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ACA Qué (What)? A Policy Wonk’s Mother Still Wonders How it Affects Her and Latin@ Families

4:11 pm in Uncategorized by RH Reality Check

Written by Marisol Franco for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

We are now in the aftermath of the historic and significant Supreme Court ruling in favor of the Affordable Care Act (ACA). Our celebrations have simmered down and now we are analyzing what it all truly means and educating our  communities, while pushing back against the relentless opposition (i.e. the 33rd vote by the House to repeal ACA).

As I monitored the SCOTUS blog at the crack of dawn on the day of the ruling, I reminded myself that my mother, who had already been at work since 5 a.m. inside the hotel where she has worked for over 35 years, probably did not hear about the decision. While those who work on reforming our health care delivery system blasted emails, tweeted, blogged, and spoke with media, I wondered what she would have thought if she heard President Obama speak. Despite having a health policy wonk for a daughter, she would probably still wonder how this decision affects her, as most people did that morning and still do.

Despite the onslaught of reporting that day, the majority of discussions did not address how the ACA would benefit Latina/o individuals and families. Based on a xenophobic narrative, coverage about the fastest growing ethnic group in the country falsely pegs Latinas/os as immigrants who “drain” the system, and ignores contributions of immigrant and non-immigrant families as well as the less than half of Latinas/os who have access to job-based health insurance.

Overall, California Latinas/os stand to gain the most with the ACA, whether currently insured or uninsured. Latinas are the most uninsured group in the state with 4 out of 10 of us lacking health coverage. With this decision, over 2 million more California Latina/os will have access to affordable health care in 2014. It will also help the Latinas/os who already have employer-based coverage through regulatory and broader public health provisions.

My family is part of the 38 percent of Latinas/os in California who have employer-based coverage. Despite a debilitating work-related injury to her shoulder, my mother continues to work full-time through the pain she feels when cutting fruits and vegetables for the hotel restaurant, so that she can obtain health coverage for herself and two of my younger siblings. Latinas/os value health care and will often go to great lengths to obtain affordable health care for their families.

For California Latinas/os, the ACA means:

  • About 1.1 million California Latinas/os who are low-income citizens or qualified immigrants with incomes under 133 percent of federal poverty level ($30,657 for a family of four) will qualify for Medi-Cal.
  • More Latinas will have access to no-cost basic women’s preventive health, including contraception and cancer screenings.  This is extremely important for Latinas who are disproportionately affected by breast cancer and cervical cancer.
  • More families will have access to no-cost preventive care, including physical exams and immunizations.
  • More funding will go to community health centers, where anyone regardless of insurance or immigration status can receive care.
  • For those whose employers do not offer health coverage, which is a large percentage among Latinas/os, the ACA will provide tax credits to families on a sliding scale to purchase their own insurance through new insurance marketplaces called Exchanges.

The ACA also keeps insurance companies in check:

  • Insurance companies now have to justify to the Insurance Commissioner if they plan to raise their rates by more than 10 percent.
  • Insurance companies can no longer charge women more than men for the same insurance policy.
  • Insurance companies can no longer deny coverage to children for pre-existing conditions.
  • Insurance companies must spend the bulk of our premiums on providing care and not CEO bonuses. Families will receive rebates for un-spent premium dollars.

While we share and celebrate the positive changes that the ACA has already accomplished and those to come, we must also continue to fight for equal access to health care for everyone in our communities, specifically our undocumented brothers and sisters. Twenty-six (26) percent of uninsured Latinas/os in California would be excluded due to citizenship and immigrant clauses that prohibit undocumented residents from participating in public programs, receiving tax credits and using their own money to purchase coverage through the Exchange. We must inform immigrants about which public programs and health centers they can access, and at the same time work on solutions to cover all Californians, regardless of immigration status.

Opponents of the ACA can use scare tactics to inflame “the taxpayers” about all of the immigrants they would have to be responsible for providing health care – but the bottom line is that when families in our community cannot access care we all lose. Emergency care costs are mounting and safety net providers are over-burdened and under-resourced. And let us not forget that our immigrant families are also “taxpayers” and contribute invaluably to California’s and the nation’s vitality. Immigrants, regardless of status, are equally entitled to their human right to health care.

