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Study: Nearly Half of Texas’ Legal Abortion Providers Have Closed Post-HB 2

RH Reality Check - Wed, 07/23/2014 - 11:24

Forty-six percent of Texas’ legal abortion providers have closed since May 2013, according to a new study led by university researchers in Texas, California, and Alabama, that evaluates the impact of HB 2, the omnibus anti-abortion law passed by Texas lawmakers in July 2013.

Researchers estimate that while the number of unintended pregnancies has likely increased in Texas, the number of legal abortions in the state decreased by 13 percent—and the number of medication abortions decreased by 70 percent—between the six-month period before the passage of HB 2 and the six-month period after the passage of HB 2 and the implementation of three of its four provisions: those that restrict the prescription of medication abortions, require abortion-providing doctors to have hospital admitting privileges, and ban abortion after 20 weeks.

Researchers also estimate that the number of Texans living hundreds of miles from legal abortion facilities has increased by tens of thousands, from 10,000 living more than 200 miles from a clinic in May 2013 to 290,000 by April 2014.

According to the study (abstract available here), the provision of HB 2 that requires abortion-providing doctors to have hospital admitting privileges “was almost certainly the main driver of the large number of clinic closures observed in the months preceding and following its implementation.” At that point, “vast swaths of the state were left without a provider, and the number of women required to travel great distances to reach a provider increased dramatically.”

The corresponding decrease in the overall abortion rate “may have been muted by a potential increased demand for abortion following the severe reduction in public funding for family planning in Texas in 2011.”

The study, to be published in the medical journal Contraception, is the first academic evaluation of the impact of HB 2 to be released since the law passed last year. Researchers at the Texas Policy Evaluation Project, Ibis Reproductive Health, the Bixby Center for Global Reproductive Health, the University of Alabama School of Public Health, and the Population Research Center and Department of Sociology at the University of Texas focused on three six-month periods: November 2012 through April 2013, before legislators filed HB 2; May 2013 through October 2013, during public debate and passage of HB 2 but before it went into effect; and November 2013 through April 2014, when three of HB 2′s four provisions went into effect.

Researchers drew their conclusions from data provided by 36 of the 41 abortion providers that were open in Texas in November 2012, including all six of Texas’ abortion-providing ambulatory surgical centers, along with demographic data from the U.S. Census Bureau.

“Our findings suggest that most women desiring an abortion—but not all—overcame the barriers of distance and additional cost to obtain the service they needed,” wrote the researchers. “In addition, the public opposition to HB2 galvanized a coordinated response among activists who provided financial and logistical support to women seeking abortions.”

Throughout all three research periods, researchers found that less than a quarter of legal abortions in Texas were performed at the state’s ambulatory surgical centers, which will be the only remaining facilities licensed to practice legal abortion care after September 1, when the fourth provision of HB 2 goes into effect. At that time, according to the study, “it seems highly unlikely that existing facilities could expand their capacity four-fold to meet the demand for services.”

Image: Closed sign via Shutterstock

The post Study: Nearly Half of Texas’ Legal Abortion Providers Have Closed Post-HB 2 appeared first on RH Reality Check.

Stop Calling U.S. Christian Lawmakers the ‘Taliban’

RH Reality Check - Wed, 07/23/2014 - 11:17

I saw it on posters last summer at the Texas capitol, during protests against the state’s omnibus anti-abortion law: “TEXAS TALIBAN.” I’ve heard pundits and preachers on cable news, decrying the “American Taliban” that wants to take away birth control and abortion access.

These phrases aren’t clever, and they aren’t insightful. They’re racist, and they’re Islamophobic, and people—especially white people—who work in social justice movements and who do advocacy for women’s rights need to stop using them yesterday.

Because there is indeed a powerful, well-funded and rigidly patriarchal religious movement behind America’s most misogynist laws, and it isn’t any iteration of Islam.

It’s Christianity.

There’s no need to try and incite fear that right-wing lawmakers are going to turn America into an extremist Islamic theocracy when they’re doing just fine turning it into an extremist Christian theocracy. The answer to countering right-wing attacks on Americans with uteri isn’t to create a turban-wearing bogeyman looming half a world away, but to look at what’s happening right here in our own country, in our own statehouses, at our own national capitol.

I seem to remember someone once saying something about removing the plank from your own eye before trying to pluck a splinter out of someone else’s.

I’ve followed the “Holly Hobby Lobby” meme with eyes rolling hard, as lefty Americans work themselves into a froth about a young white American woman holding a rifle and a bible. But what’s scary about that photo isn’t that the woman pictured is echoing the posture of an Islamic extremist, it’s that she’s using a rifle and a bible to advocate for government-sanctioned misogyny. American government-sanctioned misogyny.

The five judges who joined the majority opinion on Hobby Lobby aren’t Muslim. They’re Catholic. So are Rick Santorum and House Speaker John Boehner (R-OH). Rep. Louie “Terror Babies” Gohmert (R-TX) is a Southern Baptist, and so is Sen. Ted Cruz (R-TX). Texas Gov. Rick Perry (R) attends an evangelical megachurch, and Minnesota Rep. Michelle Bachmann (R) is also an evangelical Christian. Oklahoma Gov. Mary Fallin (R) is a member of the Church of God. Sen. Rand Paul (R-KY) is a Presbyterian.

The call is coming from inside the house, y’all.

We need to ask ourselves: What’s wrong with our own American Christianity that we are unable to face the very real fact that we are perfectly capable of using our own Christian traditions to oppress the most vulnerable among us?

There have been a grand total of two Muslim Americans elected to the United States Congress—the first in 2007. Islam, and its many variants, are not a threat to the U.S. legislative system. American lawmakers didn’t learn misogyny from Muslim extremists in Afghanistan—we grew it ourselves, right here on American soil. We’ve baked it into every slice of the American pie.

To fixate on an “American Taliban” is to derail an important and necessary conversation about the ways Christianity has been used, and continues to be used, as an excuse and a means to oppress and marginalize American citizens, right here on our own turf.

