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Contraception: Expand Access, Not Exemptions

10:55 am in Uncategorized by RH Reality Check

Open Access - Don't Limit It! (Image: wakingtiger, flickr)

Open Access - Don't Limit It! (Image: wakingtiger, flickr)

Written by Jessica Arons 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 article is cross-posted with permission from ThinkProgress Health.

As the Obama Administration debates whether to expand an exemption to a new health insurance requirement to cover all FDA-approved methods of contraception, there are some important facts to keep in mind:

– The average woman spends five years pregnant, postpartum, or trying to get pregnant, and at least 30 years trying to avoid pregnancy.

More than 99 percent of women of reproductive age who have had sexual intercourse have used at least one method of family planning.

– Contraception is the most commonly prescribed medication for women ages 18 to 44

Eighty-eight percent of voters support access to birth control

– Approximately three-quarters of Americans agree that insurance should cover contraception

Fifty-eight percent of pill users rely on oral contraception at least in part for non-contraceptive reasons

Eighteen percent of women on the pill reported inconsistent use, such as skipping doses, as a cost-cutting measure

Under the Affordable Care Act, or the ACA, women will benefit from greatly expanded access to contraception—which has been shown to improve health. But this important consumer protection is at risk of being undermined by an unreasonably expansive religious exemption. Read the rest of this entry →

On Contraceptive Coverage, It’s Not Up to Obama to Decide What is More “Catholic”

11:51 am in Uncategorized by RH Reality Check

Benedict XVI (Photo: catholicism, flickr)

Benedict XVI (Photo: catholicism, flickr)

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

See all our coverage of the Birth Control Mandate 2011 here.

This article was amended at 2:22 pm Friday, November 25th to add a missing paragraph and missing words in three sentences.

When it comes to contraception Catholics have stopped listening to popes, bishops and other institutional leaders.  It seems the only person left listening is President Obama. Obama however lacks the theological training –and it would seem the scholarly advice –needed to figuring out if the bishops and various hospitals, universities and social service agencies clamoring for a “religious exemption” from new federal regulations really need them in order to be good Catholics. The regulations require insurance plans offered by employers to cover contraception without a co-pay, although they exempt churches and other specifically religious institutions from the requirement.

The President seems unaware of the fact that Catholic disagreement with the ban on birth control goes far beyond the average Catholic lay-person. Some bishops, many priests, religious orders, theologians and church-related groups have publicly and privately disagreed with blanket prohibition of contraception. All of them, individuals and institutions, are free to follow their conscience on contraception and there is ample evidence that many of the very groups asking for an exemption from the new federal regulations have not followed church regulations religiously. Some within the organizations may agree with the ban, but not all, and none are required to do so.

Of course, it would take courage for organizations such as the Catholic Health Association (which is now siding with the Bishops publicly in their fight to broaden exemptions) or Catholic Charities to publicly buck the U.S. bishops and just follow the law and give their employees health insurance that makes it possible to avoid pregnancies they cannot afford or do not want; but after all, being a Catholic is all about courage and helping the poor and marginalized. A fair number of employees of Catholic institutions are low-income workers, struggling to get by on a minimum wage. We Catholics are taught to follow our conscience rather than the positions of the Catholic church, even if it means getting kicked out of the church.  If Obama’s current religious advisors don’t know that, all he has to do is call one of the most trusted of Catholic theologians, Fr. Richard McBrien of  Notre Dame. McBrien will repeat what he has said in his widely used text Catholicism:

If, after appropriate study, reflection and prayer, a person is convinced that his or her conscience is correct, in spite of a conflict with the moral teachings of the church, they not only may but must follow the dictates of their conscience rather than the teachings of the church.”

Centuries earlier Thomas Aquinas said the same thing.  Yet, the Catholic-affiliated institutions asking for a religious exemption insist that corporations, like persons have a conscience. Read the rest of this entry →

Who is the White House Serving, the People or the Bishops?