This “win” was not just for the policy and advocacy community, it was for families–like mine, like yours, and many other Latina/o families in California. Because of the Supreme Court ruling, I can rest assured that when my mother, who is still far from Medicare eligibility, can no longer work the required hours, we will be able to find her affordable health coverage.  

While most people have moved on to the latest breaking news, the decision did pique people’s interest. They want to know more about the ACA and how it will affect them. We all have a responsibility to inform our family, friends and broader communities about the details and importance of the ACA especially as conservative politicians push back and muddle the facts. We must speak clearly, loudly and relentlessly. Now is the time to drown out the naysayers and stand up for health care for all.

Questions for Paul Ryan, Mitt Romney and Other Opponents of Health Care Reform: Where Are Your Facts?

12:09 pm in Uncategorized by RH Reality Check

Written by Amanda Marcotte for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Paul Ryan (United States Congress / Wikimedia Commons)

The Supreme Court ruling on the Affordable Care Act (ACA) on Thursday has caused a rush of panic from the opponents of universal health care. Lots and lots of claims about what the law does are being tossed around, and many of these claims are what you might call puzzling to those of us who actually know what’s in the ACA. Now, I don’t want to accuse anyone of intentionally lying without gathering more evidence, but without a deeper understanding of what various conservatives mean by their claims, it’s hard to suppress the sense that they may perhaps just be lying. So, I’ve made a list of questions I want opponents of health care reform to answer so I can better understand how their seemingly outrageous claims about the ACA make sense outside of the most obvious “lying” angle.

How does one “go on” Obamacare? Paul Ryan, denouncing the bill: “Millions of people who are otherwise going to go on Medicaid, are now going to go on Obamacare which costs a whole lot more money.” What is this “Obamacare” that people can go onto? I looked around to see if I could get an insurance plan through the “Obamacare” that Ryan and other conservatives are talking about Americans going on to and all I can find are the same old private insurance companies that existed before. The way Ryan & Co. talk about “Obamacare,” it sounds an awful lot like they think there’s a public option people can buy if they don’t want private insurance and aren’t eligible for Medicaid. But those of us who recall the big political fight over the ACA can tell you that there was originally a public option in the bill, but it was removed in order to get more votes from conservative Democrats. So what is this “Obamacare” conservatives keep insisting you can buy into and where do I find it?

How does the ACA remove your choice or get between you and your doctor? Various claims are being tossed around about health care reform “getting between you and your doctor” or taking away people’s choices in what medical treatments to pursue. In his remarks after the ACA ruling, Romney repeated this claim by saying the government is getting “more and more intrusive in your life” and “separating you and your doctor.”

So my question is: How? What medical decisions will the government now be making for you under the ACA? (Obviously, under conservative-supported legislation, the government has a lot of power to make decisions for women seeking abortion or contraception, but those laws aren’t part of ACA.) If you’re referring to the fact that insurance companies will retain the right to deny coverage for certain procedures they deem unnecessary, well, insurance companies already do that. If anything, the ACA has limited the ability of insurance companies to deny you the ability to pursue medical treatments you and your doctor choose, because the ACA has removed spending limits and banned insurance companies from denying you coverage based on pre-existing conditions.

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A Pyrrhic Victory? In ACA Ruling, Roberts Court Takes Big Swipe At Social Safety Net

11:12 am in Uncategorized by RH Reality Check

Written by Jessica Mason Pieklo for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

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When the legal challenges to the Affordable Care Act first started taking form, the assertion that Congress did not have the power to regulate the health insurance industry under either the Commerce Clause or the Necessary and Proper Clause was largely seen as an academic argument that had percolated in law schools thanks to a robust presence of the Federalist Society. After all, how could an industry that accounts for approximately 16 percent of economic activity in this country be said not to affect interstate commerce? Of course it can be regulated. Under the even the most cynical view opponents of the Affordable Care Act peddled these arguments simply as political cover for the Court to invalidate the law since the tension between the Obama administration and the conservative wing of the Roberts Court was nearly palpable.

The Court declined the political cover, a fact I think speaks loudly to the rumors that Chief Justice Roberts was concerned about the partisanship and rancor brewing within and around the Court, and the implications of this for his legacy. But the Chief Justice hardly “joined the liberal wing” of the Court in upholding the law. In fact, his decision gives conservatives a potentially significant tool to further attack the social safety net in its limitation of the Commerce Clause.

