You are browsing the archive for Health care.

Improving Abortion Access, Bringing Health Care Home

12:11 pm in Uncategorized by RH Reality Check

Written by Renee Bracey Sherman 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 piece is part of the Echoing Ida project, cross-posted with permission from Strong Families.

Toni Atkins

Toni Atkins of San Diego is part of a movement to increase abortion access.

Each time I take a road trip down California’s magnificent highways, I can’t help but think of the dozens of people who have stayed in my home while in the Bay Area for an abortion. I pass the road signs indicating the off-ramps for Modesto, Los Banos, and Humboldt thinking fondly of the friends I made, but sad about how far they had to travel for their abortions.

For over a year, I have served as a Practical Support Volunteer for ACCESS Women’s Health Justice; I house, prepare dinners for, and give rides to people staying in the Bay Area for an abortion procedure. They come by bus, train, and sometimes car, traveling for four-to-five hours at a time, because access to abortion procedures near their hometown is lacking. They come because they didn’t realize they were pregnant until it was past the gestational limit and the clinic nearest to them couldn’t perform the abortion. They come because the time they took to thoughtfully consider all their pregnancy options meant their procedure would cost more.

They come because the clinic closest to them shares an abortion provider with several other clinics and it could be a while before they can get an appointment. They come because while they were working and saving money to pay for an abortion, they crossed a gestational threshold and now must find more money for a more expensive procedure. They scrimp and save to take off more time from work to travel for what was a one-day, but is now a two-day procedure; get someone to cover a work shift; ask someone to watch their children; and, if they’re able to, find a supportive friend or partner to join them as they travel across the state to a city they’ve never been to … all for health care.

When my friends stay in my home, we sit on the couch and talk over dinner. We talk about how far they’ve traveled, their lives back home, their beautiful children, and what the next couple of days might look like. They often ask me why they couldn’t have an abortion in their own towns, where their support people could accompany them and hold their hands, where they would be able to go home the same day and tuck their children in at night after the procedure. Until now, I didn’t have an answer for them. But now that answer is waiting for a vote and a signature. The answer is California’s Early Access to Abortion Bill.

Earlier this year, assembly member Toni Atkins (D-San Diego) introduced AB 154, a bill that would increase the number of abortion providers, by allowing trained certified nurse midwives (CNM), nurse practitioners (NP), and physician assistants (PA) to provide early abortion care. This means that more people, especially in rural areas, will be able to have access to comprehensive abortion care earlier in their pregnancies, which would help reduce the rate of complications, bring down the cost for the procedure, and allow a patient to get the care they need closer to home. Many people don’t know that almost half of the counties in California don’t have an accessible abortion provider, and 22 percent of counties don’t have a provider at all. This creates an additional hardship on those in rural areas who have to travel further for their procedures.

Recently, the University of California, San Francisco’s Bixby Center for Global Reproductive Health conducted a multi-yearlong study in which they trained and evaluated CNMs, NPs, and PAs as they performed first trimester abortions alongside the doctors performing the same procedure—the outcomes were the same. With 92 percent of abortions in the United States occurring within the first trimester, the bill would reduce barriers and increase access for the majority of people seeking abortion care. AB 154 is legislation that supports the needs of our communities.

In the United States, 6 in 10 people having an abortion are already parenting a child, while 3 in 10 have two or more children. In the evening, I often hear clients making phone calls, putting their children to bed, telling them how much they love them. “Don’t worry,” they say, “I’ll be home to put you to bed tomorrow.” Wouldn’t it be nice if they could get the care that they need and be home in time to kiss their children goodnight? Instead of having to leave their families and travel five hours for a simple medical procedure, imagine if care were provided in their own hometown. I was fortunate—my abortion provider was a 15-minute ride from my house. I felt safe knowing that I wasn’t far from my home and I would be able to rest in my bed with my family nearby soon after the procedure.

The Early Access to Abortion bill is model legislation that will put patients and families first and contribute to healthy communities.

Read the rest of this entry →

Immigrant Women Should Not Have to Wait Years to Access Health Care

1:20 pm in Uncategorized by RH Reality Check

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

Stethoscope

Immigrant women face long wait times for medical care.

Most people hate waiting. We complain about lines or being put on hold. Right now, some politicians are looking to make immigrant women and their families wait to gain access to health care—a truly cruel thing on which to make someone wait. A provision included in an immigration reform bill could keep immigrant women from accessing essential health services for up to 15 years.

