2000 RFN
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Reproductive Freedom News

February 2000
Volume IX
Number 2

Cover
The Reproductive Rights of Disabled Women

Worldwide
U.N. Treaty Condemns Discrimination

Hill Update
1999 Federal Legislative Summary

In the States
Contraceptive Equity Bills Gain Momentum

On the Docket
Off to the Supreme Court


Cover

Fully Entitled:
The Reproductive Rights of Women with Disabilities

For several days in December, news organizations around the globe reported on the predicament of Laura, a pregnant, 13-year-old Italian girl who is developmentally disabled and described as having the mental capacity of a six-year-old. News stories focused on the battle lines drawn between her parents and family doctor, who wanted her to have an abortion, and anti-choice forces that ultimately succeeded in ensuring that she carry her fetus to term. But the situation also brought home the dilemma facing the approximately 300 million women around the world who have mental and physical disabilities and are routinely denied information, education and services related to their reproductive health.

"Too often," says Mindy Roseman, a staff attorney with the International Program for the Center for Reproductive Rights, "the laws and policies related to reproductive rights are blatantly discriminatory toward women with disabilities, or are silent. We as an international community need to move toward a more robust recognition of both the human rights and the reproductive freedom of these women, and keep politics out of it."

To foster that goal, the Center for Reproductive Rights has just completed a formal analysis of the reproductive rights of women with disabilities that explores four interrelated freedoms in an international human rights framework: (1) the right to equality and non-discrimination; (2) the right to marry and found a family; (3) the right to reproductive health including family planning and maternal health information, education and services; and, (4) the right to physical integrity.

As the briefing paper shows, there exist a variety of international documents that support the rights of the disabled. The Vienna Declaration and Programme of Action (which governments agreed to at the 1993 World Conference on Human Rights) was notable for being the first instrument to explicitly assert that "[s]pecial attention" must be given in order to ensure "non-discrimination, and the equal enjoyment of all human rights and fundamental freedoms by disabled persons, including their active participation in all aspects of society."

"They told me 'she is retarded and has no reason to know about [sex],' but the reality is she is a sexual being and without sex education she becomes more vulnerable to sexual assault."

- Karen Raye, former Director,
Women's Rights Advocacy Initiative

But despite that international consensus and the fact that women with disabilities comprise 10% of all women worldwide, discrimination is rampant, and countless laws and policies violate their physical integrity. For example, in Zimbabwe forced sterilization of women with physical disabilities is based on the assumption that it is in their best interests not to bear children. Cambodian law dictates that "people who are mentally ill or insane may not marry." U.S. studies show that only 19% of physically disabled women receive sexuality counseling, and that about 83% of all women with disabilities are assaulted at some point during their lifetime. In Japan, the controversial hogo-sha system requires that family members make health care decisions on behalf of someone with a mental disability, sometimes without procedural safeguards.

These biased laws and practices run counter to the equality norms established in international human rights laws which plainly state that, to the extent that women with disabilities can consent to marriage or be involved in decision-making about their reproductive rights, they should be permitted to the fullest extent allowed by their capacities. "In other words, to the degree that a woman can give her informed consent, she is entitled to do so," says Roseman.

At the same time, women with mental disabilities are often more vulnerable to sexual abuse and other forms of exploitation. While these vulnerabilities entitle them to heightened protection, their rights to reproductive and sexual autonomy must not be compromised. Reproductive health services, particularly contraception, sterilization and abortion, cannot be forcibly or coercively imposed. Sexual freedom must not be unduly restricted, even in institutional settings.

Karin Raye, whose field research for the Women's Rights Advocacy Initiative of Mental Disability Rights International was a catalyst for the Center for Reproductive Rights' briefing paper, says women with disabilities are often stigmatized as asexual. During a fact-finding mission to Eastern Europe, she recalls the staff of one psychiatric hospital in Armenia responding with disgust to her inquiry about the sexual education of an adult woman with mental retardation who had just begun to menstruate. "They told me, 'she is retarded and has no reason to know about that,'" says Raye. "But the reality is, she is a sexual being and without sex education she becomes more vulnerable to sexual assault. These women need the facts just like any other women, and they need to be able to make decisions based on options."