People, for reasons of their own, often fail to do things that would be good for them or good for society. Those failures—joined with the similar failures of others—can readily have a substantial effect on interstate commerce. Under the Government’s logic, that authorizes Congress to use its commerce power to compel citizens to act as the Government would have them act.

That is not the country the Framers of our Constitution envisioned.

For centuries the Court has held that these congressional powers are broad and expansive, and that the main risk an expansive view of federalism poses is a political risk, not any real risk to individual rights or liberties. Then, in 1995, in the Court’s decision in United States v. Lopez, Chief Justice Roberts’ predecessor re-discovered those limits.

The Lopez decision invalidated the law banning the possession of guns near schools on the grounds that the activity challenged — gun possession and presumably gun use — was too far attenuated from the stream of commerce for Congress to regulate. Gun rights activists heralded the decision as a triumph of the Second Amendment, but social conservatives saw much more in the ruling. They saw the dawning of a new Golden Age limiting federal power and future legal avenues to challenge laws and policies they deeply opposed — like the Affordable Care Act.

In rejecting Congress’s ability to regulate the health insurance industry under the Commerce Clause while still upholding the mandate under Congressional taxing authority, Chief Justice Roberts builds on the Lopez line of reasoning in a way that did no broad political damage to the Court — after all, the mandate survived and only those on the hard right seem intent on calling for Roberts’ impeachment — while still giving lots of juicy tidbits for federal judges to cite in future rulings hemming in other Congressional action. And since so much of Congressional action on domestic programs relies on its authority under the Commerce Clause and the Necessary and Proper Clause, it’s too soon to say if this distinction is again merely academic.

More importantly, Roberts extends the logic of Lopez which may prove to be more significant than we realize even now as the Court considers future challenges to Medicaid funding, efforts to defund Planned Parenthood and affirmative action challenges. As the logic goes, just because social ills have a broad economic impact does not mean Congress is empowered to fix them.

It’s a logic that whole-hardheartedly rejects the very premise of the New Deal and our social safety system and one that was just reinforced within the confines of a win on health care reform. Those of us that support the bill should celebrate the victory but we cannot get comfortable now. Chief Justice Roberts made it clear he upheld the law because he had to, both legally and politically. But in many ways the decision is a chilling repudiation of the heart and soul of its reform and a rallying cry for more vigorous challenges to the safety net. And we can expect conservatives to heed the call.

Religious Freedom or Religious Control? Employees Should Get to Decide Where Their Paychecks Go

7:51 am in Uncategorized by RH Reality Check

Written by Christine Charbonneau for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

I am the CEO of Planned Parenthood of the Great Northwest.  I am also an employer.  In the latest round of the War on Women being waged by Congress and the legislatures of the 50 states, much has been written of late about employers; what they want and do not want to insure, and most recently, how employers would be allowed to “weigh in” on the reproductive decisions of our employees.  Spare me.

I have 500 employees in three states.  Like most employers, I have a finite budget for the health insurance I offer my staff.  My goal, as I see it, is to get them the richest package of services I can find for the money I have to invest.  I consider the premiums I pay for this health care to be part of each employee’s compensation.  I also know that covering my staff appropriately results in a happier workforce, with less downtime due to medically related absences, so the investment is good for business, as well. 

Just as I would never dream of telling my staff what to do with their bi-weekly paychecks, I have no interest in telling them how to use their insurance benefits.  After the premium is paid, it is NONE OF MY BUSINESS. 

However, as Planned Parenthood has made it a goal to ensure that reproductive health services are covered in the larger marketplace, I will not purchase a health plan which does not cover contraception, and every outcome of pregnancy, including abortion. Three years ago, while completing the merger of Planned Parenthood affiliates in Western Washington, Alaska and Idaho, I sought to unify the health insurance plans which covered our employees, so that they would all get the same benefits and to save my organization the cost of administering multiple plans.

As we were selecting our insurance provider, I was told that they would be unable to cover abortion services for my employees in Idaho.  I was flummoxed.  After all, this is America, and I was fairly certain that there would have to be a way to buy coverage for a legal procedure.  So I told the plan in question that they would write me the coverage I was asking for, or I would write my $2,000,000 a year premium check to someone who would.

