On How a Bill Becomes a Law: The bill that will likely become the reconciliation bill on healthcare has been posted (PDF). Ezra Klein explains what it means.

Democratic leaders say a bill will pass this week.  House Minority Leader John A. Boehner (R-Ohio) pledges obstruction, saying Republicans will do “everything we can to make it difficult for them, if not impossible, to pass the bill.”

Jen Nedeau covers the multiple threats to women’s health and reproductive rights that must be addressed, including the House anti-abortion language. You know it as the Stupak/Pitts admendment. But Richard Doerflinger, the U.S. Conference of Catholic Bishops’ point man on abortion, should have had his name in there, too. Meanwhile, Jessica Arons tries to see the world through the lens of Rep. Bart Stupak (D-Mich.).

In an editorial in Monday’s paper, The New York Times urges anti-abortion Democrats to accept the Senate’s restrictive provisions, the lesser of two evils.

Too Many Tests, Too Much Treatment: “A spate of recent reports suggests that many Americans are being overtreated. Maybe even President Barack Obama, champion of an overhaul and cost-cutting of the health care system,” reports Lindsey Tanner of the Associated Press.

“More care is not necessarily better care,” wrote cardiologist Dr. Rita Redberg, editor of Archives of Internal Medicine, commenting on Obama’srecent physical, which included prostate cancer screening and a virtual colonoscopy. The PSA isn’t recommended at any age and a colonoscopyisn’t recommended under age 50.

Over-testing may be due to a combination of what is known as “defensive medicine” — doctors ordering tests and procedures because they’re trying  protect themselves against lawsuits (or because they’ll be compensated by a fee-for-service system) — and patients insisting on tests and treatments that they’ve heard about or know is commonly prescribed. But the thinking around more care = better care may be shifting.

“This week alone,” writes Tanner, “a New England Journal of Medicine study suggested that too many patients are getting angiograms – invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.”

Stopping the Campus Rape Crisis: Jaclyn Friedman, executive editor of Women, Action and the Media and co-editor of “Yes Means Yes,” wrote a must-read op-ed in the Washington Post on ending the silence around sexual assault on college campuses.

First, colleges can eliminate the “miscommunication” excuse that many rapists use by creating an on-campus standard that requires any party to a sexual interaction to make sure their partner is actively enthusiastic about what’s happening — not just not objecting. They can create judicial boards equipped to seriously investigate rape accusations, instead of throwing their hands up at the first sign that the accused’s testimony contradicts the accuser’s. They can defend the safety of the entire campus by permanently expelling those found guilty of sexual assault. And they can be transparent about every step of the process.

Plus: The Center for Public Integrity recently released “Sexual Assault on Campus: A Frustrating Search for Justice,” an in-depth report filled with useful data, articles and resources.

Recognition for Midwives: Granny midwife Margaret Charles Smith was inducted into the Alabama Women’s Hall of Fame at Judson College this month. Smith attended nearly 3,000 births between 1949, when she received her midwife permit, and 1981, when she attended her last birth. Her life story is told in a book Smith co-wrote with Linda Janet Holmes, “Listen to Me Good: The Life Story of an Alabama Midwife.”

Plus: Rachel previously noted that the National Library of Medicine is featuring an exhibition on African American midwives. ”Nothing To Work With But Cleanliness: African American ‘Grannies,’ Midwives & Health Reform” tells the story of “granny” midwives and the state and local training programs that educated them and succeeding generations of midwives. View a wonderful set of photos from the exhibition on Flickr.

Utah’s Controversial Law Charges Women and Girls With Murder for Miscarriages: Writing at AlterNet, Rose Aguilar breaks down the problems with Utah’s new law that makes it a criminal offense for having miscarriages caused by “intentional or knowing” acts.

“What happens to women who are in abusive relationships?” asks Planned Parenthood’s Melissa Bird. “What happens if a woman threatens to leave the abuser, falls down the stairs and loses the baby? What if the abuser beats the woman and causes a miscarriage? Could he turn her in? Who would the prosecutor believe? What happens if a drug addict who’s trying to get clean loses her baby? Will she be brought up on murder charges?”

Some critics point out the legislators erred in not considering the lack of access that young people have to comprehensive sex education, and the overall lack of contraception and health services, especially in remote parts of the state.

The Girls Who Kicked in Rock’s Door: Not exactly health related (unless you’re like me and consider loud music essential for well-being), but I am completely intrigued by the “The Runaways,” the new film about the 1970s all-girl rock band, starring Dakota Fanning and Kristen Stewart. Sia Michel writes about the story behind the film and its director, Floria Sigismondi.

We wanted to share this important notice from SisterSong regarding a Georgia House bill created ostensibly to protect women of color from being targeted by abortion providers. Note the Trust Black Women press conference on Tuesday on the steps of Georgia’s Capitol, mentioned at the end of this bulletin.

For more information about the current anti-abortion billboard campaign in Georgia, visit SPARK Reproductive Justice Now.

