The Title X Factor: Why the Health of America's Women Depends on More Funding for Family Planning

Oct 28, 2013

Download the paper (PDF) by Andrea Flynn

The Patient Protection and Affordable Care Act (ACA) represents an unprecedented expansion of the nation’s health care system and an historic investment in the health of American women and girls. The ACA has already improved the lives of millions and will make health care accessible for millions more as rollout continues this year and next.

Download the paper (PDF) by Andrea Flynn

The Patient Protection and Affordable Care Act (ACA) represents an unprecedented expansion of the nation’s health care system and an historic investment in the health of American women and girls. The ACA has already improved the lives of millions and will make health care accessible for millions more as rollout continues this year and next.

Fulfilling the promise of the ACA depends on the continued support and success of existing programs – like Title X, the federal family planning program – that serve as pillars of the nation’s still fragile primary health care infrastructure. Title X provides critical medical care and “wrap around” services for family planning clinics nationwide, enabling them to pay for and maintain facilities, train and hire staff, purchase equipment and supplies, and offer a host of services for specific populations.

Family planning is central to women’s health and social and economic security. Given the tenuous state of the U.S. economy, the vulnerability of women’s health programs in the face of unrelenting political attacks, and the fragility of the social safety net more broadly, public funding for family planning is more critical than ever. Critics may argue that because the ACA meets the needs of many women, Title X is no longer necessary. In fact, the opposite is true. Continued – indeed, increased – funding of Title X will maximize the impact and reach of the ACA and ensure continued care for those who will remain uninsured despite this landmark legislation.

Key Findings:

  • The ACA demands an unprecedented scaling up in the nation’s health infrastructure, and fulfilling the promise of the law will depend on the continued support and success of Title X.
  • The demand for Title X-funded clinics will only increase in coming years as more individuals seek care and those who already rely on safety net providers continue to do so.
  • Despite their coverage status,women will continue to rely on Title X-funded clinics because of the clinics’ experience in and commitment to providing care in a safe, confidential setting.
  • For many women, particularly young women and low- income women, Title X-funded clinics are a critical entry point into the health system. These clinics will be in even greater demand in the coming months as more women obtain coverage and seek a variety of health services.
  • Despite the extraordinary promise of the ACA, many will remain uninsured and for those individuals Title X providers will remain one of the only sources of quality, affordable family planning care.

Read "The Title X Factor: Why the Health of America's Women Depends on More Funding for Family Planning," by Roosevelt Institute Fellow Andrea Flynn.

Share This

Daily Digest - October 28: Watching the Surveillance State - and its Money

Oct 28, 2013Rachel Goldfarb

Click here to receive the Daily Digest via email.

Data Shows Democrats Fully Embraced by Surveillance Industry (The Real News Network)

Click here to receive the Daily Digest via email.

Data Shows Democrats Fully Embraced by Surveillance Industry (The Real News Network)

Roosevelt Institute Senior Fellow Tom Ferguson speaks to Jaisal Noor about his new working paper, which drew a connection between the surveillance state and campaign donations. When PRISM became public, it was hard to miss the connection in the data.

  • Roosevelt Take: "Party Competition and Industrial Structure in the 2012 Elections," by Tom Ferguson, Paul Jorgensen, and Jie Chen, is available here.

Post-Partisan: Fixing our ideological divide (Reuters)

Roosevelt Institute Senior Fellow Jonathan Soros argues that geographic segregation among ideological lines is causing more partisanship then gerrymandering. Changing district lines won't fix that, but some alternative election models might.

Politics and Reality Radio (Public Reality Radio)

Roosevelt Institute Fellow Mike Konczal speaks with Joshua Holland about how the rollout of Healthcare.Gov vindicates an old-school New Deal style of liberalism. Neoliberal approaches to social insurance are causing the problems here, not progressive ideas.

  • Roosevelt Take: Mike wrote about this topic for Next New Deal last week.

Making government simpler is complicated (WaPo)

Roosevelt Institute Fellow Mike Konczal considers what a "simple" regulation really means. If "simple" policies aren't easy to implement with clear and simple results, are they are simple, or just inefficient nudges?

The Republicans' War on the Poor (Rolling Stone)

Elizabeth Drew writes on the GOP's assault on food stamps, which ignores the program's decades of success. This is a prime example of the current government dysfunction, in which the Tea Party disrupts long-standing policies for its anti-Obama crusade.

Bipartisan Budget Love Suddenly in the Air (NY Mag)

Jonathan Chait suggests that there may finally be space for compromise in budget negotiations. For one thing, some Republicans are finally admitting that compromise doesn't mean that the Democrats give in to all their demands.