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Why the Affordable Care Act is Critical For Women Living With HIV

9:27 am in Uncategorized by RH Reality Check

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Written by Brook Kelly for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

In January 2012, Women Organized to Respond to Life-threatening Diseases (WORLD) and 16 other organizations led by Lambda Legal filed with the Supreme Court a friend-of-the-court brief in support of the Affordable Care Act (ACA). This week, the Supreme Court held a three-day hearing on the constitutionality of health care reform. As we hold our breath to see how the Court will decide the fate of the ACA, now is a good time to remind ourselves of the importance of health care reform for women living with HIV and affected by HIV.

We know that the HIV epidemic thrives on a lack of quality, acceptable, affordable and accessible health care. We also know that discrimination in health care based on race, ethnicity, gender and gender identity, pre-existing conditions, and economic status is rampant. No one law can solve all of these problems but the Affordable Care Act is a first and necessary step toward reforming our health care system to better meet the needs of all people.

The full implementation of health care reform is vital to women living with and affected by HIV for a number of reasons:

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Do New Health Law Mandates Threaten Conscience Rights and Access to Care?

1:31 pm in Uncategorized by RH Reality Check

Written by Jon O’Brien for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

This testimony was submitted to the US House of Representatives Committee on Energy and Commerce’s Subcommittee on Health on November 2, 2011. It is written testimony for the hearing record on “Do New Health Law Mandates Threaten Conscience Rights and Access to Care?”

The article was amended at 12:38 p.m., Thursday, November 3rd to correct links in one paragraph.

Mr. Chairman, Ranking Member Pallone and Members of the Subcommittee, thank you for this opportunity to present testimony on behalf of Catholics for Choice on this important question of conscience rights and access to comprehensive healthcare.

For nearly 40 years, Catholics for Choice has served as a voice for Catholics who believe that the Catholic tradition supports a woman’s moral and legal right to follow her conscience on matters of sexuality and reproductive health. Throughout the world, we strive to be an expression of Catholicism as it is lived by ordinary people. We are part of the great majority of the faithful in the Catholic church who disagrees with the dictates of the Vatican on matters related to sex, marriage, family life and motherhood. We represent those who believe that Catholic teachings on conscience mean that every individual must follow his or her own conscience — and respect others’ right to do the same.

Certainly, at Catholics for Choice, we are no strangers to the intersection of religion, sex and politics. While religious voices and traditions are a vital part of public discourse, religious views should not be given disproportionate weight in public policy discussions. When this happens the lives of men and women can suffer greatly. We believe in a world where all voices, the voices of the religious and of the secular, of Catholics and non-Catholics alike, are heard in public policy discussions.

This hearing seeks to answer the question: Do new health law mandates threaten conscience rights and access to care? I firmly believe the requirements under the Affordable Care Act, and the slate of regulations being created to implement it, infringe on no one’s conscience, demand no one change her or his religious beliefs, discriminate against no man or woman, put no additional economic burden on the poor, interfere with no one’s medical decisions, compromise no one’s health — that is, if you consider the law without refusal clauses. When the question is asked in light of these unbalanced and ever-expanding clauses, the answer becomes yes, it would do all these things. When burdened by such refusal clauses, the new health law absolutely threatens the conscience rights of every patient seeking care for these restricted services and of every provider who wishes to provide comprehensive care to their patients. These restrictions go far beyond their intent of protecting conscience rights for all by eliminating access to essential healthcare for many, if not most patients, especially in the area of reproductive healthcare services. This will make it harder for many working Americans to get the healthcare they need at a cost they can afford.

The Affordable Care Act has many positive elements to it. Millions will now be able to access insurance coverage for their health needs and, with the basic level of coverage required under the new law, these newly insured and the millions of those better insured will now have greater access to a wider range of services than ever before. However, the law includes a refusal clause which has been expanded in the past decades to threaten the consciences of both those who seek to receive and those who want to provide services. Advocates of these expansive refusal clauses claim these are necessary to protect conscience rights. Others believe that refusal clauses such as these are simply part of attempts to derail the Affordable Care Act and to curb access to reproductive healthcare services entirely. Moreover, proposals to expand existing refusal clauses increase threats to the conscience rights of patients and providers by including not just abortion but also family planning services and, should some get their way, any other service deemed “unacceptable” by a tiny minority.

In recent years, under the guise of protecting religious freedom and “conscience rights” we have seen a dramatic upswing in attempts to expand the scope of refusal clauses, their application, and the entities able to utilize them. These new, ever-broader refusal clauses do far more than allow those healthcare professionals or social service providers with conscience objections to opt out. Instead, they are effectively being used as a means to refuse some treatments, medications, benefits and services to all comers.

