, the inspector general’s report is silent on whether members were offering emotional support to abortion patients during work or non-work hoursan important distinction. Pieklo noted, “AmeriCorps volunteers are free to work as abortion doulas on their own time and not wearing AmeriCorps gear to do so.”

Pieklo also pointed out that the same federal law that bars providing abortion services or referrals permits individuals to “exercise their rights as private citizens and may participate in the activities listed above [such as the abortion restrictions] on their initiative, on non-AmeriCorps time, and using non-CNCS funds.”