* * * * * * *

SisterSong Women of Color Reproductive Justice Collective OPPOSES House Bill 1155 — The Sex and Race Selection Bill. This bill seeks to ban the solicitation and targeting of women of color by abortion providers throughout the state.

This misleading issue of abortions for sex- and race-selection in Georgia means that we have to use facts and science to stand up for women of color without undermining our support for abortion rights or without enforcing racial stereotypes about women of color. Intent on driving a wedge between reproductive justice and racial justice organizations, and pro-choice advocates, the bill reflects the false assumption that abortion providers throughout the state “solicit” women of color.

If implemented, this bill will adversely impact abortion providers by requiring them to prove that they are not targeting women of a certain race or ethnicity. This burden could result in delayed medical services, particularly for women of color. Additionally, this legislation would alter the racketeering laws of the Georgia Code to include abortion providers. This is unacceptable as abortion is legal in the State of Georgia, and the alleged abuses of this medical procedure are unfounded. Such a bill would have a terrible effect on women’s ability to access reproductive health care services throughout the state.

This bill comes on the heels of a controversial billboard campaign that targets Black women in Georgia. The blatantly sexist and racist billboards declare Black children as an endangered species and prey on the conscience of Black women. The mere association between the born and unborn with endangered animals provides a disempowering and dehumanizing message to the Black community, which is completely unacceptable.

The statewide 80-billboard campaign is sponsored by The Endangered Species Project, a collaborative effort between The Radiance Foundation and Georgia’s Operation Outrage. We recognize that the lived experiences of women of color, and Black women specifically, drive how and when women choose abortion, not abortion providers who defend women’s rights. In order to protect the lives of women and families, abortion must remain safe, legal, affordable, and accessible. Any attack on women’s rights is in violation of all of our human rights.

SisterSong will detail the damaging effects of HB 1155 and how the public can advocate for the reproductive justice, reproductive rights, and reproductive health of women of color. Sponsored by SPARK Reproductive Justice NOW, during their Legislate THIS! Action Day, the Trust Black Women Press Conference will take place on Tuesday, February 16, 2010 at 12:00 pm on the steps of Georgia’s Capitol.

By now you may have heard about the Focus on the Family-sponsored anti-choice ad slated to run during the Super Bowl. The ad features football player Tim Tebow and his mother discussing her decision not to have an abortion when pregnant with the star player.

The ad has been controversial for many reasons, including that it marks a change from CBS’s past “no advocacy/controversy” policy (an ad for a gay dating site was declined), glosses over issues related to privilege and the illegality/safety of abortion in the Philippines, and presents a situation in which Tebow celebrates her own choice (to go through with the pregnancy) and its resultant football star while advocating against other women having the same choice.

We don’t yet know the exact form the ad will take, except that CBS has worked with the anti-choice Focus on the Family on the language, and it will highlight Pam Tebow’s decision not to have an abortion with a tagline of “Celebrate family, celebrate life” (as though one can’t do those things and be pro-choice?).

Planned Parenthood has already released a preemptive response video featuring former football player Sean James and Olympic gold medalist Al Joyner espousing a message we can get behind – one of choice and trusting women. Among their comments:

I respect and honor Mrs. Tebow’s decision. I want my daughter to live in a world world where everyone’s decisions are respected.

We are working toward the day where every woman will be valued. Where every woman’s decision about her health and her family will be respected.

Related: Jacyln Friedman writes at The Nation about sex and the Super Bowl, arguing that “the Tebow/Focus on the Family ad is just a new expression of a longstanding Super Bowl tradition in which women are valued only in direct relation to their usefulness to male athletes and fans.”

After deliberating for only 37 minutes, a Kansas jury found Scott Roeder guilty of first-degree murder in the shooting death of George Tiller.

Watch closing arguments by Roeder’s attorney and the prosecutor. You can also view the guilty verdict being read.

Roeder, 51, took the witness stand Thursday and admitted killing Tiller, who was one of the few doctors in the country to perform late-term abortions.

“I did what I thought was needed to be done to protect the children,” said Roeder. “I shot him.”

Roeder said he was not remorseful. After the killing, which took place in Tiller’s church, Roeder said he felt “a sense of relief.”

Roeder was also found guilty of two counts of aggravated assault. Sentencing is set for March 9. District Attorney Nola Foulston said she would be requesting the “Hard 50,” meaning Roeder would not be eligible for parole for 50 years.

The Wichita Eagle has a good collection of background information and trial stories, along with links to other media coverage and related abortion issues. View: http://www.kansas.com/news/tiller/index.html

Jeanne Tiller, George Tiller’s widow, and the Tiller family, released this statement:

“The family of Dr. George Tiller would like to thank the jury, District Attorney Nola Foulston and her office and law enforcement for their service in this difficult matter. Once again, a Sedgwick County jury has reached a just verdict. We also want to thank George’s countless friends and supporters in Wichita and around the country who have offered their comfort.

“At this time we hope that George can be remembered for his legacy of service to women, the help he provided for those who needed it and the love and happiness he provided us as a husband, father and grandfather.”

