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In Letter, Texas Department of Health Accused by Ten Democratic Legislators of Subverting Democratic Process

11:37 am in Uncategorized by RH Reality Check

Texas Has Oil, Cattle, Cotton & More

(photo: Calsidyrose/flickr)

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

In opposition to new proposed abortion reporting restrictions in Texas, ten Democratic legislators have sent an open letter to Health and Human Services Executive Commissioner Tom Suehs urging him to not to move forward with the new rules, which would increase the amount of information gathered on abortion-seeking people and require doctors to report vaguely defined “complications” from abortion.

“The proposed rule does not represent the will of the legislative body and, if implemented through rulemaking, would serve to circumvent the legislative process,” wrote the legislators.

The new rules are being proposed after anti-choice, Tea Party-endorsed legislator Rep. Bill Zedler and his past colleagues were repeatedly unable to enact them through democratic means in the Texas Legislature over the past several years. Texas health officials have agreed to look into adopting the failed legislation by rule rather than law. In their letter, the Democratic legislators say this sets a “terrible precedent.”

“If this rule is published and adopted, it sets a terrible precedent and will have serious ramifications for years to come,” write the legislators.

But Texas health officials seem anxious to appease Zedler, though they are increasingly backtracking on initial openness about cooperating with the legislator.

As originally reported by RH Reality Check, at the first public meeting discussing the new requirements in April 2012, Department of State Health Services regulatory unit manager Renee Clack said the meeting was called to discuss “some amendments the department has included that specifically relate to a request by Representative Zedler.”

DSHS’ openness about the origins of their new rule are also illustrated in documents obtained by the Austin Chronicle and shared with RH Reality Check this week. They include a March 21, 2012 memo sent from Department of State Health Services Commissioner David Lakey to Executive Commissioner Suehs “to discuss possible reporting requirements that relate to an amendment by Representative William Zedler.” The memo describes the rules’ background thusly: Read the rest of this entry →

Unnecessary Restrictions on Abortion Care: How Democracy Side-Stepping Sausage Is Made, Texas-Style

11:53 am in Uncategorized by RH Reality Check

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

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Next week, the Texas Health and Human Services Commission Council will consider whether to adopt new abortion reporting requirements in the state–requirements that are being proposed at the behest of a Republican politician who failed to get his desired requirements passed through democratic means in the state legislature last year.

Tea Party-endorsed Rep. Bill Zedler wants the state to collect more personal information about abortion-seeking women and increase vague “complication” reporting requirements for abortion providers. The Texas HHSC is considering the new requirements as a kind of consolation prize to Zedler, who tried and failed to pass the requirements as an amendment to the Texas law that bars Planned Parenthood (and other “abortion affiliates”) from participating in the Medicaid Women’s Health Program in the state.

The amendment wasn’t added,” Department of State Health Services press officer Carrie Williams told RH Reality Check in April, “but at the time HHSC and DSHS agreed to look at the additional requirements and determine what elements could possibly be adopted by rule.”

RH Reality Check filed a public information request for correspondence between Rep. Zedler’s office and the DSHS to find out how the department came to be catering to one anti-choice Republican’s demands. Documents show the answer is simple: mighty politely, in true friendly Texan style. Zedler’s office asked for what it wanted, and DSHS did its best to comply with their requests.

The original version of Zedler’s amendment is farther reaching than the new requirements proposed by HHSC. Zedler originally wanted to find out, as reported by the Dallas Observer, the abortion-seeker’s:

Read the rest of this entry →

Repro-Briefs: Graphic Billboards, Defunding Services, and Other State News

9:42 am in Uncategorized by RH Reality Check

Written by Robin Marty for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

When it comes to creepy, offensive anti-choice billboards, Texas has decided to one up Georgia. Midland Catholics for Life has taken Radiance’s "abortion is genocide" message even further, adding in some graphic images and even more overwrought rhetoric to its display.

Via CBS 7:

A graphic downtown billboard is turning heads and raising questions in Midland.

Some who have spoken out against the public display considers the billboard’s depiction of a dead baby inappropriate.

Located at the corner of Texas Avenue and Ft. Worth St., right across the street from Planned Parenthood’s Midland Office, the billboard shows what appears to be a dead baby in a doctor’s hand on the left side.

On the right side it shows what looks like a woman in emotional distress. Above the left side it reads “one dead” and above the right side it reads “one injured.”

