Tag Archives: Women’s health

Doctors Aren’t Dummies: Support the Patient Trust Act

By Kate Michelman, WomenVote PA and Susan Frietsche, WLP Senior Staff Attorney

Doctors aren’t dummies.

They don’t need politicians to tell them what they can and can’t say to patients, or how to administer tests and treatments.

On September 8, the House Democratic Policy Committee convened to explore the need to pass the Patient Trust Act in Pennsylvania. Physicians, medical ethics experts, and patient advocates met in Pittsburgh to discuss the dangers patients face when medical care becomes politicized.

Introduced by Rep. Dan Frankel (D-Allegheny) and Senator Mike Stack (D-Phila) in July, the Patient Trust Act is part of the Pennsylvania Agenda for Women’s Health, a pro-active, pro-choice package of bills developed by the bipartisan Women’s Health Caucus in the Pennsylvania Legislature.

The Patient Trust Act protects patients. It says that politicians have no business putting words that are “not medically accurate and appropriate for the patient” into the mouths of doctors.

Since antiquity, physicians have taken an oath to treat patients to the best of their ability, with knowledge rooted in clinical experience and scientific consensus. But in recent years, politicians have made it difficult — and in some cases even illegal — for doctors to keep that sacred obligation.

These government-intrusion laws run the gamut from prohibitions on discussing gun storage safety with patients to gag orders preventing doctors from naming the toxic chemicals that are poisoning a patient’s body. A significant number of these government-intrusion laws are proposed by lawmakers trying to disguise their opposition to contraception and abortion by disingenuously claiming that these laws promote women’s health and safety.

Recently, the National Partnership for Women and Families released a report that explored the nationwide spike in laws that command doctors what to say and coerce them to administer — and bill patients for — medically unnecessary procedures.

Bad Medicine: How a Political Agenda is Undermining Women’s Health found that the majority of states — 35 in all — have passed such laws. In many cases, the information doctors are forced to give patients is not even medically and scientifically accurate.

The report’s authors concluded that “anti-choice laws are requiring health care providers to choose between following their medical training and their ethical obligations to their patients — and following the law.”

From the Bad Medicine report:

*Five states force doctors to tell patients of a false link between abortion and breast cancer.

*Five states force doctors to falsely advise a patient that an abortion will affect her future fertility.

*Eight states force doctors to provide misinformation that falsely indicates the only possible emotional response to abortion is negative.

*Twelve states force doctors to provide unfounded information that fetuses can feel pain, despite lack of scientific evidence.

In 2012, anti-choice Pennsylvania lawmakers proposed mandating that doctors perform medically unnecessary ultrasounds on women seeking an abortion. The bill, one of the most severe of its kind in the country, was quietly abandoned after a similar bill led to a backlash in Virginia.

But that doesn’t mean the mandatory ultrasound bill, or legislation like it, won’t be proposed in Pennsylvania again.

Laws like these enable politicians to act like ventriloquists, throwing their words into the mouths of doctors. It’s time for politicians to stop masquerading as ideological ventriloquists.

Doctors aren’t dummies. Patients deserve better. Women need to be able to trust that the voice they’re hearing is from their physician, not from Harrisburg’s political puppeteers.

Kate Michelman is co-chair of WomenVote PA, an organization that educates, engages, and mobilizes Pennsylvanians to make equality a reality for women. She is also president emerita of NARAL Pro-Choice America and author of “With Liberty and Justice for All: A Life Spent Protecting the Right to Choose.”

Sue Frietsche is a senior staff attorney in the Western Pennsylvania office of the Women’s Law Project.

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Filed under Contraception, Health Care, Health insurance, PA Legislature, Pennsylvania, Reproductive Rights, Women's health

Pennsylvania is Failing Women

By Kate Michelman and Sue Frietsche

So much for Pennsylvania as the birthplace of freedom and democracy. A report last month from the Center for American Progress offered some alarming statistics about the Commonwealth of Pennsylvania and the way   it treats the six million or so women who live here, assigning us a “C-” grade, and ranking our state 28th of the 50 states on women’s rights.

