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Anti-Choice ‘C-Streeter’ Opposing Pelosi for Minority Leader

7:04 am in Government, Health care, Legislature by RH Reality Check

Written by Jodi Jacobson for – News, commentary and community for reproductive health and justice.

Remember the words, “Stupak Amendment?” Keep those in mind as you read further.

Democratic House Speaker Nancy Pelosi today announced that she would place herself in the running to become House minority leader when Congress reconvenes.

Pelosi, the first female Speaker of the House, was in large part responsible for ensuring the success of virtually every piece of legislation passed during the Obama Administration, including health care reform. Some bills that succeeded in the House failed in the Senate due to lack of effective action to pass them. Pelosi did not allow this to happen in the House while she held the gavel in her hand.

While clearly elements of some of these laws leave something to be desired–such as the ban on coverage for abortion care in private insurance policies–Pelosi’s ability to navigate and garner majority votes from an often fractious Democratic majority has won accolades even from opponents.

Pelosi also endured–seemingly without batting an eyelash–a flood of mean-spirited and sexist campaigns against her by both Republican and Tea Party actors seeking to vilify her through the use of imagery and strategies devised by people with the maturity level of sixth graders, and in what could only be described as a bid to distract from their own lack of ideas, lack of experience, lack of true leadership ability, or all of the above.

Pelosi, however, is being challenged by none other than Congressman Heath Shuler, a good ol’ boy conservative southern Blue Dog Democrat. Read more

“Third Way” Goes the Wrong Way on Abortion Restrictions in Health Reform

9:20 am in Uncategorized by RH Reality Check

Written by Jodi Jacobson for – News, commentary and community for reproductive health and justice.

At this point it’s not news to anyone that our ostensibly pro-choice President has presided, through a combination of silence and pre-emptive capitulation, over some of the greatest setbacks to women’s reproductive rights in more than a generation, culminating with the recent ban on coverage of abortion care for women entering high-risk insurance pools because they have high-risk health conditions that may be complicated or exacerbated by pregnancy.

In a mid-July article on the abortion coverage ban published by RH Reality Check, Jessica Arons, Director of the Women’s Health and Rights Program at the Center for American Progress wrote:

a commotion arose over the question of whether Pre-existing Condition Insurance Plans, also known as high risk pools, can include abortion coverage.  The Obama Administration responded immediately by imposing a total ban on abortion coverage in the pools that echoes the Stupak Amendment, even though nothing in the law requires such action.

Repeat: "…nothing in the [health care reform] law requires such action."

How we got here under President Obama is the focus of another and forthcoming analysis.

For now, it’s worth examining the claims being made about the abortion coverage ban by the self-proclaimed "progressive" group that appeared at the front of the line last week to apologize for this newest setback.

Enter Third Way.

Third Way is one of those groups that has pushed hard for so-called common ground on abortion issues. You know, the "common ground" on which the most fundamental rights of individual women to decide whether, when, and with whom to bear children–and to act in accordance with their own consciences, morals, and religious traditions in the best interests of their own and their family’s health and well-being–would be subject to a modern-day sacrifice to salve the qualms of religious fundamentalists and political opportunists for whom huge gaps in access to contraception, comprehensive sexual and reproductive health education, child care, economic support for poor women, aid to communities beset by environmental toxins, school lunch programs, Head Start and all else that is "life-affirming" never seem to rise to quite the red-level-threat of urgency as does the reality of women having control over their own bodies.

The abortion coverage ban was bad, and the Administration knew it. And if you are going to break a huge promise to a huge constituency that worked incredibly hard to get you elected for no reason other than you can’t stand up to the bullies, than it’s always convenient to have a group or two that will help with CYA on even the most onerous or heinous policies. So when the regulations were put out there, and health and human rights groups cried foul, Third Way, purportedly at the request of some "progressive policymakers," stepped right in with an analysis intended it seems to pat all us womenz on the head and assure us that these regulations are really in sync with the "spirit and the letter" of the health care reform law. Don’t worry your pretty little head, darlin’.

Except they are wrong on both the spirit and the letter of the law as well as the spirit of the President’s repeated, repeated promises that no one would lose current coverage under health reform, and his later "promise" (after breaking the first one) that the so-called status quo in federal funding for abortion care would be preserved.

Third Way makes the following claims to support the coverage ban:

1) Federal funds cannot be used for non-Hyde abortions

2) High-risk pools are not like Medicaid

3) High-risk pools more closely parallel the Federal Employees Health Benefits Program (FEHBP)

4) The ban does nothing to change the rules for private insurance.

Let’s take these claims one by one:

Claim 1: Federal funds cannot be used for non-Hyde abortions

Third Way argues that because the Hyde Amendment forbids federal funding for abortions, and because the high-risk pools are federally funded, it is "fundamentally consistent…to apply to the pools the same limitations that accompany federal funds in other areas of the health care law" even though, as they clearly state, "there is no specific legislative provision limiting coverage of abortion in the pools."

There are a number of things that make this analysis particularly shallow.

First, as Arons points out:

There is not one, over-arching law that restricts abortion funding for all sources of federal funds.  Rather, abortion opponents have had to fight to obtain funding restrictions for each separate source. Moreover, those restrictions are not permanent; they must be re-approved each year through the annual appropriations process and their contours have changed over time.

What, in effect, the Administration has begun to do in its expansive interpretation of existing law is to create a larger umbrella banning abortion coverage than exists in written law, thereby further (and further) eroding already-existing access to abortion care. This is neither the spirit of the health care law as the Administration publicly and consistently described it nor as the majority of Democrats in Congress intended it. In fact, as Arons further points out, the compromise that finally resulted in passage of the Patient Protection and Affordable Care Act (PPACA) was to preserve the "status quo" of Hyde, not expand it.

[T]he whole point of the compromise was to preserve the status quo, which included both restricted and unrestricted spheres of abortion funding.  Moreover, the terms of the agreement were carefully negotiated.  Abortion opponents who participated in the bargaining did not raise concerns about high risk pools or other specific potential sources of federal funding, and they should be able to live with the deal they made.

Second, the compromise was based on the fact that while federal funds would be prohibited from being used to pay for abortion, the law would maintain the availability of abortion coverage in health insurance plans by preserving the rights of women to use private funds to pay for that coverage. The high-risk pools are not "completely federally funded" (as Third Way asserts) because they in fact require participating individuals to use their own private funds to pay for their premiums. While the federal government is providing funding to offset the extremely high costs of providing insurance to those with pre-existing conditions, it is incorrect to say that this insurance will be paid for entirely with federal funds. That is yet another aspect of the "status quo" obliterated and an affront to the rights of all women to purchase and pay for the health care insurance they need.

Finally, the restriction on high-risk pools is not, as Third Way states, the same limitation placed on health care plans in the exchange. Subsidized individuals enrolled in a plan a state exchange will be able to purchase health insurance that includes abortion coverage as long as the health insurance company segregates the federal from private dollars to ensure that federal funds are not used for abortion. Participants in the high-risk pool, on the other hand, will be completely prohibited from purchasing health coverage that includes abortion coverage.

Claim 2: The high-risk pools are not like Medicaid

Third Way argues that the Administration "will apply the same rules to federal contributions in the high-risk pools as currently apply to federal contributions to Medicaid."

This is a misleading analogy. First, the Hyde Amendment does not apply to the high-risk pools because the funding does not go through the Labor-HHS Appropriations Act to which Hyde applies, but is appropriated directly from the Affordable Care Act. 

Even in making an analogy to the Hyde Amendment and the Medicaid program however, this analysis falls short. Third Way distinguishes the availability of abortion coverage in the Medicaid program versus the high-risk pools based on the ability of states to use their own funds to pay for abortion services under the Medicaid program.  While it is true that the newly created high-risk pools will not include state funding, the Hyde Amendment explicitly allows the use of both state and private funds for abortion coverage. If the high-risk pools did fall under the Hyde restriction like the Medicaid program, states could allow the coverage of abortion in their high-risk pools by using private funds to pay for the coverage.

Claim 3: The high-risk pools more closely parallel the Federal Employee Health Benefits Program (FEHBP)

Third Way next likens the high-risk pools to the FEHBP.

But these pools do not closely parallel the FEHB program. The FEHB is employer-based health insurance that provides health insurance benefits exclusively for federal employees, while the high-risk pools will provide coverage for individuals who cannot find insurance elsewhere due to a serious pre-existing condition, and as the Administration stated in the proposed rule, is a “temporary Federal insurance program in which the risk is borne by the Federal government up to a fixed appropriation.”  The fact that both FEHB and the high risk pools will be administered by the Office of Personnel Management (OPM), another assertion made by Third Way, also does not mean that the programs are similar.  In fact, OPM will also administer the multi-state plans established under the Affordable Care Act, which are not only separate and distinct from FEHBP, but will be allowed to cover abortion.