These expansions have increased not only the services that may be refused—including reproductive health services as well as insurance coverage for those services and even training for medical professionals—but they have also the number of those who may claim these protections. Almost everyone, including most Catholics, agrees that it is reasonable to allow healthcare professionals, including doctors, nurses and pharmacists, to opt out of providing essential reproductive healthcare services and medications to which they conscientiously object. There is no doubt that there are times when the conscience of an individual doctor, nurse or pharmacist may conflict with the wishes orneeds of a patient. This often happens in cases related to abortion. Except in emergency situations, it is reasonable and indeed prudent to allow those who are opposed to abortion to opt out of providing the service. In these situations, women seeking these services should not have to worry about the religious and moral beliefs of their healthcare providers interfering with the provision of the best possible care. Therefore, it is in the best interests of all that only medical professionals committed to providing such services do so. Women need support and compassionate care when they access reproductive healthcare services, not judgment and disdain.

When this is not possible, a reasonable ethical fallback is for the institution to guarantee timely referrals to ensure that patients receive continuity of care without facing an undue burden, such as traveling long distances or encountering additional barriers to obtaining the desired services. Moreover, good practice should also compel a religious institution to make sure that the consciences of both the healthcare (or social services) provider and the patient (or client) are accommodated by having policies in place that enable individuals to receive whatever medications they are prescribed, procedures they require or services they seek.

Like many Catholics, I accept that conscience has a role to play in providing healthcare services, but recent moves to expand conscience protections beyond the simple right for individual healthcare providers to refuse to provide services to which they personally object go too far. Increasingly, demands and regulatory proposals attempt to grant that option to an institution or any individual along the spectrum of care, funding and coverage. It is incredible to suggest that a hospital or an insurance plan has a conscience. Granting institutions, or entities like these, legal protection for the rights of conscience that properly belongs to individuals is an affront to our ideals of conscience and religious freedom.

Allowing religious institutions to dictate the medical care available to their employees or religiouslyaffiliated organizations to dictate what services their beneficiaries are allowed to access would encroach on the individual consciences of those seeking care and assistance. Refusal clauses such as these fly in the face of true religious freedom by promoting the interests of certain elements of particular religions over the consciences and beliefs of individuals. They ignore the moral agency of the many who do not share the beliefs of a particular religious ideology. If allowed to stand, these refusal clauses do nothing but endanger many women’s access to the healthcare they need. When codified into law at the federal or state level, these “protections” actually constitute state-sponsored discrimination against women based on where they are employed, where and how they buy health insurance and where they seek to receive care.

Today, the 98 percent of sexually active Catholic women in the US who have used a form of contraception banned by the Vatican have exercised their religious freedom and followed their consciences in making the decision to use contraception. Thus, they are in line with the totality of Catholic teachings, if not with the views of the hierarchy. The problem is very clearly with the Catholic hierarchy and not the Catholic church, which includes the vast majority of the 68 million Catholics in the United States who use and support the availability of comprehensive reproductive healthcare services for all those who choose to utilize them.

Having failed to convince Catholics in the pews, the United States Conference of Catholic Bishops (USCCB) and other conservative Catholic organizations are now attempting to impose their personal beliefs on all people by seeking special protection for their “conscience rights.“ They claim to represent all Catholics when, in truth, theirs is the minority view. The bishops have identified several sympathetic high-profile allies in healthcare, education and social service provision to assist them in promoting their demands, but these allies are heavily reliant on the bishops for funding and prestige. Hospitals and colleges can lose their Catholic designation at the bishop’s whim, as happened recently in Phoenix, Arizona.

At a Catholic hospital in Phoenix, medical professionals acted to save the life of a pregnant woman by performing a life-saving abortion on a mother of four. The local bishop decided that his authority over the hospital allowed him to second-guess the medical decisions they made and he stripped the hospital of its Catholic designation. This is antithetical to the Catholic social justice tradition, which would not leave a woman’s life out of any healthcare equation.

What occurred in Phoenix helps to illustrate the problem with the bishops’ intrusion into medical decisions. The personal and professional freedom to make healthcare decisions is being threatened by expansive refusal clauses. The exemptions that the USCCB and other conservative Catholic organizations are demanding do not offer any more protection for religious freedom, but rather impede the religious freedom of millions of Americans, taking reproductive healthcare options away from everybody.

