1) “We’re about risk-avoidance.”
2) “We are evidence-based.”
3) “We’ve never called ourselves ‘abstinence-only’. We’re abstinence-centered. . . We do talk about contraception.”
4) “Comprehensive sex education just talks about the physical – we’re more holistic than that.”
A November 2008 NAEA letter to then President-elect Obama prophesies the transfiguration as evidence-based, risk avoidance, abstinence-centered, holistic sex education that includes contraception. (That’s a pretty good description of programs that I’ve been supporting for thirty years.)
When the Department of Health and Human Services removes abstinence-only restrictions from federal funding and instead requires that these funds be used to support evidence-based medically accurate teen pregnancy prevention efforts, the agencies sending in the Requests for Proposals will include the same agencies which are now receiving abstinence-only-until-marriage funds:
• The crisis pregnancy centers that refuse to give out information about emergency contraception;
• The ‘virginity pledges;’
• The ‘abstinence clown;’
• The folks who carefully explain the failure rates of condoms and contraceptives without explaining the infection and pregnancy rates when they’re not used.
As frustrating and perplexing as the reincarnation of abstinence-only-until-marriage programs will be, the principle of competition for grant funds is time-honored and broadly accepted. We would like to believe that the cards will be unmarked and the deck will not be stacked against comprehensive sex education. But if the NAEA has its way, there won’t be a fair deal. In the May 11th WPR interview, Ms. Ladky says: “We’re looking for funding parity. We think that each of us should have one-half of the funds.”
The advocates for abstinence-only-until-marriage programs argue that family planning funding, especially Title X, which provides medical services related to contraception, cancer prevention, and STD testing and treatment should be put into the pot with the sex education funds. In other words, family planning funds should be added to the pot and the abstinence programs should be guaranteed half of the winnings before the cards are dealt.
Equating Title X family planning health care services with community and school-based sex education is problematic and unworkable. Hundreds of thousands of women and men would potentially lose access to primary preventive reproductive health care. It is a cynical ploy to take funding away from Planned Parenthood and other family planning programs. The monumental irony in the “abstinence-centered” faithfuls’ request that half of the stakes be set aside for them before the game begins is that if abstinence-only-until-marriage and comprehensive sex education are both evidence-based and medically accurate – if both program models include risk reduction instruction such as contraceptive methods and condom use – on what distinction would the parity division of money be based?
It was simpler when comprehensive sex education advocates refused these funds and worked to eliminate them because they are sectarian and because they have been ineffectively used. After Congressman Obey carries out the Presidential budget sentence, advocates on both sides will compete for the redefined “common ground” teen pregnancy prevention funds -- and it will require an act of faith to tell them apart.
Even American Catholics practice a fundamental, and not fundamentalist, right to reproductive self-determination. During the 2008 campaign, most Catholic voters ignored the sacramental threats of shepherds like Reverend Jay Scott Newman, who told his parishioners that their souls were at risk if they voted for pro-choice candidates. (Catholics voted for Obama with a 54 to 45 percent margin.) As Kathleen Kennedy Townsend and Patrick Whelan pointed out, voters may have noticed that abortion rates declined more under the Clinton administration’s policies than under Reagan’s or under either of the two Bush’s. Voters may have decided that there are higher priority pro-life issues; such as economic desperation, unending war, and global environmental degradation.
For some, positions on abortion and birth control are simply not susceptible to earthly persuasion. More than forty years ago, when a majority of a Vatican commission on birth control seemed ready to support a reversal of the church’s ban, Father Marcelino Zalba fervently asked the members what would happen "with the millions we have sent to hell" if previous teaching was invalidated. Commission member Patty Crowley responded: "Father Zalba, do you really believe God has carried out all your orders?"
Nancy Belden, a Washington-based public opinion researcher, recently showed that one side of the abortion debate is unlikely to change the hearts and minds of the other. Her polling demonstrated that support or opposition to legal abortion has moved a few polling points one way or the other in the last thirty-five years, but in 2007 56% favored legal access and 40% opposed – a return to 1973. American families have made up their minds and for the most part, they ignore the arguments and the arguers on the other side.
