We just posted a new Policy Watch piece on the Unintended Pregnancy Prevention Act, sponsored by Sen. Hillary Rodham Clinton (D-NY). Our hope is that that article and others in our Policy Watch archive can be helpful references for tracking Congressional activity and understanding what is happening on reproductive health issues in government.

The Unintended Pregnancy Prevention act, introduced a month ago, would expand Medicaid coverage for contraception and family planning services. It represents a trend in Sen. Clinton’s policymaking and messaging of late.

She adds this act to another piece of legislation she is sponsoring, the Putting Prevention First Act, which would increase funding for family planning services in this country. Along with Sen. Patty Murray (D-WA), she has put a hold on the approval of acting FDA Commissioner Andrew Von Eschenbach as permanent Commissioner until that organization issues a decision on the over-the-counter status for emergency contraception drug Plan B. And last week at a NFPRHA luncheon, she spoke to the need for such a trend:

“Let us unite around a common goal of reducing the amount of abortions…Not by making them illegal as many are attempting to do, or overturning Roe v. Wade and undermining the constitutional protections that decision provided, but by preventing unintended pregnancies in the first place through education, contraception, accessible health care and services, empowering women to make decisions.”

With these words and with this legislation, Sen. Clinton is putting herself at the heart of a changing debate in this country. It has for years been about abortion on the surface, but recent reporting, policy activity, and statements from activist groups have made it clear that the wider controversy is now about contraception (and perhaps has been all along).

Sen. Clinton’s legislation and statements will hopefully draw this debate further out into the open for the American public. What they might find will likely surprise them: that the same conservative groups who claim to spend their energies fighting to end abortion will make few or none of the moves most likely to do just that. They will not support funding for family planning programs for poor women who are disproportionately likely to have abortions after an unintended pregnancy. They will not support adoption programs that would provide homes for unwanted children for mothers who choose not to have abortions if those homes are with loving and qualified gay parents. Despite the nearly unanimous recommendation of an FDA panel of experts, they will not approve over-the-counter status for emergency contraception which would provide the means to prevent a huge number of unintended pregnancies before the choice to have an abortion must be made.

The move to bring prevention efforts to the center of this debate is crucial because it will end in one of two places. It will either unite opposing sides in a common goal to reduce the need for abortion services, or it will expose radicals on the conservative side for their opposition to most or all forms of contraception.

In other words, the gauntlet has been thrown down. Think abortion is at odds with “pro-life” beliefs? Then do something about it – help prevent the need for one from ever arising. The old dichotomies never really feel right. After all, how many people are really against life? Or against choice? (I know, that one's a bit more debatable…) With these changes, the dichotomy can shift to being over prevention. Are you for it, or against it? Finally, we might have a useful question.