Nancy Keenan, president of NARAL Pro-Choice America, issued the following statement in response to the conviction:

“The jury examined the facts of this case and rightfully convicted Scott Roeder for the brutal murder of Dr. George Tiller inside his church in Kansas. Our thoughts are with Dr. Tiller’s family and friends. Even though this conviction brings a murderer to justice, it won’t replace the husband, father, and grandfather they lost last May. Dr. Tiller was a tireless advocate for reproductive health who called on us to ‘trust women’ to make the personal, private decisions that are best for them and their families. We will continue to honor his legacy of compassion and resolve.

“We also call on opponents of a woman’s right to choose to end the practice of inflammatory rhetoric and tactics that inspire this kind of violent action from the most extreme factions of the anti-choice movement. No other abortion provider’s family should have to endure the tragedy of seeing their loved one killed for providing an essential and legal health service to women.”

A forthcoming article in the journal Contraception, “Pregnancy coercion, intimate partner violence and unintended pregnancy,” looks at whether adolescent and young women have experienced birth control sabotage, pregnancy coercion, and/or physical or sexual violence.

Researchers from UC Davis conducted a survey of 1,278 16-29 year old women seeking care in five California family planning clinics in 2008-2009. The participating women were Hispanic (30%), Black (28%), White (22%), Multiracial (7%) and “Asian/other” (13%). Pregnancy coercion was defined as being told not to use birth control by a partner, threatened with physical harm if they did not agree to get pregnant, being forced or pressured to become pregnant, having hidden birth control because of fear that the partner would become upset, or being told that the partner would have a baby with someone else or leave if they did not become pregnant.

Birth control sabotage was defined as having a partner take off a condom while having sex, put holes in a condom on purpose, take away birth control, or forced sex without a condom.

Participants were also asked about their lifetime histories of physical and sexual violence and history of unintended pregnancy.

The key findings:

• 53.4% reported having experienced partner violence
• 40.9% had experienced at least one unintended pregnancy
• 19.1% had experienced pregnancy coercion
• 15.0% had experienced birth control sabotage

The authors also reported that women who had experienced partner violence in the past were also more likely to have experienced pregnancy coercion or birth control sabotage (35% of those reporting violence compared to 15% of those not reporting violence). Women who had experienced reproductive control (coercion or sabotage) were also more likely to have experienced an unplanned pregnancy. When looking at the data by exposure to partner violence, reproductive control was associated with unintended pregnancy only among those who were exposed to partner violence.

Although the authors looked at lifetime exposures and so could not look at associations within specific relationships or the order of these events in time, one co-author of the study suggested that the associations may “explain why unintended pregnancies are far more common among abused women and teens.”

The researchers conclude that:

Comprehensive screening in clinical settings for the prevalent experiences of pregnancy coercion, birth control sabotage and partner violence should be considered a priority, particularly in the context of family planning and related programmatic efforts to reduce unintended pregnancy. Such screening may facilitate the critical work of addressing barriers to contraception among affected women and girls so as to reduce their elevated risk for unintended pregnancy.

The lead author of the study was also one of the researchers for a smaller study of intimate partner violence and birth control sabotage that we reported on in 2007.

[Note: Although I was able to get a copy of the article, it is not yet readily available online. I'll try to add a link if an abstract/full text becomes available.]

This post was written in connection with the annual Blog for Choice Day, Friday, Jan. 22. Apologies for the delay!

This year marks the 37th anniversary of Roe v. Wade, and the fifth anniversary of Blog for Choice Day, started by Jessica Valenti and NARAL Pro-Choice America.

NARAL is dedicating Blog for Choice 2010 to the legacy of Dr. George Tiller, who was murdered last May in his church foyer as he welcomed parishioners attending morning mass. Tiller provided abortions to women who often had no place else to turn and whose health, or the health of the fetus, was threatened.

Scott Roeder, 51, a vocal anti-abortion advocate, admitted in November that he killed Tiller, and he claims the killing was justified. Roeder’s first-degree murder trial started on Friday — yes, Roe v. Wade’s anniversary. You can follow the trial coverage at http://www.kansas.com/news/tiller/index.html.

- Utah and D.C. enacted laws to ensure that sexual-assault survivors receive information about and access to emergency contraception in emergency rooms.

Setbacks
In 2009, 14 states enacted 29 anti-choice measures, increasing the number of anti-choice measures enacted in states since 1995 to 610. Examples include:

- Virginia enacted a law that establishes “Choose Life” license plates. A portion of the proceeds from these plates funds anti-choice organizations known as “crisis pregnancy centers” that target women considering abortion and often mislead, coerce and intimidate them.

- Arizona enacted a far-reaching law that includes a litany of anti-choice provisions that, among other things, subject women to state-mandated lectures and waiting periods that delay access to abortion care. The law also allows certain individuals or entities to refuse to provide abortion services and to refuse to provide or dispense contraceptives.

Watch
Grit TV with Laura Flanders
This episode includes a discussion with Carol Joffe, author of “Dispatches from the Abortion Wars,” Lynn Paltrow, executive director of National Advocates for Pregnant Women, and Silvia Henriquez, executive director of the National Latina Institute for Reproductive Health. Learn about the current state of reproductive health and rights and how anti-abortion efforts — whether through legislation or terrorism — hurt all pregnant women.