Specifically, the immigration reform bill that passed through the Senate includes language that bars an immigrant woman who is working to obtain citizenship from utilizing means-tested federal benefits like Medicaid for a minimum of ten years. She will also face a five-year delay under the current law if she does not naturalize as soon as possible, after the initial ten-year period.

The five-year waiting period was imposed on permanent, legal residents as an inclusion to the Affordable Care Act (ACA) for benefits like Medicaid. Given that the goal of the Medicaid program is to reduce financial barriers to essential health care for low-income families, this limitation affects those who already face tremendous obstacles to quality health-care services and do not have the ability to pay for care out-of-pocket.

Current policies will also make immigrant women ineligible for premium tax credits and subsidies to facilitate participation in the state health insurance marketplaces that are being established under the ACA. This places private health insurance plans out of reach for many families. All this means that an immigrant woman may have to wait up to 15 years—or more—before she can access affordable health coverage options.

Delayed access to preventive care like mammograms and Pap tests could be the difference between life and death for all women, including immigrant women. Lack of routine testing could mean that an undetected, untreated sexually transmitted infection could cause infertility. Holding back access to health services could have a dramatic effect on the health of individual women, their families, and their communities.

This kind of punitive, restrictive policy-making on the backs of women is all too familiar to many reproductive health advocates. Whether it is legislation that literally imposes a waiting period to delay a woman who is seeking abortion care or barring public hospitals from making agreements with abortion clinics to accept their patients in emergencies, we are used to seeing political games played with women’s health.

Hundreds of laws have been introduced in recent years with the goal of making it harder to get an abortion or closing clinics to shut off availability of care. With fewer providers, women are often forced to travel long distances to seek care; a recent Guttmacher Institute report estimates that in 2008, 16 percent of women traveled 25 to 49 miles, 11 percent traveled 50 to 100 miles, and 6 percent traveled more than 100 miles. This presents a particularly burdensome hardship for low-income women who may not have a car or be able to take time off from their job to travel. These restrictions also make abortion care more expensive by adding the cost of travel or child care or putting up so many extra hurdles that a woman is pushed later into pregnancy, when a procedure may be more complicated and costly.

Read the rest of this entry →

Texas Health and Human Services Says Women Don’t Want to Change Providers—Actually, Many Can’t

12:58 pm in Uncategorized by RH Reality Check

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

Doctor with stethoscope

Texas women struggle to see doctors they trust after changes to health care programs.

Without Planned Parenthood, the new Texas Women’s Health Program (TWHP) has seen a 23 percent reduction in medical claims and thousands fewer Texans enrolled in the program in the first half of 2013 as compared to the same period last year, when the program was still the Medicaid Women’s Health Program. The state’s explanation? Women just don’t want to change doctors.

“We expected to see a drop off in the number of claims when we moved to the state program because we knew some women wouldn’t want to change doctors,” said Texas Health and Human Services Commission (HHSC) spokesperson Stephanie Goodman in a statement this week.

Goodman’s statement is at best glib and at worst a kind of victim-blaming that puts the responsibility for the state’s failure to provide low-cost reproductive health care squarely on the shoulders of the very people it is supposed to be serving.

The TWHP provides contraceptives and well-woman exams to low-income Texans. From 2007 to 2012, it operated as part of Medicaid, receiving a 90 percent federal match in funds and, at peak enrollment, saw almost 130,000 clients. But in 2012, the state kicked Planned Parenthood out of participating in the program because it considers the organization to be an abortion “affiliate” and thereby ineligible to provide health care using public funds in Texas. At that time, the federal government dropped its support of the program because the arbitrary exclusion of any qualified health provider from a Medicaid program is a violation of the Social Security Act, which dictates that Medicaid enrollees have a right to receive care from the physician of their choosing. To fund a program that denies Texans the ability to see the qualified doctor of their choice would, according to the Center for Medicaid Services, be a violation of its own law.

Undeterred, Texas launched a new, entirely state-funded Women’s Health Program in January of this year, and so far it has seen its service numbers plummet without the involvement of Planned Parenthood, which historically saw about half of all Women’s Health Program patients.

According to preliminary data provided by the Texas HHSC, current enrollment in TWHP is estimated to be about 97,000 clients, the lowest number of enrollees since September 2009, when the program was just two-and-a-half years old. This July, the TWHP counted over 10,000 fewer enrollees than it did in the same month last year. Add this to the fact that, according to the University of Texas’ Texas Policy Evaluation Project (TPEP), more than 60 family planning clinics in Texas—most of which were not Planned Parenthood facilities—have closed since 2011 due to family planning funding cuts, and it’s clear that there’s a serious, and growing, hole in Texas’ reproductive health safety net.