A Texas protester holds “Stop Texas Taliban” sign at a Planned Parenthood rally in Austin, Texas, in March 2012. [via Jessica Luther]

The reality is that words mean things—if that sounds pedantic and obvious, consider the fact that people who don’t agree with me are going to claim I’m getting all riled up about something that’s no big deal, while they fight tooth and nail to say these things without being criticized.

Words express shared cultural ideas, and to pretend that “American Taliban” or “Texas Taliban” are just cute accidents of speech, or innocent verbal shorthand, is to ignore the very real history of organized, politically endorsed, and perpetuated systemic racism expressly meant to oppress and silence a particular group of non-white folks, both inside and outside the United States.

It’s no accident that, in the vast and varied religio-cultural landscape of planet Earth, which offers no shortage of examples of misogynist ideologies, Americans choose “Taliban” when they want to try and insult right-wing lawmakers, and try to incite their fellow citizens to action against those lawmakers. Because 9/11. Because the war in Iraq. Because racism. Because brown people from the Middle East are, more than any other people, the “baddies” right now in American culture.

The result? Widespread American Islamophobia, a fear of the millions of Muslims who call this country home. Anti-Muslim violence in America is a very real problem, as the Los Angeles Times reported way back in 2010:

Law enforcement authorities in California classified the vandalism at the Madera Islamic Center in the Central Valley that nearly smashed a window as a hate crime when they discovered signs that read “Wake up America the enemy is here” and “No temple for the god of terrorism.” In New York, an intoxicated man forced his way into a mosque in Queens and urinated on several prayer rugs. Michael Enright, a 21-year-old New York film student, is being charged with attempted murder in connection with the stabbing of a Muslim cab driver. The act has been classified as a hate crime.

Maybe you’re not the kind of American who’s going to plant a pipe bomb at a mosque, but when you try and foment fear by hollering “AMERICAN TALIBAN!” at the top of your lungs, you give those who might an awful lot of culturally sanctioned leeway to try.

Muslim Americans, and people who are perceived to be Muslim Americans, are singled out at airport checkpoints and targeted in domestic spying operations. Women who wear hijab in public are ridiculed and harassed. And every cry of “Texas Taliban!” or “American Taliban!” makes it worse, because we do not have, and have never had, a nuanced, thoughtful national conversation about Islam—in part because we usually stop with “Taliban!” and a pat on the back.

Last year, right here in supposedly hyper-liberal Austin, Texas, a Muslim woman named Beeta Baghoolizadeh joined the thousands of Texans who descended upon our state capitol to show support for abortion rights. On her first trip, she accidentally wore blue:

Lest anyone assumed that I was another anti-choice activist—and a Muslim one no less—I quickly created a sign reading “PRETEND I’M WEARING ORANGE.” I wanted to make sure people didn’t conflate my blue outfit with Christian-centric religious arguments. I didn’t need any #creepingsharia tweets with my picture on them.

Later, Baghoolizadeh wrote of another trip to the capitol, wearing an orange scarf, and seeing protesters holding signs “about the Sharia and Taliban taking over Texas.” Afterward, she saw a disturbing image:

It was a picture of woman dressed in a black burqa with a “Miss Texas” sash around her inside the Capitol. It felt like a slap across the face. I had gone to the Capitol wearing an orange scarf–not a black burqa–and was forced to deal with a more intense fast than usual because of my decision to stand for women’s rights, health and engage in the democratic process. In return, I was met with a caricature of a “Muslim woman” to protest the GOP’s [non-Muslim] oppression.

No matter how orange my scarf was that night, people had managed to conflate the politics of the swaying, praying Christian right with “oppressed” Muslim women swathed in black. Suffice to say, this shallow, knee-jerk polemic both disappointed and infuriated me. Indeed, this atrocious bill has given birth to (no pun intended) a number of facile and unfortunate proclamations about the Muslim world.

A pro-choice protester at the Texas state capitol dresses in a burka on July 12, 2013, the day lawmakers voted to pass HB 2. [via Students4LifeHQ on Twitter]

We—liberals, progressives, Democrats, social justice activists—cannot believe in systemic oppression only when it suits us, and only when it is perpetuated against the “right” kind of people. We cannot say we are invested in a “big tent,” and then put up a velvet rope, woven of ignorance and fear, at the door.

I mean, we can technically do those things—but only if we’re unwilling to confront the fact that in doing so we are charging admission for our allyship, telling people that they need to be the right color, the right religion, the right sex, the right gender in order to receive our support.

I also see another side to the “American Taliban” rhetoric, one that’s not just racist and Islamophobic but misogynist, one that is about a certain kind of fetishization of the oppression of women of color, about the kind of subconscious work a phrase like “American Taliban” or “Texas Taliban” does for white people: it titillates us, allowing us to imagine ourselves as beneficent saviors of brown-skinned damsels in distress. In the popular American cultural conscience, women of color are particularly situated as sexual objects according to particular racist stereotypes about what it means to be not-white and also a woman—seductive or submissive, aggressive or unrapeable. On the surface, “American Taliban!” centers an imagined male figure, but the reason why the “Taliban!” as a linguistic trope is supposed to incite such fear in the first place is because that imagined male figure is abusing, oppressing, silencing a woman—not just any woman, but a woman of color. A woman who, by virtue of the way she is embodied in the world, we expect to be oppressed, abused, silenced.

We can imagine that woman being oppressed in the way we expect her to be oppressed, and imagine ourselves—Americans wielding lipstick and high heels—as liberators. As if beauty products and fashionable shoes were unknown to Muslim women, and as if wearing lipstick got us government-mandated parental leave, and high heels have earned American women equal pay for equal work.

When a white person cries “Texas Taliban!” or “American Taliban!” what they’re saying is “I thought only brown people deserved to be oppressed.” They’re saying, “My whiteness was supposed to insulate me from things like this.” They’re saying, “I’m afraid—for my privilege.”

But patriarchy and misogyny pay no heed to national borders, and are not uniquely suited to certain geographical climes. They thrive everywhere—including in America, and including in our churches.

And yes, I know, not all Christians. Are there compassionate, loving Christians out there who are deeply invested in committing radical acts of social justice? Absolutely—for reference, see North Carolina’s Moral Monday protests. Are there reasonable Christians out there who believe in science and medicine? Definitely. Are there Christians out there who just like to go to church and do the Jesus thing and have a nice time in fellowship? Indeed; I just described about 99 percent of my relatives.