In extreme cases, substituted judgment may be appropriate when a severe emotional disturbance or cognitive impairment compromises an individual's ability to give informed consent. However, an objective process, subject to review, must ensure that unfounded and inaccurate assumptions about a woman's ability to consent do not jeopardize her autonomy. Any action which limits her reproductive rights must be as minimal as possible, and not based on the convenience of others.

- Ann Farmer

WORLDWIDE

U.N. Treaty Condemns Rampant Gender Violations

Millions of women worldwide encounter gender discrimination and reproductive rights violations in their daily lives, including women in the U.S. However, the U.S. remains the only industrialized nation not to have ratified the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). This pact has been signed by 165 nations and is the only comprehensive international treaty guaranteeing women's human rights and the prevention of discrimination against women. The following are some of the violations that have been condemned under the treaty.

In Chile:

  • Women may be imprisoned under criminal law for having an abortion for any reason, and health professionals are legally required to report women who undergo abortions to law enforcement agencies;
  • A woman who wants to be sterilized must obtain her husband's consent and must already have four children;
  • Pregnant girls at some schools are expelled (and the boys who impregnated them are not), despite a government recommendation discouraging expulsion;
  • Family law restricts women's ability to administer their own or joint property, and contains no provision for divorce.

In Nepal:

  • Harmful traditional customs are prevalent, including child marriage, dowry, polygamy, deuki (dedicating girls to a god or goddess to become "temple prostitutes"), and badi (forcing young girls to become prostitutes);
  • Abortion is a criminal offense without exception and women are frequently imprisoned for abortion;
  • Women are restricted from independent use of their own property and from inheritance;
  • School curricula and textbooks convey gender stereotypes and entrench a perception of male superiority.

In Spain:

  • Domestic violence is increasing;
  • Women's unemployment rate is almost double that of men, and women earn about 30% less than men;
  • As of 1999, women comprised only 22% of the national Parliament;
  • While women are becoming integrated into the labor force, men are not becoming involved in parental and household tasks in a comparable number and manner.

In Nigeria:

  • Harmful traditional practices exist, including polygamy, inhumane rites undergone by widows, female circumcision and similar customs;
  • Women often cannot travel without permission from a male relative;
  • There is a low female literacy rate and low attendance rate by girls at secondary schools;
  • Commercial banks frequently deny women credit.

In collaboration with local women's organizations, the Center for Reproductive Rights has produced "shadow reports" for the CEDAW on seven countries that have ratified the Women's Convention: Chile, Colombia, Mexico, Nigeria, Peru, South Africa and Zimbabwe. The reports highlight those countries' discriminatory laws, policies and customs. They can be obtained by calling the Center for Reproductive Rights at 917-637-3600 or emailing publications@reprorights.org.

- Julia Ernst

Useful Websites for Research on International Reproductive Rights

The Internet has become a valuable research tool for the area of international reproductive rights. Readers of RFN may already be aware of the extensive information available on the Center for Reproductive Rights' website. Several other websites are valuable resources.

The Women's Human Rights Resources website (http://www.law-lib.utoronto.ca/diana/index.htm), maintained by the Bora Laskin Law Library of the University of Toronto, provides a wealth of information on the international legal aspects of reproductive rights.

For information on activities of the United Nations aimed at promoting women's rights, including reproductive rights, go to Womenwatch (http://www.un.org/womenwatch). From there you can access information on the United Nations' conferences on women, including the International Conference on Population and Development (Cairo, 1994) and the Fourth World Conference on Women (Beijing, 1995). You can also find information on the United Nations' five-year review of the Fourth World Conference on Women, which is taking place this year.

For national-level developments worldwide in the area of reproductive rights, an indispensable resource is the Annual Review of Population Law website (http://www.law.harvard.edu/programs/annual_review). A helpful search function allows the researcher to search by country, subject or date. The website also has the full text of about 70 national abortion laws.