President Obama frequently demonstrates a pragmatic and realistic approach to reproductive health policy: rescinding the theological stem-cell federal funding restrictions; removing the ‘Global Gag Rule’ (Mexico City Policy) that penalized international family planning agencies for supporting reproductive rights, and; rolling back the Bush administration’s ideological 11th hour “conscience protection” regulations. While the President has reached out to listen to fundamentalist members of Congress and to interest groups who disagree, most of the time he has tried to set policy based on practical scientific decision-making instead of partisan crowd noise.
The new Congress and the new Administration must continue on this course of providing leadership on the principle that reproductive health care policy will be based on two foundations of American democracy – reason and science. We must not be distracted from that principle by battles over who holds the high moral ground. Instead, we must keep our attention on developing reproductive health care policy that is down to earth.
]]>Sometimes drivers back away from the demonstrators. Parents coming to WIC with strollers don't expect a vehicle to back out of the drive-through and they have enough to pay attention to already.
I haven't asked these women if they are visiting our clinic to get food for their infants or prenatal nutritional education. I haven't asked whether they use natural family planning, or condoms, or hormonal birth control pills, or the patch, or an IUD. I don't ask whether they are married or faithful or abstinent. I don't ask whether they are Catholic, Protestant, Jewish, Buddhist or non-believers. Neither do the demonstrators who intimidate them.
FPHS is a non-sectarian health care provider with a mission to prevent unintended pregnancies. More than 95 percent of all American women use modern contraceptive methods. We're proud to support access to safe, legal voluntary reproductive health care as a human right. The women who come to our clinic do not come to get an abortion or an abortion referral. We prevent abortions, we do not provide them.
The "prayer warriors" know that women and men come to us for birth control. Aspirus and Marshfield Clinics also provide confidential birth control. Unlike us, they probably make medical referrals for pregnancy termination when necessary. Walgreens and Wal-Mart deliver hormonal birth control pills and every hospital emergency room now gives out emergency contraception to rape victims.
No theological or political issue is going to be resolved by frightening the women who come to us for health care. We have been providing high-quality, affordable and confidential health care for 36 years and we will continue to provide that care as long as there are women who choose to come to us to receive it.
]]>
It isn't Speaker Pelosi whose thinking is seriously out-of-date. Inclusion of Medicaid family planning access in the economic stimulus package does not imply a belief that "more people mean less economic growth," as the WSJ assumes. Equally unsubstantiated and even internally contradictory, is the editorial board's rather medieval argument that we must produce more children to support us in our retirement. (Although, after last year's stock market crash, maybe children are the only pension plan we have left.) Although the editorial suggests that contraceptives as a part of an economic stimulus plan are "loopy," the editorial's assertion that we need to have more children to maintain domestic consumption is clearly the all-out loopiest - tracing its roots, perhaps, to the "go shopping" response to terrorist attacks. "Larger families have more credit cards, so have a larger family."
Access to contraceptive care enables women to meet their educational goals, to participate fully in society, to time pregnancies for health as well as to achieve career aspirations. Family planning is voluntarily prevention of unintended pregnancies -- meaning women and their families are able to determine for themselves whether and when to have children. The human capital connection is that the cost of unintended pregnancy is also borne by employers in the form of higher insurance premiums, more family medical leaves, substitution expenses, rehiring/recruitment costs, retraining costs, and lost productivity.
]]>This piece also appeared on Belowthewaist.org.
Reproductive health care advocates and providers have written extensively the last few weeks about proposed HHS "conscience protection" regulations -- the period for public comment ends this Thursday, September 25.
In Wisconsin, approximately one-third of all health care organizations are religiously affiliated and many workers sign a contract promising to follow the United States Conference of Catholic Bishops Ethical and Religious Directives for Health Care Services. A July letter from the bishops to members of Congress eagerly embraced the regulations. But the bishops may have neglected the fact that many workers in Catholic hospitals and clinics have moral convictions supporting contraceptive care and reproductive rights and other health care that the church does not sanction or permit.
If the regulations are adopted, family planning service providers, like us, could be forced to hire people who have moral objections to contraception. We would be unable to discipline employees who refuse to provide birth control or other services to our patients, central to our mission. Employees of sectarian health care institutions would operate under the same protections.