On the right side near the woman it reads, “One wounded.”

The two-sided billboard also has a message on the back.

That side says, “Abortion is genocide” and is accompanied by two photos.

The left side depicts what is presumably a healthy baby and the right side shows what looks like a baby that is not alive.

The purpose of the graphic photos, which only recently went live, is to "expose the atrocities that are occurring in Planned Parenthood every week," according to the president of the group. The pictures used are originally from anti-choice group The Center for Bio-Ethical Reform (note, links go to graphic photos), and allegedly depicts an aborted 13 week fetus (11 weeks post fertilization) and 26 week fetus (24 weeks post fertilization), even though 90 percent of all abortions performed are done prior to 12 weeks, and the majority of these before 10 weeks.

The Midland anti-choice group asserts that subjecting the public, even possibly children, to bloody fetus photos, is the only way to make women understand the choice they are making. Planned Parenthood clinic staff disagree. From MyWestTexas.com:

Those who oppose abortion, [president of Midland Catholics for Life Pebbles] Kincheloe said, don’t like seeing images of bloody developing babies either. But, she added, as a group they agreed that’s what it was going to take to "open our eyes to Planned Parenthood being in our backyard."

She said those who support a woman’s right to choose an abortion often call the fetus "a blob of tissue" and that their sign is meant to show women the developing baby is a human who they believe God intended to be born.

The backside of the billboard also displays a baby and says "Abortion is genocide," which supporter Danny O’Grady said represents all the families they believe are being killed.

[Carla] Holeva and Planned Parenthood Choice say particularly for children in the area, they think the images are too graphic. They also question why the group acts as if it knows God’s will for area women.

Women who are clients at Planned Parenthood, Holeva said, are presented with all of the options and the organization assists thousands in carrying out their pregnancies to birth as well as connecting several with adoption agencies.

But, she said, they make it a point not to make the decision about what’s best for their clients and they wish others would provide them the same courtesy instead of posting signs and yelling things like "God will not forgive you" at those who come into the clinic.

Both groups do state however, that more needs to be done to prevent unwanted pregnancies in the first place. It comes as little surprise that the Midland Catholics for Life approach, however, is a "Just Say No To Sex" push, that they believe should not include any safer sex or contraception education.

In fact, contraception, safer-sex education, and general reproductive health access are fairly low on the list of priorities for the anti-choice in Texas, who are still working to see if they can convince the Attorney General to strip funding from state Planned Parenthood organizations — even those that don’t provide abortion services. And more voices are starting to join into the fray, as News8Austin reports:

Planned Parenthood clinics provide family planning services, such as screening for breast and cervical cancer, testing for sexually transmitted diseases and prescribing birth control to women. Some Planned Parenthood clinics in Texas also perform abortions.

But the Austin area clinic’s spokesperson said clinics under the state’s Women’s Health Program strictly provide family planning services.

"If Planned Parenthood isn’t able to participate in the Women’s Health Program, it basically means that there are tens of thousands of women across the state that probably aren’t going to get that health care," Sarah Wheat, with Planned Parenthood, said.

Anti-abortion advocates like Joe Pojman, with Texas Alliance for Life, say that’s not the case. Pojman backed up Sen. Deuell’s request to the attorney general to clear up any confusion about the 2005 law that states participating clinics can’t "perform or promote elective abortions" or be "affiliates of entities that perform or promote elective abortions."

"Women and families will get excellent treatment by the other, more than 400 family planning providers across the state of Texas that do not run abortion facilities or are affiliated with abortion facilities," Pojman said.

A recent Health and Human Services Commission study shows that the Women’s Health Program prevented more than 10,000 unplanned pregnancies in 2008 and saved the state about $40 million a year.

The Senator claims he’s simply trying to get the money to clinics that provide "comprehensive care," something he asserts Planned Parenthood clinics do not do. It is unclear what he thinks is more comprehensive than providing cancer screenings, birth control, gynecological exams and testing and treatments for STIs.

But of course Texas isn’t the only state in which anti-choice legislators are on a crusade to defund Planned Parenthood. A State Senator in Indiana is claiming he will reintroduce a bill next legislative session that will require the state not enter into any contracts or grants with the group. It would also cancel any current funding the group receives from the state. State Senator Greg Walker (R-Columbus) also introduced the same bill this legislative session, but it was never brought up for a vote.