You might be one or all of these kinds of Christians. If you are, I’m not talking about you. Keep doing that good work you’re doing.

People know what they’re doing when they say “Texas Taliban” or “American Taliban.” Everybody else does, too. That’s why they say it in the first place: They want to make clear that when American lawmakers are bad, they’re imitating brown men on the other side of the world, where the “real” oppression happens. The word “Taliban” conjures up images of brown men wearing turbans, and brown women wearing burkas. Nevermind the fact that white, male Americans are doing just fine at oppressing women with bibles at their right hand. Using “Taliban” rhetoric to describe American politics is a salve that serves only to soothe Americans into dangerous complacency.

If you get to the end of this piece and you’re raring for a fight so that you can continue to holler “Taliban!” every time a white Christian man rails against birth control, I want you to ask yourself: Why am I so invested in being able to continue using this word? Like, really sit with that. If you could never say “American Taliban” or “Texas Taliban” ever again, how would you be unable to do good social justice activism? How would never saying those phrases again impede your ability to help Americans access legal abortion care? Will equal pay, or mandated family leave, become a reality only on the condition that you get to keep saying “Taliban”?

Or will you be able to drop an ignorant, racist dogwhistle that helps no one, hurts many, and does nothing to stop or silence the American Christians behind our country’s worst laws?

Image: Religious freedom via Shutterstock

The post Stop Calling U.S. Christian Lawmakers the ‘Taliban’ appeared first on RH Reality Check.

This study confirms what we already knew: anti-choice, sex-selective abortion ba...

NARAL Pro-Choice America - Wed, 07/23/2014 - 10:00
This study confirms what we already knew: anti-choice, sex-selective abortion bans are based in racist myths.

Study Debunks Myths Surrounding Sex-Selective Abortion Bans - NBC News
A new study, “Replacing Myths with Facts: Sex-Selective Abortion Laws in the United States,” debunks the myth that Asian cultural preferences for sons contri...

WHO: Men Who Have Sex With Men Should Consider Pre-Exposure Prophylaxis

RH Reality Check - Wed, 07/23/2014 - 09:48

Last week, the World Health Organization took a seemingly bold step by suggesting that all men who have sex with men should consider Pre-Exposure Prophylaxis (PrEP) as a means of preventing HIV. Headlines appeared almost instantly questioning why the organization would want all gay men to be on PrEP when not all men who have sex with men are at risk of HIV. The organization quickly clarified that this was not the intent of its announcement. Instead, the group wants all men who have sex with men to work with their health-care providers to assess their personal risk and determine whether this option is right for them.

This clarification brings the World Health Organization (WHO) guidelines in line with those released by the Centers for Disease Control and Prevention (CDC) in May. While not nearly as provocative as initial reports suggested, the release of these guidelines indicates growing support for PrEP and a new global focus on groups that remain disproportionally affected by the HIV epidemic.

PrEP is a combination of two anti-retroviral drugs—tenofovir and emtricitabine—used to treat individuals who have HIV. When used daily in HIV-negative individuals these drugs have been shown to prevent transmission of the virus.

In the United States, PrEP is given using one pill that contains both medications, sold under the brand name Truvada. Truvada was approved by the Food and Drug Administration for prevention purposes in 2011. Studies have found that it is very effective. One study of men who have sex with men, for example, found that those who were given PrEP were 44 percent less likely to contract HIV than those who weren’t. More importantly, those who remembered to take their medication every day or almost every day saw a reduction in risk of 73 percent or more (some up to 92 percent). Studies of HIV-discordant, heterosexual couples (couples in which one partner has HIV and the other does not) found that PrEP reduced the risk of the uninfected partner becoming infected by 75 percent, or as much of 90 percent among those who took the pill every day or almost every day.

There has been mixed reaction about PrEP among public health professionals since the drug was introduced. Many are excited about this new addition to the HIV-prevention arsenal, which has been the relying on risk-reduction and condoms for too long. Some, however, worry that it is too expensive; in the United States it costs upwards of $10,000 a year. Others say that it is hard enough to get people who have HIV to stick to a daily drug regimen and suggest that it’s unreasonable to expect compliance from healthy individuals. The most heated debate, however, is about whether taking PrEP will give individuals an excuse to stop using condoms and taking other precautions (such as limiting the number of partners they have) and will ultimately drive the rate of other sexually transmitted diseases up.

In May, PrEP got a big endorsement from the CDC, which released guidelines suggesting that HIV-negative individuals who are at “substantial risk for HIV infection” consider taking the drug. The agency defined those at substantial risk as: anyone in an ongoing relationship with an HIV-infected partner; gay or bisexual men who are not in a mutually monogamous relationship with an HIV-negative partner and who have had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months; heterosexual men or women who are not in a mutually monogamous relationship with an HIV-negative partner and do not regularly use condoms when having sex with partners known to be at risk for HIV (such as injecting drug users or bisexual male partners of unknown HIV status); or anyone who has injected illicit drugs and shared equipment or been in a treatment program for injection drug use within the last six months.

The CDC emphasizes that PrEP is not for everyone and that those who choose to use it have to commit to taking the pill every day (at least for the period of time in which they are at risk) and must be monitored by a health-care provider and tested for HIV every three months. It also stresses that PrEP should be used alongside other prevention methods such as partner reduction, selecting low-risk partners, and using condoms.

Though the WHO’s guidelines sound broader than the CDCs, the intent is similar. Rachel Baggaley, an official with the group’s HIV department, told NPR:

We’re not suggesting that PrEP will be an appropriate choice for all men who have sex with men. It may be something that some people will want to use for a short period of their life. Or it may be appropriate for use in the long term. It will be something that they will come to a decision on with their health care provider.

The emphasis on men who have sex with men is new for the WHO but comes as the organization sees the epidemic changing in many places around the world. Baggaley explained, “In countries like Ghana, or Kenya or Nigeria, where it was once generalized, now more than 30 percent of new infections are among these key vulnerable populations.” She added that men who have sex with men are usually not targeted by existing intervention strategies and often face discrimination, stigmatization, and abuse.