For example, clinic employees might refuse to distribute abstinence-only materials because they are incomplete, inaccurate, and deny a patient's right to informed consent. They might have a moral conviction to explain that condoms, correctly and consistently used, are a reliable means to prevent unintended pregnancies, and sexually transmitted infections -- including HIV transmission to fetuses.
Catholic hospital employees might feel, as a matter of conscience, that to deny information about emergency contraception to a victim of rape is morally wrong or that providing pregnancy options information to a high-risk patient without discussion of termination as well as adoption is willful neglect.
Many health professionals in sectarian medical teaching institutions believe that physicians must be trained in modern contraceptive methods, sterilization procedures, and how to perform emergency abortions.
Earlier this year, a Colorado bill, parallel to these regulations, would have prohibited religion-based hiring discrimination. It was loudly criticized by Denver Archbishop Chaput, who said the law would "...greatly hinder organizations like Catholic Charities from maintaining their mission and purpose as specifically religious institutions."
The federal regulations proposed by Secretary Leavitt and supported by the US Conference of Bishops incorporate moral conviction as well as religious belief and extend to all health care providers receiving federal funds. Speaking from the point-of-view of health care providers who understand unintended consequences, here's a thought for the bishops and the Bush administration: "Asking for federal protection for employees who refuse to put patient welfare above personal belief may be equivalent to the fisherman's wife wishing to be the ruler of universe. By asking to rule everything, they ended up with nothing and there the fairy tale ends."
]]>Last week the Journal of the American Academy of Pediatrics published a study showing that urban minority teen girls lacked knowledge about emergency contraception. Almost all of the sexually active adolescents had heard of emergency contraception, but were not knowledgeable about how it works or when to take it. Girls who were not sexually active had less information.
In 2006, FPHS did a Wisconsin study on whether teens who called family planning clinics, emergency rooms, and crisis pregnancy centers got information to help them get EC. The findings were that while family planning clinics did well, emergency rooms were not prepared to deal with telephone inquiries, and crisis pregnancy centers typically did not have accurate or useful contraceptive information.
As family planning providers,
here's what we are doing about it (with a lot of collaboration):
We explain to every woman and girl of reproductive age who calls the hotline or visits our clinics that she should have Plan B on hand and should understand when to take it. The most common reasons are that she may forget to take birth control pills, a condom may beak, or unplanned/non-consensual sex may put her at risk of an unwanted pregnancy. The woman at risk makes the decision when to take Plan B. Having it on hand enables her to act promptly.
Every female patient of reproductive
age who visits any one of our seven clinic locations or who calls the
statewide toll-free response line (866-EC FIRST) is offered Plan B and receives education
that emergency contraception is more effective the sooner it is taken
after unprotected sex. Most of our callers are low-moderate income
and underinsured, so they are eligible for Wisconsin's Medicaid
Family Planning Waiver.
For them, prescription Plan B will be provided at no charge.
How can she get the pills?
If it is an emergency and she can't get to a local family planning clinic:
That is focusing on the practical
-- as for dealing with other dimensions such as the moral, the medical,
the historical and the political, there are good sources of information
about emergency contraception and how we came to be where we are:
Health Care Education and Training has an excellent website about how EC works at http://www.hcet.org/ec/default.htm.
The Wisconsin Family Planning and Reproductive Health Association (WFPRHA) took several preparatory steps on the way to wide EC access, including:
The most important piece of the puzzle is that Wisconsin's Department of Health Services implemented policies that enable uninsured and underinsured low and moderate income women to receive Medicaid-paid contraceptive services and supplies. Being able to give EC at no charge in advance of need is the foundation on which EC access is based.
As for results: at FPHS clinics, positive pregnancy tests as an annual percentage of total patients has dropped from (pre-Family Planning Waiver) 5.5% (about 350 positive pregnancy tests) to 2% (about 180 positive pregnancy tests) for the last three years. There may be a non-EC explanation, but it's not likely. Because preventing unwanted pregnancies is how we can define EC success, for FPHS, free EC in advance has been a success. Maybe it is as simple as that.