In fact, a quote from the report reads, “Pennsylvania stands out as one of the states that is among the worst in the nation for women. Across 36 factors of economic security, leadership, and health, Pennsylvania ranks 28th in the nation for how women are faring. This illustrates the long path ahead before women in Pennsylvania can get a fair shot at achieving economic security, reaching success, and living a healthy life.”

It goes from bad to worse in the report, whether it’s the fact that we scored a “D+” on economic factors for women (e.g., the 76 cents we still make to every dollar a man makes or the fact that 15% of us live in poverty), a “D” in leadership (our entire Congressional delegation contains one lone woman, and we hold less than 37% of the managerial positions in the state despite being 52% of the population), or a “C” in health (there is only one OB/GYN for approximately every 20,000 women in the state, we have the 12th highest infant mortality rate in the country, and our lawmakers are making it as difficult as possible for women to get reproductive health care).

It is beyond dispute that when the women of Pennsylvania do well, their families do well, their children thrive and communities prosper. That is reason enough for Pennsylvania to start climbing up from the bottom rungs of the 50 states.

But there is an even better reason, and simply put, it’s that Pennsylvania women deserve an equal shot at a good life. They deserve a state where they are treated equally at home, at work, and at school. They deserve a seat in the boardroom and at the table of government. They deserve a chance to live and work safely, with dignity – even when they’re pregnant or raising a family. They deserve the basic economic security essential to getting and staying healthy. They deserve the freedom to decide whether or not to have children in accordance with their beliefs, not under the boot of other people’s politics or religion.

So what can you do? Read the report, get motivated and do something about it. Get involved by getting smart about who you’re electing (or not electing) into office. Become an educated, vocal participant in exercising your civic duty, whether it’s visiting your legislators, writing letters to the editor, helping out at the polls – whatever inspires your civic passion. Above all, make your voice heard by voting, because Pennsylvania badly needs you in order to get back on the right track for our state’s women.

We’ve made great strides in the last 50 years, but a report like this shows we have miles to go. The women and men of Pennsylvania need to unite to effect real change for women, whether it is access to healthcare, economic security, or freedom from violence. And we need to pick up the pace while we’re at it. It’s simply taking too long to reach a place of true equality.

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Kate Michelman is co-chair of WomenVote PA, an organization that educates, engages, and mobilizes Pennsylvanians to make equality a reality for women. She is also president emerita of NARAL Pro-Choice America and author of “With Liberty and Justice for All: A Life Spent Protecting the Right to Choose.”

Sue Frietsche is a senior staff attorney in the Western Pennsylvania office of the Women’s Law Project.

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Filed under Domestic violence, Economic Justice, economic security, Family Violence, Health Care, Pennsylvania, Pregnancy, Reproductive Rights, Violence Against Women, Voter turnout, women voting, Women's health, Women's Law Project, women's rights, WomenVote PA, working mothers, working women

Pennsylvania Women’s Advocacy Leaders Condemn Anti-Obamacare Ad

Kate Michelman and Carol Tracy Call for Immediate Stop to Ad

Leaders from women’s rights advocacy group the Women’s Law Project and its action arm WomenVote PA, expressed strong condemnation today about the anti-Obamacare ad from the group Generation Opportunity and has called for its immediate stop.

“We join other women’s organizations today in expressing our outrage at Generation Opportunity’s new online ad ‘Want Creepy Uncle Sam?” said Kate Michelman, co-chair of WomenVote PA.  Michelman continued:

This ad represents a profound violation of a woman’s personal privacy and blatantly uses a woman’s most vulnerable situation – an OB/GYN exam – for political purposes.  It left me nearly speechless for the shocking insult it is to a woman’s dignity.  Further, this ad makes the case for removing government interference in health care, yet is brought to you by the same people who work day and night to insert government into decisions affecting a woman’s right to privacy and access to abortion and contraception.

Carol Tracy, executive director of the Women’s Law Project and co-chair with Michelman of WomenVote PA, said:

This ad is beyond offensive.  The strange Uncle Sam character is not just creepy; it is menacing and, with a leering grin and speculum in hand, it a clear depiction of sexual violence.  Those media outlets choosing to run this ad should be forewarned: the gender gap will undoubtedly grow larger with ads like this and women will be watching.  We believe this ad should be removed from circulation immediately.