Listen
PRX: “Hyde-ing” the Right to Choose
While lawmakers in Washington mull over the nuts and bolts of health care reform, advocates are concerned that a woman’s fundamental right to reproductive health services is endangered. We explore how access has been denied for decades to young women and poor or low-income women who are disproportionately women of color. On this edition, Stupak, the Hyde Amendment, and religion.

Featuring:
Stephanie Poggi, Executive Director, National Network of Abortion Funds
Jenny, shares her story about having an abortion
Jon O’Brien, Catholics for Choice President
Guadalupe Rodriguez, ACCESS/Women’s Health Rights Coalition Program & Public Policy Director

Last week, Raising Women’s Voices and Women of Color United for Health Reform delivered a letter [PDF] to House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid and several committee chairs on health care reform. The letter — signed by Our Bodies Ourselves and many other supporting organizations — thanks these leaders for their support of healthcare reform and provides recommendations related to women’s health for inclusion in the final legislation.

The signing organizations believe that the final legislation must not add new barriers or burdens to women’s access to abortion coverage and should eliminate the controversial Nelson/Stupak amendments. Instead, they argue, the legislation should return to the Capps amendment [PDF], which “preserves the ban on use of federal funds for abortion coverage, but does not exclude abortion from private insurance policies for which women will be using their own funds.” (See the Planned Parenthood Action Center for a good discussion of the three provisions.)

The groups also recommend a requirement that women’s preventive health services and screenings be covered without co-pays or deductibles; coverage of more people through expansion of Medicaid eligibility; establishment of an “exchange”; coverage for legal immigrants without a five-year waiting period; and making coverage more affordable while keeping penalties for violating coverage mandates less burdensome for low-income people.

The letter also expresses support for expansion of translation/language services; bringing Medicaid payment rates up to the same level as Medicare payments (in order to increase the number of providers accepting Medicaid); and a mandate that all Health and Human Services agencies collect data on ethnicity and primary language along with gender, race and other categories .

RWV is also running a cartoon postcard campaign to encourage people to contact their legislators and express their dissatisfaction with current versions of health care reform.

Related: The Center for Reproductive Rights recently released a video questioning the singling out of abortion for restriction in health reform legislation. The video asks what else an individual might not want to pay for with their own tax dollars. Watch it below, or read the transcript at Feministe.

Oral arguments began this week in the Florida case of Samantha Burton, a pregnant woman who visited her doctor when she was 25 weeks pregnant with signs of a potential miscarriage. The doctor ordered bed rest, which Burton declined with the intent of seeking a second opinion, as her two job and two existing young children made bed rest a difficult prospect. The doctor then contacted the state.

According to the New York Times:

She was ordered to stay in bed at Tallahassee Memorial Hospital and to undergo “any and all medical treatments” her doctor, acting in the interests of the fetus, decided were necessary. Burton asked to switch hospitals and the request was denied by the court, which said “such a change is not in the child’s best interest at this time.” After three days of hospitalization, she had to undergo an emergency C-section and the fetus was found dead.

I am appalled. But I am not surprised.

The NY Times points to an ACLU rep’s statement at Daily Kos which neatly sums up the problem:

Don’t get me wrong — of course I want pregnant women to follow their doctor’s advice. But I do not think that pregnant women should be confined against their will if they are unwilling or unable to do so. If we allow the government to confine a pregnant woman for not following orders to remain in bed, what’s next? Will we forcibly hospitalize pregnant women for having a glass of wine with dinner? Or eating too much fast food? What if they don’t take their prenatal vitamins? Or miss their doctor’s appointments? What if a pregnant woman refuses a cesarean section? While we each may have strong opinions about such behaviors, our government cannot interfere in a woman’s personal private medical decisions. Allowing the government to make medical decisions for pregnant women means that literally every decision and every activity a pregnant woman engages in could be regulated by the state.

Of course, our government DOES interfere with a “a woman’s personal private medical decisions” — just look at abortion laws –and this case is just one more example.

The same values that lead to restricting women’s choices about following medical advice also affects the choices women have in birth. Many hospitals will not allow vaginal births after cesareans or allow women to chose whether they are continuously monitored, implying that the “only thing that matters” is getting a healthy baby at the end, and that the woman’s “experience” does not matter. In such a framework — where women’s desires are readily ignored (and made to seem trivial) –  court intervention with regards to bed rest does not seem extreme. We have already seen cases in which court-ordered cesareans have occurred.

In this case — as in abortion and birth choices –the fetus is prioritized. A woman’s bodily autonomy and preferences for how her pregnant body is treated and used are held secondary to fetal outcomes. People other than the individual woman are allowed rights to control her reproduction.

The ACLU argued in its amicus brief [PDF] on the case that such interference “invites State requests for court intervention in nearly all aspects of pregnant women’s behavior and medical judgments,” and may discourage women from seeking care. “In turn, some women will be discouraged from coming to a hospital for pregnancy care if they know that any disagreement may lead to forced medical treatment.”