The USCCB and some Catholic organizations, many that receive taxpayer money, are asking to be allowed to:

  • deny condoms as part of HIV outreach;
  • ban employees and their dependents from getting the benefit of no-cost contraceptive coverage that other insured Americans enjoy;
  • opt out of providing emergency contraception to victims of sexual violence who come to Catholic hospitals for help; and
  • deny abortion care to everybody — even those women whose lives are threatened by their pregnancy.

They claim that they are representing all Catholics, but this is not true. The majority of Catholics support equal access to contraceptive services and oppose policies that impede upon that access. 

Two-thirds of Catholics (65 percent) believe that clinics and hospitals that take taxpayer money should not be allowed to refuse to provide procedures or medications based on religious beliefs. A similar number, 63 percent, also believes that health insurance, whether private or government-run, should cover contraception. A strong majority (78 percent) of Catholic women prefer that their hospital offer emergency contraception for rape victims, while more than half (55 percent) want their hospital to provide it in broader circumstances. This support for the full range of contraceptive services is unsurprising, as restrictions such as refusal clauses or prohibitive costs affect Catholics just as often as non-Catholics — 98 percent of sexually active Catholic women have used a modern method of birth control,mirroring the rate of the population at large (99 percent).

Advocating for expansive refusal clauses in healthcare delivery regulations would affect all patients — whether those patients are Catholic or not. Seeking exemptions for religious organizations to cover essential health benefits, such as full coverage of recommended preventive services including contraception, under the Affordable Care Act will only serve to endanger many women’s access to the healthcare they need — whether those employees share those religious beliefs or not. In reality, these exemptions would deny the right of everyone seeking comprehensive healthcare.

When religious voices are allowed to direct policymaking, the best interests of those seeking healthcare services can be ignored. This is clear in the case of the Catholic healthcare industry which, despite providing much valuable service, persists in refusing to provide a full range of reproductive healthcare services, even to those who are in desperate need of them.

Respect for individual conscience is at the core of Catholic teaching. Catholicism also requires deference to the conscience of others in making one’s own decisions. Our faith compels us to listen to our own consciences in matters of moral decision-making and to respect the rights of others to do the same. Our intellectual tradition emphasizes that conscience can be guided, but not forced, in any direction. This deference for the primacy of conscience extends to all men and women and to their personal decisions about moral issues.

Our faith also compels us to respect religious pluralism and religious freedom. Religious freedom is an expansive rather than restrictive idea. It has two sides: freedom of religion and freedom from religion. It is not about telling people what they can and cannot believe or practice, but rather about respecting an individual’s right to follow his or her own conscience in religious beliefs and practices, as well as in moral decision making. The protections we put in place to preserve religious freedom do not permit religious institutions or individuals to obstruct or coerce the exercise of another’s conscience.

Sweeping refusal clauses and exemptions allow a few to dictate what services many others may access. They disrespect the individual capacities of women to act upon their individual conscience-based decision. They impede the rights of women and men to make their own decisions about what is best for their own health, and that of their families, as well as restricting their right to act upon those decisions without undue and unjust burdens.

One woman who saw these burdens placed on her conscience rights is “Sandra,” a science teacher at a Catholic school in the Midwest. Her story is an example of the many Americans who fall under these types of expansive refusal clauses being pushed by the bishops and their allied organizations. What is a reality for Sandra today is what many women can look forward to in their future.

As with almost all Catholic schools, Sandra’s employers follow diocesan rules regarding employees’ insurance — meaning no contraceptive coverage, regardless of medical necessity. When she first learned of the refusal clause proposed in the recent regulation to implement the preventive health services under the Affordable Care Act, she was outraged. As she explained to us, they added “insult to injury” by ignoring the healthcare needs of women like her and allowing her employers to continue to deny her coverage.

“I just never assumed that in 2011 I would be denied birth control,” she said. “I’m in my mid-twenties. I have no intention of having kids at the moment. I like teaching kids, but it’s a whole other thing having them.”