Again, Third Way persistently states that the high-risk pools are run with federal money by federal rules. The high-risk pools however, will actually include a substantial amount of private funds due to premium contributions from participating individuals. According to the federal government’s own health care reform website, the premium for an individual in New York state’s high-risk insurance pool will range to $400 to $600 per month. And while the federal government will administer some of the plans, 28 states will administer their own plans. 

Claim 4: This action does nothing to change the rules for private insurance plans.  

Third Way argues that the rules issued by the Administration do nothing to change the law for private insurance companies.

It is technically true that the Administration’s new restrictions don’t change those on health care plans in the exchanges under the Affordable Care Act.

However, Third Way incorrectly distinguishes the Stupak Amendment from the restriction on high-risk pools. In fact, like the Stupak Amendment, the restrictions prohibit those enrolled in the program from purchasing coverage that includes abortion with their own private money, which is the exact principle that was rejected when the Stupak Amendment failed to be included in the law. 

Third Way states that the restriction on the high-risk pools does not prohibit consumers from purchasing private insurance plans that include abortion coverage as long as they use their own money. However, the individuals who will qualify for coverage under the high-risk pools are by definition unable to purchase health insurance elsewhere on the private market.  Since there is no other way for these individuals to purchase health coverage, they are in fact prohibited from purchasing health insurance coverage that includes abortion with their own private money.

Third Way concludes that the Administration has applied “existing federal law and precedent.”

As Jessica Arons pointed out in her original piece, there is no existing federal law that requires this restriction for the newly-created high-risk pools. And the Congressional Research Service confirmed in a July 23rd 2010 memo to the Senate Committee on Health, Education, Labor and Pensions that the Hyde Amendment does not apply to the high-risk pools and that there is no other federal law or regulation, including the Affordable Care Act and the subsequent Executive Order, that requires this result.  

What Third Way’s analysis further neglects is the reality of abortion politics today, in which far right politicians, bereft of any ideas whatsoever to address profound economic, environmental and social challenges instead spend entire legislative sessions thinking up ways to make it increasingly difficult for women to prevent unintended pregnancies in the first place, or secure terminations of a pregnancy even when their lives are at imminent risk.

On all of these counts, Third Way’s analysis is a completely indefensible effort to excuse  a completely indefensible policy.

Let’s just call it what it is: This is a new restriction on coverage of abortion care for those who are most in need of comprehensive coverage, imposed by an Administration capitulating–yet again–to pressure from anti-choice groups. Last I remember, those groups did not vote for the President, contribute money to his campaign or campaign for him. Quite the contrary.

Still, Third Way for some reason sought to excuse it.  But the shallow nature of the analysis suggests that either Third Way didn’t read the laws involved, or doesn’t quite understand them, or both. Or perhaps the group is so enamored of its own limited analyses of the abortion debate that it completely misses or disregards what really motivates debates around sex and reproduction in this country–race, class, control of women, and craven power grabs by fundamentalist religious figures and politically opportunistic politicians.

The President broke a fundamental and profound promise by reaching outside an already-restricted law to further undermine women’s fundamental rights. There is no "third way" or other way to slice it.

Stupak and Health Reform’s Second Trimester

6:27 am in Uncategorized by RH Reality Check

Written by Rebecca Sive for – News, commentary and community for reproductive health and justice.

In the (political) heat of late March, in the first trimester of President Obama’s proposed, and then signed, Executive Order “codifying” The Hyde Amendment (a deal done for Rep. Bart Stupak, he of the Stupak Amendment), in order to get the President’s healthcare reform legislation, “The Patient Protection and Affordable Care Act”) passed, I called on the Speaker of the House, the women U.S. Senators, and the leaders of the national pro-choice organizations to call for aborting the Executive Order. 

They didn’t, and a few days later, surrounded, (only, and with no press present), by Bart Stupak and his equally rabid, anti-choice ring members, the President signed Mr. Stupak’s evil Order.

Why was I so direct, so inflammatory in my call-to-action? Well, exactly because I wanted to sound a very loud alarm, for fear of what might be coming down the pike, if we failed to “bust the cap” on this disingenuous (keep reading) Executive Order. I feared that unless we busted it, we’d be faced with just the sort of (hatred-of-women) next steps we’ve–surprise, surprise– experienced this week.

You ask: What happened? I thought this was a great week, what with financial reform and capping the BP oil well and all? Well, not so fast, it turns out.

Turns out, earlier this week, in this, the (equally hot, politically), but second trimester of the President’s Hyde-redux-and-more, Stupak-evil, though the President said otherwise, (keep reading) Executive Order, it became clear that the White House had instructed Kathleen Sibelius, Secretary of Health and Human Services, to avoid any dustups about abortion in her regs’-writing for the healthcare reform bill, no matter the cost to America in the loss of American women’s lives.

How to do this?

Well, for starters, deny women, any woman in any state, even a woman proposing to spend her own money (lest there be any doubt about how The White House really feels about abortion), from obtaining an abortion, if she’s (we thought lucky, but how wrong we were), a member of her state’s high-risk insurance pool, part of the President’s Patient Protection and Affordable Care Act).

No matter, the lives of women in ill health (and, therefore, in the high-risk pool), for whom an abortion might be a vitally needed medical procedure. The President’s poll numbers are in the dumpster. Unless you’ve been raped, are a victim of incest, or your life has been endangered, you’re SOL.

Mr. President: A word to the wise:  Better not further jeopardize your standing, when we’re not sure whether the BP cap won’t go bust. Mr. President:  A word to the wise, even if it becomes clear you’ve gone back on your staff’s statements that your Stupak-evil Order doesn’t do anything more than “codify” existing law. Better to continue to say, albeit falsely, that the Stupak Amendment you once said you wouldn’t abide (either) wouldn’t be a part of anything you do. This abortion matter? Well, it’s just too touchy to do otherwise (even if “otherwise” is the right thing for half of all Americans).

In fact, and as we all know, the Executive Order was nothing but a most willingly made sop to Rep. Stupak. For, after all (after months and months and months of all—all that healthcare wrangling), it was Mr. Stupak’s vote that stood in the way of passage of the healthcare reform law, the one for the history books the President most wanted.

As such, the Executive Order’s creation and signing was a deeply hypocritical and cynical act.  “Hypocritical,” because it did not do (only) what the President’s men said it would do—“codify” existing law, i.e., The Hyde Amendment. “Cynical,” because the Order’s utility depended on the willingness of White House women-leader allies to suspend disbelief, and say: Oh, yes, we agree, when you say that this isn’t going beyond The Hyde Amendment (knowing that it did).

Do you think for one minute that Bob Bauer, the President’s campaign and personal, political lawyer, now his White House Counsel, didn’t know all the potential ramifications (read: opportunities) of the Executive Order—both for the law and for the politics—when he directed his staff to draft the Executive Order?

Do you think for one minute that Don Verrilli, an Associate White House Counsel, rumored to be appointed U.S. Solicitor General–once Elena Kagan is confirmed as a Supreme Court Justice–missed this either? 

Not, hardly: These guys are really, really smart. These guys don’t miss these things: That’s why they are doing what they are doing. That’s why they are where they are.

Putting the best face on it, Mr. Bauer and Mr. Verrilli saw what the White House women-leader allies also saw, and, again, like the pro-choice leaders, didn’t protest, for fear the whole healthcare reform applecart would be upset.

But, make no mistake:  Mr. Bauer and Mr. Verrilli also saw the Executive Order as a useful context for massaging federal healthcare reform regulations that could help diminish dustups over abortion; dustups never good for a President or a President’s men’s futures.

Why was the Executive Order AT ALL NECESSARY if all it did was “codify” existing law? The answer is it wasn’t, because it didn’t. And now we’re in the dumpster: Read here:

So now, in the Executive Order’s second trimester, we have the leaders of our pro-choice movement asking the government to “reconsider” (Marcia Greenberger for the National Women’s Law Center); expressing their “deep disappointment,” and calling on us to protest (Cecile Richards for Planned Parenthood); and remonstrating that these regulations are neither necessary as a legal matter (for they go beyond The Hyde Amendment), nor useful as a policy matter (because the women most likely to be in the state-based high risk pools are among those most likely to have complications from pregnancy and therefore needing an abortion (Laura Murphy for the ACLU)).

Like I said:  The Executive Order should have been aborted.

I’ve argued in these pages for many months that the ameliorative approach national pro-choice leaders have pursued with this Presidential administration –pursued both by the leaders representing the big organizations, and by those making the laws in Congress–is fatally flawed. I think we now have proof. [It’s a short distance from the dumpster to the graveyard.]