Archives of the oral archives should become available soon at available at the website of the Florida 1st District Court of Appeal.

Jill at the Unnecesarean also has a couple of posts on the case. For more on issues related to the rights of pregnant women generally, see the National Advocates for Pregnant Women.

[adapted from a post at Women's Health News]

Today pro-choice folks are converging on D.C. for a National Day of Action to support health care reform that includes a full range of reproductive health services for women and to oppose the Stupak Amendment, which prohibits abortion coverage in any public option and creates bureaucratic hurdles that could make it difficult for women to pay for abortion coverage with their own money.

Christine has written about the amendment several times on this blog, and the NPR pieces linked above also provide good background info.

Supporters include Planned Parenthood, NOW, YWCA, Choice USA, the Religious Action Center of Reform Judaism, NARAL Pro-Choice America, the Center for Reproductive Rights, the American Association of University Women, the Religious Coalition for Reproductive Choice, the ACLU, and others. Each of these organization websites has information on the basic schedule for the day, background materials on the issue, and tips for/ways of taking action for those not in D.C., including petitions, draft emails, and guidance for making phone calls to Senators/Representatives.

Tweets from the event can be followed at #stopstupak. Have photos or reports from the scene? Let us know in the comments!

Scott Roeder, the man accused of shooting abortion provider George Tiller, confessed to the killing today and said that he plans to argue at his trial that his actions were justified.

Roeder, 51, talked to an AP reporter for more than 30 minutes by telephone. He has been charged with one count of first-degree murder in Tiller’s death and two counts of aggravated assault for allegedly threatening two church ushers who tried to stop him when he shot Tiller in a church foyer in May, just before the start of a Sunday mass.

The confession has no bearing on Roeder’s “not guilty” plea. His trial is scheduled to begin in January.

“Because of the fact preborn children’s lives were in imminent danger this was the action I chose. … I want to make sure that the focus is, of course, obviously on the preborn children and the necessity to defend them,” Roeder told the AP.

“Defending innocent life — that is what prompted me. It is pretty simple,” he said.

Roeder also said he has no regrets about killing Tiller.

“No, I don’t have any regrets because I have been told so far at least four women have changed their minds, that I know of, and have chosen to have the baby,” Roeder said. “So even if one changed her mind it would be worth it. No, I don’t have any regrets.”

A small group of abortion opponents today released a document — “Defensive Action Statement 3rd Edition” — that proclaims “whatever force is legitimate to defend the life of a born child is legitimate to defend the life of an unborn child.” The 21 signers state that “if Scott Roeder did in fact kill George Tiller, his use of lethal force was justifiable,” and he should therefore be acquitted.

According to this document (and bear in mind, it is difficult to read), this  statement was originally written by Paul Hill in 1993 and signed by 29 people who supported Michael Griffin’s shooting of Florida abortion provider David Gunn. One year later, Hill shot abortion Florida provider John Britton. Hill was executed in 2003.

The document is kept at the website of David Leach, who has written a legal brief (pdf) for Roeder to use in his defense.

The House is debating the Stupak amendment limiting access to abortion services — you can watch it on C-SPAN.org, or follow along on the Twitters (hashtag #stupak), where many of us are quoting the representatives for and against. I’m @cmc2

For more background, read “Abortion Fight Erupts in Health Care Debate” at The New York Times, and “House Democrats Will Consider Stupak’s Abortion Amendment On The Floor” at Think Progress’ Wonk Room.

And in case the current House bill’s provisions on abortion are in doubt, read Maggie Mahar’s analysis: “The fact of the matter is that the House bill contains more than two dozen references to abortion and virtually all of them describe how insurers can restrict or deny coverage for the procedure.”

Update: Amendment passed 240-194-1 (Republican Rep. John Shadegg of Arizona cast the lone “present” vote). A surprising number of Democrats – 64 — joined Republicans in passing the amendment. View the roll call here.

Jodi Jacobson just posted a piece at RH Reality Check that begins:

Tonight, with the aide of some 60 Democrats, women’s rights were effectively negated by the US Congress as the House passed the Stupak amendment to HR 3200, the Affordable Health Care Act of 2009.

More in-depth analysis of how we got here is forthcoming. But one thing is clear: The US Conference of Catholic Bishops (USCCB) apparently is running the US government, aided by a cadre of “faith-based advocacy groups,” the House Democratic leadership, the White House and members of the Senate.

Remember, this amendment is not a done deal. It still has to pass Senate and then survive the conference committee, and women’s groups are already mulling action in the weeks to come. But what a sad day it is when the only way to gain health care coverage is to lose a legitimate, legal health care procedure.

Another distressing point: The New York Times reports that only one male lawmaker — Rep. Jerrold Nadler of New York — joined women who spoke against the amendment on the House floor. A correction is in order: My own Congressman here in Chicago, Mike Quigley, also spoke out (cheers!). But that may have been it.

