A new study published in the Journal of the American Medical Association found that about 20 percent of 17-year-olds who called in to a pharmacy to ask for emergency contraception that day were unable to receive it. Seventeen-year-old women legally have access to the morning after pill, also known as Plan B, without a prescription. The decision would have removed a prescription requirement for any woman seeking emergency contraception.

According to the study:

The availability of emergency contraception did not differ based on neighborhood income. However, in 19 percent (n = 138) of calls, the adolescent was told she could not obtain emergency contraception under any circumstance. This misinformation occurred more often (23.7 percent vs 14.6 percent) among pharmacies in low-income neighborhoods. When callers queried the age threshold for over-the-counter access, they were given the correct age less often by pharmacies in low-income neighborhoods (50.0 percent vs 62.8 percent. In all but 11 calls, the incorrect age was stated as erroneously too high, potentially restricting access.

The researchers concluded that “although we found approximately 80 percent same-day availability of emergency contraception in US metropolitan areas, misinformation regarding access was common—particularly in low-income neighborhoods.”

Immediate access to emergency contraception is vital to its effectiveness. Prolonged wait times or other types of barriers to same-day access can lead to an unplanned pregnancy, which is why many women’s health advocates have criticized the federal government for intervening in the FDA’s request.

Since Health and Human Services Secretary Kathleen Sebelius announced her decision, reproductive health advocates and policy-makers have expressed disappointment with the decision and claim it was based on political calculations, and not on scientific research. Last week, more than 35,000 signatures were sent to President Obama denouncing the decision.

The Center for Reproductive Rights has already sought legal action challenging the federal agency’s decision and a judge is considering hearing it.

Since Health and Human Services Secretary Kathleen Sebelius announced her decision, reproductive health advocates and policy-makers have expressed disappointment with the decision and claim it was based on political calculations, and not on scientific research.

According to the group’s press release:

Nancy Keenan, president of NARAL Pro-Choice America, today sent a letter signed by 35,194 Americans to President Obama opposing the administration’s recent decision to overrule a recommendation from the Food and Drug Administration (FDA) to follow medical experts’ recommendations to remove a restriction on the Plan B® emergency contraceptive.

“We had a major opportunity to improve young women’s access to contraception, which is the best way to reduce unintended abortions and thus the need for abortion, and the Obama administration missed the mark,” Keenan said. “We will continue to call on the administration to follow sound science and recommendations from health experts.”

The grassroots letter, which comes almost a week later, is leading a grassroots public-education and advocacy campaign to mobilize grassroots supporters to take action in response to the administration’s decision reject the FDA’s recommendation. NARAL Pro-Choice America leveraged its activist network to launch a public-education effort immediately after the administration’s decision was announced. The group’s efforts also came as senators, led by Sen. Patty Murray (D-Wash.) and members, led by Rep. Rush Holt (D-NJ) and Rep. Gwen Moore (D-WI), sent letters to the administration expressing their disapproval of this action.

Since U.S. Health and Human Services Secretary Kathleen Sebelius announced her decision, reproductive health advocates have expressed disappointment and claim that the decision was based on political calculations, and not on scientific research.

The Center for Reproductive Rights has reopened “its 2005 lawsuit against the Food and Drug Administration (FDA) for imposing unnecessary age restrictions on emergency contraceptives, and seek immediate relief to allow broader access to available drugs,” a new press release from the group states.

The group has also sought to add “Sebelius as a defendant in the reopened case for her role in overruling the FDA’s approval of Plan B One-Step last week,” according to the press release.

According to the group:

This fight is far from over. We intend to take every legal step necessary to hold the FDA and this administration accountable for its extraordinary actions to block women from safe, effective emergency contraception,” said Nancy Northup, president and CEP for the Center for Reproductive Rights. “It has been ten years of battling to bring emergency contraception out from behind the pharmacy counter. The FDA cannot simply continue moving the goal posts down the field for women’s reproductive health care.”

While U.S. District Court Judge Edward Korman found the contempt motion moot because late last night, the FDA decided to deny the 2001 Citizen Petition to lift age restrictions on emergency contraceptives— two years after the judge had ordered the agency to fairly reconsider the petition— he proceeded to invite the Center to reopen its 2005 lawsuit and agreed that the Center could add Secretary Sebelius as a defendant.

During the hearing, Judge Korman repeatedly noted the striking similarities between recent events —including last night’s denial of the Citizen Petition and Secretary Sebelius’ unprecedented decision to intervene and block the unrestricted sale of the drug—and the findings in 2009 that the FDA under the Bush Administration had “acted in bad faith and in response to political pressure.”