Further, I believe this acquiescence, and its requisite suspension of disbelief, has led to the abandonment of American women in most need, i.e., to the presence of anti-choice wolves at their doorsteps, in every state.

The strategy is accomodationist. It’s post-facto. It violates the first rule of organizing to win (on the people’s behalf):  Know your bottom line, and how to get it, before you walk into any meeting. Otherwise, don’t walk in:  Scream, holler, embarrass, and demand, until you’re on equal footing and can negotiate a fair deal.

Sure, I’ll negotiate with you ad nauseum, instead of refusing to participate until my demand for equal treatment is met (Barbara Boxer in the Senate). Sure, I’ll send threatening letters with no force of law or policy (Diana DeGette in the House), in hopes that you’ll do the right thing. Sure, I’ll support you when you tell me it’s a good idea to (only) “codify” in an Executive Order something, (The Hyde Amendment), which, by any measure, has been horrible for women for over two generations (The Speaker and her pro-choice Member leaders). Sure, I’ll believe you when you say that this Executive Order won’t have any additional force of law in any upcoming circumstance that matters to women’s health (again, the Speaker and the women Members).  Sure, I’ll believe you, Mr. President–when you sign Mr. Stupak’s evil Order–with no press present and surrounded by the architects of hateful acts against my sisters–when you tell me nothing is amiss.

In no way that I can see is this a strategy for winning the war to protect America’s women and ensure their equal rights. This is appeasement. And history tells us that, until appeasement is set aside, people die. Today, in America, those dead people will be American women.

“Bust the cap (on it);” bust the cap on this well of cowardice.

Earlier this week, I drove across upstate New York on my way home to Chicago. Mid-afternoon, I approached the Thruway exit for Seneca Falls. I thought:  Why not stop?  Why not pay my respects to our foremothers, to women who wouldn’t know acquiescence or appeasement if it hit them over the head.  So, I did. And here’s what I got to read when I got there:

‘We hold these truths to be self-evident: that all men and women are created equal; that they are endowed by their Creator with certain inalienable rights; that among these are life, liberty, and the pursuit of happiness; that to secure these rights governments are instituted, deriving their just powers from the consent of the governed

“….[W]hen a long train of abuses and usurpations, pursuing invariably the same object, evinces a design to reduce them [American women] under absolute despotism, it is their duty to throw off such government…Such has been the patient sufferance of the women under this government, and such is now the necessity, which constrains them to demand the equal station to which they are entitled.”

Repeal Abortion Ban for Servicewomen

6:25 am in Uncategorized by RH Reality Check

Written by Amie Newman for – News, commentary and community for reproductive health and justice.

Sen. Roland Burris (D-IL) introduced an amendment to the National Defense Authorization Act that would repeal the long-standing ban on abortion care for military women seeking an abortion on a U.S. military base – even for a servicewoman willing to use her own money. According to the ACLU:

The ban, which applies even if a woman pays for the procedure with her own private funds and in cases where a woman’s health is at risk, was first put into place in 1988 with an internal Department of Defense memorandum. In 1993, President Bill Clinton reversed the policy by executive order but Congress intervened two years later to codify and reinstate the ban.

The amendment, therefore, would codify the repeal of the ban and take the ball out of play, so to speak. By leaving it up to a Democratic president to issue an executive order and then up to a Republican congress to reinstate the ban, we’re just playing ping pong with military women’s health and lives. From NARAL Pro-Choice America:

Since 1979, the Department of Defense (DoD) appropriations bills have prohibited the use of federal funds for abortion services at overseas military hospitals in almost all cases. In 1985, the ban was made permanent by the DoD authorization bill.1 In 1988, DoD issued an administrative order – without congressional consultation – extending the funding ban to prohibit women from obtaining abortion care with their own funds at military facilities overseas. Prior to the 1988 restrictions, women would have to pay for the procedures themselves.

Vania Leveille, ACLU Legislative Counsel says,

“There are hundreds of thousands of women serving in our military who put their lives on the line to protect our freedoms yet they are prevented from exercising their own reproductive freedom. Servicewomen stationed overseas are disproportionately affected by this ban. Allowing American servicewomen to use their own private funds to obtain abortion care at U.S. military facilities is fundamental and should never have been questioned in the first place. Senator Burris’ leadership was crucial to this victory and we are grateful to members of the Senate Armed Services Committee for voting to repeal this unjust and unfair policy."

In order for a woman fighting for our country, currently, to exercise her right to a safe and legal abortion, using her own money, she must first seek abortion care off of a United States military base (and, of course, if abortion is not legal in the country in which she is currently stationed, then what?), then she must request leave stating the reason for her leave and thirdly she must, of course, have the time and money to seek safe abortion care wherever she can find it. Barring women from using their own money to exercise a legal right to access the care they decide is best for them endangers women’s health and lives. Seems to me that the Stupak Amendment is the not so long lost child of this inequitable abortion ban for military women; barring women from using our own money to pay for a legal procedure.

The Newsweek Article: Reflections by a Young Prochoice Activist

7:23 am in Uncategorized by RH Reality Check

Written by Elise Higgins for – News, commentary and community for reproductive health and justice.

My name is Elise, and I’m a pro-choice activist from Kansas. I have never-ending gratitude for those who have devoted their lives to reproductive rights. At the same time, I have some serious problems with comments made that disparage my generation’s involvement in the pro-choice movement.

For the last four years I’ve grown as an activist, surrounded myself with other activists and helped to train new activists at my school. I’ve pretty much devoted my college career to making a ruckus for reproductive justice. So imagine my surprise when I read Newsweek’s piece “Remember Roe! How can the next generation defend abortion rights when they don’t think abortion rights need defending?”

My peers and I are full-time feminists. We’re planting pro-choice gardens at the University of Northern Kentucky and throwing Sextivals at the University of Kansas. We’re working with organizations like Choice USA that lift up the voices of young people. We’re volunteering for local, statewide and national organizations. And we’re blowing up the Internet with the tools and information to create change. There are thousands of us working hard for the movement every day. How disappointing to find that those in positions that we will surely take someday doubt our passion.

We are more passionate than you can imagine. We know that the right to an abortion alone is meaningless without contraception, sex education and freedom from sexual assault and domestic violence. We’re expanding our understanding of “choice” and talking about all the ways that race, gender identity, class and sexual orientation impact reproduction, AND we’re doing it all while performing underpaid or unpaid labor that sustains giant, national pro-choice organizations.

Some say that millennials don’t view abortion as imperiled or in need of defense. I beg to differ with this massive generalization. Do I think we need to be defensive about our abortion rights? No. I think we need to launch some offense. From the Hyde Amendment to the Nelson Amendment, universal rights to safe abortions have eroded since Roe, and no one knows that better than young people. We are on the front lines; we’re victims of policies that marginalize poor people, queer people, people of color and people with disabilities. We’re more than aware that abortion rights are imperiled. We live that reality every day.

Meanwhile, about the moral complexity some claim that advocates haven’t quite grasped: I have never heard a pro-choice activist tell me that the decision to make an abortion is an easy one. In fact, from the beginning of my involvement in the pro-choice movement, great pains have been taken to demonstrate to me what a complex, difficult decision abortion is. I have been inside a clinic and heard the stories of women who have chosen abortion. Those experiences have only solidified my conviction that we must listen to Dr. Tiller’s words: Trust Women. No one understands the complexity of a reproductive decision better than the person making it.

One of my favorite things about the feminist movement in general and the pro-choice movement in particular is our tendency toward self-reflection. Self-reflection is only effective, though, when you listen to dissenting voices and not just your own. So take heed: Youth are advocating for choice, and the pro-choice movement must do better by us. Leaders in the movement need to acknowledge our contributions, and work to make us the movement’s next leaders.

Abortion Foes Set New Sights on 2010 Elections

6:48 am in Uncategorized by RH Reality Check

Written by Wendy Norris for – News, commentary and community for reproductive health and justice.

A trio of anti-choice religious groups outlined their plans in a recent national teleconference to avenge a recent series of stinging legislative rebukes in Congress.

Forget the health care reform burr in their saddle. They’re going for the big guns — promoting ultraconservative state and federal candidates in the 2010 and 2012 election cycles. People who could have an important role in watering down regulatory language before the complex new health reform law fully kicks in over the next four years.

Fr. Frank Pavone of Priests for Life led the call featuring institutional anti-choice activists Douglas Johnson and Ernie Ohlhoff from the National Right to Life Committee and Focus on the Family Action lobbyist Tim Goeglein.

It would be easy to dismiss the male-dominated strategy call as typical fear-mongering politics. They don’t have the weight of say U.S. Chamber of Commerce fat cats who will reportedly spend $50 million on electoral races this year to boost ideologically-preferred anti-tax candidates.