11:13 am in Uncategorized by RH Reality Check

Insurance And Reproductive Experts (Photo: catholicism, flickr)

Insurance And Reproductive Experts (Photo: catholicism, flickr)

Written by Sarah Lipton-Lubet, Policy Counsel for the ACLU Washington Legislative Office, for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Over the last few weeks, the rumor mills have been churning, with everyone asking: just how much influence does the powerful U.S. Conference of Catholic Bishops’ lobby have in Washington? A timeless question really, the version du jour is – what’s going to happen to important new federal guidelines that ensure insurance plans include coverage of contraception (also known as the latest target in the bishops’ campaign to force their beliefs on the rest of us)?

Before the Department of Health and Human Services even released the guidelines this August, detailing which essential preventive services new health insurance plans need to cover, the bishops and their friends were lobbying to keep contraception out. Because if the politically powerful bishops don’t like it, no one can have it. Now they’re waging a campaign to make Swiss cheese out of the guidelines by creating a loophole for all sorts of religiously affiliated organizations that would deny employees comprehensive insurance coverage that includes birth control. Is it working?

If you read the paper, and you’re among the 99 percent of sexually active women who have used contraception, you might start to worry. According to the Washington Post, “Obama [i]s ‘very sensitive’ to the bishops’ concerns” over the birth control guidelines. The New York Times reported that after his private meeting with the president, Archbishop Timothy Dolan, president of the bishops’ conference, felt “a bit more at peace about this issue than when [he] entered.” Connecting the dots, RH Reality Check‘s Jodi Jacobson and Salon’s Irin Carmon asks whether the administration is going to “cave” to the bishops’ parochial demands.

We know that the bishops, as political actors, have outsized influence; politicians seem to listen to them on reproductive health even though most Catholics don’t. We know that the bishops are savvy with messaging, crying victim whenever someone disagrees with them over public policy (the rest of us call it democracy). And we know that the bishops are leaving no stone unturned. Read the rest of this entry →

Did God Tell Congress to Wage War on Women?

1:35 pm in Uncategorized by RH Reality Check

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

See all our coverage of the Birth Control Mandate 2011 here

 

God has apparently signed off on the war on women.

Thanks to at least one member of Congress for setting us straight on that.

“It is not our job as Catholics to tell God what he should do. It is our job to learn and follow his teachings. Conscience is not convenience. We must enforce the laws of God.”

This was Rep. Tim Murphy (R-PA), who, having ascertained that the supreme deity is male, explained why Congress should deprive employees of Catholic schools, hospitals, and charities of the right to purchase affordable birth control, regardless of the employees’ own beliefs or practices. His statements were made at a hearing of the Health Subcommittee of the House Committee on Energy and Commerce on Wednesday, November 2, 2011.

Republicans in Congress are truly on the warpath against women’s rights, and in many cases against reason.

Just a few points here about women and contraception. For starters, while it usually takes two to conceive a child, only women get pregnant. The right and ability to make independent decisions about whether and when to become a parent are fundamental to every other aspect of a woman’s life: whether society recognizes women as autonomous, independent, responsible, and competent; and whether women themselves experience the same opportunities as men to acquire education and employment, and to construct a meaningful life based on loving relationships.

Cost is a barrier to purchasing birth control for lower-income women. More effective forms like new, safe intrauterine devices (IUDs) cost more than a year’s supply of birth control pills or devices like diaphragms which are cheaper overall but also are less reliable. The rate of unintended pregnancies is soaring among low-income women, and at 132 per thousand women ages 15 to 44 is five times higher than the rate for higher income women (those over 200 percent of poverty). Low income women are more likely to have unplanned births. The costs of contraception are minute compared to the costs of pregnancy and delivery, in dollars as well as in human health.

The new health reform law, the Affordable Care Act (ACA), calls for covering preventive health care services without requiring co-payments, effective in 2010. Co-payments are fees individuals must pay when they go for care, in addition to their premiums, and are intended to discourage health care visits. The problem is that they discourage people from getting care they need, particularly low-income people. Preventive health care services like flu shots can protect health by avoiding illnesses entirely or catching them early, and also save money. The ACA eliminated these co-payments for prevention.

Except in the case of contraception.

In 1968, despite the recommendation of the majority of Catholic bishops, the Pope adopted the minority recommendation to declare that using birth control was inconsistent with the Church’s beliefs. Nevertheless, U.S. Catholics continue to use birth control at the same rate as other Americans.  Virtually all heterosexually active couples of child-bearing age in the United States use birth control.  Still, the U.S. Conference of Catholic Bishops (USCCB) has grown increasingly insistent on enforcing the birth control ban.