- Laura Katzive

To obtain a copy of the briefing paper, The Reproductive Rights of Women with Disabilities, contact the Center for Reproductive Rights at 917-637-3600. In addition, Mental Disability Rights International, a Washington, D.C. based international human rights advocacy organization, invites any individuals with information or interest in documenting or acting on this issue to contact director Eric Rosenthal at 202-296-0800.

Hill Update

1999 Federal Legislative Summary

The following is a summary of the legislative action that took place during the first session of the 106th Congress (1999) in the area of women's reproductive health. Social conservatives in Congress continued to try to restrict access to family planning and abortion services, both domestically and internationally, and made some substantial and disturbing gains. Additionally, many objectionable bills were introduced and passed either in the House or the Senate in the last session and will certainly resurface in the next session beginning in late January.

Legislative Threats to Roe v. Wade

"Partial-Birth Abortion" Bill
Abortion opponents in the Senate, led by Sen. Rick Santorum (R-PA), succeeded by a vote of 63-34 in once again passing a bill to ban so-called "partial-birth abortions." This year's vote again fell short of the two-thirds majority necessary to override a certain presidential veto. As part of the debate, Senators Tom Harkin (D-IA) and Barbara Boxer (D-CA) offered a symbolic but high stakes "sense of the Senate" amendment to reaffirm support for a woman's right to choose as embodied in Roe v. Wade. The substantive vote on the Harkin amendment (51-47) put 47 Senators on record as opposing Roe v. Wade. We can definitely expect to see PBA in the House during the next session.

Unborn Victims of Violence Act
In July, Rep. Lindsay Graham (R-SC) introduced the Unborn Victims of Violence Act, HR 2436, in the House. The measure would impose criminal penalties on a person who "injures or kills a child who is in utero." This blatant attempt to shift the focus of legal action from the woman to the fetus would, if successful, represent the first federal statutory recognition of fetal rights separate from the rights of a woman. The controversial bill passed the House 254-172. The Senate is expected to take up the measure in the next session.

Child Custody Protection Act
For the second year in a row, the House voted in favor of the Child Custody Protection Act (HR 1218) 276-159. The bill would impose stiff penalties on any person, other than a parent, who knowingly transports a woman under the age of 18 across a state line to obtain an abortion, if she has not met the requirements for parental notification or consent in her state of residence. Parents whose daughters have abortions under such circumstances could pursue civil action. The vote is sufficient to sustain a likely presidential veto. The Senate did not take up its version of the bill (S. 661) but is expected to during the next session.

Family Planning - International and Domestic

Payment of United Nations Arrears with Global Gag Rule Language
The most high profile defeat for family planning supporters - and a major political victory for anti-choice forces which will reverberate well into the next session - was the disastrous "deal" the Administration made to exchange payment of approximately $1 billion in back U.N. dues for "global gag rule" restrictions on international family planning. The final agreement includes appropriations for payment of U.N. arrears with the stipulation that no organization that uses its own non-U.S. funds to perform abortions (except in cases of rape, incest or threat to the woman's life) or lobbies on abortion could receive any of the $385 million in FY 2000 U.S. family planning assistance. The legislation permits the President to waive this restriction - which he did - but this triggers a shift of $12.5 million or 3% from international family planning assistance into child survival and disease prevention programs. Moreover, the U.S. government is required to investigate which foreign NGO's receiving U.S. funds also provide abortions or lobby on abortion with their own money. A total of no more than $15 million could be given to these groups.

Payment to United Nations Population Fund
One bright spot for proponents of international family planning occurred when the $25 million U.S. contribution to the United Nations Population Fund (UNFPA) was restored during the end of session budget negotiations. The U.S. contribution had been eliminated in the omnibus spending bill last year and there was a bitter fight to have the funds restored.

Title X
A clear victory for family planning supporters occurred during the final budget negotiations between the Administration and the Republican leadership, when the Title X family planning program received an unprecedented $24 million or 10% increase. The increased funding is as much a policy victory as it is a financial gain and affirms Congress' commitment to family planning. A number of restrictive amendments had been discussed, including parental consent, but did not emerge as anti-abortion policy riders to the final bill.