Sandra lost coverage when she began working under the jurisdiction of her local diocese. “I went to fill my birth control prescription like I always do. I say ‘Here’s my new insurance card,’ and they say I’m not covered,” she related. “They thought that it was weird and asked where I worked. As soon as I said I worked in a Catholic school, they said, ‘Oh, 99 percent of Catholic schools will not cover it. We’ve never had it covered before.’ I had no clue.”

For Sandra, this posed a significant hardship. She had taken a salary reduction in order “to go to work every day saying that it’s what I love.” She and her husband had carefully considered their insurance plans and determined that it was more economical for them to remain on separate policies, but once she had to pay out of pocket for the birth control that was best for her, a non-generic prescription, their careful financial planning was all for naught.

“Birth control is a lot of extra money on top of the salary reduction, but the principle of it is really what gets me,” she told us. “I don’t like being told by some guy that I’ve never met that I can’t use it. The bishops are not even having sex in the first place. How are they supposed to know how to tell me what to do in that situation?”

Her story, as she recognized, is all too common and reflects the repeated marginalization of many women by the Catholic hierarchy—the same women whose voices have been deemed unimportant by those on both sides of the recent debates. Sandra is just one of the many individuals whose conscience is not being protected by refusal clauses exempting entire institutions from covering their employees for services guaranteed to everyone else by the new law.

Catholic teachings on conscience require due deference to the conscience of others in making decisions — that the employer should not be allowed to dismiss the conscience of the employee seeking coverage for the healthcare services guaranteed to any other. In light of this precept, the public policy efforts of the hierarchy should take into account the experiences of individual Catholics as well as the beliefs of patients and clients, workers in social services and healthcare providers of other faiths and no faith, so that patients will not be refused any legal and medically appropriate treatment or be denied services they seek.

You have heard from some conservative Catholics on this issue, but it would be a grave mistake to confuse the individual positions of a few powerful interest groups with the majority view of the more than 68 million Catholics in the United States. For Catholic employers to claim to be the arbiter of any person’s good conscience is clearly disingenuous. When medical professionals refuse to provide legal reproductive health services, or provide timely referrals to other providers, they violate the right to conscience of the person seeking those services. This does not fall under anybody’s definition of a good conscience. Catholics for Choice and the majority of Catholics respect everybody’s individual conscience and their ability to act in accordance with their personal beliefs. However, we expect the hierarchy and their allied organizations, in keeping with the teachings of our shared Catholic faith and our American tradition, to respect our consciences and the consciences of the patients and clients who seek the services they need. We hope that those who serve to represent all of us in public service and in government will respect our consciences, too.

Protecting the freedom of conscience for all Americans no matter what their beliefs may be — for the atheist, for the employee of a Catholic institution, for the sexual assault victim who seeks care at a Catholic hospital — is indeed the job of the government. Expanding individual refusal clauses to include institutions and exemptions for religious institutions to deny the rights of all would sacrifice these people’s rights. Public policy should be implemented to further the common good and to enable people to exercise their conscience-based healthcare decisions.

Lawmakers of all political hues can come together to support a balanced approach to individual conscience rights and access to comprehensive healthcare. It makes sense for all those who want to provide more options to women seeking to decide when and whether to have a child. It makes sense for those who want to keep the government’s involvement in healthcare to a minimum. And it makes sense for those who think that it is the government’s role to facilitate the healthcare decisions that people want to make. Above all, it makes sense for a society that believes in freedom of religion — a right one can’t claim for oneself without extending it to one’s neighbor. The bottom line is that protecting conscience rights and preserving access to care shouldn’t just be about protecting those who seek to dictate what care is and is not available to all. Nor should it be for those who would dismiss the conscience of others by imposing their view of which consciences are worth protecting.

Protecting individual conscience and ensuring access to affordable, quality care is not just an ideal, it is a basic tenet of our society and it is the right thing to do. I thank the Subcommittee for inviting me today and for your attention. I look forward to any questions Members may have.

House Committee Votes to Reinstate Global Gag Rule (Again) and Other Misogynistic Amendments

8:23 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RHRealityCheck.org. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

A central motto of today’s GOP and Tea Parties appears to be: Never let evidence get in the way of efforts to pass a law undermining women’s access to healthcare.

An addendum to this motto appears to be: Never let an opportunity pass to deny funding to or politicize services providing care to the poorest and least-enfranchised women in the world, most particularly those who suffer high rates of maternal death due to lack of access to family planning services and high rates of complications of pregnancy and unsafe abortion.