But between the three tax-exempt groups they raked in a lot of dough of their own. In 2008, their collective coffers swelled to $31 million largely from private donations by conservative single-issue anti-choice voters whom they can rally to the polls and to their checkbooks.

And as these groups know well in the game of bare-knuckle politics the burden of truth should never gets in the way of a good sound bite.

Case in point: the supreme irony of RTL’s Johnson falsely alluding to the Obama Administration’s secret plan to ration Medicare and enact death panels while his organization schemes to actually deny reproductive health care to women.

And through their proxies in Rep. Bart Stupak (D-Mich.) and Sen. Ben Nelson (D-Neb.) they nearly succeeded in bringing the whole landmark bill down.

While they’re stoking fears that taxpayers will be on the hook for "abortion surcharges" hidden in their own insurance premiums to cover the uninsured deadbeats, pro-choice advocates should expect to be joined by a new foe on the block — community health centers.  Multiple remarks on the call point to a new litmus test of opposing public health care for the destitute for forthcoming conservative candidates to earn the Religious Right’s vote.

Right wing talkers are already flapping their gums that publicly funded medical clinics are not subject to the Hyde Amendment which bars federal dollars from financing abortion services except in limited circumstances.

Except it’s categorically untrue, according to a U.S. Dept. of Health and Human Services memo obtained by Mother Jones magazine and the testimony of multiple health and legal experts. Besides the pesky fact that community health clinics don’t perform abortions — despite Johnson’s fictitious claims that the abortion pill, Mifepristone (RU 486), will be freely distributed. Presumably on the super-secret, double-dog-dare direct order of President Barack Obama and his handmaiden Planned Parenthood of America president Cecile Richards.

What does that mean for the summer and fall leading up to Election Day?

The cynical public relations ruse declaring "Black Children Are an Endangered Species" that was recently test marketed in Georgia will likely metastasize to other states. Only now "community health center" will become right wing code to attack health care for minorities and low income people under the guise of a so-called pro-life agenda.

And the most likely home for this unconscionable message — churches.

Pavone and Ohlhoff each devoted significant amounts of time on the call encouraging listeners to lobby their pastors with prepared materials for parishes to conduct what can only be described as non-partisan-in-name-only electoral activities and pre-written sermons on conservative social issues to rally church-goers to the polls.

But quite honestly those tactics are nothing new since the obdurate rise of the fundamentalist faith-fueled political movement of the 1980s. A "moral majority" of slippery televangelists and political operatives that declared war on anyone and anything that fell outside the narrow confines of the traditional family unit — the frequently divorced, corrupt and sexually licentious among their merry band excepted, of course.

No, what’s far more interesting is witnessing the theological oil and water melding of conservative evangelical Protestants and orthodox Catholics. Their mutual fanaticism over defeating the health care reform bill forged the two factions into a virtually indistinguishable emulsion of brute political force and Dominionist culture warriors.

Call it 2,000 years of well-honed Vatican politics weds the youthful, smooth-talking, prosperity preaching global religious movement with deep ties at every level of public life. The C Street gang has nothing on this holy union of political convenience.

That certainly helps explain Pavone’s fawning over Goeglein who joined the hour-long call 53 minutes late.

He reportedly couldn’t break away from the Susan B. Anthony List base featuring Minn. Gov. and 2012 GOP presidential hopeful Tim Pawlenty and anti-choice luminaries Minn. Rep. Michele Bachmann, Rep. Virginia Foxx of North Carolina and former Colo. Rep. Marilyn Musgrave.

A special assistant to President George W. Bush, Goeglein was described as"[Karl] Rove’s legman on the right" until he resigned in disgrace over plagiarism charges. Focus on the Family hired him shortly thereafter in 2009 to be "its eyes and ears in Washington."

Besides shoring up the single-issue, anti-choice conservative base with a former White House powerbroker comes a jaw-dropping effort to influence international lawmakers. Another of Pavone’s spin-off groups, Gospel of Life Ministries, is now housing the Parliamentary Network for Critical Issues.

Led by long-time Capitol Hill maven Marie Smith, wife of Rep. Chris Smith (R-N.J.), the tax-exempt group advocates anti-choice policy and writes sample legislation for conservative lawmakers around the world.

The Smiths — both ultraconservative Catholics — have close connections to the well-heeled conservative political and corporate elite across the globe. Rep. Smith, who has served 15 terms in office, chairs the Congressional Pro-Life Caucus and is the senior member of the House Foreign Affairs Committee and the ranking subcommittee member overseeing Africa and global health issues.

He was also the proud recipient of the Distinguished Community Health Defender Award by the National Association of Community Health Centers, according to his official biography.

But that didn’t stop him from joining fellow GOP lawmakers in attacking the health care legislation on the House floor. Smith told the Camden, N.J., Post-Courier that Republican members would have voted for it if it was "a good bill."

"Instead, blunt force is being applied like a vice grip to convince the unconvinced and undecided to cave, conform and capitulate," Smith said.

Much like the coercive tactics Pavone and his newfound friends will be applying from the pulpit and in the smoke-filled rooms to extract vows of anti-choice and anti-public health fealty from political hopefuls in the coming elections.

Is it Nov. 2 yet?

Why Does Congress Allow a Pedophilia-ridden Church to Control Women’s Rights?

7:56 am in Uncategorized by RH Reality Check

If you are, like me, confused about the answer to this question, please raise your hand….or better yet….ask your Congressperson and Senator.  And ask the President.

Why is a pedophilia-ridden, pedophilia-hiding, child-abusing Church allowed to write laws controlling women’s rights?

I am talking, of course, about the Catholic Church and specifically about the hierarchy….not the good people of the Catholic faith. 

The Church whose leadership, in case we didn’t already know this, has now been proven to have purposefully hidden an epidemic of pedophilia and–to protect priests, not born children–reassigned serial sex offenders to other parishes to offend again.  The kind of people who, if they were not priests protected by the hierarchy of the Church would not be allowed by US law to come anywhere near children or schools?

According to the newest revelations reported in the New York Times:

Top Vatican officials — including the future Pope Benedict XVI — did not defrock a priest who molested as many as 200 deaf boys, even though several American bishops repeatedly warned them that failure to act on the matter could embarrass the church, according to church files newly unearthed as part of a lawsuit. [emphasis mine].

The internal correspondence from bishops in Wisconsin directly to Cardinal Joseph Ratzinger, the future pope, shows that while church officials tussled over whether the priest should be dismissed, their highest priority was protecting the church from scandal.

The documents emerge as Pope Benedict is facing other accusations that he and direct subordinates often did not alert civilian authorities or discipline priests involved in sexual abuse when he served as an archbishop in Germany and as the Vatican’s chief doctrinal enforcer.

As many as 200 deaf children molested.  The Pope himself as Cardinal–and as the Church’s chief doctrinal enforcer–more worried about the possible scandal to the Church than the abuse of born children.  As a mother, I am so sickened I can barely type.

You know that doctrine that they enforce?  The one that makes women lower on the totem pole than a fertilized egg?  The one that in Nicaragua has a woman whose life is threatened with cancer, hospitalized at 8 weeks pregnant, refused either an abortion or cancer treatment because the egg, embryo, fetus is so much more important than that woman’s life (or the future of her 10-year-old daughter)?  You know the doctrine that says they will excommunicate the mother of a 9-year-old girl in Brazil because she insisted that her daughter, pregnant with twins as a result of rape by her step-father (rape of a then-8-year-old girl) be allowed an abortion?  The one that talks incessantly about the "sanctity of life" (until after you are born)?  The Church that supports organizations that threaten to remove the social services they provide to all poor people in the District of Columbia because they find offering insurance benefits to married same sex couples so offensive?

The Church that refuses to provide even preventive reproductive health care to women while using federal dollars because it "offends their morals?"

The Church of "abstinence-only" programs that have resulted in countless teens across this country obtaining sexually-transmitted infections and unintended pregnancies?

I ask again: Why is that Congress allows a pedophilia-ridden, pedophilia-hiding, child-abusing Church allowed to write laws about women’s rights?

And I am talking about deals cut over the past several years with the consent of House Speaker Nancy Pelosi, and other leading Democrats including:

  • The 11th hour vote on the Stupak Amendment last fall in the health reform debate allowed by Speaker Pelosi after closed door meetings with the U.S. Conference of Catholic Bishops.