For Some, Joblessness Is Not a Temporary Problem (NYT)

Floyd Norris looks at the international problem of long-term unemployment, which is even worse in other developed countries than in the U.S., where for the first time since World War II, more people have been unemployed for over a year then for less then four weeks.

Share This

Daily Digest - October 25: Imagining A Tech-Friendly Government

Oct 25, 2013Rachel Goldfarb

Click here to receive the Daily Digest via email.

The U.S. Needs a Tech-Smart Government (Bloomberg View)

Click here to receive the Daily Digest via email.

The U.S. Needs a Tech-Smart Government (Bloomberg View)

Roosevelt Institute Fellow Susan Crawford argues that the embarrassing rollout of HealthCare.gov is proof that it's time for government to take a new approach to technology. The trouble is that tech innovation and government function in such disparate ways.

Addicted to the Apocalypse (NYT)

Paul Krugman suggests that the people who are constantly crying that the deficit will ruin our economy need to take a second look. After years of fear mongering, there's been no debt-apocalypse, and he doesn't think it's coming.

The Cost of the Financial Crisis Hits Americans Harder Than Banks (The Guardian)

Heidi Moore argues that even though the dollar costs of the mortgage crisis are greater for the banks than the average homeowner, the settlements are almost meaningless. JP Morgan Chase seems unapologetic, while people lost their homes to foreclosure.

The Goldilocks Curse: How America's Job Creation Story Got So Boring (The Atlantic)

Derek Thompson says that because job growth has been basically flat for two years, the news story is no longer interesting. He also wonders if things would have been so stagnant if the U.S. wasn't always shifting from one fiscal crisis to the next.

CHARTS: The Hidden Benefits of Food Stamps (MoJo)

Christopher D. Cook looks at some of the benefits of food stamps, like generating farm jobs and economic activity, and reducing children's risk of obesity and diabetes. That's all beyond fulfilling the basic purpose of feeding people who are hungry.

Detroit Pensioners Await Bankruptcy Ruling (MSNBC)

Ned Resnikoff reports on pensioner reactions to the beginning of the federal trial to determine whether or not Detroit can file for bankruptcy. The people he spoke to say that the "haircut" being suggested for the pensions would chop off a lot more then that.

How Congress is Aiming to Defang Patent Trolls (Quartz)

Tim Fernholz looks at new legislation introduced by Rep. Bob Goodlatte (R-VA) that would protect businesses from patent trolls, who buy up patents in order to make money off infringement suits and licensing fees.

 

Share This

Daily Digest - October 23: Jobs Report Wasn't Worth the Wait

Oct 23, 2013Rachel Goldfarb

Click here to receive the Daily Digest via email.

Weak Job Gains May Cause Delay in Action by Fed (NYT)

Click here to receive the Daily Digest via email.

Weak Job Gains May Cause Delay in Action by Fed (NYT)

Catherine Rampell reports on the September jobs report, released more then two weeks behind schedule thanks to the shutdown. The September numbers are weak, and the rest of the year's jobs reports will be impacted by the whiplash of shutdown.

The Jobs Report was Totally Blech. And it May Get Worse. (WaPo)

Neil Irwin considers what conclusions should be drawn from the September jobs report. His top two are that the Fed's decision to maintain quantitative easing looks better and better, and that sequestration is probably to blame for weak growth.

Wall Street’s Government Disconnect (The Daily Beast)

Daniel Gross asks why Wall Street reacts so frantically to every suggestion of federal or state government default, when such a thing has never happened. Only municipalities have defaulted, so why did so many companies shed bonds that were due in October?

Don’t Blame Health Law for High Part-Time Employment (WSJ)

Ben Casselman says that for all that anti-Obamacare politicians try to connect the law to rises in part-time employment, the data just isn't there. Over the past year, when the employer mandate was still expected for 2014, part-time work has stayed flat.

There Is No Evidence That Obamacare Will Make Poor Americans Less Likely to Work (The Atlantic)

Matthew O'Brien argues that Oregon's 2008 Medicaid expansion, which offered slots in the program by lottery, offers proof that obtaining health insurance won't cause people to stop working. That isn't surprising: healthcare doesn't buy groceries.

Sara Ziff’s Underage-Model Bill Gets Signed Into Law (NY Mag)

Charlotte Cowles celebrates the new law that gives underage models the protections that other child performers in New York have had for years, like education requirements. The law will be in effect before the next New York Fashion Week.