Restrictions on Abortion

D.C. Abortion Language
As in the past, the final consolidated appropriations bill contained language prohibiting the District of Columbia from spending any federal money as well as any of its own money to fund abortions except in the cases of rape, incest or life endangerment.

Women in Federal Prisons
Once again the Commerce-Justice-State (CJS) appropriations bill contains language restricting funding for abortion for women incarcerated in federal prisons, except in the cases of rape, incest or life endangerment. Representative Diana De Gette (D-CO) offered an amendment to lift the ban, but it failed by a vote of 268-160.

Legal Services Corporation
The CJS appropriations bill also contains a provision which prohibits the Legal Services Corporation from using any federal funds to participate in abortion related litigation, except in the cases of rape, incest or life endangerment.

Women in the Military
Attempts in both the House and the Senate to repeal the long-standing ban on privately funded abortion for U.S. servicewomen and dependents at military hospitals overseas failed. Senators Patty Murray (D-WA) and Olympia Snowe (R-ME) were unsuccessful (51-49 on a motion to table their amendment) in their attempt to repeal the ban in the FY 2000 Department of Defense appropriations bill. A similar amendment in the House, offered by Representative Loretta Sanchez (D-CA), lost by a vote of 225-203.

Federal Employees
Once again the Treasury-Postal appropriations bill contains a long-standing ban on Federal Employee Health Benefits Program (FEHB) coverage of abortion services.

Ban on Mifepristone Not Included in Final Agriculture Bill
In June, the House voted in favor (217-214) of an amendment to the Agriculture appropriations bill (which includes the Food and Drug Administration) which would have prohibited the "testing, development or approval" of drugs for the "chemical inducement of abortion." This was clearly aimed at the imminent approval of mifepristone (formerly RU 486). This language, however, was not included in the final appropriations bill, thus clearing the way for final FDA approval of mifepristone sometime in the first quarter of 2000.

Contraceptive Coverage

Contraceptive Coverage for Federal Employees in Treasury Postal Service Appropriations Bill
Congress affirmed its continued support for contraceptive coverage for federal employees, by requiring the federal employee health benefits program (FEHB) to provide contraceptive coverage for the 1.2 million women of reproductive age insured through FEHB. Rep. Nita Lowey (D-NY) was able to keep restrictive language out of the final Treasury-Postal appropriations bill approved by the President. However, conscience clause language restricting federal employee access to contraceptives was included in the unrelated Commerce, Justice and State appropriations bill. See section on "Conscience Clauses" below.

Equity in Prescription Insurance and Contraceptive Coverage Act (EPICC) This bill to improve private insurance coverage of contraceptives and related services was reintroduced this session in both the House and the Senate. Introduced by Harry Reid (D-NV) and Olympia Snowe (R-ME), the bill has 37 co-sponsors in the Senate. In the House, Jim Greenwood (R-PA) and Nita Lowey (D-NY) introduced the bill, which has 123 co-sponsors. Unfortunately, as there was no action on it in 1999, the bill has stalled.

Research

Stem Cell Research Contentious fights over the issue of embryonic stem cells were narrowly avoided in this most recent session of Congress. Since 1995, Congress has banned the use of federal funds for any research in which a human embryo is destroyed or discarded. However, in 1998 the ban was called into question when two privately funded U.S. researchers were able to isolate and cultivate stem cells from early-stage human embryos and cadaveric fetal tissue, thus paving the way for important research in numerous areas. In accordance with a Department of Health and Human Services (DHHS) General Counsel opinion, the National Institutes of Health (NIH) published draft rules, which permit research on embryonic stem cells so long as federal funds are not used in the actual derivation or retrieval of those cells.

There had been speculation that pro-life leaning members of Congress, who continue to claim the existing ban on embryo research extends to stem cell research, would attach language to the appropriations bill that funds NIH, specifically prohibiting federal funding of stem cell research. This didn't happen. Instead, Senator Arlen Specter (R-PA) has been assured by Senate Majority Leader Trent Lott (R-MS) that the issue will be brought up again early in the next session, so that the matter can be decided outside of the context of the appropriations process.

