Analysis Politics

In Arkansas, A Lose-Lose Proposition for the Pro-Choice Movement?

Teddy Wilson

The Arkansas gubernatorial race features one firmly anti-choice candidate, and one with a vacillating stance on abortion rights.

The Arkansas gubernatorial race features one firmly anti-choice candidate, and one with a vacillating stance on abortion rights.

Arkansas Gov. Mike Beebe is one of the last Southern Democratic governors, and due to term limits he is not eligible for reelection. The campaign to replace him is between two politicians who were born and raised in the state, and who are both attempting to appeal Arkansas’s moderate electorate.

Democrat Mike Ross and his Republican opponent, Asa Hutchinson, both easily won their primary elections without significant opposition.

Ross is a traditional Southern Democrat who began his political career as a staffer for former Gov. Bill Clinton. Ross has spent most of his adult life in politics, having served ten years in the Arkansas State Senate and another 12 years in the U.S. House of Representatives.

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Hutchinson is running for governor for a second time, having lost in 2006 to Gov. Beebe.

Hutchinson has had a diverse career in public service and politics, beginning with his appointment as U.S. Attorney by President Reagan. He would lose an election for U.S. Senate and state attorney general before being elected to Congress in 1996. Hutchinson served in Congress from 1997 until 2001.

The gubernatorial campaign has focused on a variety of issues, but one of the critical issues to the campaign is healthcare and how best to expand access to the state’s low income residents.

Arkansas has historically struggled with poverty and poor public health. According to the United Health Foundation, the state ranks 49 in health-care outcomes. This is in large part due to the state having the fourth highest percentage of residents living in poverty. The median household income, over the past decade, has been among the lowest in the nation, and has seen little improvement.

The Private Option

A bipartisan compromise was brokered in the Republican-controlled legislature that created a path for the state to expand Medicaid under the Affordable Care Act (ACA) through a private health insurance exchange. Gov. Beebe has been a vocal supporter of the policy that he signed into law, and has advocated that the state continue the program.

Arkansas conservatives have been critical of the policy, and Republican lawmakers faced primaries challenges largely based on their support of the plan. One of the Republican architects of the plan was challenged and defeated in the primaries. The state is currently considering proposed changes to the program, and looking toward Republican governed states for policies to adopt.

The criticism of the private option stem in large part from Republican opposition to the ACA. Both Ross and Hutchinson have said that they oppose the health-care reform law.

Ross has a long legislative record of opposing the ACA. While in Congress he voted against both the House version and on final passage. During the months of negotiations Ross was one of a handful of lawmakers to broker compromise with Democratic leadership to reduce cost of bill by limiting subsidies to the uninsured and doubling exemptions for small businesses.

After the Republicans regained control of the House in the 2010 midterm elections, Ross was one of only three Democrats to join with the Republicans in voting to repeal the new health-care law.

“An overwhelming majority of my constituents continue to oppose this healthcare reform law and I believe we should repeal it, start over and listen to the majority of the American people – not the special interests and party leaders in Washington,” Ross said in a press release following voting to repeal the law in January 2011.

“I voted against the federal healthcare law, or the Patient Protection & Affordable Care Act, four times and I voted to repeal Obamacare 23 times,” Ross says on his campaign website. “But, at the time, I said there were good parts and there were bad parts to Obamacare. I think Arkansas’s Medicaid expansion, which passed with overwhelming Republican support, is one of the good parts.”

“I know further reform in healthcare is needed,” said Hutchinson in a campaign statement. “I look forward to working with our health care professionals and the legislature to determine what changes will be needed in the future. The reforms I will advocate will reflect those needed changes while balancing the need for a stable budget.”

Hutchinson says that he has consistently opposed the ACA and characterized the law as “train-wreck” and a “terrible job killing policy that is fatally flawed.” Hutchinson claims the ACA has caused health insurance premiums for residents of the state “to skyrocket” and has has denied resident the opportunity “to keep their health insurance if they like it.”

In fact, the Arkansas Insurance Department is projecting that insurance policies will see a decrease by 2 percent in premiums for the Arkansas Health Insurance Marketplace, the health insurance exchange created by the ACA.

Like many state that expanded Medicaid under the ACA, Arkansas saw significant increases to access to health care for low-income residents. More than 183,000 residents have received health insurance through the program. According to Gallup polling, the uninsured rate in Arkansas has dropped from 22.5 percent to 12.4 percent.

During a meeting of the Southern Governors Association, incumbent Arkansas Gov. Mike Beebe (D) lauded the private option for reducing the number of the state’s uninsured more than any other state in the country since the ACA was fully implemented.

Ross has criticized Hutchinson for being evasive on his position on the state’s private option. Hutchinson has repeatedly said that the way in which the state has decided to deliver healthcare to low-income residents has been badly designed, but has been vague in saying how he would have designed it differently.

Hutchinson, who has said that there is a “debate on whether we’re going to extend insurance coverage for the working poor,” opposes the expansion of Medicaid under the ACA. “I would have designed the healthcare plan for Arkansas differently. But as governor, I will inherit the decisions the governor and General Assembly made in the fiscal session.”

“We’ll do the right thing in terms of making the adjustments that are needed to reflect the values of Arkansas and to make sure this program is an incentive for people to work and not an incentive for people not to work,” said Hutchinson at a Delta Grassroots Caucus conference in Little Rock.

Reproductive Rights

Historically, Arkansas politicians have been hostile to reproductive rights, and there is limited access to reproductive health care in the state. There were several legislative attempts in 2013 to restrict reproductive rights in the state. In March, a ban on telemedicine abortions was introduced, and in April the legislature attempted to de-fund Planned Parenthood.

During his campaign announcement, Ross addressed legislative actions to restrict reproductive rights in the state capitol.

“Over the past few months, some misguided politicians have taken over the state legislature and have made divisive issues of the past their top priority instead of working to create jobs, improve education and strengthen the economy. Here lately, it seems the only time Arkansas makes national news is when these divisive politicians succeed at pushing through their attacks on women and families,” said Ross.

Ross would later clarify that he was specifically addressing two pieces of legislation passed by the Arkansas legislature: a ban on abortion after 12 weeks of gestation and ban on abortion after 20 weeks.

The ban on abortion after 12 weeks is one of the most stringent restrictions on abortion in the country. The law was blocked by a federal judge in March, and is currently under litigation. Ross claims that he would have vetoed both bills.

As governor, Hutchinson says that he would have signed both the 12-week and 20-week abortion bans passed by the Arkansas General Assembly.

Ross opposition to restricting reproductive rights is a dramatic change from his legislative record, as over the course of his political career he does not have a history of supporting reproductive rights. During his time in Congress he has received low ratings for his votes on reproductive rights-related issues from organizations such as NARAL Pro-Choice America and Planned Parenthood.

When asked why he now is opposed to restrictions on reproductive rights, Ross told the Arkansas News that his position has not changed. “I am personally opposed to abortion. My position is the same as Gov. Beebe’s – I think from a public policy standpoint it should safe, legal, and rare,” said Ross.

Ross and Hutchinson served in Congress together for one year in 2001 during the 107th Congress, during which time Hutchinson would be appointed by President George W. Bush as director of the Drug Enforcement Administration. Ross received a rating from Planned Parenthood for 50 percent for votes on issues concerning reproductive rights, while Hutchinson received a rating of 0 percent for those same votes.

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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