In a press release, the WHO noted that rates of HIV infection among men who have sex with men remain high almost everywhere, and new prevention options are urgently needed. The organization estimates that PrEP use among men who have sex with men over a ten-year period could reduce HIV transmission by 20 to 25 percent—representing a million new infections—worldwide. In order for this to happen, however, men who have sex with men need access to PrEP. For this reason, the WHO guidelines also say that countries need to remove the legal and social barriers that prevent many people from accessing these services.

Image: Shutterstock

The post WHO: Men Who Have Sex With Men Should Consider Pre-Exposure Prophylaxis appeared first on RH Reality Check.

Colorado Activists Rally Against Personhood USA-Backed Ballot Measure

RH Reality Check - Wed, 07/23/2014 - 08:27

Abortion rights organizations in Colorado launched a campaign Tuesday opposing a proposed constitutional amendment on the November ballot that would add “unborn human beings” to the state’s criminal code.

Speakers at a rally on the west steps of the state capitol warned that the initiative, called Amendment 67, would go much further than allowing prosecutors, for example, to file murder charges against a drunk driver who hits a pregnant woman and terminates her pregnancy without killing her.

Instead, the “deceptive measure” is “truly an attack on family planning and women’s health,” Vicki Cowart, president of Planned Parenthood of the Rocky Mountains, told the crowd. With “unborn human beings” left undefined, the measure would lead to a ban on all abortion, even in cases of rape or incest, and restrict access to birth control, she said.

“Amendment 67 would do exactly the opposite of protecting women and their babies from drunk drivers,” Cowart said.

“Amendment 67 would eliminate a woman’s right to make personal and private decisions about her health,” said Cristina Aguilar, interim executive director of the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), who delivered her speech in both Spanish and English. “For a woman who has suffered a miscarriage, this allows the government to investigate.”

“Amendment 67 is, put simply, bad medicine for women and for Colorado,” Dr. Ruben Alvero, professor of obstetrics and gynecology at the University of Colorado, told the crowd. “We want to protect pregnant women from harm, but Amendment 67 is not the way.”

Before being shuffled off by police to a public sidewalk near the “Vote No 67” rally, backers of Amendment 67 said the warnings about far-reaching impacts of their measure were unfounded.

Similar “fetal homicide” laws in other states have “never led to an abortion ban,” Personhood USA spokesperson Keith Mason told RH Reality Check. Personhood USA supports Amendment 67.

“Who looks at Brady and says he wasn’t a person?” asks Mason, referring to a fetus killed by a drunk driver who slammed into Heather Surovik two years ago. A photo of Brady is on the campaign materials of backers of Amendment 67, which they refer to as the Brady Amendment.

Colorado law allows abortion throughout pregnancy, and a fetus doesn’t receive legal protection under state law prior to birth. A 2013 Colorado law, passed after Surovik’s tragic loss of her pregnancy, allows prosecutors to file charges if a pregnancy is terminated due to reckless acts of violence, but murder charges cannot be brought because the fetus is not considered a person under state law.

“Amendment 67 is just about protecting babies like my son Brady,” said Surovik, who wants murder charges to be filed in cases like hers.

Asked whether the passage of Amendment 67 could lead to government investigations of miscarriages, Surovik said, “My intent is that babies are protected.”

November will be the third time Colorado citizens vote on “personhood” amendments, which were defeated overwhelmingly by voters in 2008 and 2010. Activists fell just short of gathering enough signatures to place a “personhood” amendment on the ballot in 2012.

The 2010 “personhood” measure, like the similarly worded 2008 proposed amendment, would have defined a “person” in the Colorado Constitution as “every human being from the beginning of the biological development of that human being.”

This year’s ballot question asks if voters want to protect “pregnant women and unborn children by defining ‘person’ and ‘child’ in the Colorado criminal code and the Colorado wrongful death act to include unborn human beings.”

The presence of Amendment 67 on November’s ballot could intensify the election-year debate about abortion and contraception issues.

Already, Sen. Mark Udall has been pounding his opponent, Rep. Cory Gardner, for his previous support of a personhood ballot initiative and for his ongoing co-sponsorship of a federal “personhood” bill.

ProgressNow Colorado Director Amy Runyon-Harms sent an email to Gardner Tuesday, asking him, in light of his decision this year to un-endorse state personhood amendments, to attend the Vote No 67 rally.

You may have read that the NO on Amendment 67 campaign is kicking off their opposition to this year’s Personhood abortion ban amendment with a rally at the Capitol today. Can I tell them you’ll be joining us?

Runyon-Harms told RH Reality Check she did not hear back from Gardner, who’s run TV advertisements emphasizing that he’s withdrawn his previous support for “personhood” bans.

In fact, Gardner has not withdrawn his support for the federal “personhood” bill. To do so, Gardner would have to make a brief speech from the floor of the U.S. House of Representatives.

This month, Gardner’s spokesperson stated, erroneously, that the federal “personhood” legislation, co-sponsored by Gardner, “simply states that life begins at conception” and does not aim to confer legal protections on fertilized human eggs.

Image: Jason Salzman

The post Colorado Activists Rally Against Personhood USA-Backed Ballot Measure appeared first on RH Reality Check.

Anti-choice activists in Colorado are trying for a third time to restrict reprod...

NARAL Pro-Choice America - Tue, 07/22/2014 - 19:00
Anti-choice activists in Colorado are trying for a third time to restrict reproductive rights through a ballot measure. The NARAL Pro-Choice Colorado team and their allies organized a fantastic rally to stop them!

Voters, take note: All but 10 of the representatives co-sponsoring a “personhood...

NARAL Pro-Choice America - Tue, 07/22/2014 - 19:00
Voters, take note: All but 10 of the representatives co-sponsoring a “personhood” bill in the U.S. House are running for reelection or campaigning for a seat in the Senate.

Are Voters Concerned About a Bill That Could Outlaw Abortion and IVF?
An astonishing number of politicians supported it.

Massachusetts' Safe Access Bill proposed will help protect reproductive health c...

NARAL Pro-Choice America - Tue, 07/22/2014 - 18:00
Massachusetts' Safe Access Bill proposed will help protect reproductive health clinics and make them a comfortable, safe environment for women. Contact your state representative and ask them to make sure the bill passes tomorrow!