Here, from the Times, are bits of what other lawmakers said during the debate:

Representing the abortion-rights segments of the Democratic membership, Representative Diana DeGette of Colorado called the amendment a “wolf in sheep’s clothing” that would deny women access to care. Representative Lois Capps of California argued that the underlying bill already prohibited federal financing of abortions. The amendment, she said, “Actually restricts coverage of a legal medical procedure.”

“Not one other medical procedure is singled out for rationing” in the larger bill, she said.

Others contended that this amendment would result in women having to go out and buy insurance that would cover such a procedure, a prospect one lawmaker scoffed at, saying a woman does not plan for an unplanned pregnancy.

Representative Nita Lowey, Democrat of New York, called it “a disappointing distraction” from the main event. Representative Barbara Lee, Democrat of California, said the amendment would take women “one step back” toward the dark days of back-alley abortions. Representative Rosa DeLauro, Democrat of Connecticut, said, “We should not be injecting this divisive and polarizing issue into our debate.”

And the full speech by Rep. Jan Schakowsky of Illinois:

This Stupak-Pitts Amendment goes way beyond current law. It says a woman cannot purchase coverage that includes abortion services using her own dollars — even middle-class women using exclusively their own money will be prohibited from purchasing a plan including abortion coverage in every single public or private insurance plan in the new Health Care Exchange.

Her only option is to buy a seperate insurance policy that covers an abortion — a ridiculous and unworkable approach since no woman plans an unplanned pregnancy.

This amendment is a radical departure from current law that will result in million of women losing the coverage they already have. Our bill is about lowering health care costs for millions of women and their families, not for further marginalizing women by forcing them to pay more for their care. This amendment is a disservice and an insult to millions of women throughout the country, and I urge a NO vote on this amendment.

These strong responses ultimately weren’t enough to kill the amendment, but they did serve as a reminder of the urgency of electing more pro-choice women to Congress. Anyone else have points to share?

We’ve received news that these Democrats are on the fence about the Stupak amendment that would restrict abortion coverage in the health reform bill (read this post for background).

If you live in any of these districts, or know someone who does, please call your representative *now* and let him know (yep, they’re all men) that women’s healthcare should not be negotiable.

Rep. Chris Carney (Pennsylvania – 10th district)

Rep. Ben Chandler (Kentucky – 6th district)

Rep. Jim Cooper (Tennessee – 5th district)

Rep. Henry Cuellar (Texas – 28th district)

Rep. Artur Davis (Alabama – 7th district)

Rep. Joe Donnelly (Indiana – 2nd district)

Rep. Richard Neal (Massachusetts – 2nd district)

Rep. Earl Pomeroy (North Dakota – at large)

Rep. Vic Snyder (Arkansas  - 2nd district)

Rep. John Tanner (Tennessee – 8th district)

Rep. Peter Visclosky (Indiana – 1st district)

The House is expected to vote today on a $1.055 trillion health care package that would expand coverage for up to 36 million people — but first there will be a vote on an amendment that severely limits abortion coverage in a new government-run insurance plan and through private insurance that is bought using government subsidies.

After a back-room fight last night, House Speaker Nancy Pelosi agreed to allow the amendment proposed by Rep. Bart Stupak (D-MI). It reads:

The amendment will prohibit federal funds for abortion services in the public option. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions. However, it allows individuals, both who receive affordability credits and who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.

If you are reading this on Saturday, stop. Call your representatives and tell them this amendment is unacceptable. Go, now. We’ll wait. [Update: See this list of 11 representatives who are on the fence. These members, in particular, need to hear from you.]

It looks likes the amendment has enough votes to pass may be a close vote, and lawmakers need to know that a health care bill that tosses out a legal medical procedure used by millions of women every year is unacceptable.

The Washington Post’s Ezra Klein writes:

The amendment is expected to pass with relative ease. Republicans will join with anti-choice Democrats to push it over the finish line. Once the amendment passes, the bill is cleared for a vote, and all parties expect that vote to succeed. Today looks likely to end with a historic, and important, vote. A vote that is a first step towards helping more than 30 million people secure health-care coverage, and making sure hundreds of millions are better protected from the vagaries of the insurance industry. But Stupak’s amendment is a bitter start. It is, however, not the end. Even if it muscles into the House bill, it will also have to pass in the Senate, and then survive conference, before it becomes law.

Illinois Democrat Jan Schakowsky told C-SPAN’s “Washington Journal” that she’ll vote for the bill’s passage today, even with the Stupak amendment, but would opposed the final bill if the amendment survives the conference committee.

“If that language were in the final final bill, I certainly couldn’t support it,” Schakowsky said.

Plus: This morning, members of the Democratic Women’s Caucus went to the microphone, one by one, to explain how the overall health care bill would benefit women. Republican Rep. Tom Price of Georgia responded with a stream of “I object. I object. I object.” It got ugly.

Here’s a five-minute video showing what went down; if you’re short for time, below is the “I object” mashup created by Media Matters.