And yet the state says that if fewer and fewer low-income Texans are receiving publicly funded reproductive health care, it must be because women don’t want to change doctors. Considering the very real logistical, physical, and emotional challenges women face now that they have been forced by the state government to find new reproductive health providers, the HHSC’s statement seems an egregious simplification of a deeply complex and personal issue.

Amanda Stevenson, a TPEP researcher who studies the impact of family planning budget cuts on low-income Texans, told RH Reality Check that research shows changing doctors is not simply about personal preferences, but rather about the complex ways Texans choose their providers and the many factors that influence their decisions.

“There’s lots of other complexities that are hidden by [Goodman's] statement,” Stevenson said, citing spatial distribution and capacity of providers as just two factors that affect whether someone is able to switch to a new doctor. “Maybe you don’t want to go to a doctor who is 50 miles from you, but you also sort of can’t,” she said. “Preference is not the right framework for this.”

Read the rest of this entry →

McDonald’s Sample Budget Is Not ‘Good for Us All’—Especially Not Women With Children

12:13 pm in Uncategorized by RH Reality Check

McDonalds Sign

McDonald’s budget for workers highlights their unlivable wages.

McDonald’s has taken some heat for its Practical Money Skills Budget Journal, a financial planning guide for its low-wage workers that suggests monthly spending on a variety of expenses. That’s pretty ironic since heat was one of the things McDonald’s failed to anticipate in the guide’s first iteration—it was later included in the sample budget in response to public pressure.

News coverage has noted the implausible monthly $600 rent (compared with the national average of $1,048). Many people have pointed out the impossibility of spending just $27 a day on gas and groceries, and the absence of a clothing budget. All of these criticisms are completely valid.

McDonald’s has defended the second income required to balance this budget, indicating that it could be representative of a two-person household, with both contributing. Let’s play along with this scenario.

Two-thirds of fast-food workers are women, according to the federal Bureau of Labor Statistics. The majority are older than 32—in their prime years for raising children. In fact, almost a third of minimum-wage earners are raising children. Thus, there’s a good chance that our theoretical couple has children. But let’s back up.

Assuming that the full-time McDonald’s worker qualifies for the company’s $14 a week health-care plan and that costs already have been deducted from the gross pay in this budgeting scenario, the plan caps coverage at $10,000 a year—a measly amount, particularly for a female employee (or insured female partner of an employee) who gives birth to a child.

The joy of that child would surely be dampened by the realization that no money is left to dedicate to child-care costs—the average of which exceed average rent costs in half of all states for just one child. Using the financial planning guide’s insanely low projection of $600 for rent, this family would likely need at least $600 for child care, leaving merely $200 to feed and clothe a family of three each month.

And that’s being generous. That child-care figure is slightly lower than the results of a recent Restaurant Opportunities Center United study funded by the Ms. Foundation for Women, entitled The Third Shift, which found that working mothers in the restaurant industry (with similarly low-paying occupations as in the fast-food industry) spend an average of 35 percent of their wages on child care. In the sample budget, 35 percent of the net income would be $721.

While the McDonald’s budgeting tool may use “generic examples,” as the company claims, there are real women and families struggling. The Third Shift relays the story of Teresa (whose last name was not published, by request), who balances two jobs in the restaurant industry while raising two children on her own in Los Angeles. When her children were young, she relied on her sister for child care. When her sister wasn’t available, her neighbor cared for her children, but the cost was significant on her meager earnings. Teresa’s children are older now, but economic stability continues to elude her.

“Having a job is a blessing,” Teresa said. “But having a higher wage, for me, as a single mom, would allow me to be able to spend more time with my children. And mothers with younger ones would be able to pay for quality care.”

McDonald’s may have been sincere in its attempt to help employees budget. But the company is blind to the realities. The federal minimum wage is $7.25 an hour. If this budget assumes only one earner working two jobs, that equates to 74 hours a week at minimum wage. If that worker is a single mother, like Teresa, she may need child care for those 74 hours, the cost of which would be astronomical.

While these aren’t issues unique to McDonald’s employees, McDonald’s has a unique opportunity as a worldwide leader of the fast-food industry to raise the standards by which companies treat low-wage employees. The budgeting tool is a transparent acknowledgement that its employees are struggling. Let’s ask McDonald’s to go one step further in tangibly improving the lives of its employees.