]]>The New York Times recently uncovered that the Department of Health and Human Services is drafting regulations that would "prohibit discrimination" against certain health care employees who refuse to deliver contraceptives because of religious or moral objections. Medical organizations, elected officials and activist citizens are protesting the proposed rules because they would declare many forms of contraception to be equivalent to abortion and impose unnecessary and burdensome personnel "conscience protection" rules on federally funded hospitals and clinics in a thinly-disguised effort to interfere with access to birth control. Help us stop the rule change.
Take Action!
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Learn more:
Come senators, congressmen
Please heed the call
Don't stand in the doorway
Don't block up the hall
Last week, Susan Orr resigned as head of the Title X (federal reproductive health grant)
program. Dr. Orr is not a supporter
of hormonal contraceptives,
so the resignation is welcomed by the reproductive health and reproductive
rights community. We hope it is a sign of change to come.
Walking the halls of Congressional offices last, I imagined echoes of change. Were they echoes from the past or the future? New voters are registering, activists are organizing, and communication technologies are harmonizing old and new ideals and activists. The current President and Congress united the old activist generation with a new generation of young activists and advocates by insulting and injuring all of us with a $1.5 billion federally endorsed chastity belt called ‘Abstinence-only Education,' which many reports classify as ineffectual at best. A new President and Congress could instead stop wasting $300 million every year and invest the money in proven comprehensive sexuality education programs.
This is a good time to plan
ahead and to advocate for health care policy change - especially
for reproductive health care. We know that access to voluntary
and confidential contraception, STD testing and treatment, and comprehensive
sexuality education is affordable, achievable, and long overdue.
The Wisconsin Family Planning and Reproductive Health Association (WFPRHA) recommended to an Institute of Medicine Review Committee (IOM) on Monday, May 19, that Title X, Medicaid-paid family planning, and access to public prescription drug pricing should be interwoven into a national reproductive health safety-net. The proposal would prevent unintended pregnancies among low income women and free up millions of dollars for preventive primary health care.
Here is a 2009 inaugural chorus
we can sing together next year proudly and loudly:
And, as unconscionable as the disparities across the U.S. are in access to reproductive health care, around the world they are even less defensible. While they're at it, the next President and the next Congress should also take the abstinence-only chastity belt off the President's HIV/AIDS assistance program (PEPFAR). Removing that restriction would help achieve worldwide access to primary preventive reproductive health care.
WFPRHA laid out a plan to the IOM, but whether we unite behind that
plan or another, it is time for all of us to think and plan ahead and
to speak out at every political and public policy event for the right
to universal access to evidence-based reproductive health care and education.
To our elected officials, we need to be clear that on reproductive rights and health care and education: "You better start swimmin' or you'll sink like a stone, for the times they are a changin'."
]]>Pro-Life Wisconsin's campus newspaper ads state: "Be good to yourself over spring break. Make smart choices the night before ... that way you won't have any emergencies to deal with the morning after!" Good point. Everyone agrees that good responsible sexual choices are safer, healthier, more respectful, and less likely to result in life-changing negative consequences -- just plain smarter.
But the PLW ad goes on to state that; "emergency contraception is a powerful, high dose of steroids that tricks a woman's body into thinking it is pregnant" and can cause "chemical abortions and deadly blood clots." PLW promiscuously crammed as many misleading and unsupported claims into one short statement as it possibly could, but the main and most clearly refutable points are often heard and too often echoed across the country: "chemical abortions" and "blood clots."
The latest World Health Organization information is explicit that EC works by preventing ovulation and fertilization. There is no evidence that EC prevents implantation and there is substantial evidence that Plan B's rate of not preventing implantation of a fertilized egg fully explains the pregnancies that occur after the pills have been taken. In other words, the primary argument that opponents of EC make (we should not risk the destruction of a single fertilized egg) is scientifically, theoretically, and statistically head-of-a-pin microscopic.
Weighed against the larger risks of an unwanted, untimely, or risky pregnancy or perhaps an abortion at a later stage of a real pregnancy, the microscopic objection should vanish completely. And, since unlike many forms of hormonal birth control, Plan B does not contain estrogen, PLW's warning about "blood clots" seems to be based on their own beliefs and very little else.