The ad produced by conservative group Generation Opportunity and funded by the Koch Brothers, depicts a horror-movie version of Uncle Sam rising from between a young woman’s legs at her doctor’s office and assuming the doctor role himself — a satirical jab at President Obama’s government being allowed to “play doctor.”

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Filed under Government, Health Care, Health insurance, Women's health

Ohio, Texas, North Carolina, Wisconsin – Let’s End This List

By Kaitlin Leskovac, WLP Summer Intern

Three weeks ago, under the watchful eyes of six male state legislators (photo), Governor Kasich (R) of Ohio signed the new state budget. As many have noted, the symbolism in this photo is marked, as Ohio’s new budget reads bankrupt for abortion rights. HB 59 contains drastic cuts in funding for Planned Parenthood; it threatens to withhold public funding for rape crisis clinics if clinic employees provide counseling on abortion care; it requires a woman seeking an abortion to have and pay for an ultrasound; and it prohibits transfer agreements between abortion clinics and public hospitals, a measure that is already threatening to close one of only twelve clinics in the state.

In the last couple of weeks, the Texas legislature passed the anti-abortion legislation that Senator Wendy Davis and thousands of other women and men, in Texas and across the country, have been fighting since “the people’s filibuster” late last month. This is the law that is predicted to close all but five of Texas’ abortion clinics. Three Planned Parenthood clinics have already announced they will have to close their doors come August, as a result of the law’s new mandates. As if this doesn’t go far enough, several legislators have sponsored HB 59, a fetal heartbeat bill that would bring the threshold for legal abortion down to 6 weeks.

North Carolina and Wisconsin have also passed recent anti-abortion legislation. In NC, the prohibitive cost of mandated upgrades threatens closure of all but one of the state’s 16 abortion clinics. In WI, AB 227 (aka SB 206) would require women seeking an abortion to have an ultrasound and require doctors providing abortions to have admitting privileges at a local hospital. Opponents of the law say it would close two of only four clinics in the state.

And that is exactly the point.

What this recent wave of draconian anti-abortion legislation renders overwhelmingly clear is the importance of who our state legislators are. In the matter of abortion, where individual states retain enormous discretion, the actions of state legislatures can devastate abortion rights. This has been demonstrated time and time again: in Texas, in North Dakota, and in Pennsylvania. Therefore, every election, presidential or not, is essential to the security of women’s rights. However, voting rates in off year elections for state representatives remain notoriously low. Female voter participation in particular has been shown to drop by over a million votes in off year elections in Pennsylvania.

In evaluating state legislative actions against abortion rights, we must carefully consider who it is that we elect to our state legislatures. It’s no surprise that women’s rights are getting short shrift in many states. After all, women are still underrepresented in public office. Women compose only 18% of Congress, and it is hardly better at the state level. In Ohio, women make up 24% of the state legislature; in Texas, 21%; in North Carolina, 22%; and in Wisconsin, 25%.The dearth of women in our state assemblies matters when it comes to setting legislative priorities and countering efforts to restrict access to abortion, not because all women support abortion rights—they do not—and not because electing more women to public office is the silver bullet to end the “war on women.” Rather, as Senator Davis so eloquently demonstrated, the voices of women who are directly affected by public policy have the power to inform the public debate and transform how legislatures approach issues of concern to women. The key is to elect a legislature that is diverse in experiences, viewpoint, and perspective.  If we want to change the outcome, that is, put a stop to threats against reproductive rights, it matters who the players are.

Fact: Women compose only 18% of the Pennsylvania General Assembly. Consider this in the larger picture of state governments, which nationwide have become more conservative since 2010. According to the Guttmacher Institute, in the first half of 2013, states enacted 43 abortion restrictions, as many as were enacted in the entire year of 2012. With trends like these, it will take a long time to pin down the ever-evolving standard for the nation’s “strictest” abortion laws.