Serra Sippel, CHANGE; Aziza Ahmed, Harvard School of Public Health; Grace Sedio, Bomme Isago Association (Botswana); Sergia Galván, Colectiva Mujer y Salud (Dominican Republic); Massachusetts Representative Kay Khan; Dr. Fisseha Mekonnen, Family Guidance Association of Ethiopia

by Kimberly Whipkey, Center for Health and Gender Equity

“At Colectiva Mujer y Salud, we view each woman as a complete person. If a woman comes seeking an HIV test, we will make sure she also receives information about contraception, screening for gender-based violence, education about her sexual health and a better understanding of her rights.”
– Sergia Galván, Executive Director, Colectiva Mujer y Salud, Dominican Republic

Reproductive health care that is comprehensive, accessible and woman-centered is far from a common reality — anywhere in the world. Global women’s health advocates are campaigning for a more holistic approach that better serves women and their families.

In mid-October, the Center for Health and Gender Equity (CHANGE) invited reproductive health experts from the Dominican Republic, Ethiopia and Botswana to participate in CHANGE’s Reproductive Justice Ambassadors Tour. The tour made stops in Boston, Philadelphia and Washington, D.C., to meet with NGO leaders, activists and key decision-makers.

At each venue, experts discussed why investing in comprehensive sexual and reproductive health and rights is critical at this moment, and they offered suggestions on how the United States can strengthen human rights-based care overseas that breaks down the divisions among HIV/AIDS, reproductive health, and maternal and child health.

The three health experts — Dr. Fisseha Mekonnen Alemu, Grace Sedio and Sergia Galván — offered hope that it is possible to provide comprehensive and rights-based care, even in the face of poverty, a weak health infrastructure and social, political and legal environments hostile to reproductive rights. The obstacles, however, are formidable.

Dr. Mekonnen, executive director of the Family Guidance Association of Ethiopia, discussed his country’s dire maternal health statistics. Only 6 percent of pregnant women have a skilled attendant at delivery, and an estimated 100,000 Ethiopian women suffer obstetric fistula — an entirely preventable condition. Rural women have little or no access to modern health care. And 30 percent of women who die as a result of pregnancy or childbirth do so as a result of unsafe abortion.

Women living with HIV in many countries face layers of stigma and discrimination. Grace Sedio, project officer at Bomme Isago Association in Botswana and member of the International Community of Women Living with HIV/AIDS, spoke about HIV-positive women — especially those who are pregnant— being blamed by public officials in Botswana for spreading the virus. They are often treated as vectors of disease rather than as women with reproductive health needs and rights.

While Sergia Galván, executive director of Colectiva Mujer y Salud in the Dominican Republic, provides comprehensive care through her feminist health center, serious challenges to attaining critical reproductive health services remain. Legislators recently ratified an article within Constitutional reform that prevents liberalization of abortion laws, which currently prohibit abortion under any circumstance. The Constitutional changes were largely influenced by ideological opposition to abortion from conservative factions, including the Catholic Church.

“One Cardinal said he would rather see two deaths [the woman and the embryo or fetus] than one abortion,” Galván said at a Congressional briefing in Washington, D.C.

For eight years under President Bush, the global gag rule stifled NGO advocacy around safe and legal abortion, creating a vacuum in the Dominican Republic that helped enable the Constitutional reform. So, whether a woman is raped, a victim of incest, or suffering life-threatening complications of an ectopic pregnancy, she cannot legally access abortion care, and the situation is unlikely to change anytime soon.

The Ambassadors often highlighted how decisions made in the United States have had major impacts in their countries. They also offered suggestions for how people in the United States can promote reproductive justice globally. For example, Congress is in the early stages of re-writing the Foreign Assistance Act of 1961, which governs how foreign assistance is spent.

One immediate action step is to contact your members of Congress and urge them to support the inclusion of comprehensive reproductive health. For more information, we encourage you to read CHANGE’s new report: “Investing in Reproductive Justice for All: Toward a U.S. Foreign Policy on Comprehensive Sexual and Reproductive Health and Rights.”

At an NGO breakfast meeting in Philadelphia with the Ambassadors, a participant said, “At our health center in Philadelphia we view every woman as an opportunity.”

So, too, should U.S.-funded domestic and international programs see each woman as an opportunity to provide comprehensive and rights-based health services — and an opportunity to improve the health of women worldwide.

Kimberly Whipkey is a senior associate for advocacy and outreach at the Center for Health and Gender Equity in Washington, D.C.

The health care reform debate hasn’t been encouraging for reproductive health advocates, but on Wednesday the Senate Finance Committee pushed back against a Republican amendment designed to “doubly triply restrict abortion coverage in the bill,” as Rachel Maddow described it last night.

Republican Olympia Snowe of Maine joined almost all of the Democrats to defeat the amendment 13-10. Sen. Kent Conrad of North Dakota, a Democrat, voted for the restrictions along with the rest of the Republicans. Robert Pear of The New York Times explains the framework of the amendment:

The bill, written by the chairman of the Finance Committee, Senator Max Baucus, Democrat of Montana, says that no tax credits could be used to pay for abortions except as allowed in the latest appropriations for the Department of Health and Human Services — in case of rape or incest or if the life of a pregnant woman was in danger.