Fetal Tissue Research An amendment related to fetal tissue research was introduced by Sen. Bob Smith (R-NH) as part of the "Partial-Birth Abortion" bill. Alleging the existence of a lucrative trade in illegal fetal body parts, Smith proposed burdensome disclosure and filing requirements for entities involved in the transfer of fetal tissue. Smith's amendment failed by a vote of 46-51. Most Democrats were opposed based on privacy issues surrounding the reporting requirements, not because the underlying assumptions about the transfer of fetal tissue for research were inaccurate and inflammatory.

House Resolution of Alleged Sale of Fetal Tissue In a related move, on November 9, the House approved, by voice vote, a resolution expressing the "sense of the House with respect to private companies involved in the trafficking of baby body parts for profit." Representatives Tom Tancredo (R-CO), Chris Smith (R-NJ) and Joseph Pitts (R-PA) introduced the resolution, which will result in hearings next session. The opposition has succeeded once again in inflaming the abortion debate by conjuring up preposterous images of an illegal trade in "body parts" and implying that such practices are commonplace when, in fact, current law already adequately protects against such practices.

Conscience Clauses

Restrictive Language on FEHB Contraceptive Coverage Although the Treasury-Postal appropriations bill does include contraceptive coverage for federal employees, at the last minute anti-family planning members of Congress were able to insert restrictive language into the unrelated Commerce, Justice and State appropriations bill, which in turn was included in HR 3194, the consolidated appropriations bill. This new legislative language could undermine access to contraceptives by expanding existing federal law to allow not only individuals who "prescribe" but also those who "otherwise provide for" contraceptives to opt out of providing contraceptives based on their "moral convictions." The addition of the clause "otherwise provide for" was intended to allow pharmacists and nurses to refuse to provide contraception without fear of retaliation by employers.

Religious Liberty Protection Act In September, the Senate held its second hearing to consider a bill that had already passed the House, the Religious Liberty Protection Act (RLPA), which provides that federal, state or local governments shall not substantially burden a "person's" religious exercise unless the burden furthers a compelling governmental interest. The bill was strategically written to protect religious objections with a compelling interest test, a high standard which ensures that religious objections to laws that, among others things, protect women's health, would take precedence over women's reproductive rights. The bill also fails to define the term "person" and could conceivably exempt not only individuals but also organizations and corporations. Among other things, members of the pro-choice coalition are concerned that the bill could create a national conscience clause that would: allow individuals and entities to avoid abortion counseling and referral, allow employers and insurers to avoid contraceptive coverage, and allow pharmacies and pharmacists to avoid dispensing contraceptives; inhibit minors' access to confidential reproductive health services; allow teachers to avoid teaching contraception or sexuality education; and allow medical schools and individual providers to refuse to provide abortion and reproductive-health related training to medical students and residents. The Senate is expected to vote on this proposal sometime next session.

Limiting Reproductive Choices

Adoption Bills A number of bills were introduced in the past session in an effort to push women with unintended pregnancies towards adoption and away from abortion. Particularly alarming is a trend towards legislation that would directly deny women facing crisis pregnancies full information about their choices. Abortion opponents have long believed that the best way to promote adoption is to prevent family planning providers from discussing abortion and have repeatedly tried to "gag" Title X providers from discussing a full range of pregnancy options.

To this end, staunchly anti-choice and anti-family planning Represent-atives Jim DeMint (R-SC) and Tom Bliley (R-VA) introduced the Adoption Awareness Act (HR 2511). A companion bill (S. 1382) was introduced in the Senate by Senators Sam Brownback (R-KS) and John McCain (R-AZ). The bill would provide $7 million to national adoption organizations to "train staff of eligible health centers in providing adoption counseling to pregnant women and infertile married couples." Significantly, the bill states that centers eligible to receive training are those that do not perform or make referrals for abortion or provide or make referrals for counseling and present abortion as an option.