  • The midnight-rewriting in 2008–the night before a vote–of the original reauthorization bill of the President’s Emergency Plan for AIDS Relief (PEPFAR) in which the United States Conference of Catholic Bishops–aided in this case by Congressman Chris Smith (R-NJ), Congressman Joe Pitts (R-PA), and Congressman Mike Pence (R-IN)–worked long into the night with Congressman Howard Berman (D-CA) and his staff–with the blessing of the Speaker–to:


  • deny HIV-positive women access to contraceptive supplies to avoid unwanted pregnancies (because these women knew already they would not live to raise any child born);


  • restrict integration of HIV prevention and family planning services, even though both unintended pregnancies and HIV infection are catastrophic public health problems in Africa and both result from unprotected sexual intercourse;


  • re-insert into that bill abstinence-only-until marriage policies despite the fact that the Government Accoutability Office, the Institutes of Medicine and countless other analysts had proven these programs only served to leave people vulnerable to HIV infection.


I am talking about an HIV epidemic in which women now make up the majority of those infected and in which women and girls face the highest rates of new infections.  I am talking about policies that consigned untold numbers of women to death and continue to do so.

I am talking about the Church that is invited into decision-making bodies on teen pregnancy, HIV prevention, comprehensive sex ed, by this Administration, in which the needs of "faith-based" organizations continue to take precedence over the health and rights of women, over pro-choice and women’s rights groups representing the majority of women in the United States, and over public health evidence and human rights in shaping public health policy.

I am talking about a Church which the male-dominated media goes out of its way to protect.

And I am offering here but a few examples of things about which I could easily write a book.

When will this stop?  When will we actually–not just rhetorically–care more about science than ideology?  About women’s rights over a misogynistic male organization that can not even keep its hands off of children.?

Only President Obama and the Democratic Leadership in both the House and Senate can provide those answers and only you can make them do so.

Written by Jodi Jacobson, editor of – News, commentary and community for reproductive health and justice.

Abort the Executive Order

8:02 am in Uncategorized by RH Reality Check

Written by Rebecca Sive for – News, commentary and community for reproductive health and justice.

“The (Patient Protection and Affordable Care) Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges.”

Barack Obama, President of the United States,

March 21, 2010

This text is from theExecutive Order ensuring enforcement and implementation of abortion restrictions in the Patient Protection and Affordable Care Act.”

In Chicago, we call it getting out-hustled. That’s what the President and the Speaker did to their opponents over this weekend; they out-hustled them, in order to get the House of Representatives to pass the President’s healthcare reform bill, the one which, by-the-by, creates new barriers—both federal and state—to American women’s access to reproductive health care.

What does out-hustled mean? Well, in Chicago politics, it means you bust your you-know-what to get what you want, which too often means damn the consequences, most especially those consequences that appear to be (only) niceties, or appear arcane, or appear to affect few, or most-of all, obscure the message of ever-so-needed victory, any victory, if-it-comes-to-that.

But, in out-hustling their opposition, the President and the Speaker forsook the women of America; for they decided, by-the-by, that it was OK to make life–life hard enough already–all that much harder for women of modest resources when they face, for most, the hardest decision of life, the (constitutionally-protected) decision to terminate a pregnancy.

A couple weeks ago, I wrote in these pages regarding the Speaker’s specious claim that "This (the healthcare reform bill) is not about abortion,” 

To the contrary, I said, and I was proved right (keep reading): Getting the healthcare bill passed was going to be  “…about nothing but abortion.”

Of course, the Speaker knew this, too: She’d known this at least since last November when she called the Stupak Amendment for a vote, and it passed.

In fact, the Speaker’s statement to the contrary was just pure political ploy—typically political in that, in its narrowest fact context, it was true– the bill was and is about lots of aspects of healthcare, not just about abortion—but, equally typically political, false regarding the politics of getting the bill passed.

And that’s exactly what happened. Getting the healthcare bill passed was about nothing but abortion; at the end, it was about nothing but abortion-related deals; deals that, to boot, weren’t just any old deals, but deals with thePresident, his own self, to coin another Chicago term-of-art.

Indeed, Mr. I-used-to-can’t-stand-what-the-President-stands-for-if he’s-for-choice Stupak, of all people, got himself a little ole Executive Order, all about abortion.

And, lo and behold, once he got it, the Speaker got Mr. Stupak’s vote, and the bill passed.

Sometimes, being right doesn’t bring much satisfaction with it. Girl: Is that true this time.

For “…about nothing but abortion” turns out to mean that Washington will moot this women’s right with hardly a passing glance: Need an Executive Order, no problema; come on over and negotiate with my lawyers.

Need an Executive Order, no problema; let’s go right ahead and negotiate an Executive Order that no Democratic, nor, for that matter, any Republican, President has ever offered up; a document that Presidentially codifies a law whose sole purpose is to deny poor, and now middle-class (for the healthcare reform bill subsidizes middle-class families’ health insurance, too), women the same access to reproductive health care that wealthy women have.

Need an Executive Order, no problema; let’s just go right ahead and codify that Hyde Amendment in an Executive Order. And, while we’re at it, let’s go ahead and expand the reach of Mr. Hyde’s Amendment; expand it by extending its provisions to those new healthcare exchanges, all fifty of them; those health exchanges already a disaster for women, for what insurer in his right mind is going to want to tussle with local-pol-healthcare regulators regarding the right insure abortion and the right to undertake all kinds of new accounting procedures just to have the privilege of insuring a woman’s abortion. Exactly none.

Need an Executive Order, no problema:  We’ll just blithely ignore the constitutional complications here.

But wait: This Executive Order is about a matter that only affects, maybe, a couple- million-max American women annually. What’s the big deal? Won’t we be able to fix whatever all might be wrong with it later?

I say  “no,” for both policy and political reasons.

Here’s my take on one important policy reason: American history has shown over, and over, and over again that policies sacrificing or mooting constitutional rights, for the supposed “greater good,” are never sacrifices that protect the rights of women, minorities, the poor, or anyone else who doesn’t have the ability to buy her way into the offices of D.C. power brokers, and change powerbrokers’ minds.

What’s next: Sacrificing the notion that creationism is poppycock in order to get the votes of conservative Texas Democrats for education reform?  Sacrificing Miranda rights in the name of security when anyone with a plastic knife and training in martial arts can cause chaos on any airplane?

As to the political reasons, let’s start here, with this morning’s message from one leader of a big D.C. women’s group.  Here’s what she sent along:

“And once that work (Senate passage of the healthcare reform bill) is done, you and I will insist that Congress take the necessary steps to reverse the appalling anti-choice provisions contained in health reform and render the President’s Executive Order null and void.”

I could scream with frustration. But that’s not the point.  Here is the point. Actually, there are two (points).

Politics Rule One: In the words of Frederick Douglass, “Power concedes nothing without a demand. It never did and it never will.

You can insist forever; you can insist till the cows come home; meanwhile, the cows, and all the horses, besides, are out of the barn.

You can, and losers do, “insist,” while those horses run to another barn, a barn whose doors are dead-bolt locked when you try to enter.

Not a plan, that “insisting” thing.

By contrast, as Douglass pointed-out, “demanding” is a plan; demanding without standing down till you get what you want is a really, really good plan, when the chips are down.

So, here’s a corollary to Politics Rule OneDon’t get out-hustled, if your goal is winning.

Why, exactly, did the Speaker insist, “This isn’t about abortion.”

Why? Because she knew that when D-Day (decision day) came, she would do whatever she needed to do, to make the bill’s passage appear to have nothing to do with abortion, or, if about abortion in some way, only in a way that appeared innocuous, e.g., as it then happened, accompanied by an Executive Order that meets this threshold, (supposedly).

To this supposed point, catch these words of Dan Pfeiffer, White House Communications Director: “The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle.

The pro-choice Members obliged. Oh, the bill doesn’t include ‘Stupak;’ oh, OK, we’ll vote for that.

At no time in the course of the Speaker’s march to “wreckonciliation” for poor American women did these Members stand up, and do like Stupak did:  March anywhere, and demand a deal on their terms, the terms their female constituents and millions of other American women need.

Instead, they obliged, and then, blithely, declared victory: We fought back Stupak, as though the Stupak Amendment language were, or could be, the only language used to sacrifice the rights of American women. Well, the President, Speaker, and Mr. Stupak sure proved you wrong on that one.

Out-hustled means you think faster; do harder; stand on that proverbial street corner 24-7, and do what you need to do every minute of everyday. You don’t take people’s words at face value—you negotiate your own terms and your own words.

This is what real “players” do, to use a related Chicago term. They do what Bart Stupak did. They demand to be heard by those in power, in their presence, offer up nothing till they are (heard, in that room), and then get their deal in writing.

Didn’t happen; power conceded nothing ‘cause this wasn’t done, and we women are the worse for it.

But wait, there is one more chance:  Abort the Executive Order.

Of course, this would mean that since the nefarious deed is done, the Executive Order would now have to be rescinded.

No biggie: The President knows signing it was a bad idea (why else would he have prohibited press at the signing; he wasn’t proud of this one).