As of August, 2011, after a year of studying whether or not contraception is a preventive health care service, and therefore should be covered without co-payments and deductibles, the federal Department of Health and Human Services (HHS) arrived at an answer: Yes on all counts.

In covering contraception as a preventive service without co-payments, HHS granted an exception for actual churches who provide health insurance to their employees, but required all other religiously-sponsored institutions such as hospitals that offer health benefits to follow the rule.

Catholic organizations have gone to court in the past to avoid state rules that require including coverage for birth control in the health care plans they provide for employees, and failed every time. The Church sponsors large organizations that include health care providers, universities and social service agencies, as well as churches. They employ millions of Americans, many of whom are not Catholic. Their work generates the funds their employers use to pay for health insurance. Most economists assert that the costs of employee health benefits are reflected in lower pay; that is, employers calculate benefits as a form of compensation, and many reduce wages accordingly. In effect, the money that pays for health insurance is really money that employees generate, and belongs to them.

This evidence is not good enough for the USCCB and the extremist Republicans running Congress. While dire economic threats face many Americans, Rep. Joe Pitts (R-PA), decided to change the subject. He called a hearing entitled “Do New Health Law Mandates Threaten Conscience Rights and Access to Care?”

Now let’s be very clear here. The Republicans and the Bishops are claiming that institutions have a conscience. Not a policy. A conscience.

Here is Joe Pitts’ description of his concern:

“Many entities feel that it [the proposed policy] is inadequate and violates their conscience rights by forcing them to provide coverage for services for which they have a moral or ethical objection. The religious employer exemption allowed under the preventive services rule — at the discretion of the HRSA [Health Resources Services Agency] — is very narrow.

“And the definition offers no conscience protection to individuals, schools, hospitals, or charities that hire or serve people of all faiths in their communities. It is ironic that the proponents of the health care law talked about the need to expand access to services but the administration issues rules that could force providers to stop seeing patients because to do so could violate the core tenants of their religion.”

In fact, there is no involvement of any individual employer in this matter, or any issue of an individual’s conscience except that of employees deciding to purchase and use contraceptives. The rule requires employers’ health plans to cover contraception without any additional co-payment. There are three parties involved here: employers, employees, and health plans. No provider or caregiver is involved, nor is any patient, student, or recipient of charity. At the most extreme, every Catholic institution could claim it will close their doors absent this exclusion. So far no such institution has done so where state requirements are in effect, and when Rep. Jan Schakowsky asked representatives of Catholic institutions at the hearing if they would close, they affirmed that they would not.

Rep. Gingrey (R-GA), opined: “Imposing the dictates of the state on the will of employers sounds un-American to me.”

And another gem: “Should we force religious employers to violate their consciences? To recognize same-sex marriage? Will we ethically neuter health care professionals?”

To a person, articulate Democrats on the committee–Henry Waxman (D-CA), Frank Pallone (R_NJ), John Dingell (D_MI), Lois Capps (D_CA), Tammy Baldwin (D_WI), Jan Schakowsky (D-IL), Edolphus Towns (D_NY), Eliot Engel (D-NY)–challenged this tripe.

Tammy Baldwin: “This is a war on women.”

Lois Capps: “An employer is not a person. Your boss’ conscience is not your own.”

Witnesses Jon O’Brien of Catholics for Choice and Dr. Steve Hathaway were articulate and brilliant in defending the truth.

But Rep. Tim Murphy, a psychologist in his fifth term in the House, was on fire:

“Conscience is at the core of Catholic teachings… and it is not left up to individuals to decide, thank goodness. Father Anthony Fisher tells us that …there is an objective standard of moral conduct. Vatican II teaches us that the moral character of actions is determined by objective criteria, not merely by the sincerity of intentions or the goodness of motives. It is not, I repeat, it is not our duty as Catholics to tell God what he should do or what image he should adhere to, or what he should think, but it’s up to us to shape our conscience to conform with the teachings he’s given us.

“Conscience, sir,” Murphy continued, “is not convenience.”