The bill also goes on to redefine the non-directive counseling Title X grantees must use to include everything but abortion. The absence of this option is antithetical to the long-standing requirement of the Title X program that women be given information on pregnancy care, pregnancy termination, adoption and referrals for these services. The DeMint language was also incorporated into a broader adoption bill sponsored by Rep Chris Smith (R-NJ). In addition, both the House and Senate introduced bills to allow Title X projects to offer full-blown adoption services.

Women and Children's Resources Act Going one step further than the adoption bills, Rep. Joseph Pitts (R-PA), Rep. Mary Bono (R-CA) and Sen. Rick Santorum (R-PA) introduced the Women and Children's Resources Act. This legislation would authorize $85 million a year in block grants to fund "alternatives to abortion." It is significant to note that under the provisions of the bill, no grant funds would be provided to groups that provide, refer or advocate the use of contraceptives as well as abortions.

Abstinence Only During the final budget negotiations, $20 million was added to the abstinence-only Adolescent Family Life program. Last year this small program was funded at $17.7 million. The program has no proven record of success, particularly if viewed in the context of Title X funding, which has a long history of proven success in preventing unwanted pregnancies.

In addition to the $20 million in funds added to the abstinence-only Adolescent Family Life program in the final appropriations bill, the House found another vehicle for its abstinence-only message. The House Commerce Committee approved, by voice vote, the Breast and Cervical Cancer Treatment Act, which would give states the option of providing Medicaid coverage for women diagnosed with breast or cervical cancer. Rep. Tom Coburn (R-OK) successfully included language aimed at advancing his abstinence-only message that would require condom labels to state that condoms are ineffective against the transmission of the human papilloma virus (HPV) and can cause cervical cancer. Most public health groups oppose the warning labels, fearing they will only have the effect of deterring condom use.

- Kathryn Viguerie

What to Look for Next Congressional Session When the second session of the 106th Congress opens in late January a number of anti-family and anti-choice bills are likely to come up.
  • A House vote on the Partial Birth Abortion bill.
  • A Senate vote on CCPA.
  • A Senate vote on the Unborn Victims of Violence Act.
  • A Senate vote on the Religious Liberty Protection Act.
  • Senate action on embryonic stem cell research.
  • House and Senate action on the Women and Children's Resources Act.
  • House and Senate action on adoption bills.
  • Hearings and possibly a bill on the "sale of fetal tissue."
  • Battles over appropriations bills, including funding levels for international family planning, UNFPA and Title X.
  • Efforts to keep global gag rule language out of the FY 2001 appropriations bill.
In the States

Contraceptive Equity Bills Continue to Gain Momentum in State Legislatures

In the United States almost 50% of pregnancies are unintended. Contraceptive equity legislation could reduce the number of unintended pregnancies and the need for abortion by providing affordable and reliable contraception for women.

Why Does Business Oppose Covering Contraception in Health Plans?

THEY SAY: The role of health insurance is to treat illness and to provide a safety net between health disasters and the poorhouse. Pregnancy is neither an illness nor a disaster.

WE SAY: This is a disingenuous argument. Anyone involved in health care knows that the disease and disaster management model has gone the way of the medicinal leech. Insurers and employers in today's marketplace understand that preventive medicine is good for the bottom line and for customer/employee satisfaction. Today's health plans cover or help subsidize hundreds of preventive services (such as exercise programs and prenatal care) that would have been unthinkable 20 years ago. And besides, while it's true that a wanted pregnancy is a joyous occasion, an unwanted pregnancy can be a major crisis. Bottom line: if "crisis" were truly the criterion, surely erectile dysfunction wouldn't qualify any more than pregnancy; yet health plans nationwide are eagerly agreeing to cover Viagra.

THEY SAY: Many women already pay out-of-pocket for their birth control - why would we voluntarily take on that expense? A change in policy would result in an immediate increase in reimbursement expenses.