  • Roosevelt Take: Roosevelt Institute Fellow Dorian Warren wrote about Sarah Ziff and the Model Alliance when they first began their labor organizing efforts.

CHART: Welfare Reform Is Leaving More In Deep Poverty (MoJo)

Stephanie Mencimer looks at a Center on Budget and Policy Priorities report on TANF, which finds that monthly cash benefits have steadily lost value since 1996's welfare reform. That's happened alongside an 130% increase in families with children living in extreme poverty.

Share This

The Truth About the GOP's Phony Shutdown Offer

Oct 14, 2013Jeff Madrick

President Obama can't negotiate with Republicans if they won't drop their threats against the government and the economy.

President Obama can't negotiate with Republicans if they won't drop their threats against the government and the economy.

It’s very important that President Obama and his aides make clear to the American public that the Republican Party’s right wing, supported by moderates, offered no serious deal to him by proposing a postponement of their threat to let the U.S. default. They pointed a gun at his head and then said they may not pull the trigger for another six weeks. That is still extortion of the worst kind. Obama is simply saying, “Put the gun down and I will negotiate.”   

I notice a bias in the media. For example, The Wall Street Journal’s front page today said point blank that Obama turned down the Republicans’ offer to negotiate without mentioning that they did not withdraw their threat to do this all over again, which is the obstacle in the first place.

Meanwhile, I was asked by Sky News yesterday why I am only picking on Republicans. I answered that any make-believe that there is even partial blame to go around is nonsense. Sky wasn’t taking sides so much as doing that “even-handed’ thing that mainstream media thinks passes for objectivity.    

The public can be easily seduced by the Republicans’ non-offer, so Obama constantly has to make clear they made no real offer.

The substance of all this is often lost, too. First of all, why is this small group of Republicans so profoundly disturbed by Obamacare? Here’s where a bit of history hurts. We remember that universal health care failed to get passed under FDR, who wanted such a system. It made perfectly good sense to him. The American Medical Association, the doctors’ organization, pushed hard against it, and the phrase “socialized medicine” in a time of rising anti-communism struck a chord among the people. FDR lost the battle.

We assume those same sentiments are still at work. Now, of course, big pharma and insurance companies are often the opposition to single-payer. And no doubt there is still a lot of nonsense about not letting Uncle Sam into our medical offices or creating requirements to buy insurance.

But in the case of Obamacare, we may be fooling ourselves. The source of opposition to it could be as simple as intense racial prejudice and anti-abortion attitudes. Obamacare would radically expand Medicaid, a service for the poor. In the South, that mostly means black people. And many southern governors, even though it would cost them almost nothing because the federal government would pick up 90 percent of the cost, are not implementing the plan.   

The Republicans also want a “conscience” clause to allow individual corporations to refuse abortion financing. The Washington Post reported that in a closed-door session, Paul Ryan said Republicans can’t accept an extension of the deadline because they need it as “leverage” for demanding the conscience clause. Undermining Obamacare is still high on the agenda.   

The Republican counter, of course, made it seem that Obamacare wasn’t their current concern anymore, and that a broad negotiation to reduce the deficit was now the issue. On this, Larry Summers has an important piece in the Financial Times today showing that the 10-year deficit is now a non-issue. More important, he is claiming the long-term deficit is also a non-issue. By his calculation, we only have to grow by 0.2 percent more a year to keep it manageable, even as Medicare and Medicaid costs rise rapidly.  

Coming from the man who seemed to support a budget deficit-cutting commission early in Obama’s term, when he should have known better, this seems to be a helpful shift back to reality.

Growth is what matters, to which the Republican respond that they want more government cuts. The Senate Democrats won’t agree to retain the sequester and thereby do a deal with the Senate Republicans, but Mitch McConnell boasts how much it has cut government spending. He left out the part about how it is seriously impeding America’s economic growth at the same time. 

Without the sequester, the U.S. would very likely be growing at a healthy pace now, reducing unemployment and probably the deficit compared to GDP as well.

It would be nice to get serious talk about the economy back on track. The media could help. Wishful thinking.

Jeff Madrick is a Senior Fellow at the Roosevelt Institute and Director of the Bernard L. Schwartz Rediscovering Government Initiative.

Share This

The Shutdown Shows the GOP Can't Accept Defeat in the War on Women

Oct 2, 2013Andrea Flynn

When the GOP attempts to deny women access to contraception in the lead-up to a government shutdown, it’s hard to see how the party hopes to regain women’s support.

Yesterday the federal government shut down for the first time in two decades due, in part, to the GOP’s growing opposition to contraception. Republicans are intent on rolling back women's rights, and this time they are holding the federal government hostage in an attempt to advance their agenda.