“Conscience is formed through prayer, attention to the sacred and adherence to the teachings of the church, and the authority of Christ’s teachings in the church. So asking a group in a survey whether or not they have ever acted or thought of acting in a certain way that runs counter to the Church’s teachings is no more a moral code than asking people if they ever drove over the speed limit as a foundation for eliminating all traffic laws.

 

“I end with a quote from John Adams, in 1776,” said Murphy, “when he was writing our Declaration of Independence of the United States: ‘It is the duty of all men in society, publicly and at stated seasons, to worship the creator and preserver of the universe, and no subject shall be hurt, molested or constrained from worshipping God in the manner most agreeable to the dictates of his own conscience, or for religious profession or sentiments, provided he does not disturb the public peace or obstruct others in their religious worship.’ The foundation of our nation is not to impose laws that restrict a person’s ability to practice their faith, sir.”

Well, actually, Tim: Exactly.

To do something about it click here: http://action.prochoiceamerica.org/site/Advocacy?pagename=homepage&id=5059&s_src=2011_adv_bc4me_whitehouse_web

and here: http://emilyslist.org/20111117_accesspoll/

 

The Other 99 Percent: Will Obama Betray Them?

12:56 pm in Uncategorized by RH Reality Check

the pill #1 (Photo: mr_b, flickr)

the pill #1 (Photo: mr_b, flickr)

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

See all our coverage of the Birth Control Mandate 2011 here.

There is another 99 percent group in our country, distinct from but inextricably entwined with the now more familiar #99Percent, those everyday Americans, who–in such a brilliant framing by the Occupy Wall Street movement–are to varying degrees affected by the vast economic inequality that characterizes American society. I refer to the 99 percent of American women who have ever had sexual intercourse and have used a birth control method at least some of the time.

Contraception obviously is a deeply held value by American women. But the fact that in the United States a startling half of all pregnancies are unintended makes clear that birth control is used only sporadically by some. There are a number of reasons why this is so, but a chief one is that so many women cannot afford contraception, especially the most expensive—and most effective–methods, such as birth control pills, and long lasting reversible contraception, for example, the newer (and far safer) models of IUDs (intrauterine devices).  In short, the same economic disparities that pervade every other area of American life manifest here as well: poor women depend on publicly-funded programs for their contraceptive services, but, according to the Guttmacher Institute, only a little more than half of the 17 million women who need these services currently receive them.

This situation of tremendous inadequacy was supposed to improve considerably. In one of the best pieces of news in the otherwise embattled reproductive health world since the battles over health care reform began, the Obama administration announced last August that it would accept the recommendations of a special panel of the Institute of Medicine and include contraception—including all FDA-approved birth control methods—as part of the basic package of preventative health services that health insurance plans must offer, without co-payments. Read the rest of this entry →

Public Funding of Family Planning is Essential, Even Under Health Reform

7:06 am in Uncategorized by RH Reality Check

Written by Britt Wahlin and Amanda Dennis for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This week, as we celebrate the first anniversary of the Affordable Care Act, which promises to bring great benefits to women in this country, new threats to women’s health care have emerged. Last month the House of Representatives voted to eliminate federal funding of Planned Parenthood and cut entirely the Title X program, which supports family planning clinics across the country. Though the Senate has since rejected this proposal, House Republicans have vowed to continue to push for these cuts.

Many have spoken out about the harm this would have on low-income women, who rely on Planned Parenthoods and other family planning clinics for important preventive care like contraception and cancer screenings. Even in Massachusetts, where 98 percent of residents have health insurance due to groundbreaking state health reform, such cuts would be devastating.

Massachusetts has a robust network of family planning clinics, Planned Parenthood among them, which offer contraceptive services and counseling, sexually transmitted infection testing and treatment, and cervical and breast cancer screening on a sliding fee scale. In the wake of Massachusetts reform, family planning clinics continue to play a role in providing services to the Commonwealth’s most vulnerable residents.

In 2008, a year after Massachusetts’ health reform law took effect, Ibis Reproductive Health and the Massachusetts Department of Health Family Planning Program undertook research to explore the impact of reform on low-income women’s access to contraception. We conducted a survey and interviews with family planning providers and also held focus groups with English- and Spanish-speaking low-income women.

We found that health reform has provided a number of benefits to women and many women expressed relief over finally having insurance.

But our research also uncovered new barriers. … Read more