“The FDA has essentially been holding women’s reproductive health hostage to political calculations,” said Suzanne Novak, the senior staff attorney who argued for the Center for Reproductive Rights.

The Washington Post reports today that “Korman said he was willing to hear arguments over whether the agency should have allowed the sale of the morning-after pill to girls younger than 17 without a prescription, and he instructed advocacy groups to file the appropriate legal motions.”

According to new information, a provision in the Affordable Care Act has helped 2.5 million young adults gain health insurance since the law took effect.

It was previously estimated that about 1 million young adults under the age of 26 were affected by President Obama’s health care reform law, but new reports suggest it was more than twice that number.

The Associated Press reports:

Under the health overhaul, children can remain on their parents’ health insurance plans until they turn 26, and families have flocked to sign up young adults making the transition to work in a challenging economic environment. But the fate of President Barack Obama’s signature domestic accomplishment remains uncertain, with the Supreme Court scheduled to hear a constitutional challenge next year, and Republican presidential candidates vowing to repeal it.

“The increase in coverage among 19- to 25-year-olds can be directly attributed to the Affordable Care Act’s new dependent coverage provision,” said a draft report from the Health and Human Services Department. “Initial gains from this policy have continued to grow as … students graduate from high school and college.” A copy of the report was obtained by The Associated Press.

…

Using unpublished quarterly statistics from the government’s ongoing National Health Interview Survey, analysts in Sebelius’ policy office determined that nearly 36 percent of those age 19-25 were uninsured in the third calendar quarter of 2010, before the law’s provision took effect.

That translates to more than 10.5 million people.

By the second calendar quarter of 2011, the proportion of uninsured young adults had dropped to a little over 27 percent, or about 8 million people.

The difference — nearly 2.5 million getting coverage — can only be the result of the health care law, administration officials said, because the number covered by public programs like Medicaid went down slightly.

While most of the health care reform law does not go into effect until 2014, the provision in question went into effect last fall and most employer health insurance plans started following through with this change on Jan. 1, the AP reports.

In a statement announcing her decision, Sebelius said that although “the science has confirmed the drug to be safe and effective with appropriate use, the switch from prescription to over the counter for this product requires that we have enough evidence to show that those who use this medicine can understand the label and use the product appropriately. ”

“I do not believe that Teva’s application met that standard. The label comprehension and actual use studies did not contain data for all ages for which this product would be available for use,” she said.

Reproductive rights advocates immediately denounced the decision. Numerous groups have already released statements and written letters to Sebelius and the White House expressing disagreement with the decision.

The Washington Post reports that now a group of U.S. senators have written a letter to Sebelius requesting an explanation.

According to the letter:

We feel strongly that FDA regulations should be based on science. We write to you today to ask that you provide us with the rationale for this decision.

As numerous medical societies and patient advocates have argued, improved access to birth control, including emergency contraception, has been proven to reduce unintended pregnancies. Nearly half of all pregnancies that occur in the United States each year are unintended. Keeping Plan B behind the counter makes it harder for all women to obtain a safe and effective product they may need to prevent an unintended pregnancy.

We ask that you share with us your specific rationale and the scientific data you relied on for the decision to overrule the FDA recommendation. On behalf of the millions of women we represent, we want to be assured that this and future decisions affecting women’s health will be based on medical and scientific evidence.

President Obama has publicly supported Sebelius’ decision.

President Barack Obama (Photo: Flickr/The White House)

Women’s health advocates all over the country were stunned yesterday when Health and Human Services Secretary Kathleen Sebelius reversed an FDA request to expand access to over-the-counter emergency contraception for teenagers under the age of 17. In press releases denouncing the decision, a common theme has emerged: President Obama has followed in the footsteps of his predecessor, George W. Bush, on the heated issue of emergency contraception.

The political fight during the Bush administration over Plan B, also known as the morning after pill or emergency contraception, was a volatile one. Conservatives were dead-set against the FDA’s approval of the drug and did all they could to stall access to it once it was approved.

As feminist writer Jessica Valenti has written on the subject:

As you may remember, the concerns the FDA cited over emergency contraception were not about women’s health or the safety of efficacy of the drug. Instead, they were worried about young women getting all slutty. Dr. W. David Hager, one of the FDA committee members who voted against EC’s over-the-counter approval and a key player in making sure Plan B got held up, told The New York Times: “What we heard today was frequently about individuals who did not want to take responsibility for their actions and wanted a medication to relieve those consequences.” Some things to keep in mind about Hager: in suggested in a book he wrote that women could cure PMS with prayer, and his wife accused him of rape. So yeah, a bit scary that he was in charge of women’s health.