On its website, McDonald’s claims, “From the start, we’ve been committed to doing the right thing. And we’ve got the policies, programs and practices in place that allow us to use our size and scope to help make a difference. Because what’s good for us is good for us all.”

The Ms. Foundation challenges the corporate giant to live up to its own rhetoric by using its size and scope to improve the lives of its hundreds of thousands of employees. That really would be good for us all!

Read the rest of this entry →

The Final Contraceptive Coverage Rule: Why You Should Stay Away From Any Organization That ‘Self-Certifies’

9:43 am in Uncategorized by RH Reality Check

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

increase contraception, duh.

Increase contraception

On June 28, the Obama administration released the final version of the contraceptive coverage rule. Beginning January 1, 2014 women who aren’t already benefiting from the Affordable Care Act’s mandated contraceptive coverage, like those employed at religiously affiliated organizations that took advantage of the enforcement safe harbor, will be able to receive contraceptive coverage directly from their insurance companies, rather than their employer-provided plans. This “religious accommodation” makes employers’ involvement in contraception use even more remote, while ensuring that women still have access. [1]

The bishops and other anti-contraception crusaders will not be happy with the religious accommodation, so expect the lawsuits dismissed as premature or held in abeyance back in court soon. That aside, it is important to understand how far the Obama administration bent for the contraception opponents and how little it demanded in return. Organizations are not even required to make their religiously based objection to birth control public.

Granting the religious accommodation without abandoning women with religiously affiliated employers is possible because of the unusual economics of contraceptive coverage: the Obama administration can tell insurance companies to cover contraception without a co-pay, because providing it is cost-neutral for insurers. All (reasonable) parties can have their way—employers don’t have to provide plans with coverage, but employees can still get it, and insurers don’t have to pick up “the bill” because there really isn’t one. But the problem remains that religiously affiliated employers are being excused from the law without having to make even the smallest disclosures about their organizations in return. This sets an unwelcome precedent for future demands for special treatment.

I argued both in a piece for RH Reality Check and in a comment to the rule that the “self-certification” for the religious accommodation should entail explicit and public disclosures about how the organization “holds itself out as religious,” who determines what constitutes the religious beliefs of the organization, and what those beliefs are. In releasing the final rule, the government acknowledged it received comments to that effect, but further reduced the disclosures required for the accommodation. In order to qualify for the religious accommodation, organizations need only fill out a two-page form and file it with their insurer. And the form no longer even requires organizations specify the contraceptive services to which they object.

This is an invitation for organizations to characterize themselves as religious when they want an exemption from the law but secular when they want government funding. For example, Manhattan College and St. John’s University tell the state of New York they are not church-controlled to get taxpayer funds, then turn around and tell courts they are church controlled when they don’t want to have to deal with employees unionizing or abide by the Americans with Disabilities Act.

There are lots of reasons the claim that requiring contraceptive coverage is a religious freedom violation shouldn’t fly. But given the increasing frequency with which religiously affiliated organizations get what they want, simply requiring them to own up to whatever they purport to believe would be a big step in the right direction. Instead, they are currently free to make opposite representations depending on who is asking without any consequences.

The self-certification is insufficient, but it can still serve as a useful litmus test. Before you enroll or accept a job at any religiously affiliated organization, find out if it self-certified. If it did, steer clear. I realize, that may not be possible if you are a social worker in an area where Catholic Charities has a monopoly, or if you need to go to whatever school gives you the best financial aid, or if you’ve worked somewhere for years that has just now discovered it opposes contraceptive coverage. But the general rule should be: stay away from institutions that self-certify. It is impossible to anticipate on what other grounds they will claim an entitlement to discriminate or otherwise impose religious doctrine in the future. Even if they tell you separate birth control coverage is one quirk at an otherwise welcoming place for women, or gay people, or Jews, or whoever else—stay away. They probably have or would take the opportunity to discriminate in other contexts.
Read the rest of this entry →

In Memory of Dr. Tiller, on the Fourth Anniversary of His Death

2:05 pm in Uncategorized by RH Reality Check

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

A vigil held in honor of Dr. Tiller, Minneapolis 2009

I am a family doctor and I was a proud colleague of Dr. George Tiller’s. It is difficult to believe four years have passed since his murder.

George’s skills allowed him to help women further along in their pregnancies than I could. There were many times I sent patients to him, and I was so grateful to have him there to take care of women in his gentle and respectful way. George always lived as he believed, like many of us abortion providers try to do. He believed that no woman should ever be forced to continue a pregnancy, and he did all he could to help women in need of abortions. He dedicated his life, until the end, to this belief and this work.