In Colorado, the battle over "personhood" continues, this time with the American Congress of Obstetricians and Gynecologists weighing in. In a publicly released statement, ACOG stated unequivocally that the language being used to define "person" is both scientifically inaccurate and would greatly jeopardize a doctor’s ability to provide health care to a patient. From the press release:

1. The phrase “the beginning of biologic development” is not a scientific or medical reference point in the process of human reproduction. Developmental Biology is a scientific field that studies the mechanisms of development, differentiation, and growth in animals and plants at the molecular, cellular, and genetic levels. Developmental biology includes the study of embryology and the complex factors involved in human reproduction which leads to the birth of a human being. “The beginning of biologic development” has no specific meaning in the context of human embryology and could even refer to the growth of specific human cell lines, for example, in the study of human transplant possibilities and the cure for diseases such as diabetes and spinal cord injuries.

2. Human reproduction (briefly described as the development of egg and sperm, their union into a fertilized egg (or zygote), then division of the embryo and differentiation into a blastocyst, implantation into the uterine wall, and then growth into a fetus, and then viable newborn) is an intricate and inefficient process. The overwhelming majority of potential egg-sperm unions do not result in human beings.

3. Current medical and scientific practice/procedures that involve the term “person” as defined by Amendment 62:

Treatment of Miscarriage: Miscarriages are commonly treated with medical and surgical therapies as well as supportive means; the goal is the removal of the pregnancy tissue from the uterus, which cannot, by any therapy available, produce a live born infant. There were an estimated 102,517 pregnancies in Colorado in 2006, resulting in 70,737 live births (CDPHE, Health Statistic Section) and an estimated 15,377 spontaneous miscarriages in this year alone.

Treatment of Ectopic Pregnancy: In the U.S., ectopic pregnancy is the leading cause of pregnancy related death in the first trimester. Once detected, an ectopic pregnancy is treated with the removal and destruction of the pregnancy either by medical or surgical means, as it cannot result in a live born infant, and yet the growing pregnancy tissue is a threat to the health and life of the mother.

Infertility treatments: Infertility affects at least 10 percent of couples who desire pregnancy; for many of them, assisted reproductive technologies are necessary. Currently 1 out of every 100 babies born in the United States are born through in vitro fertilization (CDC, 2009). This amendment would hold a patient and her physicians liable for embryos which fail to develop or do not result in a pregnancy due to completely natural biologic processes despite rendering the best possible medical care. This amendment can be seen as blocking the rights of infertile couples within the state of Colorado from having a family and will set back the standard of infertility care in this state to the level of medical care practiced in the United States before 1980. What could more antithetical to “family values” and the “right to life”?

· Treatment of Molar Pregnancy: Approximately 20 percent of patients will develop malignant sequelae requiring administration of chemotherapy after initial treatment. All molar pregnancies need to be ended as they cannot produce a live newborn and substantially threaten the mother’s health and life.

· Stem cells research: Stem cells are a unique population of unspecialized cells characterized by their ability to continuously renew themselves for long periods of time through cell division. Researchers are using stem cells to study conditions such a spinal cord injury, diabetes, Parkinson’s, and Alzheimer’s disease. Human embryonic cells are commonly derived from unused fertilized eggs (donated with the consent of the infertile couple).

· Safe and legal abortion: Although not mentioned in the Amendment itself, the intent of Amendment 62 (from www.personhoodcolorado.com) is to provide a legal framework to make all abortions illegal. The American Congress of Obstetrician and Gynecologists opposes unnecessary regulations that delay or limit women’s access to needed medical care and that subject physicians to criminal charges for practicing according to accepted medical standards. [v]

Finally, Louisiana is taking a page out of Oklahoma’s book when it comes to the new mandatory ultrasound law, with six clinics challenging the language of the new regulations. From Courthouse News Service:

Six medical clinics have challenged Louisiana laws on abortion, including the "Ultrasound Statute," which could force doctors to make women take home ultrasound pictures of their fetuses, even if the women resist, according to the federal complaint.
The Hope Medical Group for Women and five other clinics say the two state laws are vague, "will deter qualified, reasonable health care providers from entering the field of abortion provision," will "make it more difficult for women in Louisiana to obtain abortion services," and are "not rationally related to any legitimate state interest."
The two statutes in question are the Exclusion Statute, which, the plaintiffs say, would exclude abortion services from medical malpractice coverage, and the Ultrasound Statute.
"The plain language of the Exclusion Statute applies only to health care providers when they are performing certain illegal abortions," the complaint states. "Plaintiffs believe, however, that defendants intend to apply the Exclusion Statute to health care providers performing lawful abortions. Such application would be unconstitutionally vague. It would also deny abortion providers equal protection of the law by excluding them from access to benefits that are available to all other health care providers."
A doctor’s failure to comply with either statute could subject them to criminal and civil liability and professional discipline.