Whether or not these recent anti-abortion laws are ultimately challenged and/or struck down, in passing these measures, state legislators demonstrate an overwhelming lack of respect for women’s choices. In Wisconsin, Governor Walker claims the new bill, “improves a woman’s ability to make an informed choice.” Choice is the operative word here because ultimately, these laws preclude it. A woman can’t very well choose to have an abortion if she is unable to access an abortion.

In the first half of 2013, the efforts to restrict women’s reproductive rights were astounding, and continued and increasing counter efforts are needed to turn the tide. The image of Governor Kasich of Ohio surrounded by only men as he signed the new state budget reads as a lot more than the beginning of a new fiscal year. It reads as a need to continue fighting to secure women’s reproductive rights in every state. It reads as a fundamental lack of diversity in the vast majority of leadership positions in society. And it reads as a need to remind ourselves of the significance of our votes, and the relationship between the who and the what in the matter of legislative priorities. After all, as Ohio State Rep. Connie Pillich (D) summed it up, is your uterus a budget issue?

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Filed under Abortion, Abortion Access, Democracy, PA Legislature, Planned Parenthood, Politics, Reproductive Rights, Voter turnout, women in Congress, women in legislature, women voting, Women's health

Texas Filibuster Raises National Spotlight on Restrictive State Abortion Laws

By Kaitlin Leskovac, WLP Summer Intern

Texas State Senator Wendy Davis (D)  led an epic filibuster Tuesday night protesting a sweeping and restrictive anti-abortion bill, Texas Senate Bill 537. Holding the Senate floor for approximately 11 hours, Davis’ awe-inspiring display of conviction was successful in delaying a vote on the bill, with the expiration of the special legislative session at midnight. However, Governor Rick Perry (R), who called the special session and put the bill on the agenda, has already called a second special session so lawmakers may consider the bill again.

Texas Senate Bill 537 contains some of the nation’s most restrictive abortion regulations. If passed, Texas Senate Bill 537 threatens closure of all but 5 of Texas’ 42 abortion clinics. The bill bans abortion after 20 weeks of pregnancy; requires all abortion clinics to meet standards for ambulatory surgical centers; and mandates all doctors performing abortions to have admitting privileges at a nearby hospital. Texas is not alone; these types of regulation are surfacing in state legislatures around the nation.

In June of 2012, new regulations for Pennsylvania abortion clinics took effect as part of Act 122, signed into law by Governor Corbett in late 2011. Similar to parts of the Texas legislation, this new law requires freestanding facilities performing surgical abortions to conform to financially burdensome and medically unnecessary requirements associated with ambulatory surgical centers. These upgrades are unnecessary to provide safe abortion care. The act is part of ongoing efforts to restrict access to abortion care.

Two weeks ago, Governor Tom Corbett (R) signed HB 818 limiting abortion coverage under health care insurance policies offered in the federal insurance marketplace starting next year, as per the implementation of the Affordable Care Act (“Obamacare”). The law will prohibit private insurance coverage for abortion, even in cases of medical emergencies endangering the health of the pregnant woman, and even in cases of fetal anomaly incompatible with life. This provision is an additional restriction on abortion rights and disproportionately affects poor women’s access to important medical care.

The present unavailability of Medicaid and the recently enacted ban on insurance coverage of abortion in the exchange will make hospital-based abortion services too costly for many women in comparison to clinic-based care. In Pennsylvania, over 90% of abortion care is delivered by the frail network of 14 non-hospital-based freestanding abortion providers. With limited abortion coverage and rising costs, PA’s restrictive abortion policies threaten women’s right to choose and have a costly impact on women’s health. Accessibility to safe, legal abortion services is essential to preventing dangerous illegal abortions.

The victory of abortion rights advocates in Texas has implications nationwide. That hundreds of supporters came to rally at the Capitol, tens of thousands more watched the filibuster online, with an outpouring of support on Twitter sends a clear message to legislators. The filibuster demonstrates that abortion rights are in fact extremely important to many women and men who will not be silent while policymakers enact more dangerous and far-reaching restrictions. Davis’ testimony detailed the impact of these restrictions on the lives of real women. We in Pennsylvania can take inspiration from the women of Texas and join them in fighting back hard.