NARAL Pro-Choice America's Choice Action Network : Contact Your Representative about the Public...
Join us to send a powerful message that Massachusetts will continue to lead in expanding access to reproductive healthcare. Click here to be a part of the Virtual Rally!

Federal Appeals Courts Split on Obamacare Subsidies. Now What?

RH Reality Check - Tue, 07/22/2014 - 16:28

Within minutes of each other Tuesday, two separate federal appeals courts handed down conflicting rulings as to whether or not the text of the Affordable Care Act (ACA) allows the federal government to subsidize insurance premiums in its federally run exchanges.

First came the decision from a divided three-judge panel of the D.C. Circuit Court of Appeals, which ruled in Halbig v. Burwell that federally run health insurance exchanges cannot provide subsidies for residents of the more than 30 states that participate in the federal exchanges.

Then a panel of judges for the U.S. Court of Appeals for the Fourth Circuit unanimously ruled the opposite, in King v. Burwell, finding that the text of the ACA does not prevent the administration from providing subsidies in those markets where states have refused to set up their own exchanges.

The decisions, and their differing results, encapsulate the political-turned-legal fight over one of the Obama administration’s most significant policy achievements.

The conservative case against subsidies in the federal health-care exchanges started in 2012, when the Cato Institute’s Michael Cannon and law professor Jonathan Adler wrote a paper setting out the argument adopted by those challenging the subsidies, including one self-described “Republican operative” at the front of the D.C. Circuit case. They claim that the statutory language of the ACA only allows states, and not the federal government, to subsidize health-care payments. According to the challengers, the actual text of the law says that the sliding-scale tax credits that millions of Americans currently receive are available only for coverage purchased “through an exchange established by the state,” and since only 16 states have established insurance exchanges so far, only residents in those states can qualify for subsidized coverage.

The challengers’ argument is compelling in its simplicity—after all, the statute doesn’t say “through an exchange established by the state and federal government.” But accepting that argument means ignoring the entire context and purpose of the ACA, including all the ways in which the federal government is required to step in when states fail to do so, including when states throw political temper tantrums and refuse to participate in health-care reform. This is the point made by Judge Harry T. Edwards in his dissent in Halbig. “This case is about Appellants’ not-so-veiled attempt to gut the Patient Protection and Affordable Care Act,” wrote Edwards.

The decision, Edwards notes, is effectively a “poison pill to the insurance markets in the States that did not elect to create their own Exchanges. This surely is not what Congress intended.”

He continues:

This [plaintiffs'] claim is nonsense, made up out of whole cloth. There is no credible evidence in the record that Congress intended to condition subsidies on whether a State, as opposed to HHS, established the Exchange. Nor is there credible evidence that any State even considered the possibility that its taxpayers would be denied subsidies if the State opted to allow HHS to establish an Exchange on its behalf.

But denying subsidies to taxpayers who are otherwise entitled to them because of a typo or a hyper-constrained reading of the statute is exactly the case conservatives are making in these challenges, and it’s a case two Republican appointees were more than willing to advance. “We conclude that appellants have the better argument: a federal Exchange is not an ‘Exchange established by the State’ and section 36B does not authorize the IRS to provide tax credits for insurance purchased on the federal Exchanges,” the majority in Halbig wrote.

“No one—not the people who wrote the law in Congress, not those who implemented the law in the states—understood this law to work the way that two judges of the D.C. Circuit today said it does,” Elizabeth Wydra, chief counsel at the Constitutional Accountability Center, said in a statement in reaction to the Halbig ruling. The Constitutional Accountability Center wrote the legal brief on behalf of Senate Majority Leader Harry Reid, House Democratic Leader Nancy Pelosi, and every major committee chair involved in writing the ACA, as well as state officials from across the country.

So far about 5.4 million people have signed up for health insurance through a federal exchange, and about 87 percent of those consumers received subsidies in the form of sliding-scale tax credits to make that coverage affordable. This savings is critically important in states where mostly Republican lawmakers are politically opposed to the ACA and have refused to establish their own exchanges and expand Medicaid to increase insurance coverage and affordability. For example, as reported by the Washington Post, an individual in Wyoming who buys a mid-grade plan on the federal marketplaces is receiving a subsidy of around $444 per month, which cuts their monthly premium cost to a much more affordable $99 per month. So there’s a lot on the line in these cases, beyond just arguing over the semantics of where the bureaucratic burdens of health-care reform may lie. Real lives are at stake.

Thankfully, the immediate impact of Tuesday’s conflicting rulings will be mostly show among pundits and political organizations. Nobody will immediately lose their subsidies, nor is the ACA immediately gutted. And even though there is a momentary disagreement among the federal courts on the legality of the subsidies, that doesn’t necessarily mean the Roberts Court will immediately jump in to resolve it. The Obama administration has said it plans to ask for a full-panel review of the D.C. Circuit panel opinion, a process that could take months and which helps keep the case away from the Supreme Court for the time being.

The full D.C. Circuit Court of Appeals now comprises mostly Democratic appointees; while that doesn’t guarantee a ruling in the administration’s favor, it doesn’t hurt its chances either. Should the full D.C. Circuit Court of Appeals rule in favor of the administration, that could mean, at this point at least, that there’s no longer any disagreement in the federal courts as to whether or not insurance purchased via a federal exchange qualifies for subsidies. Without that kind of split in the federal courts, the Supreme Court may not have any means to get involved in the case, which is good news, since the Roberts Court is not known to respect precedent, especially if there’s a good political reason not to.

In the meantime, federal courts in both Indiana and Oklahoma have similar legal challenges pending, which means that like the legal challenges to the contraception coverage requirement that persist despite the Hobby Lobby ruling, we’re as far away from resolving the legal challenges to the various provisions of the Affordable Care Act as we are from resolving the political ones.

Image: Shutterstock

The post Federal Appeals Courts Split on Obamacare Subsidies. Now What? appeared first on RH Reality Check.