When the GOP attempts to deny women access to contraception in the lead-up to a government shutdown, it’s hard to see how the party hopes to regain women’s support.

Yesterday the federal government shut down for the first time in two decades due, in part, to the GOP’s growing opposition to contraception. Republicans are intent on rolling back women's rights, and this time they are holding the federal government hostage in an attempt to advance their agenda.

With less than a day until the government would shut it doors, House Republicans put forth a spending bill that would enable employers, universities, and health insurance companies to deny coverage for contraception based on moral or religious beliefs. The bill would delay the “contraceptive mandate” – an Affordable Care Act provision that requires coverage of contraceptive and reproductive health services without co-pays – until January 2015. More broadly, the bill would delay the implementation of most ACA provisions for another year and would repeal a tax central to the law’s financing. Of course, delaying the law by a year is simply an attempt to overturn it altogether. Even Mitt Romney, who as Governor of Massachusetts implemented the very health overhaul on which the ACA is modeled, said a delay is the most strategic path to repeal.

The past few years have been an exercise in Republican tenacity as the party attempts to sink Obama's landmark domestic policy achievement. The fact that Obama won a second term in a decisive victory and that the U.S. Congress passed Obamacare into law and the U.S. Supreme Court deemed it constitutional is apparently meaningless.  

The GOP, hijacked by the right wing of its party, is redefining what it means to lose. Elizabeth Warren said it best on Sunday:

In a democracy, hostage tactics are the last resort for those who can’t win fights through elections, can’t win fights in Congress, can’t win fights for the presidency, and can’t win their fights in the courts. For this right wing minority, hostage-taking is all they have left: a last gasp for those who cannot cope with the realities of our democracy.

Since 2010, Republicans have voted 43 times to overturn the ACA. They have challenged the contraceptive mandate ad nauseam, have protested the employer mandate, and at the state level have refused to participate in the Medicaid expansion that would extend benefits to millions of uninsured, low-income individuals.

And President Obama, to the consternation of some on the left, has made concessions in hopes of advancing his overall agenda. Earlier this year, he compromised on the contraceptive mandate by enabling a broader group of self-defined faith-based organizations to qualify for a religious exemption, creating an accommodation where employees of those organizations can obtain full family planning coverage directly from insurance companies. He has responded to complaints from business lobbyists by agreeing to delay the employer mandate until 2015. (That provision requires employers with more than 50 full-time employees to offer affordable coverage for their workers, including children up to age 26.)

Republicans emphatically insist they are acting in the best interest of the American people. They aren’t. The ACA is good for women and for the entire nation. It has already expanded contraceptive coverage to millions of women, and within the next three years, approximately 13 million more uninsured women will be able to access affordable family planning and reproductive health services. The law will enable the majority of American women to access annual well-woman visits, screenings for cancer and STDs, maternal health care, emergency contraception, and pregnancy testing and counseling. Because of the ACA, individuals with pre-existing conditions will be able to get coverage and gender discrimination by insurance providers will be illegal. This law represents the most significant advancement in women’s reproductive health in nearly a century.

The unfolding debacle goes hand in hand with the reasons the GOP lost the women's vote in 2012 and is partly why they will not seize it back any time in the near future. Earlier this year, I wrote about the party’s self-reflective autopsy examining why and how Democrats carried the women’s vote by 36 points in the presidential election. They blamed their loss on a failed communications strategy but found little to be objectionable in the substance of their arguments. This week’s shutdown starkly illustrates the GOP’s inability to accept that the majority of Americans do not share their vision for the nation.

It’s becoming increasingly impossible for the GOP to argue that they care much at all about the women’s vote. Afterall, 69 percent of Republican women reported being opposed to a government shutdown, and 67 percent of registered voters believe that all workers should be allowed to access health care services regardless of their employer’s beliefs. And it turns out the only place contraception is controversial is in the halls of Congress; it is nearly universally accepted and used by Americans.

The GOP likes to say the "war on women" is a Democratic canard used to manipulate women at the voting booth. If only that were the case.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

 

Pills and calendar banner image via Shutterstock.com

Share This

The Next Real Fight for Obamacare Will Be in 2014

Sep 23, 2013Richard Kirsch

Progressives must get out in front of the battle to preserve the biggest expansion of the social safety net in decades.

It's been 100 years since ideological conservatives joined with doctors and insurance companies to kill the first movement in the United States for what was then called "compulsory health care." Now, on the eve of their epic loss, those who deeply hate the idea that we have a collective responsibility to care for each other are desperately trying to stop history's clock.