It later came to light that FDA medical official Janet Woodcock wrote in an internal memo that over-the-counter status for Plan B could cause “extreme promiscuous behaviors such as the medication taking on an ‘urban legend’ status that would lead adolescents to form sex-based cults centered around the use of Plan B.” It has Lifetime Original Movie written all over it. Of course this but-it-will-make-girls-slutty argument is hardly new. It’s the same excuse legislators have given when attempting to limit women’s access to birth control, and more recently, to the HPV vaccine.

Because the argument against emergency contraception wasn’t rooted in any medical or scientific argument, advocates were sure the Obama administration would uphold the recommendation. Furthermore, it was unlikely that a health secretary would publicly overrule the FDA.

According to The New York Times:

Although Ms. Sebelius had the legal authority to overrule the F.D.A., no health secretary had ever publicly done so, an F.D.A. spokeswoman said. Nor had such a disagreement been the subject of such extraordinary dueling press statements. Dr. Margaret Hamburg, the F.D.A.’s commissioner, issued a lengthy statement saying it was safe to sell Plan B over the counter, while Ms. Sebelius countered that the drug’s manufacturer had failed to study whether girls as young as 11 years old could safely use Plan B.

However, the conversation about whether to remove the barrier of a required prescription for girls under the age of 17 was about making sure emergency contraception was available to all sexually active women in an emergency. Requiring a prescription for a young girl could remove Plan B as an option altogether.

Women’s advocates also expected Sebelius and the Obama administration to protect women’s health issues, no matter the political fallout. The administration took a hit from politically powerful Catholic groups when it upheld a recommendation from the Institute of Medicine to include contraception in a list of preventive medicines to be covered without co-payments.

But in the months since the decision to include contraception in the list was made, reproductive justice advocates have been less sure that the administration will stand its ground, and they now consider yesterday’s decision a sign of things to come. Worse, advocates now see the Obama administration as continuing the politics of the Bush administration.

Nancy Keenan, the president of NARAL Pro-Choice America, wrote in a press release yesterday that the group “expected this kind of action from the Bush administration, so it’s doubly disheartening and unacceptable that this administration chose to follow this path.”

“We had a major opportunity to improve young women’s access to contraception,” Keenan said in a statement, “which is the best way to reduce the need for abortion, and the Obama administration missed the mark.”

The Center for Reproductive Rights released a statement saying, “Six years ago, we sued the Bush administration for rejecting science and playing politics with women’s health by denying emergency contraception for over-the-counter sale.”

“We are stunned to see the same behavior from the Obama administration,” said Nancy Northup, president of the Center for Reproductive Rights. ”It is unacceptable that the approval for drugs supporting women’s reproductive health is held to a completely different standard.”

One of the country’s oldest feminist groups, the National Organization for Women, aslo said in a statement that:

It is an unusual and infuriating move for the Obama administration to overrule that decision, especially at a time when rumors are flying that the president is on the brink of caving in to the U.S. Conference of Catholic Bishops by expanding religiously affiliated employers’ ability to deny contraceptive coverage to women under the Affordable Care Act.

NOW calls on the president to stop playing politics with the lives of women and girls. During the Bush years, women’s reproductive health was under constant attack. We don’t need more of the same from the Obama administration.

The Center for Reproductive Rights will be in federal court on Tuesday, according to their stament, continuing to fight for over-the-counter emergency contraception. The group filed a petition years ago, “along with attorneys Andrea Costello of Florida Institutional Legal Services and Natalie Maxwell of Southern Legal Counsel on behalf of the Association of Reproductive Health Professionals (ARHP), National Latina Institute for Reproductive Health, grassroots activists, and parents who seek over-the-counter access for their daughters.”

A federal court ordered the FDA to reconsider and rule on the petition filed by the Center in 2001. However, the FDA has yet to follow the order, the Center says.

Groups expect to hear whether Sebelius will uphold her decision to include contraception in a list of preventive services some time this week.

A couple of months ago, a federal health agency announced it would require health insurance companies to cover contraception as preventive care — which would remove co-payments. A final decision on whether the administration will stand its ground and keep the policy is expected some time this week.

Women’s health advocates have feared the president will capitulate to the demands of some of the biggest opponents to the policy: Catholic bishops.

The bishops’ demands have ranged from asking the policy be stricken “in its entirety” to asking that the rule allow a broad exemption for religious objectors. Catholic leaders have said the existing exemption is “too limited” and might leave out Catholic hospitals.

Women’s group — including NOW — are asking the president to not give in.