WE SAY: Yes, it's likely that if health insurance plans started covering prescription birth control, there would be an immediate increase in claims from women already using it. But, it would probably also result in more women deciding to use more highly-effective and appropriate methods of prescription birth control. The resulting cost savings from even a small number of avoided pregnancies among new users would be more than enough to offset the costs of reimbursing previous users. Research shows that women who report unintended pregnancies tend to have poorer birth outcomes than those who say their pregnancies were planned -more complications and higher incidence of low birth weight babies, for example. Bottom line: helping women plan their pregnancies is not only better for their health and that of their children, it is cost effective.

THEY SAY: The marketplace, not government mandates, should dictate what is covered in insurance plans.

WE SAY: When it comes to such basic necessities as education, public safety and healthcare, government plays an important role in protecting the rights and health of its citizens. Historically, those in the private sector in charge of setting health insurance policy have suffered from a major blind spot: women's health. It wasn't until the 1970s that insurers even covered all costs associated with delivering a baby. The much-vaunted marketplace had nothing to do with changing the laws to require insurers to cover regular mammograms and pap smears, for example. Those changes came about after years of public outcry. Now, the public is telling Congress that prescription contraception should be included in health plans; it is entirely appropriate for Congress to respond with legislation. Bottom line: The marketplace doesn't exist in a vacuum; government should intervene when the public health is at stake.

THEY SAY: Small business can't afford to cover any more services. This mandate could mean that some business will simply stop providing health coverage.

WE SAY: Why doesn't this concern ever come up when the $10-per-pill Viagra prescription is considered? Not only does this reluctance reveal the sexism underlying our health policy; it is the epitome of penny-wise, pound-foolish thinking. An Alan Guttmacher Institute study found that the average total cost of adding coverage for the full range of reversible prescription contraceptives is laughably small - $1.43 per employee per month. Bottom line: Basic common sense will tell you that helping female employees avoid accidental pregnancies will save far more money than skimping on prescription contraception coverage.

Why Does the Religious Right Oppose Coverage?

THEY SAY: ". . . birth control pills and 'emergency contraception' kill babies in the womb. For years, there has been a conspiracy of silence surrounding the true nature of how contraceptives work," said American Life League President Judie Brown.
(From the American Life League website)
". . . contraceptives themselves are homicidal drugs and devices. They are more widely lethal than the commonly known surgical forms of killing unborn children . . . " , says Father John A. Hardon, S.J., promoting the book, "Infant Homicides through Contraceptives" by Dr. Bogomir M. Kuhar.

WE SAY: Birth control pills, emergency contraception regimens and IUDs are not methods of abortion. They stop conception before it occurs. Ask any medical professional, look in any medical manual and you will see that the medical community defines conception as starting after a fertilized egg has implanted in the uterine lining - not before. Low-dose pills, the IUD and emergency contraception all work by either stopping the egg from being fertilized or preventing a fertilized egg from implanting in the womb. Bottom line: the opponents of legal birth control and abortion are more than willing to ignore medical fact in the service of imposing their religious views on the rest of us.

THEY SAY: Pregnancy is a naturally occurring event, it doesn't need to be "cured."

WE SAY: Yes, pregnancy is a naturally occurring event, and so are diseases. No one would ever use such a rationale to deny coverage for a rubella vaccine, for example. Bottom line: Those who care about stable families and healthy children should be doing all they can to support women trying to plan their pregnancies.

WHAT THEY DON'T SAY: Birth control (and abortion) make it easier for women to venture outside the home, pursue an education and realize career aspirations. The Religious Right's opposition to contraception (and abortion) springs not from a concern about anyone's health but from a deep fear of women's autonomy.

-Susanne Frank

Contraceptive Equity Bills Passed*

State Year Passed Effective Date Religious Exemption
California 1999 1/1/00 Yes
Connecticut 1999 10/1/99 Yes
Georgia 1999 7/1/99 No
Hawaii 1999 1/1/00 Yes
Maine 1999 3/1/00 Yes
Maryland 1998 10/1/98 Yes
Nevada 1999 10/1/99 Yes
New Hampshire 1999 1/1/00 No
North Carolina 1999 1/1/00 Yes
Vermont 1999 7/1/99 No

*Women who are covered under "pill bills" can get payment from their health insurance for the costs of contraceptive prescriptions and services to the same extent that other prescriptions and services are covered.