In keeping with this, just weeks after publication of a major report underscoring the benefits of robust U.S. investment in family planning worldwide, the GOP-controlled House Foreign Affairs Committee voted in the early hours of the morning today to reinstate the Global Gag Rule (GGR) as part of the draft Fiscal Year 2012 State Department Authorizations Act, except this time with broader and more damaging implications than ever before.

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For Latinas, The IOM Recommendations on Women’s Health Represent a Big Win

8:09 am in Uncategorized by RH Reality Check

Written by Maria Elena Perez for RHRealityCheck.org. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Women are cheering this week’s recommendation by the Institute of Medicine (IOM) to eliminate costly insurance co-pays for birth control. It’s a signal that there is a growing public recognition that preventive care is more than just the provision of services at the doctor’s office. For millions of Latinas, birth control, by definition, is prevention. But, while the media has focused extensively on the birth control recommendations, the full set of recommendations detailed by federal health officials paints an even brighter picture for our community: Latinas made major gains not only in controlling our fertility, but equally importantly in keeping ourselves and our children healthy.

The IOM is made up of a powerful group of scientists and public health leaders that has enormous sway in the government’s approach to health care. It’s no surprise then that health professionals looking at the country’s essential needs recognized what many have not: removing societal barriers to health care, such as those faced by many Latinas, are critical public health priorities.

Virtually every one of the IOM recommendations will greatly benefit Latina women.

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Why Insurance Coverage for Abortion Matters

7:40 am in Uncategorized by RH Reality Check

Written by Katherine Greenier for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Late Tuesday night, on March 29, 2011, Governor Bob McDonnell (R-VA) handed down an amendment to Delegate Terry’s Kilgore’s HB 2434 bill, which directed the Commonwealth to establish a health exchange in accordance with the federal health care legislation. The Governor’s amendment will restrict Virginia’s health insurance exchange from covering abortion services, except in the cases of rape, incest, and the life of the mother.

Abortion is part of basic health care for women. For some that may seem like an odd thing to say.  Abortion has become such a hotly contested issue in this country that we’ve lost sight of the role abortion plays in women’s lives.  But if you stop and think about it, every woman’s situation is different and many things can go wrong in a pregnancy. Every woman deserves the opportunity to make the best decision for her circumstances, whether her decision is raising a child, adoption or abortion. No woman plans to have an abortion, but if she needs one, insurance should cover the procedure just as it covers all other pregnancy related care. 

Unfortunately, some politicians have introduced legislation that would make it harder for women to access the health care they need.  These measures have been proposed throughout the country, including here in Virginia, to prevent insurance companies from covering abortion care.  By introducing the amendment to HB 2434, the Governor reopens the debate on an issue that has already been addressed in the General Assembly.  HB 2147 and SB 1202, bills to ban abortion coverage in health insurance plans, were introduced at the start of session and received hearings.  Both bills were defeated in the Senate Education and Health committee.  These measures would have taken, and the amendment to HB 2434 could take away insurance coverage that millions of women currently have and make it difficult if not impossible for many women to take care of themselves and their families. Read more

How to Stop the Right’s Campaign Against Rape Victims

8:40 am in Uncategorized by RH Reality Check

Written by June Carbone for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This post was originally published at New Deal 2.0, a project of the Franklin and Eleanor Roosevelt Institute.

The Republican leadership is at it again. House Republicans rode into office on claims that President Obama and the Democratic Congress were promoting a “liberal” agenda rather than focusing on the real task at hand — job creation. Yet the first act of the new Republican House was a symbolic repeal of health care followed by a focus on the true conservative passion: regulating the sex lives of the most vulnerable and politically powerless women. The latest proposal, which would limit benefits for rape victims unless they could show that the rape was “forcible,” reintroduces a distinction that women fought for decades to eliminate — the notion that “real rape” can only occur when a stranger jumps out of the bushes and holds a woman at gunpoint. Otherwise, the woman must necessarily be complicit in the resulting pregnancy and should be forced to bear the child.

Anyone who seriously cares about women’s lives will oppose the measure. Merely trying to defeat it, however, is not enough. It continues the practice of letting the far right define the reproductive debate while those who champion reproductive justice play defense. It is time to turn the tables and propose practical changes that would actually cut public expenditures, protect rape victims and make the anti-women animus that motivates these proposals visible for all to see. Read more