What will not disappear and what is impossible to ignore in this debate about possibilities, is the question of why an organization opposed to abortions would discourage women at risk of unwanted pregnancy from acting to prevent those pregnancies? Why is an organization repulsed at the idea of risking a single fertilized egg acting in a way that puts women (including those who will subsequently abort an unwanted pregnancy) at a greater risk of pregnancy?
To a rational person seeking to reduce abortions, an unproven possibility of the presence of a fertilized egg and a theoretical possibility of preventing a potential implantation on the uterine wall is simply not morally or ethically equivalent to an unwanted pregnancy. The imbalance is dramatically and clearly shown when the woman at risk is likely to have an abortion if she becomes pregnant.
Spring break is a good time for anti-abortion advocates and supporters of accurate safer-sex education alike to call for sexual responsibility and restraint. Perhaps we can agree to exercise responsibility and restraint in our advertising too. Opponents of abortion, like Pro-Life Wisconsin, could demonstrate that they will not risk increasing the number of abortions to quench an insatiable desire for public attention.
Related Posts
When I was one year old, she decided to place me in a foster home. Nine years later, when she remarried, I decided to stay with the foster parents I'd come to think of as my parents, too. She had two subsequent failed and deeply mourned pregnancies, but at last, she had two healthy births.
On the 35th anniversary of Roe v Wade, I'm thinking of the pain she went through with the failed pregnancies and her pain at the end of her life. I'm also reminded of a story broadcast on National Public Radio last year just before her death.
Victims of Chinese government officials in Quangxi Province described their forced abortions to NPR reporter Louisa Lim. The women told of involuntary injections and officials without the simple decency to provide follow-up medical care. Denying the accusations, local officials said: "We really love and care for women here."
According to Lim, "investigators" were hurriedly cleaning up the hospital beds and dispersing the young victims to rural and remote parts of the province.
I am also thinking of last year's U.S. Supreme Court ruling that denies a few desperate women access to what may be an ugly and troubling but would have been safe and legal late-term abortion. The Court has brought the government and the opposition to abortion together in an effort which: " . . . furthers the legitimate interest of the government in protecting the life of the fetus that may become a child."
Although one government claims to respect life and the other government acts to extinguish it, I have a sickening sense that these actions are not related by love and care for women. Instead, they are connected by a conviction that women must be prohibited from making their own decisions about pregnancy and reproduction. As justification, the Court's majority opinion says: "While we find no reliable data to measure the phenomenon, it seems unexceptional to conclude some women come to regret their choice to abort the infant life they once created and sustained. . . . Severe depression and loss of esteem can follow."
Justice Kennedy, writing for the majority of the court, admits using an unsupported belief that many women later regret having had abortions to justify a prohibition. The chilling common thread is an enforceable faith that the government's end justifies the brutal means they use to achieve it.
How is a preventable maternal death less repugnant than a late-term abortion?
There are parallel moral, ethical and spiritual issues at the end and at the beginning of life. Thankfully, despite its love and care for women, the administration did not interfere with my mother's final days. On the 35th anniversary of Roe v Wade and in her memory, I am compelled to say that if we love and care for women, we will stand together to respect and guarantee the human rights of each one.
My mother was entitled to her regrets, but when she told me she wasn't always there for me, she was wrong. She did the right thing for the right reasons.
]]>The grateful prisoner was freed and the princess demonstrated that to get results in the empire, a technically subtle approach might be successful where a direct approach might fail.
Now how about freeing access to reproductive health care for women in a half-dozen states who are receiving services under Medicaid Family Planning Waivers that will end before the term of the current "tsar" on January 20, 2009?