For more on the national landscape of abortion laws, check out this must-see graphic.

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Filed under Abortion, Abortion Access, Health Care, Health insurance, PA Legislature, Reproductive Rights, Women's health

Pennsylvania Passes Yet Another Restriction on Women’s Health Care

Earlier this month, the Pennsylvania General Assembly gave final approval to House Bill 818, a measure that would force insurance plans that cover abortion care to stop providing that coverage in the state health insurance exchange. The Legislature also rejected an amendment to the bill that would have allowed insurers to provide coverage when abortion care is necessary to preserve a woman’s health.  Governor Corbett signed the bill as originally proposed into law on June 17, and it will take effect as the new health care exchange comes online later this year.

The new law states that insurance providers operating in the Pennsylvania exchange may only provide coverage of abortion care when the pregnancy is a result of rape or incest or if the pregnancy would cause imminent death. This ignores the medical needs of women who are not in immediate risk of death but for whom continuing a pregnancy could result in serious harm or health risks.  The proposed amendment that the Legislature rejected would have at least protected these women for whom abortions are crucial to maintaining their health.

HB 818’s supporters tried to argue that the bill simply prohibits “taxpayer-funded” abortions, but abortion care was already ineligible for public funding.  Unable to ban abortion entirely, our policymakers appear determined to make abortion care unaffordable and inaccessible. This misguided approach to health care not only infringes on women’s rights but could also endanger a woman’s health.

Though it passed, the bill faced spirited opposition in both chambers of the General Assembly. One of the dissenters, freshman Representative Erin Molchany, told her colleagues in the first speech she ever made on the house floor, “House Bill 818 is a bad bill, full of unintended consequences . . . this house is making decisions for women in this state—deeply personal decisions.  While all of us come from different professional backgrounds, we are all legislators—not medical professionals, not insurance companies, and for the most part not women.”

Most people agree that politicians shouldn’t be allowed to take away a woman’s health coverage just because of where she gets her insurance.  People rely on their health insurance to provide coverage for unexpected medical situations, and all women deserve the peace of mind that comes with knowing that they can obtain the health care they need—whether or not that includes an abortion.

It is a shame that Governor Corbett didn’t take a page out of conservative Michigan Governor Rick Snyder’s playbook.  Late last year, Gov. Snyder vetoed a measure similar to HB 818 because “insurance companies and private buyers of insurance should be able to conduct their own affairs.”  It is a sorry day when even free-market politics and the interests of private businesses have to take a backseat to restricting women’s health care and infringing on women’s autonomy.

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Filed under Abortion, Abortion Access, Health Care, Health insurance, PA Legislature, Pennsylvania, Philadephia Daily News, Pittsburgh Post-Gazette, Reproductive Rights, Women's health

The Questions No One is Asking about the Kermit Gosnell Case…

By Carol E.Tracy and Kate Michelman

With Kermit Gosnell’s criminal trial underway in Philadelphia, public outrage at the physician accused of murdering one woman and seven infants increases with each grisly new piece of evidence.

But the Gosnell trial raises several inescapable questions:  How could this happen? In particular, how, in a state that has led the nation in imposing restrictions on abortion, could such atrocities go undetected?  Just as puzzling is why the numerous complaints against him were ignored.  The answer is simple:  throughout the 1970s and 1980s, when abortion policy was established, the Commonwealth of Pennsylvania’s primary goal was to overturn Roe v. Wade and, barring that, impose as many barriers as possible to limit access to abortion.  By and large, our policymakers have never viewed abortion as a medical procedure – instead placing it under the Pennsylvania Crimes Code – and therefore have not nurtured a system of abortion care that is woman-focused, readily accessible, and responsive to their medical needs.  The Commonwealth’s focus has been on denying access, not protecting the health and safety of women who need this medical care. If the charges against Gosnell prove true, Gosnell was an outlaw who repeatedly violated numerous laws and should have been shut down years ago, but the state did not hold him accountable to its own laws and policies.