Progressives must get out in front of the battle to preserve the biggest expansion of the social safety net in decades.

It's been 100 years since ideological conservatives joined with doctors and insurance companies to kill the first movement in the United States for what was then called "compulsory health care." Now, on the eve of their epic loss, those who deeply hate the idea that we have a collective responsibility to care for each other are desperately trying to stop history's clock.

Beneath the tested rhetoric from opponents like the Heritage Foundation and Texas Senator Ted Cruz about a government takeover or Obamacare killing jobs and the economy, we can find expressions of the driving force behind the right's obsession. One telling quote is from Missouri State Senator Rob Shaaf, who declared, “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults.” Another is the proud statement from Steve Lonegan, the Republican candidate for U.S. Senate in New Jersey, who told me in a debate on Obamacare at the FDR Library, “I only care about me and my family.”

These celebrations of extreme individualism are bald expressions of the "47 percent of Americans are takers" ideology that has become the driving fixation of Republicans, with the latest example being the vote in the House to deny food stamps to 4 million people because they are unemployed.

The right most fears the establishment of another new program based on our common humanity. With her gift for sarcasm, New York Times columnist Gail Collins captured the irony of the Republican’s desperation to stop Obamacare before it starts: “The new health care law is going to be terrible, wreaking havoc on American families, ruining their lives. And they are going to love it so much they will never have the self-control necessary to give it up.”

If this is a defining moment for the right, it is also for the left. As Jonathan Chait wrote this week, in a great restrospective on Republican opposition to the ACA, “The transformative potential of Obamacare is not a conservative hallucination.”

For all its faults, the Affordable Care Act is the biggest expansion in half a century of the progressive belief that we all do better when we all do better. Almost 50 years ago, Medicare was greeted by Ronald Reagan – then a mouthpiece for the American Medical Association –  as a foot in the door to a totalitarian takeover. The right has long understood how high the American view of the role of government would be lifted if people came to rely on government for something as essential to a person's well-being as health care.

The battleground now shifts to how the public perceives the law's impact. I would like to believe that Ted Cruz was right about this, at least, when he told The Daily Caller, “President Obama wants to get as many Americans addicted to the subsidies because he knows that in modern times, no major entitlement has ever been implemented and then unwound.”

However, the lesson of the past three years is that the rhetoric has been more powerful than the reality. The most telling data is that the age group that has most definitively benefited from the Affordable Care Act, seniors, has the highest disapproval rating of the law. Thanks to the ACA, some six million seniors have received free preventive care under Medicare and 6.3 million people on Medicare saved over $6.1 billion on prescriptions. Still, the relentless attack messages aimed at seniors, starting with the death panel lies during the legislative debate on the law and accelerating in the 2010 election, have taken their toll.

On its face, opposing Obamacare should not be a winning electoral issue in 2014, if only because it will actually affect so few people. Several million people will get health coverage and very little else will change. But we can be certain that the right will continue to blame every established long-term trend in health care and the workforce – rising premiums, higher deductibles, fewer people getting health coverage at work – on the ACA.

The implementation of the ACA will also give its opponents new ammunition. Not just from the inevitable glitches in signing up people, made worse by Republican sabotage in many states, but from the law's biggest shortcoming: while millions will gain access to affordable coverage for the first time, others will be asked to pay more than they can afford or pay a fine.

Still, the fact that Obamacare will finally be doing what it was designed to do puts its defenders on higher ground, if we embrace the hard lessons of the past three years. Cementing the Affordable Care Act as a pillar of social security will require that Obamacare's champions aggressively respond to attacks and tell the stories of people whose lives have been transformed by the law. 

Until now, it has been almost impossible to explain to people how the Affordable Care Act will work. It has been a new, complicated concept rather than a real-life gate to getting health coverage. But the millions who will begin to benefit on January 1 will be able to tell a different story: the cancer survivor who can get coverage despite his preexisting condition; the budding entrepreneur who can leave her job to start a small business; the 60 year-old who lost her job but was still able to get health coverage.

With Obamacare a reality, not just a threat, their stories can be added to stories of a senior who is saving hundreds of dollars on Medicare prescriptions and the family whose finances were not wiped out when their 24-year-old son, still on his parents' health plan, was in an accident. 

The debate will be sharpest, and have the most impact, leading to the 2014 congressional elections. Republicans will be pushed by the right to make Obamacare a big issue, regardless of whether their pollsters advise that the failure of the world to implode after its implementation has taken some of the sting out. We can be sure that the Koch brothers will fund attack ads in swing districts and states. In 2010, the failure by Democrats to vigorously defend the law, particularly among seniors who vote most heavily in non-presidential elections, was a big factor in Republican success.