On December 7 Senator Hillary Clinton (D-NY) distributed a letter for cosigning to senators from the 26 states currently authorized to provide family planning services through Medicaid 1115 Family Planning Waivers. These Family Planning Waivers allow low and moderate income women who would otherwise be ineligible for Medicaid coverage until pregnant to receive Medicaid-paid family planning services before they become pregnant and before they have children. In the joint letter to House and Senate Leadership, she described the Waiver approval process states must go through:
Unfortunately, the current waiver process has proven increasingly unworkable. Over the last decade, only seven of the 20 proposals for income-based eligibility expansions approved by CMS have been approved within a year of when they were submitted by the state. Six applications took between one and two years for approval, and seven languished for two years or more before finally being approved. Particularly given the well-established value of these demonstrations, the current approval and re-approval required under federal law wastes critical staff resources, hamstrings states' ability to meet changing needs, and limits our efforts to reduce unintended pregnancies and meet reproductive health needs in our states.
Wisconsin is first up to the chopping block and our Department of Health and Family Services is locked in eleventh-hour plea-for-pardon negotiations with the Centers for Medicare and Medicaid Services (CMS) on behalf of health care for the 75,000 women enrolled in the program ending December 31, 2007. Beyond Wisconsin there are hundreds of thousands who would be helped in the six other states and beyond that, if Senator Clinton's proposal passes, women in the other 43 states and territories could quickly benefit as well.
Medicaid Family Planning Waivers save money by reducing more costly Medicaid-paid births by preventing unintended pregnancies. By expanding the program as Senator Clinton is proposing, the Congressional Budget Office has estimated an annual federal savings of up to $400 million. The Guttmacher Institute estimates even greater savings as well as benefits to maternal and child health.
It would be better to have a reasoned discussion of Medicaid-paid family planning services through full Congressional deliberation and passage of the Unintended Pregnancy Reduction Act (S. 1075 - H.R. 3162). But in the waning days of this empire, the women in the seven states with "Waiver execution dates" won't care whether it's a comma's position or a full debate that renders the result.
So pardon us, Mr. President.
Help win a pardon for family planning programs and a reprieve for women everywhere:
Let legislators know that the family planning expansion and access provisions of the Unintended Pregnancy Reduction Act (S. 1075 and H.R. 3162) must be included in the Medicaid physician reimbursement bill.
1) Contact members of the House Energy and Commerce subcommittee on Health and in the Senate Finance Committee. Use the ‘contact us' link at the House Energy and Commerce Committee subcommittee on Health's website at: http://energycommerce.house.gov/Subcommittees/health.shtml
2) Contact members of Senate Finance Committee at its website at http://www.senate.gov/~finance/.
3) Visit the ‘Write Your Representative" website at http://www.house.gov/writerep/ and the "Find Your Senator" website at http://www.senate.gov/general/contact_information/senators_cfm.cfm.
4) Ask friends and organizations who support expanded access to primary care, including reproductive care, to contact Congress. Direct them to this website and ask them to help spread the word.
Visit our website at www.FPHS.org if we can be of help or to learn more about us. If you do contact your legislator, let us know at info@fphs.org. Thanks for your help!
]]>Speaking of unintended consequences (and unintended pregnancies), the 109th Congress included language in the Deficit Reduction Act of 2005 (DRA) that deprived pharmaceutical companies of the ability to provide low cost drugs to campus health centers and "safety net providers." Drug companies quickly cut campus health centers off from low-cost contraceptives which forced them to increase prices to their students.
We recognize the public policy system is, at times irrational, but before we cause another accident trying to recover from this one, we should try to make sense of:
Family planning advocates aren't gamblers. In the same way that the consequences of limiting access to affordable contraceptives to students and low-income women is predictable, the consequences of relying upon the good will of pharmaceutical companies and Health and Human Services Secretary Leavitt to provide us with access to contraceptives is foreseeable. For risk-averse family planning advocates, it's a bad bet.
Drug companies, Congress, the NY Times Editorial Board, and our advocates all agree on the correction that needs to be made and we all know that the consequences of inaction will be borne by women in a far more personal and potentially devastating way than any threatened decrease in drug company profits.
Representatives Maloney and Crowley, and Senators Obama, McCaskill, and Clinton have introduced legislation to take control of the situation and restore the ability of drug companies to offer discounted pricing to campus health centers. In Wisconsin, our family planning association is wisely lining up behind the American College Health Association to help push the bill forward, but we must push deliberately or we might push ourselves into another collision with reality.