Equal Pay Day for African-American Women, By the Numbers

RH Reality Check - Tue, 07/22/2014 - 16:18

This year, April 9 was known as Equal Pay Day, representing the extra three months and change that the average woman has to work in 2014 if she wants to earn what the average man already earned by the end of 2013. But as an analysis released Monday by the National Women’s Law Center (NWLC) points out, the wait is longer for Black women: Equal Pay Day for African-American women was July 16, and Equal Pay Day for Latinas won’t come until November.

African-American women only earn 64 cents to every dollar earned by non-Hispanic white men, according to the NWLC analysis; the figure for women overall is 77 cents. That’s based on the average earnings of female and male full-time, year-round workers taken from Census data.

The pay gap for Black women varies based on age and industry. Older Black women have it the hardest—the pay gap is only 82 cents on the dollar for 15-year-old to 24-year-old Black women compared to white men, but the gap widens to 67 cents and 59 cents, respectively, for Black women ages 25-to-44 and 45-to-64.

As for industries, Black women working as physicians and surgeons—a high-wage and male-dominated occupation—make only 52 cents for every dollar paid to their white male counterparts. Black women fared slightly better in lower-paid occupations, making 86 cents on the dollar in male-dominated, mid-wage construction industries and 85 cents on the dollar working as low-wage, mostly female personal care aides.

The fact that Black women are overrepresented in low-wage jobs doesn’t help, the analysis said. Black women make up 14 percent of low-wage workers and 6 percent of the overall workforce.

Education levels don’t make much of an impact on the high wage gap between Black women and non-Hispanic white men. While more education corresponds with higher wages for both Black women and white men, Black women still make between 61 and 66 cents on the dollar compared to their counterparts at every education level. African-American women have to have at least a Bachelor’s degree to make as much as white men who didn’t finish college.

The NWLC analysis also notes that the wage gap for Black women varies by state. Louisiana, Wyoming, and Mississippi take the top three slots for worst wage inequality, but Washington, D.C., is right behind them, with a wage gap of 55 cents to the dollar. D.C.’s result is especially noteworthy because women overall in the District have the country’s smallest wage gap, 90 cents to the dollar.

The “77 cents to the dollar on average” wage gap statistic for women overall is frequently called into question because while it’s often used in pay discrimination debates, there are factors behind the figure other than outright pay discrimination. President Obama cited it when he passed an executive order, on this year’s Equal Pay Day for women overall, that will make it easier for some women to discover and redress being paid unequally due to gender bias.

But a pay gap persists even when researchers control for workers who have similar characteristics, like college majors and occupations. A report from the Center for American Progress notes that about 40 percent of the wage gap can’t be explained by work experience or occupational differences, and that much of that 40 percent is likely due to the failure of U.S. workplaces and other institutions to adapt and support working families.

Broad average statistics, like the 77-cent figure for women in general, the 64-cent figure for African-American women, or the 55-cent figure for Latinas, draw attention to the fact that women are usually the ones to make career sacrifices for the sake of raising a family. Policies like universal child care and maternity and family leave, advocates argue, would mean fewer women had to make the “choice” to take a lower-paying job, fewer hours, more unpaid leave, or fewer promotions in order to care for their children.

Image: Shutterstock

The post Equal Pay Day for African-American Women, By the Numbers appeared first on RH Reality Check.

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“If the other side is the last dying gasp of an outdated patriarchal system, the team I get to lead is the very expression of what a future looks like that embraces justice, equality and respect for diversity. My job is to help funnel that vision into reality. What could possibly not be great about that?" - our president on why she loves being a leader in reproductive freedom

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NARAL Pro-Choice America - Tue, 07/22/2014 - 12:42
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Tennessee actually provides even broader protections for reproductive health car...

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Equal Pay Day for (Some) African-American Women

RH Reality Check - Tue, 07/22/2014 - 09:09

This piece is published in collaboration with Echoing Ida, a Forward Together project.

It’s an interesting thing: Despite being a professor of political science and spending a good chunk of my time studying inequity in the lives of Black American women, I had no idea that Equal Pay Day for African-American Women was this month.

What is Equal Pay Day for African-American Women, you may ask? It’s the estimated date that the average Black woman would have to work until to earn the same annual income that men (inclusive of all races) earned in 2013. According to the National Women’s Law Center, Equal Pay Day for women overall is April 8, and for Latino women it doesn’t come until November.

So, what does this dearth in pay along race and gender lines mean in practice? Well, in terms of raw numbers, according to a report by the Center for American Progress:

Women on average earn 77 cents for every dollar a man earns for comparable work—a gender wage gap of 23 percent. Women of color suffer from an even more severe gap. According to the National Partnership for Women and Families, African American women and Latinas in the United States are paid $18,817 and $23,298 less than non-Hispanic white men yearly, respectively. That’s 64 cents and 55 cents for every dollar a man earns.

I have to admit, after looking at the numbers, I was surprised. Not only does the wage gap between men and women inclusive of all races remain sizable, but the gaps within gender and between racial groups are astonishing. The reality that African-American women make 64 cents for every dollar men make has devastating consequences, not only for Black communities, but for the U.S. economy at large. When an entire segment of the population is disenfranchised in this way, regardless of education or opportunity, it creates inequalities around basic needs (like health care, housing, and child care) that become entrenched within the economy.

The number of policy reports that have been written about this issue is staggering. Just about every liberal-leaning policy organization has written a piece about the lack of pay equity in the United States. Most of these reports are doing the good work of pushing for additional policy, executive and congressional alike. But one has to wonder, if pay discrimination was outlawed decades ago, is another executive order really going to fix it?

Don’t get me wrong, doing something is better than nothing; as the Civil Rights Act of 1964 showed us, policy with teeth can push the country into much needed political and social reform. But the most recent executive order to prevent workplace discrimination is no such piece of policy. Especially when, in Oklahoma, you can still lose your job, or be kicked out of school, simply for appearing to be gay. What’s the point of federal policy if states can completely gut it (as was the case with elements of Obamacare)?

Indeed, July 16 wasn’t Equal Pay Day for all African-American women. When the data is further disaggregated by race, sexuality, and gender, the stakes that are at issue are made more clear.