Progressives must engage in the fight now and prepare for 2014. It will not be enough to enroll people in Obamacare. We will need to organize new enrollees, their families, and their communities to be powerful spokespeople for the Affordable Care Act.

The ACA has proven to be the cat with nine lives, surviving near-death experiences during the legislative battle, the Supreme Court ruling, congressional and presidential elections, and the barrage of repeal votes, which are reaching their height now. The new day that the right has feared for a century will start in just three months. But the battle will not end then. The next big test will be November 2014. The stakes for people’s lives and livelihoods, and for the progressive expression of the American values of life, liberty, and the pursuit of happiness, could not be higher. 

Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform.

 

Health care costs image via Shutterstock.com

Share This

Daily Digest - August 27: High-Speed Internet? Not So Much

Aug 27, 2013Rachel Goldfarb

Click here to receive the Daily Digest via email.

Latest Pew Study Shows 70 Percent of U.S. Has Broadband. But Access Is Still Unequal (Wired)

Click here to receive the Daily Digest via email.

Latest Pew Study Shows 70 Percent of U.S. Has Broadband. But Access Is Still Unequal (Wired)

Roosevelt Institute Fellow Susan Crawford thinks that the Pew study has too broad a definition of "high-speed," and demonstrates the persistence of the digital divide. It shouldn't be acceptable that race, class, and region have so much effect on access.

Health Care and Education are Messed Up for the Same Reason (WaPo)

Ezra Klein argues that health care and education don't work like other markets, because people will do anything to avoid saying "no." That's the cause of the skyrocketing costs, and the reason for government subsidies in these areas.

One Way to End the School-to-Prison Pipeline (TAP)

Bryce Stucki suggests that policies that create job opportunities for low-income youth could do a lot more than keep teenagers busy for a summer. Summer jobs could be one of the keys to reducing suspensions and expulsions, and disrupting the school-to-prison pipeline.

The Outsiders: How Can Millennials Change Washington If They Hate It? (The Atlantic)

Ron Fournier's research shows that Millennials want to change the world, but don't think that public service is the way to do it. He concludes that if they take control of government, they will destroy the current system in order to radically rebuild.

An Unfulfilled Dream From the March on Washington: Labor Rights for Domestic Work (The Nation)

Bryce Covert looks at the state of domestic workers' labor rights, which haven't changed much in the fifty years since the March on Washington for Jobs and Freedom. Because they aren't covered by the Fair Labor Standards Act, domestic workers have few protections.

Why Are 83.4 Percent of Fortune 500 Board Seats Held By Men? (Slate)

Matt Yglesias thinks that since the requirements for serving on corporate boards are few, the low number of women is evidence that companies aren't putting any effort into involving women. It's not as though qualifications are keeping women out.

Look Out: Here Comes the Debt Limit (MSNBC)

Chris Godburn reports that Treasury Secretary Jack Lew has asked Congressional leadership to raise the debt ceiling before mid-October. That means it's time to listen to arguments about not raising the debt ceiling without budget cuts again.

New on Next New Deal

California's Community Colleges Teach Us How to Make Education More Affordable

Roosevelt Institute | Campus Network Western Regional Co-Coordinator Kevin Feliciano considers the changes that California has made to its colleges and universities, and suggests that the President could draw on what California has learned as his higher education proposals develop.

Share This

Delaying Abortions: A Harmful Consequence of the Pro-Life Agenda

Aug 2, 2013Andrea FlynnSusan Holmberg

The burdens placed on women's health by new anti-choice laws in the states have unintended consequences: more unplanned pregnancies, more abortions, and more abortions occuring later in pregnancy.

The burdens placed on women's health by new anti-choice laws in the states have unintended consequences: more unplanned pregnancies, more abortions, and more abortions occuring later in pregnancy.

Over the past two years, conservatives have successfully maneuvered around Roe v. Wade to enact sweeping abortion restrictions across the country. In the first half of 2013, lawmakers enacted 43 pieces of legislation restricting abortion access – as many as were enacted during all of 2012. These laws – and the ones that are sure to follow – infringe on women’s rights to access family planning and abortion services, will result in more unplanned pregnancies and therefore more abortions, and are likely to have the unintended consequence of pushing abortions later into pregnancy.