Restoring drug pricing regulations to what they were prior to the DRA still leaves student health at risk. Regulations to provide access to public sector drug discounts were deeply in need of repair long before the DRA.
In its current form, H.R. 4054/S. 2347 has neither a requirement nor an incentive to insure the pharmaceutical companies offer low prices to campus health centers or safety-net providers. Without a definition of ‘safety net provider' or an application process, the central question of access remains entirely up to the drug companies.
At the same time we push for this legislation, we must tell our elected officials and advocates that we need a clearly defined process to obtain ‘safety net provider' designation (to prevent another example of O'Rourke's theory).
"Go out and cause them yourself":
Visit our website at www.FPHS.org if we can be of help or to learn more about us. If you do contact your legislator, let us know at info@fphs.org. Thanks for your help!
]]>Senator Clinton took the opportunity to demonstrate a broad and detailed understanding of practical solutions to address gaps in access to reproductive health care. In this four minute vignette, she outlines a three-point immediate action plan to address gaps in the reproductive health safety net. We can act on each point right now:
1) Explicit and specific inclusion of contraceptive care and preventive reproductive health services in every discussion of health care reform. This means clear integration in health insurance coverage as well as regulatory reform. The senator says we can leave nothing to chance.
By including Senator Clinton's Unintended Pregnancy Reduction Act language in the Children's Health and Medicare Protection Act (as is done in the House version of the reauthorization bill), we integrate family planning with other maternal and child health services.
2) To insure that Title X's mission of access to reproductive health care for all regardless of income is fulfilled, Senator Clinton calls for adequately funding the Title X family planning program but she does not stop there.
3) When she mentions campus health care providers, she is referring to the loss of nominal pricing that was available prior to the passage of the 2005 Deficit Reduction Act.
There is language that would permit pharmaceutical companies to voluntarily offer nominally priced contraceptives included in CHAMP HR 3162, but Representative Bobby Rush has proposed much more comprehensive legislation to improve the integrity of the public sector drug pricing program - H.R. 2606.
Senator Clinton calls on us to "sound the alarm" on opponents of family planning services who are not just anti-abortion. They are anti-contraception and anti-women's rights. This is a challenge we can meet, beginning with advocacy for family planning integration in the CHAMP act.
The US Senate (SCHIP) and the House (CHAMP) passed Children's Health and Medicare Protection Act bills at the beginning of August. It will go to conference committee when they reconvene.
Now, for the first time, the Congressional Budget Office has recognized in a very conservative cost analysis, that expanding Medicaid-paid access to contraceptive care saves taxpayer dollars. Those savings can and should be used to offset the costs of providing coverage to uninsured children.
Reauthorization of the State Children's Health Insurance Program is extremely important and must be acted upon before the end of September. Because the Senate language does not include family planning access expansions, it is essential that senators and representatives hear from you right now how important it is that the conference committee's final product expands access to family planning services. With the House CHAMP bill language, we could do much more and we could do it with much less administrative red tape.
Leave nothing to chance - take these three action steps:
1) Contact Senator Clinton to thank her for her support for integrating reproductive health care access in every health care reform proposal, specifically in Children's Health Insurance negotiations.
2) Visit the ‘Write Your Representative" website and the "Find Your Senator" website and communicate to them your support for family planning in Children's Health Insurance legislation.
3) Ask friends and organizations who support expanded access to Children's Health Insurance coverage and primary care that includes reproductive care, to contact congress. Direct them to this website and ask them to help spread the word.
Visit our website if we can be of help or to learn more about us. If you do contact your legislator, let us know at info@fphs.org. Thanks for your help!
]]>The good news and opportunity for maternal and child health advocates is that the House version includes Unintended Pregnancy Prevention Act language! The Senate edition does not.
Although either bill, if adopted, would face a "road closed ahead" veto threat from President Bush, long before Congress arrives at that Presidential detour, a conference committee must reconcile the two plans. To be sure our elected officials don't take a wrong turn or lose their way, it's time for you to give them directions.