So,all you Democratic women Senators, who now sit in the catbird’s seat (Harry Reid can’t move without you; just like, apparently, Nancy Pelosi couldn’t move without Bart Stupak); do like Bart did: Walk on over to the White House. But tell the President you want Bart’s Executive Order rescinded.

Senators, for the sake of your less fortunate sisters, please tell the President you can’t abide his Executive Order that everyone in D.C. now understands does change the law and, as a practical matter, will make abortion unavailable. Senators, for the sake of your less fortunate sisters, tell the President you’re not into wreckonciliation; you’re not into wrecking the lives of the American women who most need your help.

“When faced with crisis, we did not shrink from our challenge — we overcame it. We did not avoid our responsibility — we embraced it. We did not fear our future — we shaped it.

These are the President’s beautiful words of last night.

Well, Mr. President: Sadly, you did shrink from your most important challenge—to create equality for all Americans, for all women.

Mr. President: On this point, I call your attention to the words of another great American orator; again, I quote Frederick Douglas.

“Where justice is denied, where poverty is enforced, where ignorance prevails, and where any one class is made to feel that society is an organized conspiracy to oppress, rob and degrade them, neither persons nor property will be safe.”

The Health Care Bill and Women’s Health: Wins, Losses, and Challenges

8:01 am in Uncategorized by RH Reality Check

Written by Jodi Jacobson, editor of – News, commentary and community for reproductive health and justice.

Today, President Obama will sign into law the Affordable Health Care for America Act.  Many aspects of the Act apply across the board to Americans regardless of age, sex, health history or employment status.  Some of the provisions are of particular importance to women.  Below is an initial summary of the wins, losses, and remaining challenges for women’s health and rights.


Elimination of "pre-existing conditions:"

The Act bars insurance companies from denying coverage to children due to pre-existing conditions, including children up to age 19.  This provision becomes effective 6 months after signing.

The Act bars insurance companies from discriminating against adults based on pre‐existing conditions, health status, and gender.  This is a critical provision for women, but one that does not become effective until 2014.

Why is this important? To date, insurance companies have discriminated heavily against women in various markets by categorizing as "pre-existing conditions" a wide range of health concerns and conditions.  For example, insurance companies have rejected victims of domestic violence and rape and have classified women who have undergone cesarean sections as having "pre-existing conditions."  In some cases, prior pregnancies have been considered pre-existing conditions. The new bill expressly prohibits insurers from rejecting an applicant based, essentially, on being a woman.  Again, this provision does not go into effect until 2014.

Increases access to OB-GYN and midwifery care:

Plans can not require pre-authorization or referral for OB-GYN care.  This provision becomes effective 6 months after signing.  New policies sold on the insurance exchanges would be required to cover a range of benefits, including maternity care. 

According to the Association of Certified Nurse-Midwives, the original bill in the House of Representatives, since replaced by the Act to be signed today by the President, would have expanded access to midwifery care by addressing inequities in how Certified Nurse‐Midwives (CNMs) are
reimbursed under Medicare, provided funding for home visitation by nurses for Medicaid families during or after pregnancy and improved Medicaid coverage of freestanding birth centers—a high‐quality, high‐value option for women and their families, according to the Association of Certified Nurse-Midwives.  As of this writing it is not clear whether the bill to be signed today includes these provisions, but look for updates.

Partial elimination of gender rating:

Many insurance plans charge women more for insurance coverage than they do men of the same age and health status, a practice known as "gender rating." The Act eliminates this practice for some women but not for others. Gender rating (and other forms of rating) for individuals and small employers (up to 100 employees) will be prohibited.  It will not apply to plans offered by employers with more than 100 employees, unless a state allows large employers to enter the insurance exchanges after 2017.  In the latter case, rating rules apply to all large employer coverage in that state.  The National Women’s Law Center offers materials that explain the practice of and implications for women of gender rating.

Free preventive care under new plans.

The Act requires new private plans to cover preventive services with no co‐payments and exempts preventive services from deductibles.  Effective 6 months after enactment. This requirement will apply to all plans beginning in 2018.  Preventive care is of course critical for all ages and both sexes, but dramatically expands women’s access to screening for cervical and breast cancer and other forms of preventive reproductive and sexual health care unique to women.

Expands funding for and access to community health centers and primary health care doctors.

The Act increases funding for Community Health Centers, to allow for nearly double the amount of access in terms of patients seen over the next 5 years.  This funding becomes effective in fiscal year 2010 and is an essential aspect of health care particularly for low-income women and their families. 

Expanded access to Medicaid and the Children’s Health Insurance Program

The Act expands eligibility for Medicaid to include all non‐elderly Americans with income below 133 percent of the Federal Poverty Level (FPL) and increases assistance to all states to help cover the costs of additional people to be covered under Medicaid, the nation’s public health insurance program for the low income population.  The Act also maintains current funding levels for the Children’s Health Insurance Program (CHIP) through fiscal year 2015. 

More than 20-million low-income women currently receive coverage for their health and long-term care through Medicaid, and the majority of adult beneficiaries of Medicaid (69 percent) are female.  By expanding the eligibilty requirements, the Act will expand coverage to low-income women and children who urgently need primary preventive and curative care.  This is without doubt a plus for women.

A Kaiser Family Foundation brief states:

In order to qualify for Medicaid, women must meet both categorical and income criteria. That means that one must fit into a certain “category” such as being pregnant, a mother of a child under 18, 65 or older, or having a disability. Each of these groups has different income elibiligy criteria, which vary from state to state.

Medicaid income thresholds for adults have been, however, very low. And states the KFF brief, "because women are more likely than men to fall into one of the categories and are more likely to be poor, women are more likely to qualify for Medicaid. Many very low-income women, however, do not qualify no matter how poor they are because they do not fall into one of the eligibility categories."

Medicaid is also the largest source of public funding for family planning services in the United States, financing contraceptive services for millions of low-income women. A Guttmacher issue brief,  Medicaid’s Role in Family Planning, provides an overview of Medicaid’s role in financing and providing access to family planning services for low-income women. Expansion of Medicaid services means an expansion of critical family planning and contraceptive services for women, one reason that increased access to health care helps reduce the number of unintended and unwanted pregnancies and by extension the need for abortion.

Improves access to and benefits offered under Medicare:

Women make up a majority of those dependent on Medicare services.  Kaiser Family Foundation notes that Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities.

Today, 22 million women–one in five adult women–rely on Medicare for basic health insurance protection, and women make up 57 percent of the Medicare population. Medicare helps to make health care more affordable for older women at a time in their lives when they are most likely to have multiple health problems that require ongoing and often costly medical treatment.

The Act will reduce the economic burden of health care among women and improve their access to services by reducing costs for prescription drugs by

  • providing new, free annual wellness visits to the basic services provided;
  • eliminating out‐of‐pocket copayments for preventive benefits under Medicare, such as cancer and diabetes screenings;
  • providing better chronic care; and
  • reducing overpayments to private Medicare Advantage plans.


The Act also fills the Medicare prescription drug "donut hole.  According to Kaiser, the donut hole is a "unique feature" of the Medicare Part D drug benefit is the coverage gap.  Part D enrollees are required to pay 100 percent of total drug costs after their spending exceeds the initial coverage limit and before reaching the catastrophic coverage limit. In 2010, most Part D plans have a coverage gap, which totals $3,610 in drug costs for plans offering the standard Medicare Part D benefit; by 2019, the gap is projected to be nearly $6,000.

The Act addresses this in 2010 by providing Medicare beneficiaries who go into the donut hole with a $250 rebate, after which they will receive a pharmaceutical manufacturers’ 50 percent discount on brand‐name drugs, increasing to a 75 percent discount on brand‐name and generic drugs to close the donut hole by 2020.


At the broadest scale, the statement from the National Organization for Women (NOW) most succinctly articulates the basic losses in this round of health care reform:

The bill covers only 32 million of the 47 million uninsured in this country, does not contain a meaningful public option and provides no pathway to a single payer system like Medicare for all.

While these aspects of reform affect all people, they again also disproportionately affect women.

Other losses with disproportionate or specific implications for women include:

Continuation of age-rating

The bill continues to permit age-rating, the practice of imposing higher premiums on older people. " This practice has a disproportionate impact on women," notes the National Organization for Women, "whose incomes and savings are lower due to a lifetime of systematic wage discrimination."

Continuation of gender-rating

The bill also permits gender-rating to continue under some policies. "Some are under the mistaken impression that gender-rating has been prohibited," states NOW, "but that is only true in the individual and small-group markets."

Larger group plans (more than 100 employees) sold through the exchanges will be permitted to discriminate against women — having an especially harmful impact in workplaces where women predominate.

NOW states: "We know why those gender- and age-rating provisions are in the bill: because insurers insisted on them, as they will generate billions of dollars in profits for the companies. Such discriminatory rating must be completely eliminated."