For years women have had to navigate numerous restrictions when they attempt to have an abortion. In deciding Planned Parenthood v. Casey in 1991, the Supreme Court overturned Pennsylvania’s spousal notification law but upheld both the parental consent and informed consent statutes on the basis that they did not impose an “undue burden” on women trying to abort their pregnancies. Since then, numerous states have implemented abortion restrictions on the basis that they do not constitute an undue burden.

  • Twenty-six states have waiting periods ranging from 24 hours to 72 hours. In South Dakota, weekends and state holidays do not count towards the 72-hour waiting period, meaning some women would have to wait nearly a week after their first visit before getting an abortion. Ten states have counseling requirements that also necessitate two visits to a clinic.
  • Thirty-eight states require minors to obtain parental consent and/or notification before having an abortion. Many of those states enable young women to obtain judicial bypass, a process many young women are likely to find intimidating and that surely delays the procedure into further into pregnancy.
  • Eleven states require that a physician be present to administer medication abortion, essentially outlawing telemedicine for this purpose.
  • Many states currently restrict abortion coverage in private plans, and others are beginning to impose the same restrictions on plans accessed through the health exchanges established by the Affordable Care Act. The Hyde Amendment already prohibits federal funds from being used to pay for abortions. The result is that women seeking abortion services – particularly low-income women who are un- or under-insured or are covered by Medicaid – must pay out of pocket.

Most recently, anti-choice legislators have added to those regulations even more restrictive policies that make abortion increasingly difficult to access – in some places almost impossible to access – let alone in a timely manner. Over the past few weeks, lawmakers in Texas and North Carolina passed sweeping regulations that threaten to shutter nearly all abortion providers in those states. The Texas law restricts medication abortions, places onerous requirements on physicians who perform abortions, and imposes the increasingly popular and effective TRAP laws (targeted regulations of abortion providers) on providers, requiring them to increase the width of hallways, add janitor closets, expand operating rooms, etc.

Women’s health advocates have argued that these laws will lead to more unplanned pregnancies and result in a greater number of unsafe abortions. It is also likely that women will require abortions later in their pregnancies – the very situation conservatives are legislating against.

TRAP laws have become a favorite strategy of the anti-choice movement and have the effect of closing clinics that actually perform a wide range of reproductive health services. Anti-choice activists and lawmakers often refer to these clinics as if their sole function is performing abortions. In actuality, these clinics are a pillar of our nation’s health infrastructure. They prevent thousands of unwanted pregnancies each year by providing poor women, young women, immigrant women, and women of color low- and no-cost family planning. These clinics provide pregnancy education, testing, and counseling, which enables women who do choose to have an abortion to do so early in pregnancy. It is not hard to imagine that women will have more unintended pregnancies and require abortions later into pregnancy as those providers close their doors. 

The Guttmacher Institute reports that already seven in 10 women who had a second-trimester abortion wanted to do so earlier in pregnancy but were unable to because they could not afford it. Economists who study family planning policy argue that the costs a woman seeking an abortion faces do not only come in the form of dollars, but also in the time required to access an abortion. A 2001 study by Marianne Bitler and Madeline Zavodny shows that state restrictions that impose mandatory waiting periods (in other words, a time cost) also delay abortions into the second trimester. A 1994 study of Mississippi’s mandatory delay laws showed a 17 percent jump in second trimester abortions after the law took effect.

Other research shows that adolescent women and low-income women are more likely to have abortions later in pregnancy. These are the very groups of people who rely on publicly-funded family planning clinics and who are most affected by the new abortion regulations. These studies are relatively dated; given that state-level restrictions have only ramped up since this research was conducted, the number of women delaying their abortions has likely escalated too.

These patterns are only deepened when lawmakers target not only abortion but the full range of family planning and reproductive health services that women rely on to take care of themselves and their families. Over the past two years, family planning providers across the nation have already been forced to decrease staff, cut hours, reduce services, and close as a result of funding restrictions and budget cuts. Under the new wave of restrictions, they will now face further cuts and many will be forced to close.

Anti-choice lawmakers insist their battery of abortion regulations aim to improve the health and safety of women and girls. This is simply not what the outcome will be. Women will experience more pregnancies and have abortions at later gestational ages, which only subjects them to greater financial burdens and much greater health risks. For example, the average charge for a second trimester abortion is double that for the first trimester. In addition, the potential for a major complication or death is also much higher for a second trimester abortion. If that’s not the definition of an undue burden, we don’t know what is.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Susan Holmberg is the Director of Research at the Roosevelt Institute. She holds a Ph.D. in economics and studies gender issues, international development, and corporate governance. 