Under the bill, some health plans would cover abortion, and some would not. Private insurers that chose to cover abortion would be required to segregate money, taken from private premiums, to cover the procedure.

The amendment, offered Wednesday by Senator Orrin G. Hatch, Republican of Utah, would have gone much further. It said that no money provided under the legislation could be used to pay “any part of the costs of any health plan that includes coverage of abortion,” with a few limited exceptions. Under the proposal, insurers could have offered “a separate supplemental policy” to cover abortions. Such policies would have been financed “solely by supplemental premiums paid by individuals choosing to purchase the policy.”

Once again, Sen. Debbie Stabenow (D-Mich.), who demonstrated last week during a debate about pregnancy coverage that she is a no-nonsense force to be reckoned with, fired back against treating women as second-class citizens. She argued that the amendment goes far beyond existing law, which already prohibits spending federal dollars to pay for abortions for women on Medicaid, and it would restrict access to abortion for all women. Here’s my transcript of the video above:

In fact, with all respect to my friend, as a woman, I find it offensive that in [this amendment], any woman, any family purchasing through the exchange — if they did not receive any tax credit — would be prohibited from having the full range of health care options that they may need covered. This doesn’t just refer to the tax credits. As I read this: “prohibit private insurers operating through the exchange from offering coverage” — this is an unprecedented restriction on people who paid for their own health care insurance.

Then, when we look at the fact that this offers, that people could have a supplemental single-service rider, the assumption that somehow a woman or family would say, “You know, some day we may have an unintended pregnancy, so we’re going to get a separate rider. Or maybe my pregnancy is going to have a crisis — many, many crises — and so we’re going to try to find some other rider.”

In my judgment, I don’t even know how that would work. In the few states that have tried to do that, there’s no evidence that even those kinds of riders are available.

It’s remarkable that discussions about abortion conveniently leave out that it is a legal, medical procedure. Or that one in three women will have had an abortion by age 45. Or that three-fourths of women who obtain an abortion say they cannot afford to have a child. Or — as we saw in the weeks after the murder of Dr. George Tiller, when women stepped forward to reveal their stories — the decision is sometimes heartbreakingly, medically necessary.

We’re not the only ones frustrated by the way abortion has turned into a wedge issue for health care reform.

“In a rational system of medical care, there would be virtually no restrictions on financing abortions,” reads an editorial published in today’s New York Times. ”But abortion is not a rational issue, and opponents have succeeded in broadly denying the use of federal dollars to pay for them, except in the case of pregnancies that result from rape or incest or that endanger a woman’s life.”

“There should be no restrictions on abortion coverage in the exchanges,” the editorial concludes. “Health care reformers should not retreat on this issue, but we recognize that principle is often sacrificed in Congressional bargaining. Democrats who support the compromise must find a way to prevent it from being used later to go after other tax subsidies and thus further deny Americans’ rights to make their own health-care decisions.”

Hatch put forth a second amendment to strengthen existing “conscience clause” laws protecting healthcare workers from performing abortions or other services to which they have moral or ethical objections. It also failed on the same on the same 10-13 margin; Snowe voted with the Democrats, and Conrad with the Republicans.

Funding for Abstinence Only Education

On Tuesday night, the committee approved a comprehensive sex education funding stream, the Personal Responsibility Education for Adulthood Training. That amendment, proposed by Baucus, provides $75 million for states, according to the Sexuality Information and Education Council of the United States (SIECUS), “$50 million of which would be geared to evidence-based, medically accurate, age-appropriate programs to educate adolescents about both abstinence and contraception in order to prevent unintended teen pregnancy and sexually transmitted infections, including HIV/AIDS. The remaining funds would be for innovative programs as well as research and evaluation.”

Snowe joined all Democrats in passing the amendment; the vote was 14–9.

Yet on the same night, the committee voted for an amendment introduced by Hatch to restore federal funding for abstinence-only education — “better known,” said Maddow, “as the best teen pregnancy and STD delivery system politicians have ever devised.”

Democrats Conrad and Blanche Lincoln of Arkansas joined all 10 Republicans on the Finance Committee to vote in favor of adding $50 million-a-year funding for the Title V abstinence-only program to the health care bill, despite the fact that President Obama’s 2010 budget eliminated funding for abstinence-only education programs — because they simply don’t work.

Even Texas got the message. The state that ranks first in spending on sexual abstinence has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once. As the Austin American-Statesman reported on Sunday, some school districts are giving up the abstinence-only model and adopting a more comprehensive sex education curriculum, also called “abstinence-plus.”

Both amendments still have to pass the full House and Senate, so it’s anyone guess where the dollars will fall, but SEICUS is optimistic that legislators will wake up and reject the abstinence-only funding.

“This amendment takes a giant step backward by restoring funding for the failed and discredited abstinence-only-until-marriage program for the states,” said William Smith, vice president for public policy at SEICUS. “However, because this program so clearly doesn’t work and half the states don’t even participate, we are confident it will be stripped from the final bill and ask Congressional leaders and the White House to ensure this happens.”