He was such a committed individual. I was speaking with him about a patient the same afternoon, in 1993, when he was shot the first time. Despite his injuries to both arms, George was of course back at the office the next day. This experience led me to the magical thinking that even being shot at his church couldn’t stop Dr. Tiller.

To those of us left behind, we have to honor Dr. Tiller by working to make sure that abortion access is expanded, not curtailed. We can respect his legacy by working to ensure public funding for abortion through Medicaid and reversing the discriminatory Hyde Amendment. We can defend clinics that are fighting to stay open, in the face of bills seeking to set arbitrary regulations that have nothing to do with patient safety or quality health care. We can expose the true purpose of these laws: to shut down excellent medical facilities and force women to travel great distances to find other providers.

We can also stand firm in protecting women’s access to abortion after 20 weeks. There will always be women who don’t realize they are as pregnant as they are. I, a Harvard-trained physician, missed my own unintended pregnancy—denial is a beautiful thing—until I was in my 22nd week. There will always be women who discover that they are carrying a very sick fetus, women whose life circumstances change so drastically they can no longer undertake being a mother, women who just need our help.

We can support women by removing the shame and stigma that the anti-choice movement has associated with seeking an abortion and instead treat these women and their partners and families with great love. This is what George did each day in his clinic. This would honor his life.

We must carry on for these women, and for George. This is the remembrance he deserves—and, frankly, he would expect of us.

Read the rest of this entry →

House 20-Week Abortion Ban Hearing a ‘Farce,’ Says Leading Democrat

10:29 am in Uncategorized by RH Reality Check

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

A subcommittee of the House Judiciary Committee held a hearing Thursday on a bill that would impose an unconstitutional nationwide ban on abortions after 20 weeks post-fertilization. Four witnesses sat at the table during that hearing, but there was really only one person who mattered for the Republican lawmakers—whose aim, ultimately, is to outlaw all abortions. That person was Dr. Kermit Gosnell, the Pennsylvania physician now serving a life sentence for murder and manslaughter.

US Capitol Building

US Capitol Building

According to Rep. Trent Franks (R-AZ), chairman of the Subcommittee on the Constitution and Civil Justice, under whose jurisdiction the hearing was called, Gosnell is “not an anomaly in this gruesome Fortune 500 enterprise of killing unborn children.” The rogue doctor, who was roundly denounced by pro-choice activists as soon as the horrific conditions of his clinic came to light, is, for Franks, “the true face of abortion on demand in America.”

Using Gosnell as justification, Franks has retooled his proposed “Pain-Capable Unborn Child Protection Act”—previously introduced as a measure specific to Washington, D.C.—to apply to all 50 states. A D.C. 20-week ban has also been introduced in the Senate, although it is highly unlikely to come up for a vote.

If all abortion providers were like Gosnell, of course, they could be prosecuted under existing criminal laws, as Gosnell was. But they’re not—and that’s why House Republicans want to create a way to prosecute them. The Pain-Capable Act would subject doctors who perform abortions after 20 weeks to criminal prosecution, jail time, and monetary penalties. It would provide a cause of action for a woman who has an abortion after 20 weeks of pregnancy—or her husband, boyfriend, or one-night stand, as well as her family—to sue the doctor, including for punitive damages.

By pegging the gestational time-limit to disproven claims about fetal pain (which medical experts agree is not possible before the third trimester), the bill would lay the basis for limiting abortions even earlier in pregnancy, based on even more questionable science, as demonstrated at Franks’ hearing.

Maureen Condic, a University of Utah scientist who also opposes embryonic stem-cell research, testified that it is “uncontested that a fetus experiences pain as early as eight weeks.” By continually arguing that fetal pain is experienced far earlier than the established medical evidence, Condic did provide proof of something else: that Republicans’ ultimate goal is to outlaw abortion far earlier than 20 weeks.

The bill proposed by Franks contains no exceptions for the health of a woman who needs an abortion after 20 weeks, raising the specter of a woman (or the parents of a minor) suing a doctor who, in an emergency, saved her from horrific health consequences. It also provides no exceptions for rape or incest. The woman, the man by whom she is pregnant, or the woman’s family members could even seek a court order barring the doctor from performing abortions in the future.

Another of the Republicans’ three witnesses, anti-choice activist Jill Stanek, claimed that the Gosnell case is “evidence that the lines between illegal infanticide and legal feticide, both via abortion, have become blurred.”