A major disagreement that the clinics are having with the ultrasound law is the mandate that they must provide a copy of the ultrasound in a sealed envelope to every woman, with no clarification as to whether the woman must accept and leave with the image. Each ultrasound picture reveals, among other things, private patient information such as name of patient and age of fetus. One major concern the clinics have is that such information, once discarded, could be used to target the women who may have had abortions.

"At Hope Medical, for example, every print reveals the woman’s name, the fact that she is pregnant, the gestational age of the fetus, and that fact that the woman obtained her ultrasound at Hope Medical, a facility publicly known to provide abortions."
The plaintiffs say that if "a woman is required to take a copy of her ultrasound print, there is a risk that it will be discovered by the woman’s partner, relatives, co-workers, or other persons to whom the woman may not wish to disclose her pregnancy or her consideration of an abortion."
The clinics say this could be dangerous, because for "women in abusive relationships, disclosure of a pregnancy or an abortion to an abusive partner is likely to spark violence."
The plaintiffs add that the "ultrasound print may also be discovered by anti-abortion extremists. For example, an ultrasound print thrown into a garbage can near a clinic might be discovered by extremists surveilling the clinic, particularly since the print will be contained in an envelope clearly stating its contents."

The lawsuit was filed in Baton Rouge, Louisiana on Friday, August 6th.

Reproductive and Sexual Health in the States: Two Steps Forward, Several Steps Back

6:51 am in Uncategorized by RH Reality Check

Written by Rachel Gold and Elizabeth Nash for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

By the end of March, 825 measures had been introduced in the 44 legislatures that have convened so far in 2010. Five legislatures (Mont., Nev., N.D., Ore. and Texas) do not meet this year, and North Carolina does not convene until May.

To date, seven new laws impacting reproductive health and rights have been enacted. Among the most noteworthy are measures:

  • mandating comprehensive and medically accurate sex education in Wisconsin;

 

  • allowing medical providers in Maine to prescribe or dispense a drug for treatment of STIs for a partner of a patient without first seeing the partner;

 

  • criminalizing self-induced abortion or miscarriages caused “intentionally or knowingly” in Utah;


  • requiring an abortion provider in Utah who performs an ultrasound before an abortion to show the woman the image and offer her the option of receiving a description of it;

 

  • requiring an abortion counselor in Utah to inform a woman seeking an abortion that the state’s counseling video is available online; allowing for an additional penalty for the murder of a pregnant woman in Wyoming; and

 

  • permitting a health care professional in Idaho to refuse to provide services related to abortion or family planning.

 

In addition to these laws, 49 other bills have been approved by at least one chamber of the legislature, and some interesting trends are beginning to emerge.

Treating Partners for STIs

In 2009, six states moved to expand access to STI testing, treatment and prevention by enacting legislation allowing a health care provider to prescribe STI treatment for a patient’s partner without having examined the partner. So far this year, legislators have introduced similar measures in seven states (Conn., Maine, Mo., Neb., Okla., R.I. and Wis.) to permit so-called “expedited partner treatment.” The enactment of legislation in Maine at the end of March brings to 15 the number of states with such provisions. 

The new law in Maine allows partner treatment for all STIs, as would the bills pending in three states (Neb., Okla. and R.I.). The bills in the remaining three states would be more limited. The Connecticut and Missouri measures would permit treatment only for Chlamydia and gonorrhea. The Wisconsin bill, which has been approved by the Senate and is awaiting action in the Assembly, would permit treatment only for Chlamydia, gonorrhea and trichomoniasis.

Insurance Coverage of Abortion

Given the visibility of abortion in the national debate over health care reform, it is not surprising that the issue is also garnering widespread attention at the state level. Action at the state level is clustering into two distinct categories—coverage under insurance policies currently being written in the state and coverage in policies that will be offered through the insurance exchanges created under health care reform. 