Lesbian women of color struggle even more with issues of pay inequity, high poverty, unemployment rates, and discrimination. Working gay and transgender people of color still earn less than their heterosexual and white gay and transgender counterparts, but lesbian women of color struggle even more severely. The average Latina lesbian couple earns $3,000 less than Latino opposite-sex couples. Black lesbian couples face an even greater economic disparity earning $10,000 less than black same-sex male couples. Black same-sex couples significantly lag behind white same-sex couples with median incomes of $41,500 compared to $63,500.

Furthermore, lesbian couples of color experience high rates of poverty and unemployment. In 2012 the poverty rate for black lesbian couples was 21.1 percent; for Latina lesbian couples the rate, was 19.1 percent; for Native American lesbian couples, the rate was 13.7 percent; and for Asian Pacific Islander lesbian couples, it was 11.8 percent. These numbers stand in stark contrast to white lesbian couples who had poverty rates of only 4.3 percent.

The combination of homophobia, racism, sexism, and classism keeps lesbians of color entrenched in poverty. The pay gap between lesbian of color couples and heterosexual couples means that it is nearly impossible for their wages to keep up with the rate of inflation in the United States—Black lesbian couples earn, on average, $10,000 less that Black same-sex couples.

In short, Black lesbians are hyper-marginalized within their race, gender, and sexual orientation. The rates of poverty and unemployment for Black lesbians means that we must think more critically about policy and legislation that would improve the quality of life across all marginalized groups.

In a post-Defense of Marriage Act world, a closely held secret is how little marriage legislation has meant for the lived realities of Black LGBTQ people, particularly Black trans and lesbian people. While winning the right to marriage was an important victory for many across the nation, the poverty rate for Black lesbian couples is 21.1 percent, compared to a white lesbian poverty rate of 4.3 percent. Organizations that purport to be concerned about the entire LGBTQ population should be incensed. But, then again, organizations like the Human Rights Campaign, GetEqual, and the National Gay and Lesbian Task Force failed to acknowledge the anniversary of the passing of the Civil Rights Act three weeks ago, so maybe we shouldn’t be that surprised after all.

Without a living wage, Black women continue to go without access to housing, health care, child care, or quality education. An important start to addressing this issue would be raising the minimum wage to a living wage across the United States. Next, instead of demolishing public housing, we should create low-income housing that offers a healthy and self-sustaining environment for the individuals who live there, and reinvest in public works programs that would rebuild key infrastructure in our cities. With these solutions, we can provide important work and training opportunities for the unemployed across the country, as well as rebuild major cities, whose roads, public buildings, and other infrastructure have been crumbling for decades.

We must continue to raise our voices against inequality within the United States and around the world. It is critical that as a nation, we become committed to making sure that everyone is paid a living wage in accordance with their skills, training, and experience. By bringing attention to the wage gap and the disenfranchisement that stems from it, we can improve the lives not only of Black women, but of people everywhere.

Image: Shutterstock

The post Equal Pay Day for (Some) African-American Women appeared first on RH Reality Check.

‘Water, Water Everywhere’: Racial Inequality and Reproductive Justice in Detroit

RH Reality Check - Tue, 07/22/2014 - 07:44

Every morning Kendra pushes her cart several blocks to a friend’s house, where the water has not yet been shut off. After filling various jugs and trash bins, she then makes the lengthy trip home, passing vacant lots and abandoned homes that now characterize many neighborhoods in Motown’s urban center.

When we first heard Kendra’s story, Elizabeth was transported back to Kasese District, a rural area in Western Uganda where she once worked as a maternal health fellow. She saw the never-ending parade of women carrying jerry cans heavy with water from the lakes to their thatch-roofed homes. Like Kendra, their daily journey was not an exercise in futility but, rather, an act of survival. Water is critical for their families’ hydration, cooking, and sanitation—just as it is for Kendra. Such a basic need is universal to the human race, after all.

In Detroit, stories like Kendra’s are far too common. And her story, like those of the women in Kasese, is typically isolated outside the historic and political contexts from which they spring. Instead of resourceful agents reacting to unjust living conditions, Detroit residents are labeled as “delinquent customers” who “opt not to” pay their water bills. But these are not irresponsible behaviors acted out by immoral individuals. They are the result of structural-level processes, which exist at the intersection of neoliberal capitalism, racialized exploitation, and sexism. Nevertheless, the Detroit Water and Sewage Department (DWSD) has continued to shut off water to low-income families instead of more powerful (and financially capable) account holders such as the State of Michigan or the Palmer Park Golf Club, whose outstanding debts swamp those of individual households. (On Monday, however, DWSD issued a temporary suspension of shutoffs for 15 days to give residents time to seek help in bringing their accounts current.) 

Leaders in the reproductive justice movement have called for the centering of race and women of color’s lived experiences in order to achieve true reproductive freedom for all. Using this framework, we can explore why the water shutoffs in Detroit—one of the nation’s most racially segregated cities—should deeply concern reproductive justice advocates.

Historical and Sociopolitical Backdrop

At the turn of the 20th century, Europe’s colonization of East Africa was characterized by depletion of resources, exploitation of communities of color, and underinvestment in social infrastructure. With haunting similarity, we now stand witness to these same global, political-economic forces devastating urban centers across the United States. While certainly not an outlier (38 U.S. municipalities have filed for bankruptcy since January 2010), Detroit serves as a striking example of the threats to come—particularly for vulnerable groups such as women and children who are low-income and/or Black and/or Latino.

In Detroit, the cost of water is nearly twice the national average, and approximately half of the city’s customers owe outstanding balances on their water bills. But let’s situate this against a broader historical and sociopolitical backdrop. By 2011, half of Detroit’s working-age population was unemployed, and only 27 percent had full-time work. Nearly one in five Detroit residents were below the poverty line. Approximately three in five children were living in households headed by single mothers (see Rose Brewer’s article on the prison industrial complex). Moreover, these statistics are significantly worse for the city’s Black and Latino residents.

This scenario is one outgrowth of globalization, racial discrimination, and subsequent withdrawal of city services. Michigan’s auto industry has been in decline since the 1970s, following globalization of auto manufacturing and markets. As was typical in the Rust Belt, this economic shift toward deindustrialization was quickly succeeded by white flight from Detroit’s urban center. In turn, this led to rapid suburbanization of both population and employment opportunities in the greater metro area. Subsequently, Black families like Kendra’s now live in neighborhoods suffering from the increasing withdrawal of vital public services including police, emergency medics, fire fighters, and streetlights. Water shutoffs are simply the most recent violation they’ve faced.