Lack of coverage for immigrant women

Under the Act, immigrants, a highly vulnerable population, will continue to face high barriers to acessing basic health care.  The bill imposes a 5-year waiting period on permanent, legal residents before they are eligible for assistance such as Medicaid, and prohibits undocumented workers from even using their own money to purchase health insurance through an exchange.

According to the National Latina Institute for Reproductive Health (NLIRH), "If passed, the reconciliation package (being considered in the Senate this week) will cover an estimated 9 million uninsured Latinos and increase funding for community health centers, which is a lifeline for many in our neighborhoods. In addition, 4.4 million Americans in Puerto Rico and territories will receive $6.3 billion in new Medicaid funding, increased flexibility in how to use federal funding, access to the Exchange and $1 billion in subsides for low-income residents."

At the same time immigrant women are left vulnerable.  In its statement on health reform, NLIRH pointed to these serious weaknesses:

  • Over half of all immigrants are women, and 53 percent of all immigrants are from Latin America.  The bill does not allow undocumented immigrants to buy health insurance in the exchange, and maintains a five-year waiting period for Medicaid for lawfully residing residents.  The exclusion of new immigrants from Medicaid is not only unjust, but also bad public health policy.
  • And although the reconciliation provisions are better than what the Senate originally proposed, residents of Puerto Rico are still a long ways away from receiving Medicaid and other federal health care support at the same level as other states of the Union.

Elimination of abortion care in private insurance market:

Despite the President’s promise that no American would be worse off after health reform than before, the majority of women now covered by private insurance plans now have access to coverage for abortion care, a fundamental aspect of women’s health care.

Under the language currently in the Act, incorporated at the insistence of Senator Ben Nelson (D-NE) and with the acquiescence of the White House, the Senate and House leadership, women will now lose coverage for abortion care for policies paid for with private dollars.  The implications of the Nelson language have been addressed in detail in previous articles published by RH Reality Check, but include the following:

  • Requires every enrollee–female or male–in a health plan that offers abortion coverage to write two separate checks for insurance coverage.  One of these checks would go to pay the bulk of their premium, the other would go to pay the share of that premium that would ostensibly cover abortion care.  Such a check would have to be written separately whether the share of the premium allocated for abortion care is .25 cents, $1.00, or $3.00 of the total premium on a monthly, semi-annual or annual basis.  Employers that deduct employee contributions to health care plans from paychecks will also have to do two separate payments to the same company, again no matter how small the payment.
  • Eliminates the provision in earlier versions of the Senate bill and in the original Capps language in the House bill to ensure that there is at least one insurance plan in each exchange that offers and one that does not offer abortion coverage. 
  • Prohibits insurance companies by law from taking into account cost savings when estimating the costs of abortion care and therefore the costs of premiums for abortion care.
  • Includes "conscience clause" language that protects only individuals or entities that refuse to provide, pay for, provide coverage for, or refer for abortion, removing earlier language that provided balanced non-discrimination language for those who provide a full range of choices to women in need. 

A George Washington University Study suggests that the implications of this language include:

  • moving the industry away from current norms of coverage for medically indicated abortions.
  • inhibiting development of a supplemental coverage market for medically indicated abortions.
  • "Spillover" effects as a result of administration of Stupak/Pitts will result in dramatically reduced coverage for potentially catastrophic conditions.

Women’s groups see this as a major loss.  "This battle was fought on the bodies of women and immigrant women," states NLIRH. 

In the eleventh hour, President Barack Obama caved to the demands of a handful of anti-choice Democrats by agreeing to use the lives of women as trade.  He will use his pen to add weight to the already cumbersome abortion restrictions in the health care bill.  Latinas, immigrants, and women of color are deeply affected by any language restricting abortion access – because women of color and immigrants are disproportionately poor, they are less likely to be able to pay for reproductive health care out-of-pocket, which puts them at risk for seeking alternative, unsafe abortion methods. While health reform might lead to more Latinas being covered, it leaves out a significant portion of the population.  By excluding and stigmatizing immigrants and women who need abortions, we are pushing them to the shadows of our health care system and placing unfair burden on the already-strained system of community health care centers and emergency rooms.  Over half of all immigrants are women, and 53 percent of all immigrants are from Latin America; though it has yet to be signed by the President, this bill is outdated already. 


In the coming months, and to truly fulfill his campaign promises, President Obama–along with Speaker of the House Nancy Pelosi and Senate Majority Leader Harry Reid–must lead the nation and the Congress in making the following changes to the foundation of health reform put in place today.

At a minimum, the Administration and Congress should:

  • Amend the health reform bill to establish a public option thereby increasing competition in the health insurance market.  As most analysts note, the public option is popular and also would prevent insurance companies from increasing rates by exhorbitant amounts as recently happened in California.
  • Eliminate the Nelson language in the health reform bill and revoke the Executive Order signed by the President.
  • Eliminate gender-rating in all policies, starting in 2011. 
  • Eliminate pre-existing conditions for all people in 2011.  It is not clear why we need to wait four years for insurance policies to eliminate pre-existing conditions.  Between this moment and four years from now, untold numbers of people will have to pay exhorbitant premiums to get coverage in high-risk pools due to pre-existing conditions.  It is nice to know these will be eliminated, but waiting four years defeats the purpose.
  • Remove the 5-year cap on immigrants who are legal residents and allow undocumented workers to use their own funds to purchase health insurance through an exchange.

Who Is Bart Stupak?

6:45 am in Uncategorized by RH Reality Check

Written by Ariana Childs Graham for – News, commentary and community for reproductive health and justice.

Today, Representative Bart Stupak’s (D-MI) name has become synonymous with the relentless efforts to include abortion restrictions in healthcare reform. However, before his eleventh hour heist of meaningful healthcare reform last November, if he was known publicly at all, it wasn’t for his work on anti-choice issues.

The trajectory of Stupak’s life is in many ways a classic chapter from the great American success story: Eagle Scout, community college graduate, police officer.  He later earned a bachelor’s degree in Criminal Justice from Saginaw Valley State University and then a law degree from Thomas M. Cooley Law School in Lansing, Michiga. He served one term in the Michigan House of Representatives (from 1989-90), representing Menominee, Delta and Dickinson counties, lost his run for the state senate in 1990 and beat out the Republican incumbent in 1992 for his seat in the US House of Representatives. The narrative suggested on paper by his history—of living a life steeped in hard work, fairness and public service—is one that Stupak himself seems to embrace.

While he has been recognized for his leadership in energy-related matters, Stupak’s primary reputation prior to last November has been as a public servant attentive to the concerns and needs of his constituents in the first Congressional district in Michigan–a predominantly rural area whose residents have not been forgotten by their congressman. A review of Stupak’s legislative agenda in the current session shows that 13 of the 43 bills he has sponsored or co-sponsored relate to local matters, followed by those addressing the usual mix of his priority issues relating to energy, law enforcement, armed forces and healthcare. Rarely, though, has he galvanized a base of supporters around a piece of legislation. The goals for his current term as outlined on his 2008 campaign website are to "advocate for the needs of rural areas, a fair energy policy, healthcare reform, the protection of our Great Lakes, and to ensure that this nation supports our veterans."

Healthcare has been a recurring theme for Stupak, often steeped in reforms required specifically to meet the needs of Michigan’s first: increasing the amount of payment for Medicare home health services in rural areas, holding health insurance providers accountable to anti-trust laws, ensuring that enrollment in Medicare prescription coverage is voluntary, among others. He is perhaps most well known for his crusade for better management, screening, and education in prescribing and dispensing medication to prevent mistakes in prescribing and adverse reactions to prescription drugs. He has fought for greater restrictions on drugs containing isotretinoin, including the commercially-known drug Accutane. The tragic inspiration for these efforts appears to be the death of his son, Bart Jr., who was using Accutane at the time he committed suicide. Stupak attributes side effects from the Accutane as a contributing factor.

Judging from his past, it’s pretty safe to say that Stupak didn’t come up with the anti-choice amendment to healthcare reform or the strategy behind it by himself. While he has regularly voted against funding for programs that would reduce unintended pregnancy and transmission of sexually transmitted infections, and address other sexual and reproductive health needs, he’s rarely demonstrated public leadership on these issues. And he’s certainly never been in the spotlight like this before. As he noted recently, much of his anti-choice lobbying has gone on "behind the scenes" with Democratic leadership. And he’s all but said that the lobbyists at the United States Conference of Catholic Bishops (USCCB) wrote the Stupak amendment for him.

So, that leaves one important question: Why did the anti-choice lobby choose Stupak to lead the movement to add abortion restrictions to healthcare reform?