Measures have been introduced in three states (Kansas, N.H. and Okla.) that would restrict or prohibit insurance coverage of abortion under plans currently being written in the state. Bills pending in Kansas and Oklahoma would restrict coverage offered under all such plans. The measures in Kansas would permit abortion coverage only in cases of life endangerment, rape and incest; they would allow broader coverage only under riders purchased by individuals. Oklahoma currently permits abortion coverage beyond cases of life endangerment, rape or incest only through purchase of a rider. The pending legislation would ban coverage of all “elective” abortions without defining the term, potentially limiting coverage to cases of life endangerment; the rider option would be eliminated. Five states currently restrict insurance policies (see Restricting Insurance Coverage of Abortion).

Measures specifically targeting abortion coverage in plans offered to public employees are pending in five states (Ariz., Kansas, N.H., S.C. and W.Va.). The bill in Kansas would permit coverage only in cases of life endangerment, rape and incest; the Arizona measure would permit coverage in cases of life endangerment or possible “substantial and irreversible impairment of a major bodily function.” The bills in South Carolina (a state that currently restricts coverage to cases of life endangerment, rape and incest) and West Virginia would prohibit coverage of abortion with no exceptions. The South Carolina bill has been approved by the House and is pending in the Senate. Twelve states restrict abortion coverage for public employees (see Restricting Insurance Coverage of Abortion).

Measures introduced in four states (Iowa, Miss., Mo. and Tenn.) address the question of insurance coverage in the health exchanges that will eventually be established under the national health care reform legislation. Bills introduced in Missouri, Mississippi and Tennessee would block coverage in exchanges created by either the federal or state government. The Mississippi measure failed to receive committee approval by the deadline for action. The Missouri bill would allow coverage for abortion only if the woman’s life is at risk. The Tennessee measure would completely prohibit coverage of abortion. The Iowa measure would only allow abortion coverage when necessary to protect the woman’s life, if the coverage is purchased by the state via a “trust fund” that would be created as part of health reform.

Ultrasound Requirements for Women Obtaining an Abortion

So far this year, legislators have introduced 32 measures in 17 states seeking to involve or further incorporate ultrasound into abortion services. They range from bills that would require providers to offer information about ultrasound to those that would mandate not only that an ultrasound be performed, but also that the woman be shown the image. 

Measures pending in 13 states would require abortion providers to offer some information or services related to ultrasound. Bills pending in nine states (Ala, Iowa, Ind., Kansas, Mass., Neb., N.J., N.Y. and S.C.) would require abortion providers to offer information related to ultrasound, and/or to provide the woman with information about where she can obtain the procedure. Bills in four of these states (Iowa, N.J., N.Y. and S.C.) as well as four others (Ill., Md., Mo. and W.Va.) would require an abortion provider to offer a woman seeking an abortion an ultrasound. Currently, eight states require verbal counseling or written materials to include information on accessing ultrasound services. Three states require that a woman be provided with the option to obtain an ultrasound (see Requirements for Ultrasound).

In March, a measure to add requirements for providers performing an ultrasound in preparation for an abortion was signed into law in Utah; a similar measure is awaiting action by the governor in West Virginia. The Utah measure requires providers to display the ultrasound image and to offer the woman the option of a verbal description. The West Virginia bill would require providers to offer the woman the option to view the image. With the addition of Utah, nine states currently regulate the performance of ultrasound when performed as part of preparation for an abortion (see Requirements for Ultrasound).

To date, legislators in 10 states (Alaska, Ala., Kansas, Ky., La., Okla., R.I., S.C., Va. and W.Va.) have introduced measures to mandate the performance of an ultrasound prior to any abortion procedure; two of these bills have seen significant action. In Virginia, a measure passed the House but was defeated in the Senate. And in Oklahoma, a bill is pending in the House after having been approved by the Senate. The Oklahoma bill would require that the provider display and describe the image to the woman, although she would be entitled to “avert” her eyes; it is virtually identical to legislation enacted in the state in 2008 that was struck down by the court on procedural grounds. Three states require the performance of an ultrasound on any woman seeking an abortion, and require the provider to offer the woman the opportunity to view the image (see Requirements for Ultrasound).

Click here for:

Summaries of major state legislative actions so far in 2010

A table showing legislation enacted in 2010

The status of state law and policy on key reproductive health and rights issues