So why did women go to his clinic? Why not choose a legitimate, reputable provider of abortion care? During a Senate Public Health and Welfare Committee hearing on proposed abortion regulation bills, Tyhisha Hudson, a woman who had obtained an abortion at Gosnell’s clinic, was asked why she went to him.  She testified that women in her neighborhood knew that Gosnell was the man you saw for the cheapest abortion.

Another Gosnell patient, Davida Johnson, noted in an Associated Press article that she intended to go to Planned Parenthood for an abortion procedure, but was scared away by anti-abortion protesters picketing outside the clinic. An acquaintance suggested she go to Gosnell, where protesters (ironically) were not an issue.

Evidence suggests that a number of factors influenced a woman’s decision to seek care at Gosnell’s clinic: Medicaid’s refusal to provide insurance coverage for most abortions; the scarcity of abortion providers in Pennsylvania (and across the nation); the fear of violence perpetrated by protestors at clinics, and the right-wing culture that has so stigmatized abortion that many think it is still illegal 40 years after Roe v. Wade.

It is critically important that the women of Pennsylvania know that abortion is legal and is a safe medical procedure.  As set forth in the Gosnell Grand Jury Indictment, legitimate providers, like Planned Parenthood and members of the National Abortion Federation, follow the law and standard medical procedures.

Unfortunately, politicians in Congress and in Harrisburg continue to make it more and more burdensome for women to get safe abortions.  Since 1976, Congress has annually re-authorized the Hyde Amendment, which bans federal Medicaid coverage of abortion care except in cases of rape, incest, or if the pregnant woman’s life is endangered. Pennsylvania law likewise restricts any state Medicaid money from funding the procedure except in those three rare circumstances (rape, incest, and threat to the woman’s life), so low-income Pennsylvania women are as a rule responsible for covering the entire cost of an abortion out-of-pocket. This cost equals or exceeds an entire month of TANF assistance benefits for most families.

Bills currently pending before the Pennsylvania legislature would ban coverage of abortion in health insurance policies sold in the health care exchange under the Affordable Care Act. These extreme measures would ban abortion coverage even when the woman’s health is endangered if she is forced to continue a dangerous pregnancy, and even when the coverage would be separately paid for with the woman’s own money.

Reputable, careful providers of high quality abortion care are under attack. As a result of an orchestrated campaign of harassment, intimidation and violence against individual doctors and freestanding women’s clinics by domestic terrorist organizations like the Army of God and Operation Rescue, the number of abortion providers in the United States declined 38 percent between 1982 and 2005. In Pennsylvania, there is not a single freestanding abortion provider in the hundreds of miles between Pittsburgh and Harrisburg.

To compound the provider shortage problem, the Pennsylvania legislature passed a new law in 2011 modeled after a bill on the wish list of the National Right To Life Committee:  mandating that the remaining handful of abortion providers come into compliance with volumes of costly regulations designed for ambulatory surgical facilities where much more complex surgeries take place. Today, there are just 13 freestanding providers of surgical abortion care in Pennsylvania, down from 22 two years ago.

Pennsylvania is not alone in developing strategies to regulate abortion care right out of existence. In fact, state legislatures have enacted 135 abortion restrictions in the last two years, according to the Guttmacher Institute.

For readers who feel this doesn’t apply to them, mark our words, it does, because it is likely that you know someone who has had an abortion. One in three women will have an abortion by the time she is 45. Between 30 and 40 million women have had abortions since Roe v. Wade was decided in 1973.

History tells us that whether abortion is legal or illegal, women will have abortions – the only difference is whether women live or die.  As in the pre-Roe days, women with resources can usually find quality care; but those without resources will often seek out the cheapest possible care. The long-term impact of burdening and stigmatizing abortion care could be that the most vulnerable women will once again have to risk their health and lives to get what should be a completely safe and common medical procedure.

Kate Michelman is co-chair of WomenVote PA, an initiative of the Women’s Law Project, and President Emeritus of NARAL Pro-Choice America.

Carol Tracy is co-chair of WomenVote PA, an initiative of the Women’s Law Project, and Executive Director of the Women’s Law Project.

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Filed under Abortion, Abortion Access, Reproductive Rights, Women's health, WomenVote PA