According to NOW’s recent press release:

The National Organization for Women calls on the Obama administration to stand up for women and not give in to demands from the U.S. Conference of Catholic Bishops that would deny birth control coverage for millions of women. The bishops have been lobbying the administration to expand a religious exemption that would allow a broad range of religiously affiliated organizations, such as colleges and hospitals, to take contraception coverage away from women who rely on them for health insurance. NOW calls on the president to remove the exemption altogether.

…

A recent poll by Thomson Reuters-NPR Health found that 77 percent of Americans believe private medical insurance should provide birth control without co-pays. Ninety-nine percent of sexually active women have used contraception, including 98 percent of sexually active Catholic women, as reported by the Guttmacher Institute. Yet this important health benefit could be lost for more than a million women and their families, and the decision will soon be made by the Obama administration.

The ill-considered proposed refusal clause in the women’s birth control benefit undermines women’s access to basic health care. NOW urges President Obama and HHS Secretary Kathleen Sebelius to say ‘yes’ to contraceptive coverage for all women and ‘no’ to the bishops’ relentless attempts to deny women their rights.

Health and Human Services Secretary Kathleen Sebelius (Photo: Flickr/US Mission Geneva)

This week Congress will hold yet another hearing addressing a grievance from Catholic bishops, this time about a recent loss of federal funds.

The House Committee on Oversight and Government Reform will hold a hearing on Thursday titled, “HHS and the Catholic Church: Examining the Politicization of Grants,” the committee’s schedule shows.

The hearing will discuss a decision made several weeks ago by a federal health agency to deny millions in federal funds for a charity run by the United States Conference of Catholic Bishops. The funds were for the bishops’ relief program for victims of human trafficking. The group lost the money because it refused to refer victims for contraceptives or abortion services. Three other groups that provide a wider range of services to victims were awarded the grants instead.

The bishops have exercised their immense political power to garner congressional hearings on topics they take particular issue before. Earlier this month, the House Energy and Commerce Subcommittee on Health met to discuss the federal government’s decision to require health insurers to cover birth control services without co-payments.

The debate that day centered on a provision that allows religious employers to opt out of the mandate, derided mostly by Catholic groups because they claim it is not broad enough. The bishops have led the charge in denouncing the decision.

The Washington Post reported that letters were sent to Department of Health and Human Services Secretary Kathleen Sebelius by “more than 30 Republican lawmakers,” arguing that the decision to defund the Catholic human trafficking relief program “was unfair to the Catholic group and might violate federal laws banning discrimination based on religion”:

Two of the letters are seeking internal HHS documents relating to the decision and one, sent Monday by Rep. Darrell Issa (Calif.), said his investigative committee may issue subpoenas if HHS doesn’t comply.

…

Sister Mary Ann Walsh, a spokeswoman for the bishops conference, said Friday that she welcomed the letters from Congress. “The more we look at this, the more concerned we are about it,” she said. “It appears the grant process was manipulated.”

One letter to Sebelius, by Republican Sens. Marco Rubio (Fla.), Roy Blunt (Mo.) and Kelly Ayotte (N.H.) and signed by 24 other senators, made a similar point. “The integrity and lawful administration of our federal grant process — particularly with respect to equal treatment of religious institutions — must not be compromised,” it said.

The Post previously reported that Health and Human Services officials have denied any anti-Catholic bias in their decision-making.

The bishops have become well known for using their political power to roll back important protections and legal rights, mostly in the realm of reproductive rights. The Huffington Post recently described the bishops as a “group of men with no real background in law or medicine, but blessed with a strong personal interest in women’s bodies, [that] have quietly influenced all of the major anti-abortion legislation over the past several years. “

The news signals the state has cleared one of the two major hurdles it has faced in expanding its Medicaid privatization plans statewide.

According to the Current:

The lone obstacle between the state and federal government in Medicaid 1115 waiver negotiations appears to have been settled as state officials announced on Tuesday that Florida will continue to receive $1 billion to fund health care for the poor, uninsured and underinsured.

Medicaid Deputy Director of Finance Phil Williams told a hospital panel on Tuesday that the state will continue to receive $1 billion in Low Income Pool money for three years. But the news wasn’t all good as Williams discussed with the hospital-dominated board some of the new reporting requirements and benchmarks for primary-care funding.

…

The Medicaid 1115 waiver makes possible a mandatory managed-care program in five Florida counties. But Florida has been negotiating to extend the program for more than a year. The fate of the low income pool has been one of the bigger stumbling blocks.

The waiver is important because to launch its new statewide mandatory Medicaid managed-care program the state needs the waiver. Because the existing five-county pilot program and the new statewide program are not identical, the 1115 waiver will need to be amended. Florida already has sent the amendments to the federal government to consider even though the underlying waiver still is pending.