By equating Gosnell’s criminal activity with all abortion, Franks and his supporters attempt to elide the fact that their bill is patently unconstitutional, as Rep. John Conyers (D-MI), noted. Just this week the Court of Appeals for the Ninth Circuit struck down a similar law out of Franks’ home state of Arizona.

Franks’ obvious aim is to test that conclusion, by forcing yet another legal challenge to Roe v. Wade. But he also seeks to enhance his position—at least in the court of public opinion—by attempting to persuade the public that if Gosnell, who performed illegal abortions and killed infants born alive, was found guilty of murder, all providers of abortion services must be similarly guilty.

Rep. Jerrold Nadler (D-NY), the subcommittee’s ranking member, strongly voiced his opposition to Franks’ claims. “[W]hat Dr. Gosnell did had nothing to do with abortion; it was murder,” Nadler said.

Calling the hearings a “farce,” Nadler noted that the Democrats, as the minority in the House, were not permitted by Franks to call more than one witness, while the three witnesses called by Republicans presented what Nadler called “false and misleading” medical evidence.

The one witness Democrats were permitted was Christy Zink, who recounted the heart-rending story of how she and her husband were informed during her 21st week of pregnancy that the fetus she was carrying had a lethal abnormality, agenesis of the corpus callosum. Zink said that if brought to term, her baby would have been born missing a part of its brain.

Read the rest of this entry →

Bishops Tap Veteran of Islamophobic, Homophobic Legal Shop as Top Flack

12:22 pm in Uncategorized by RH Reality Check

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

Whosoever desires constant success must change his conduct with the times. — Niccolo Machiavelli

Timothy M Dolan in his robes

Cardinal Timothy M. Dolan is part of a dangerous reframing of "religious liberty."

At a gathering of Catholics in his archdiocese last year, Cardinal Timothy M. Dolan, the archbishop of New York, uttered a strategic point that would have done Machiavelli proud. The bishops, he said, are perhaps not the church’s best messengers.

“In the public square, I hate to tell you, the days of fat, balding Irish bishops are over,” he told his flock, according to the New York Times, at a diocesan convocation on public policy. Reporting for the Times, Tim Stelloh and Andy Newman wrote of an example he gave the crowd, an apparent reference to the hiring of Helen Alvaré by the National Conference of Catholic Bishops in 1990:

[Dolan] told a story about bishops hiring an “attractive, articulate, intelligent” laywoman to speak against abortion and said it was “the best thing we ever did…”

Dolan, as president of the United States Conference of Catholic Bishops (USCCB), decided this week to operationalize his assessment by hiring Kim Daniels, a former operative for Sarah Palin’s political action committee, as his spokesperson — a new position with a much broader mission than that covered by Alvaré in the 1990s.

An attorney and youthful mother of six who echoes the bishops’ disdain for contraception and abortion, Daniels is a smart cookie with an appealing personality. In other words, an “attractive, articulate, intelligent” laywoman.

When the USCCB announced Daniels’s appointment, the thing that grabbed reporters’ attention was her work in 2010 as an operative for Sarah Palin’s political action committee, SarahPAC — a résumé entry conveniently omitted from the bishops’ announcement about their new hire. If there was any doubt remaining of the bishops’ total alignment with the most right-wing part of the Republican Party, that data point should lay it to rest. But the rest of Daniels’ career is far more interesting — and troubling.

The Reframing of Religious Freedom

Over the course of the last several decades, as reasonable people, including most lay Catholics, increasingly rejected the church’s medieval worldview on women’s rights, human sexuality, and LGBTQ rights, the political power of U.S. bishops has been on the wane. During the debate over health-care reform, President Barack Obama went around the prelates in order to confer some Catholic buy-in on the deal, ultimately winning the approval of a number of highly placed nuns, who signed a letter to that effect, as well as the head of the Catholic Health Association, who also happens to be a Catholic sister.

The bishops were incensed. At that moment, their lack of sway over their own people was revealed for all to see. They needed a new angle, one that could also speak to the hearts of those ordinary Americans who, in the wake of the church’s massive child-sex-abuse scandal, now judged them to be mere mortals, and deeply flawed mortals at that. Enter the Red, White, and Blue.

The success of the Tea Party movement, with its bigoted and misogynist underpinnings dressed in the regalia of patriotism, was apparently not lost on the bishops. On the heels of their humiliating defeat with the Affordable Care Act, the bishops found a new, patriotic-sounding cause to wrap around their attempts to codify prejudice and discrimination as secular law: religious freedom, which is guaranteed by the First Amendment to the Constitution. Summon the fife and drum!