CHAMP is a critical bill reauthorizing the State Children's Health Insurance Program that must be acted upon before the end of September. House members who are supportive of expanding access to reproductive health care have selected House Resolution 3162 as a vehicle to carry us down the road toward universal access to confidential reproductive health care. Riding with H.R. 3162 are provisions of the Unintended Pregnancy Reduction Act which allow states to easily include or to continue (as in twenty-six states) providing expanded access to federally funded family planning services in their Medicaid programs. There are also provisions that would reduce burdensome identity and citizenship documentation requirements for minors so they can more readily and confidentially receive family planning services.
Because the Senate CHAMP language does not include family planning access expansions, it is essential that your senators and representatives hear from you right now so they know how important it is that the conference committee's final product expands access to family planning services. To prevent unintended pregnancies, sexually transmitted infections, and to reduce abortions, there is nothing less expensive or more effective than free access to confidential reproductive health care. Expanded Medicaid-supported access to reproductive health care through the current (more cumbersome) Family Planning Waiver process is already reducing unintended pregnancies and abortions, improving maternal and child health, and saving taxpayer dollars in more than half of the states, with the adoption of the House CHAMP bill language, we could do much more and we could do it with much less administrative red tape.
Four steps to help the conference committee find its way:
Let legislators know that the family planning expansion and access provisions of H.R. 3162 must be included in the final CHAMP bill because they will expand access to preventive health care and improve maternal and child health outcomes while saving taxpayer dollars.
1) Contact members of the House Energy and Commerce subcommittee on Health and in the Senate Finance Committee. Use the "contact us" link at the House Energy and Commerce Committee subcommittee on Health's website here.
2) Contact members of Senate Finance Committee here.
3) Visit the Write Your Representative website and the Find Your Senator website.
4) Ask friends and organizations who support expanded access to primary care, including reproductive care, to contact congress. Direct them to this website and ask them to help spread the word.
Visit our website at www.FPHS.org if we can be of help or to learn more about us. If you do contact your legislator, let us know at info@fphs.org. Thanks for your help!
]]>The 340B Program Improvement and Integrity Act
House Resolution 2606
Representative Bobby Rush, a member of the Congressional Black Caucus, is leading an effort in the Health subcommittee of Energy and Commerce, to expand and improve the 340B program which gives patients of safety-net providers access to low cost drugs, including contraceptives.
The 340B program requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at low prices to publicly funded health care agencies that serve uninsured and low-income populations. Representative Rush's bill would require pharmaceutical companies to expand access to the program to include community hospitals, rural referral centers, Maternal and Child Health care providers (e.g. services to children with special health care needs and family planning clinics), as well as mental health and substance abuse centers. Additionally, HR 2606 would tighten up holes in the program by strengthening the Department of Health and Human Services' ability to verify eligibility as well as pricing calculations. The net result: expanded access to drugs by people in need and a projected annual taxpayer savings of $217 million.
The Unintended Pregnancy Reduction Act
Senate Bill 1075
Over the past five or six years, there has been a quiet and powerful advance in access to reproductive health care from Texas to Wisconsin and from New York to Oregon, providing free reproductive health care for those in need. For preventing unintended pregnancies, sexually transmitted infections, and reducing abortions, there is nothing less expensive or more effective than free access to confidential contraceptives and routine clinical care.
The dramatic change in the scope and shape of the reproductive health care safety net has resulted in Medicaid providing more than half of all federally-funded family planning services received by patients. The simplest reason for that shift is that twenty-six states are operating Medicaid Section 1115 Family Planning Waiver demonstration projects. These demonstration projects have proven their effectiveness in reducing unintended pregnancies as well as their cost-savings (PDF).
Senate Bill 1075, the Unintended Pregnancy Reduction Act, would expand Medicaid funded family planning services to all states and territories and would make renewals of existing waivers much easier. The opportunity to design a program that meets patient needs in rural areas, in underserved areas, and to women and men in need should be available to all states, across the nation. The success is so widely and well documented (PDF) that maintaining their status as "demonstration projects" is an anachronism.
With a reasonably accessible and comprehensive design, these Family Planning Waivers have already been proven to do the following:
Three ways to move these bills forward:
Visit Family Planning Health Services' website if we can be of help or to learn more about us. If you do contact your legislator, let us know. Thanks for your help!
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