Share This

Why the Right Doesn’t Really Want Euro-Style Reproductive Health Care

Jul 24, 2013Andrea Flynn

U.S. conservatives want Europe's abortion restrictions, but they oppose the generous systems and legal exceptions that support women's health.

U.S. conservatives want Europe's abortion restrictions, but they oppose the generous systems and legal exceptions that support women's health.

Earlier this month, Texas lawmakers witnessed and participated in passionate debates about one of the nation's most sweeping pieces of anti-choice legislation. That legislation, known as SB1, was initially delayed by Wendy Davis's now-famous filibuster and was signed into law by Governor Rick Perry last week during a second special legislative session. It bans abortions after 20 weeks, places cumbersome restrictions on abortion clinics and physicians, and threatens to close all but five of the state’s 42 abortion clinics. Throughout the many days of hearings anti-choice activists relied on religious, scientific, and political evidence to argue that the new Texas law is just and sensible.

Many of those arguments are tenuous at best, but it is the continued reference to European abortion laws that most represent a convenient cherry-picking of facts to support the rollback of women’s rights. Many European countries do indeed regulate abortion with gestational limits, but what SB1 supporters conveniently ignore is that those laws are entrenched in progressive public health systems that provide quality, affordable (sometimes free) health care to all individuals and prioritize the sexual and reproductive health of their citizens. Most SB1 advocates would scoff at the very programs and policies that are credited with Europe’s low unintended pregnancy and abortion rates.

Members of the media have also seized on European policies to argue that Texas lawmakers are acting in the best interest of women. Soon after the passage of SB1, Bill O’Reilly argued that “most countries in the world have a 20-week threshold,” and Rich Lowry, editor of the National Review, wrote, “It’s not just that Wendy Davis is out of step in Texas; she would be out of step in Belgium and France, where abortion is banned after 12 weeks.”

It’s hard to imagine any other scenario in which O’Reilly and Lowry, and most conservative politicians and activists, would hold up European social policies as a beacon for U.S. policy. After all, the cornerstones of Europe’s women’s health programs are the very programs that conservatives have long threatened would destroy the moral fabric of American society. One cannot compare the abortion policies of Europe and the United States without looking at the broader social policies that shape women’s health.

Both Belgium and France have mandatory sexuality education beginning in elementary school (in France parents are prohibited from removing their children from the program). France passed a bill earlier this year that allows women to be fully reimbursed for the cost of their abortion and guarantees girls ages 15 to 18 free birth control. Emergency contraception in both countries is easily accessible over the counter, and in Belgium the cost of the drug is reimbursed for young people and those with a prescription. Both countries limit abortion to the first trimester but also make exceptions for cases of rape, incest, and fetal impairment, to preserve woman’s physical or mental health, and for social or economic reasons. None of these exceptions are included in the new Texas law, and I’d guess it would be a cold day in hell before the likes of O’Reilly and Lowry advocate for more expansive health policies or for including such exceptions in abortion laws.  

But it would be wise if they did. This availability of preventative care contributes to the overall health and wellness of women in Europe and enables them to make free and fully informed decisions about their bodies over the course of their lifetimes. The demonization and lack of progressive sexual health policies in Texas, and in the United States more broadly, drives high rates of unintended pregnancy, teen pregnancy, maternal mortality, sexually transmitted infections, and abortion. 

Unfortunately, Texas couldn’t be further from France or Belgium when it comes to the care it provides to women and families before, during, and after delivery, as I’ve written about before. The Texas teen birth rate is nearly nine times higher than that of France and nearly 10 times higher than that of Belgium. Nearly 90 percent of all teens in France and Belgium reported using birth control at their last sexual intercourse, compared with only 53 percent in Texas. The infant mortality rate in Texas is twice that of Belgium and France. The poverty rate among women in Texas is a third higher than that of women in Belgium and France, and the poverty rate among Texas children is 1.5 times higher. Less than 60 percent of Texas women receive prenatal care, while quality care before, during, and after pregnancy is available to nearly all women throughout Europe.  

None of those hard facts were compelling enough to amend – let alone negate – the new law. It seems impossible these days to find a common ground between anti- and pro-choice individuals, but if conservatives wanted to have a conversation about enacting European-style sexual and reproductive health policies in the United States, that just might be something that could bring everyone to the same table. The more likely scenario is that once conservatives have plucked out the facts that help advance their anti-choice cause, they will promptly return to tarring and feathering Europe’s socialized health system.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States and globally. She is on Twitter at @dreaflynn.

 

Woman and doctor banner image via Shutterstock.com

Share This

Pages