The federal government has also expressed concerns over an absent medical loss ratio in Florida’s Medicaid Reform Pilot. The Centers for Medicare and Medicaid Services have asked for a medical loss ratio in the state’s plans to expand the pilots statewide. This “85/15″ requirement mandates that providers spend 85 percent on services and 15 percent on administration. The standard is one of the provisions in the federal health care reform law setting new rules for state Medicaid plans. The federal government plans to fund the expansion of state Medicaid plans to include more people who are currently uninsured.

When this issue came up a couple years ago, Gregg Mellowe of the Florida Center for Fiscal and Economic Policy said medical loss ratio rules were a good way to provide accountability, WFSU reported:

There have been concerns over the lack of accountability in the pilot project throughout its five years. And the concerns that they’ve had have not been resolved. I think that’s universally recognized. [The federal Centers for Medicare and Medicaid Services] has said look, you’re getting a waiver, all these federal rules relaxed, so in exchange for that we need some basic assurance that the power given to managed care plans is not going to be abused.

A.M. Best Company reports that “Florida wants to continue existing state MLR rules that enforce a 65 percent standard for health insurers and 70 percent for health maintenance organizations until 2014.”

Florida CHAIN (Community Health Action Information Network), a patient advocacy group, recently asked the feds to not grant insurance companies in Florida exemption from profit caps mandated by federal law. In a letter, the group asked the U.S. Department of Health and Human Services “to reject a request by Florida’s Insurance Commissioner to grant insurance companies a reprieve from new Affordable Care Act requirements intended to ensure that consumers get value for the health insurance premiums they pay.”

“The comment period for Florida’s application expired Oct. 27. CMS is due to make a determination within 30 days, a period regulations allow U.S. Health and Human Services Secretary Kathleen Sebelius to extend by up to another 30 days,” Best Company reports.

Through the Affordable Care Act, the U.S. Department Health and Human Services was tasked with selecting which types of health care insurers will have to cover as preventative care. Insurers would not be able to levy co-payments on such services.

At the request of a medical group, Health and Human Services included contraception in its list of preventative care. Even though the department also included an exemption to this requirement for religious employers, religious groups (largely Catholic) have claimed the exemption is “too limited.”

The discussion surrounding whether the new health law mandate threatens conscience rights was the subject of today’s committee hearing. Catholic groups, including pro-reproductive health groups such as Catholics for Choice, were invited to testify.

The Hill reports:

Republicans condemned the health law’s coverage expansion, calling it an unprecedented government intrusion on the religious freedoms of employers and insurers. Democrats countered that the GOP wants to put the “conscience rights” of employers before those of patients.

…

“When the healthcare law was being debated last Congress, the proponents adamantly refuted claims that this would be a federal government takeover of our healthcare system,” said Rep. Joe Pitts (R-Pa.), chairman of the House Energy and Commerce subcommittee on Health. “Now, we have the federal Department of Health and Human Services forcing every single person in this country to pay for services that they may morally oppose.

“Whether one supports or opposes the healthcare law, we should universally support the notion that the federal government should be prohibited from taking coercive actions to force people to abandon their religious principles.”

However, other religious groups disagree. Jon O’Brien of Catholics for Choice said expanding conscience (or refusal) clauses are a burden on the women looking to access birth control services.

In his testimony to the congressional panel, O’Brien said:

Like many Catholics, I accept that conscience has a role to play in providing healthcare services, but recent moves to expand conscience protections beyond the simple right for individual healthcare providers to refuse to provide services to which they personally object go too far. Increasingly, demands and regulatory proposals attempt to grant that option to an institution or any individual along the spectrum of care, funding and coverage. It is incredible to suggest that a hospital or an insurance plan has a conscience. Granting institutions, or entities like these, legal protection for the rights of conscience that properly belongs to individuals is an affront to our ideals of conscience and religious freedom.

Health and Human Services Secretary Kathleen Sebelius recently criticized pushback against the recent decision requiring insurance plans to cover birth control without co-pays.

“Forty percent of unplanned pregnancies end in those women seeking abortions,” Sebelius said during a luncheon hosted by NARAL Pro-Choice America. “Wouldn’t you think that people who want to reduce the number of abortions would champion the cause of widely available, widely affordable contraceptive services? Not so much.”

For many women, steep co-pays have deterred them from purchasing family planning services in the past, a problem that has been exacerbated by the country’s economic troubles.

A recent Kaiser Health Tracking Poll conducted by Public Opinion and Survey Research Program showed that two-thirds of Americans agree with the federal government’s recent decision to include birth control in its list of preventive services.