On the Docket

Off to the Supreme Court Nebraska's Abortion Ban on High Court Docket

In what will probably be the most important judicial decision to affect abortion rights since 1992's Planned Parenthood v. Casey, which reaffirmed women's core right to an abortion, the U.S. Supreme Court announced on January 14 that it will review the constitutionality of Nebraska's "partial-birth abortion" law.

Last September, the U.S. Court of Appeals for the Eighth Circuit struck down Nebraska's abortion statute, along with similar bans in Iowa and Arkansas. In a unanimous decision, the panel of judges determined the broadly worded statute could prohibit some of the safest and most common abortion procedures used today. A conflicting decision one month later by the 7th Circuit to uphold similarly worded "partial-birth abortion" bans in Wisconsin and Illinois prompted the High Court's decision to review Nebraska's abortion case this term.

"We at the Center for Reproductive Rights, and no doubt all pro-choice advocates, are cautiously heartened by the Supreme Court's decision," says President Janet Benshoof. "Given the split in the Seventh and Eighth circuit courts, a High Court remedy is needed to clarify the extent to which states can stop abortions."

That threat is very real. Since 1995, "partial-birth abortion" laws have been passed in 30 states by anti-choice legislators who deceptively tout them as a ban on a type of late-term abortion. However, the statutes have been blocked or severely limited in 20 of the 21 challenges to date by judges who recognize this as a back door attempt to outlaw all abortions.

In its response to Nebraska's petition to the Supreme Court, the Center for Reproductive Rights urged the Court to take the case in order to reaffirm the abortion rights established in the landmark 1973 Supreme Court decision Roe v. Wade.

"This is NOT a case about the issue of abortions late in pregnancy," says Benshoof. "It is a case in which the outcome will either affirm or deny the right of half the country's population to keep legislators, religious groups and those who think they 'know better' out of women's private, medical decisions. We hope the result will be an affirmation of what was recognized and respected 27 years ago - the ability, and therefore the right, of a woman to choose."

Texas TRAP (Targeted Reg-ulation of Abortion Providers)

Current Status: On December 29, 1999, U.S. District Court Judge John Rainey blocked Texas's new licensing regulations for private physicians who perform abortions. After a two-day hearing, Judge Rainey determined the regulations violated the providers' right to equal protection and that certain provisions were unconstitutionally vague.

This ruling prevents the state from implementing the 1999 amendments to Texas' licensing law, signed by Governor George W. Bush, which require private physicians who perform 300 or more abortions in a 12-month period to become licensed as abortion clinics. The Attorney General of Texas has appealed the decision.

Background: In October, 1999, the Center for Reproductive Rights challenged the entire Texas regulatory scheme, claiming it is unconstitutional and irrational. The Center for Reproductive Rights charges that the purpose of the regulations is not to make abortion safer but to burden women's ability to obtain a constitutionally protected medical procedure. Despite the fact that abortion is neither more risky nor more complex than other outpatient procedures, physicians who perform abortions will be subject to regulations in addition to the stringent regulations already required by the state.

Prior to the passage of the 1999 amendments to the regulations, private physicians were exempt if abortion patients did not account for 51 percent or more of their clients. The amendments also increased the criminal and civil liability for unlicensed clinics and introduced the possibility of jail time for physicians.

Janet Crepps and Linda Rosenthal of the Center for Reproductive Rights represent the plaintiffs in Women's Medical Center of NW Houston et al. v. Archer et al. (S.D. Tex. H 99-3639), along with cooperating counsel Craig Smyser and Asim Bhansali of the Houston firm Smyser, Kaplan, & Veselka.

- Margie Kelly

Clarification: The December 1999 RFN reported that Louisiana denied and abortion to a woman it decided had a 50% chance of dying from her pregnancy. More precisely, Louisiana denied and abortion to a woman it decided did not have a greater than 50% chance of dying from continuation of her pregnancy.


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