Trouble is, the bishops’ notion of religious freedom differs a bit from that of the founders, who sought to avoid the establishment of a state religion by promising Americans freedom of worship. What the bishops seek, on the other hand, is the right to impose their religious views on those who do not subscribe to their theology. Any impediment to their totalitarian view is now framed as a breach of their religious freedom. And Kim Daniels has been deeply involved in the advancement of this strategy.

Media-Friendly and Studio Ready Church Ladies

Read the rest of this entry →

The Bishops’ Lawsuit: A Colossal and Purposeful Drain on Public Funds

1:09 pm in Uncategorized by RH Reality Check

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

stack of papers

Government lawyers filed an emergency motion to dismiss lawsuit over contraceptive coverage mandate citing exorbitant costs in responding to document requests.

This week, the government filed an emergency motion in the New York Archdiocese’s lawsuit against the contraceptive coverage mandate, requesting that the court halt proceedings and dismiss the case. The emergency is that the government is hemorrhaging money defending a regulation it will never enforce against the Archdiocese.

Roman Catholic Archdiocese of NY v. Sebelius is the only lawsuit out of the 23 brought by religiously affiliated organizations not to be dismissed at the district court level for lack of standing or ripeness. The cases have been dismissed because religiously affiliated non-profits are currently completely exempt from the contraceptive coverage requirement. They enjoy a one-year safe harbor period provided for the religious accommodation to be finalized. If you haven’t been injured, you can’t sue.

The government swore up and down from the day the case was filed that the rule in its current form would never be enforced against the Archdiocese and its co-plaintiffs and that a new rule with a new religious accommodation was on the way. As promised, the Obama administration released a new proposed rule, is now reviewing comments from the public on it, and will release the final rule by August. However, in the New York Archdiocese case, Judge Brian M. Cogan found that the administration’s assurances were not enough and that the impending threat of the rule was injury enough for the plaintiffs to proceed.

The Archdiocese et al. proceeded to serve the government with requests for every document under the sun. “Discovery” is the process in which litigating parties get evidence by requesting relevant documents from each other. To respond to a document request, a party has to review documents to determine whether they are responsive to the request and make a log of documents that are responsive but won’t be turned over because they are protected by attorney-client or another privilege. Computer searches only get you so far; a human attorney or paralegal has to determine if a document is responsive or privileged.

Plaintiffs in these cases being 1 for 23, the Archdiocese may have sought to make the most of its unique situation. It made discovery requests the government calls “enormously burdensome and irrelevant.” The Archdiocese also noticed a deposition of Health and Human Services (HHS) Secretary Kathleen Sebelius. Lawsuits are brought over regulations all the time — it is pretty audacious to demand a cabinet member show up in person for yours. That was indeed too far, and Judge Cogan granted Sebelius a protective order.

The plaintiffs didn’t stop there. The Archdiocese subpoenaed the Executive Office of the President (EOP), even though it isn’t a party to the lawsuit, many of the requested documents are protected by various privileges, and you must have an extra good reason to get documents from the president. Also, the EOP being in D.C., the subpoena was issued in a district that has thrown out three of these 23 lawsuits for lack of jurisdiction.

The Archdiocese later withdrew the subpoena. We don’t know why. Perhaps it realized it was an unreasonable request. This did not happen, alas, until after our tax dollars were put to work on a very lengthy motion to quash the subpoena. But whatever that cost, it pales in comparison to the expenditures of various agencies on the New York document requests; in the emergency motion, the government estimates completing the requested document production would take eight years and cost over $10 million.

We should take that estimate with a grain of salt, of course, but the government has sought to back it up. Attached to the emergency motion are declarations from officials of various offices and agencies as to what they have spent so far on this one case and what they estimate it will cost to finish. Two-hundred HHS employees have spent have spent over 2,000 hours and located over 7.6 million pages of potentially responsive documents so far. That has cost over $177,000. Those documents haven’t been reviewed by HHS or their Department of Justice counsel yet. The Internal Revenue Service has spent over a quarter of a million dollars.

The lawyers, paralegals, and IT professionals needed to complete discovery are expensive — even those of the lower-paid government variety. Offices that don’t have enough staff for this have hired contract lawyers, but they can’t afford to do that anymore because of the sequester. Lest you think it’s not a big deal to have government lawyers tied up or that the effect is minimal in the scope of things, consider one example contained in the declaration from the Department of Labor (DOL). The DOL’s Plan Benefits Security Division investigates and litigates cases of fraud or mismanagement in employee benefits. The division, which recovered $1.38 billion for U.S. workers in 2011, argues that the impact on the public interest of putting its attorneys on document review will be far greater than the financial loss.