He’s anti-choice, though has a "mixed record" when looked at from the absolutist view of some pro-life groups.

Generally speaking, Bart Stupak is a rank-and-file Democrat. He votes with his party 96 percent of the time. He’s with the Democrats on war, spending, energy, government regulation and so on. From his voting record, it seems that the few times that Stupak has broken rank have been on issues pertaining to sexual and reproductive health and rights.

Here’s a quick look at Stupak’s record on sexual and reproductive health:

He voted for the ban on late abortions in both the Clinton and Bush eras, despite the fact that these votes went against the advice of and evidence conferred by the medical community.  He voted for the Global Gag Rule in its many iterations, a policy which research has shown actually results in an increased number of unintended pregnancies and abortions because it prohibits funding of effective family planning programs.  He voted against legislation that would have allowed female members of the military to use their own funds for abortion when serving overseas. He voted for an amendment that would prohibit the FDA from using funds for any abortion-inducing drugs.

He voted ‘yes’ on the 1993 Hyde Amendment, which prohibited federal funding for abortion except in the case of rape, incest or to save the life of the mother. He’s also voted in favor of the "Unborn Child Pain Awareness Act. All in all, Stupak has cast an anti-choice vote on over 40 separate occasions.

He has also voted against programs that would reduce unintended pregnancy, which would in turn reduce the need for abortion. For example, he voted to fund abstinence-only education programs in the United States. He has voted in support of family planning programs, but only when the use of funds for abortions is prohibited.  He voted for the Defense of Marriage Act (DOMA) as well as Don’t Ask, Don’t Tell. He voted for parental notification not only when a minor procures an abortion, but also when they receive contraceptives. He has also consistently voted against embryonic stem cell research.

His opposition to sexual and reproductive health and rights doesn’t stop at his voting record. His organizational affiliations also affirm his anti-choice ideology. The National Right to Life Campaign, which has given him scores ranging from 71 percent to 100 percent (in regard to the compatibility of his votes with the NRLC agenda), backed his 2004 campaign.  He is a member of the Pro-Life Caucus in the House, and he also sits on the Advisory Board of Democrats for Life(DFL).

As a member of DFL, he was an ardent supporter of the 95-10 initiative, which sought to reduce the number of abortions by 95 percent in 10 years through providing "accurate" iinformation about abortion, abortion counseling, tax credits for adoption and so on.  In an interesting twist, he also co-sponsored the “Reducing the Need for Abortion and Supporting Act,” legislation which some of his fellow DFL members opposed due to its emphasis on contraception.

Stupak’s voting record and organizational affiliation is more than enough to prove his allegiance to the anti-choice lobby.  Although, given that there are a number of dedicated, “prolife” Democrats, the answer to "Why Stupak?" goes deeper than votes.

He’s done their bidding before.

Every year since Stupak has been in office, an iteration of the Employee Non-Discrimination Act (ENDA), which would prohibit the discrimination of employees on the basis of sexual orientation or gender identity, has been introduced to no avail.  In 2007, though, ENDA passed in the House after Democrats dropped transgender rights from the bill.  And there was much speculation and trepidation by advocates of all stripes that ENDA may actually become law.

While the US bishops took no position on the larger bill, they—along with the Union of Orthodox Jewish Congregations of America and the General Conference of the Seventh-day Adventist Church—were eager to include a religious exemption.  And, much like with healthcare reform, Stupak was their man to get this done.

Stupak, along with Representative George Miller (D-CA), introduced an amendment to ENDA that allowed any religious organization to be exempt from ENDA and also reasserted DOMA. 

In a statement to Congress, Stupak noted the support of the USCCB and said, “No American should have to face discrimination in the workplace, regardless of their race, gender or sexual orientation. However, religious organizations should be able to hire individuals who agree with their religious beliefs. It is also important to make it explicitly clear that marriage is a union between a man and a woman and that no part of the Employment Non-Discrimination Act could be misconstrued to undercut the Defense of Marriage Act.”

Stupak voted in favor of the bill, which included his amendment.  The legislation subsequently died in the Senate.

In the same year, Stupak sponsored an amendment which failed–with Chris Smith (D-PA) to the Appropriations Bill to keep in place the "Mexico City Policy," also known as the Global Gag Rule. He also worked with Representative Joesph Pitts (R-PA) to maintain 33 percent of the President’s Emergency Plan for AIDS Relief’s spending for abstinence-only programs.

It’s as if these were Stupak’s dress rehearsals for the healthcare debacle.

His seat has been secure.

Stupak could never have held healthcare reform captive during an election year if he didn’t feel a certain security about his place in Congress.  When he first ran for the House of Representatives in 1992, he won by 10 points. Since then, his winning margin has grown exponentially. In the 2008 election, Stupak won 68 percent of the vote.

His campaign fundraising has been somewhat minimal at just over $7 millionover the span of his entire career. His top contributors have consistently been healthcare professionals and unions. Aside from a curious piece of legislation that sought to include dental health care in disaster relief services and can be traced back to large campaign contributions from the American Dental Association, he doesn’t seem particularly beholden to his healthcare-related campaign contributors. One of his biggest contributors is Blue Cross/ Blue Shield, and yet he has spoken in support of anti-trust regulations within the insurance industry.

Stupak floated a gubernatorial bid early this year.  However, in late January, he announced that he wouldn’t be running for governor, but would instead be seeking reelection in Congress.  He stated, "My seniority and experience in Congress, where I sit on the Energy and Commerce Committee and serve as Chairman of the Oversight and Investigations subcommittee, afford me a significant opportunity to affect positive change."

Democratic activist and former Charlevoix County Commissioner Connie Saltonstall will be challenging Stupak in the primary. The impetus for her run is Stupak’s involvement in healthcare reform."I decided to run because people were…mad about the health care issue," Saltonstall stated, "It’s his willingness to not have health care pass over his abortion position that has people like me upset."

As the citizens of the first Congressional district in Michigan have a long history of loyalty when it comes to voting for their representatives, the primary may prove an uphill battle for Saltonstall. Nonetheless donations to Saltonstall are pouring in and the National Organization for Women has endorsed her candidacy.

He’s "Family."

Stupak considers himself a "devout Catholic" and his opposition to sexual and reproductive health is undoubtedly connected to his allegiance to the teachings of the Catholic church hierarchy. In one interview, he put it plainly: "Look, I’m a Catholic, I’m pro-life, I listen closely to the socio-economic teachings of the church."

However, there have been moments when Stupak has questioned the actions of the US bishops. In 2004, Stupak was among the few anti-abortion Democrats who signed on to a letter decrying the actions of four bishops who threatened to deny Communion to pro-choice politicians. In signing on to the letter, Stupak stated, "There are a number of us who are Catholic and who are pro-life, and I don’t think the bishops understand. They think that when there’s a pro-life issue they turn to the Republican party and the Republican party passes it. That is absolutely wrong. The Republican party on its own cannot pass one pro-life, one Catholic issue, without the support of us 30 to 35 pro-life Democrats who vote consistently with the Catholic church and with the pro-life movement on issues."

With healthcare reform, the USCCB capitalized on these words. They needed a "pro-life" Democrat to do their bidding and they chose Stupak. Stupak himself acknowledges the close working relationship he has had with the USCCB over the past months. Upon passage of his amendment, Stupak stated, "The Catholic church used their power–their clout, if you will–to influence this issue."

Of course, Stupak is not just Catholic family, he’s "Family" as well.

Stupak is connected to the ultra-conservative, primarily evangelical Christian group, the Fellowship, also known as "the Family." The Family serves as a catalyst for partnerships and political relationships that advance a fundamentalist agenda.

Despite living in a house on C Street since 2002 that is owned by the Family, Stupak has denied any formal association with the group. However, it seems less than coincidental that Stupak partnered with Joseph Pitts, another member of the Family, when introducing this amendment which has held the health care reform bill hostage. Perhaps the Family has been grooming Stupak to assert a leadership position with the support of long-time vocal anti-choice warriors, such as Pitts, among others.

Some say Stupak is just trying to get his 15 minutes of fame.  And that may be true.  But more likely, Stupak is just capitalizing on the 15 minutes given to him by the anti-choice lobby.  He was the perfect man for the job: a consistently anti-choice Democrat who isn’t worried about reelection, who has a strong connection to the Religious Right and who has done their bidding before. He’s their chosen and willing one and by not wavering thus far, he’s done them proud.

If nothing else, the controversy generated by Stupak’s agenda, and the loss of trust by pro-choice women in the Democratic party as a result of concessions to both Stupak and Senator Ben Nelson both should serve to illustrate to the Democratic leadership the implications for the party of supporting candidates who depart from the Democratic platform on sexual and reproductive health, if in fact it can be assumed these issues are more than nominally still part of the platform at this date.