We can follow threads of the exploitation of communities of color in both Kasese, Uganda, and Detroit, Michigan, which has the highest percentage of Black residents in the United States (84 percent). In both locales, populations of color have faced similarly devastating consequences from the inherently intertwined systems of capitalism and racism. For example, both have suffered diminished access to basic necessities like water. In contrast, both white colonialists and white suburbanites have reaped magnificent wealth from their control and exploitation of Black labor. The withdrawal of public services in Detroit is typically framed as an unavoidable response to the city’s declining tax base. Alternatively, we frame these violations as a deliberate assault against communities of color and low-income families in the interest of white-controlled financial institutions.

The Shutoffs and Reproductive Health and Autonomy

Such environmental and social stressors are likely to carry significant consequences for the health of racially and economically marginalized women and their children. For example, countless studies have documented how experiences of racism and poverty contribute to cumulative wear and tear on the body over the course of a person’s life. This increased “allostatic load” has been linked to poorer reproductive and health outcomes, including premature birth, low birth weight, and infant mortality.

But perhaps more importantly, water shutoffs parallel the pervasive and life-long assaults against personal autonomy endured by women, particularly those from marginalized communities. As the United Nations recently declared, “Disconnection of water services [in Detroit] because of failure to pay due to lack of means constitutes a violation of the human right to water and other international human rights.”

We would argue that these water shutoffs also violate the human right to reproductive freedom. From the 1994 International Conference on Population and Development, UN delegates defined reproductive health as “a state of complete physical, mental and social well-being.” This implies individuals must have “the capability to reproduce and the freedom to decide if, when and how often to do so.” More explicitly, it requires “the means to do so” such that couples have “the best chance of having a healthy infant.” Clearly, the DSWD’s water shutoffs for poor families are a violation of this international agreement.

Political pundits—who, notably, have access to potable water and are not from Detroit—are currently shaming low-income Detroiters affected by the water shutoffs. Reporters, analysts, and the public are questioning why Detroit residents spend their money on nonessential items instead of water. They suggest conditional requirements for service reactivation such as the monitoring of water consumption and financial expenses among poor families.

Such patronizing statements are not made about golf clubs.

Sadly, this infantilization is a familiar experience for Black women on public assistance, who are often accused of being “welfare queens” and “crack mothers.” But like the high-income DWSD account holders in Detroit, similar judgments are never made of large businesses that receive tax breaks, subsidies, and other forms of corporate welfare.

Like their financial decisions, the reproductive choices made by low-income Detroit residents are highly scrutinized. Generally, women are blamed for “irresponsible” reproductive outcomes, whether that is having children (if you are poor or non-white) or not having children (if you are affluent and white). More specifically, Black and Latina women who receive welfare, Medicaid, or other “entitlements” are painted as lazy, greedy, and neglectful mothers. They are accused of scamming the system and criticized for “not working” as though child-rearing and domestic labor is not “work.” Of course, this is old news: “feminine” work is seen as inferior to “masculine” work and is, therefore, not compensated equally, if at all.

In turn, low-income women are caught in a treacherous double bind. They are socialized and expected to perform the important but un- or underpaid reproductive labor of keeping children and home. Simultaneously, neoliberal “budget cuts” mean they are denied resources necessary for their families’ survival, including housing, food, and water. Together, the lack of economic compensation for reproductive labor combined with decreased welfare benefits makes it impossible for low-income mothers to keep up with the rising costs of living. Viable options are further eroded for families of color, who experience significant racial discrimination in access to both education and employment. How do we expect low-income women of color to mother under such conditions?

Some researchers, including Arline Geronimus, have examined traditional American ideology, which is highly critical of both Black and teen motherhood. They have found that Black women who bear children as teenagers experience better birth outcomes (for example, lower infant mortality) in contrast to white women whose risk is highest for poor birth outcomes during adolescence. This disparate health pattern (what Geronimus calls “weathering”) is the result of “premature aging” in Black women, who accumulate exposure to sexualized racism over their life course. Similarly, this “weathering” contributes to generalized premature mortality within Black communities, which diminishes women’s familial support for child-rearing as they age. In turn, Geronimus and others have suggested that the denigration of Black teen mothers overlooks structural constraints that require this adaptive practice. Similarly, the attribution of water “delinquency” to individuals’ irresponsible (even illegal) behavior is nothing short of victim-blaming.

The Way Forward

As urban planner Jamie Peck once proclaimed during a lecture for the Detroit School of Urban Studies, we cannot use capitalist tools to dismantle the crisis created by capitalism. Detroit Emergency Manager Kevyn Orr is currently considering various bids to privatize the DWSD. But such privatization is likely to increase rates for Detroit residents and (like other forms of fiscal austerity) seeks to squeeze the last drops of life from a well that is already dry.

Instead, protesters and human rights activists have emphasized how investment in public services can lift residents out of desperation and increase their freedoms and capabilities. For example, the State of Kerala has significantly better health outcomes than other regions in India, although its income per capita is below the national average. Human and reproductive rights leaders, including Gita and Amartya Sen (who are not related but share the same last name), have attributed this anomaly to Kerala’s historic investment in social infrastructures that improve the agency of its residents. These include state support of education, health services, and women’s empowerment in addition to basic needs like food and water.

Short-sighted solutions disconnected from historical and sociopolitical contexts are likely to exacerbate suffering and inequality in Detroit.

If you are interested in donating your time, energy, or money to the activists and residents fighting for their human right to water, you can connect here for information about the Peoples Water Board.

Image: Shutterstock

The post ‘Water, Water Everywhere’: Racial Inequality and Reproductive Justice in Detroit appeared first on RH Reality Check.

We can totally win in these 10 super tough races → ← if the 70...

NARAL Pro-Choice America - Mon, 07/21/2014 - 19:00
We can totally win in these 10 super tough races → ← if the 70 percent pro-choice majority turns out. Help us make sure that happens! Join our 7 in 10 campaign today.

Join the 7 in 10 campaign
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