The Archdiocese, which employs 10,000 people in programs receiving many millions of dollars in government grants each year, will never have to provide health plans with contraceptive coverage under the rule as proposed. Despite this, it is waging a legal battle that is imposing significant costs on the taxpayers who fund its work. And this is only one lawsuit. With the additional cases brought by secular for-profit corporations, over 60 lawsuits have been filed in this scorched earth litigation campaign — which we have to pay to defend.

On the same day the emergency motion was filed, Judge Cogan granted it in part, staying all discovery and proceedings until the contraceptive coverage rule is final. So the government lawyers can get back to other business for the moment. But once the rule is final, I expect we will see that some if not all of those 22 dismissed cases (the ones that haven’t already been appealed) will be refiled.

Back in February, with the sequester looming, the U.S. Conference of Catholic Bishops, which, like the Archdiocese of New York, is led by Cardinal Timothy Dolan, signed a statement by religious leaders urging legislators to protect the interests of the poor. The Bishops’ litigiousness does not reflect the same awareness of our limited resources nor concern for those who will be hurt most by the sequester. Instead, the Archdiocese seeks to deprive its employees of affordable contraception — provided by an outside company — that will enable employees to limit their families to the size they want and can support, using up resources that are needed elsewhere in a time of economic distress.

Read the rest of this entry →

The Media and the Gosnell Case: A Case of Insecurity and a Misinformation Campaign

12:20 pm in Uncategorized by RH Reality Check

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

Pile of newspapers

A journalist looks at the barriers to reporting on women's reproductive freedom.

In recent days, amidst cries of a media “blackout,” a number of journalists have admitted to either missing or dismissing the story of Dr. Kermit Gosnell over the past two years. As one of the many journalists who has been covering the Gosnell story since it broke in early 2011, all I can say is: We tried to get the story out there. But more importantly, this politics-of-media framework distracts from the circuitous politics that enabled, and resulted from, Gosnell’s actual crimes and the women who were affected.

What Media Blackout?

After spending much of 2010 interviewing 58 witnesses, in January 2011 the Philadelphia district attorney’s office published a 281-page report accusing Kermit Gosnell of grotesque, depraved crimes.

There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with bloodstained blankets. All the women had been sedated by unlicensed staff — long before Gosnell arrived at the clinic — and staff members could not accurately state what medications or dosages they had administered to the waiting patients. Many of the medications in inventory were past their expiration dates.

Fetal remains were stored in milk jugs and cat food containers. A janitor admitted he routinely pulled fetal parts out of pipes. Unlicensed, untrained staff, including a high school student, pumped cheap, powerful drugs into the veins of women who were chemically coaxed into zombie-like stupors that sometimes lasted days.

Last week, Kristen Powers published an op-ed in USA Today that sparked a Twitter shame campaign, directly asking prominent national journalists why they hadn’t covered the case. And it worked. Now, more than three years after the raid and more than two years after the grand jury report, some national journalists who ignored the case entirely are suddenly wildly interested.

After years of coverage from outlets in Philadelphia and Harrisburg, outlets focused on women’s health issues, and yes, mainstream media outlets, apparently all it took to catch the attention of writers such as Slate‘s Dave WeigelThe Atlantic‘s Conor Friedersdorf, and Jeffrey Goldberg of Bloomberg was to target their collective egos — specifically, their insecurity about being perceived as having a liberal bias.

Weigel, one of the first writers to develop a sudden interest in Gosnell after Powers’ piece, wrote that when he read about Gosnell back in 2011, he didn’t “see a political story to chase.”

At 3801 Lancaster, the site of Gosnell’s clinic, patients chose their medicine and painkillers a la carte. In other words, the more cash a patient could give Gosnell, the more painkiller she could get. The poorer the patient, the more she would suffer. With all the talk about the Affordable Care Act, you’d think that such starkly stratified access to quality health care would be an interesting political story. The story touches on poverty, abortion, civil rights, state rights, healthcare, increasing inequality and race, to name a few topics of political interest that, if nothing else, came up quite a bit during the presidential election.

What Weigel really meant, of course, is that he didn’t see a story worth chasing. “Bored media,” indeed.

Read the rest of this entry →