On Thursday, the House GOP unveiled what Politico referred to as “the most controversial of spending bills” — a $153.4 billion measure that proposes to cut $4 billion in spending from the 2011 budget. House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Chairman Denny Rehberg (R-Mont.) authored and introduced the bill (PDF), which presents controversial cuts to education, labor and health services, particularly to women’s reproductive-health services: It would eliminate the Title X family-planning program, ban federal funding to Planned Parenthood Federation of America (unless the organization ends its abortion services), redirect teen-pregnancy-prevention programming funds to abstinence-only sex-education programs and ban private insurance companies from covering abortion.

“We believe in protecting a woman’s ability to make personal, private decisions with her doctor, and Speaker [John] Boehner’s budget violates these fundamental American values in several ways,” said NARAL Pro-Choice America President Nancy Keenan in a statement Thursday. “How will taking away women’s freedom and privacy lead to the job creation he promised voters?”

Controversial still is how the spending bill was crafted.

After Rep. Rehberg posted the legislation online, Rep. Rosa DeLauro (D-Conn.), who sits on the subcommittee, issued a statement censuring the chairman for posting the draft before public debate and accusing the Republican majority of violating its pledge to follow regular legislative order in dealing with appropriations.

“I am very concerned by reports that the Chairman has no plans to convene a meeting of our subcommittee to consider and mark up this legislation,” DeLauro said. “While this posting of the Chairman’s proposals is interesting, it is by no means an acceptable substitute for public debate and amendment. The Chairman, by himself, is not the subcommittee. … If no House markup is held, this would be the first time in nearly a decade that our subcommittee has failed to report out a bill.”

DeLauro criticized Rehberg’s proposed spending cuts, which she said injects “40 brand new legislative provisions and riders, many of them highly controversial, and most dealing with complicated subjects well outside the expertise of the Appropriations Committees.”

She said that Rehberg’s bill prohibits use of federal funds to implement any part of the Affordable Care Act; nearly eliminates the Corporation for National and Community Services, which administers Americorps and related programs; cuts the nation’s job-training program by 75 percent (but protects reemployment programs for veterans); and prohibits public radio stations from using any federal funds to acquire programming from National Public Radio.

DeLauro warned of potential consequences of defunding Planned Parenthood.

“The main effect would probably be to prohibit Medicaid patients from choosing to receive services such as contraception and cancer screenings from Planned Parenthood clinics,” she said.

DeLauro noted that eliminating family-planning funding would likely impact about 5 million people annually.

Using data from the 2006-2008 California Women’s Health Survey, the researchers studied approximately 3,000 women ages 18 to 44 and discovered that African-American and foreign-born Asian women were at a higher risk than white women of becoming pregnant unintentionally because of the types of contraceptive methods they were using. To come to this conclusion, birth-control method choice was compared to the subjects’ racial, ethnic, demographic and socioeconomic characteristics.

The research team identified the following contraceptive methods, ranked in descending order of effectiveness: male sterilization, female sterilization, intrauterine devices (IUDs), implants, injectables, vaginal ring, patch, pill, male condoms, other regular methods (i.e., spermicide, natural family planning), emergency contraception only and none. IUDs and hormonal methods were classified as “high-efficacy” and all other methods as “low-efficacy.”

(The report notes that female and male sterilization methods and the IUD have failure rates of less than 1 percent; birth control methods such as the ring, patch and pill have failure rates of 5-9 percent; and condoms have typical failure rates of 17-18 percent. However, according to the Centers for Disease Control and Prevention (CDC), condoms can be 98 percent effective if used correctly.)

When controlling for demographic and socioeconomic characteristics, the study team found that:

• Blacks, foreign-born Hispanics and foreign-born Asians had lower odds than whites of using “high-efficacy” reversible methods.
• Of all the racial groups, white women were the least likely to report using no contraceptive method during sex (19 percent), while black women were the most likely to report using no method (28 percent).
• Whites were more likely to rely on male sterilization than were other sub-groups, especially foreign-born Asians (16 percent). U.S.-born and foreign-born Asians were less likely to use female sterilization (2 percent and 4 percent, respectively) than were others (8–17 percent).
• U.S.-born Asians were more likely to use the hormonal birth control pill than any other racial group (28 percent); pill use was least common among blacks and foreign-born Hispanics (16-17 percent).
• Condoms were used most among U.S.- and foreign-born Asians (25 percent and 36 percent, respectively) and least among whites (16 percent).
• Overall, 21 percent of women reported not using any contraceptive method. Women were most likely to use the pill (23 percent) or condoms (20 percent), followed by male or female sterilization (10 percent for both) and IUDs (8 percent), followed by injectables (3 percent), the ring (2 percent) and the patch (1 percent).

Ethnic disparities were not found, however, in the use of IUDs, the report found.

The data also revealed that differences in income level also accounted for contraceptive method choice.

• Women in the highest income category were more likely to rely on male sterilization (15 percent vs. 2–6 percent in lower income groups) or the pill (26 percent vs. 17–18 percent) and less likely to report not using any contraception (19 percent vs. 23–26 percent).
• High school graduates were more likely than non-high school graduates to report not using any birth control (21 percent vs. 25 percent).
• IUD and condom use differed little by income or educational level.

National studies, such as a recent Guttmacher Institute report, on unintended pregnancies among American women, have found disparities among socioeconomic group, but the California study suggests that other factors influence what type of woman uses (or does not use) a certain kind of birth control method.

Based on the findings, the researchers identified a need for further research of birth-control use among various minority groups, coupled with intervention programs that target minority groups at high risk for unintended pregnancy.

“Our study underscores the need for improved understanding of contraceptive behavior among minority women,” the researchers write. “Other potential influences on differences in contraceptive use by racial, ethnic and income characteristics include client knowledge of contraceptives and values regarding method choice. … Asian women are of particular interest because of the relative lack of reproductive health information on this population and their relatively low rates of use of high-efficacy methods.”

By the end of this week, 40 state legislatures will have adjourned, concluding a legislative season full of proposed bills aimed to restrict women’s access to abortion and, in some cases, family-planning services. On Wednesday, lobby group NARAL Pro-Choice America, a national advocate for reproductive rights, organized a webinar and slide show (PDF) to bring attention to the number of anti-abortion rights laws that have been introduced and passed so far this year.

NARAL President Nancy Keenan said the organization is tracking nearly three times as many “anti-choice” state bills in 2011 (470) compared to 2010 (175). So far, Keenan said, the states have enacted 49 anti-abortion rights measures compared with 34 in 2010. She called 2011 “one of the five worst years for choice” since the organization started tracking state-level legislation in 1995.

The title of the webinar (PDF), “Comparing Reproductive Rights to Spare Tires and Heroin: A Look at the War on Women in the States,” was an homage to recent comparisons state lawmakers have made on the floor of their chambers. For example, when the Indiana House debated a since-passed bill that would ban abortion after 20 weeks — except in the case of rape or incest — state Rep. Eric Turner (R-Cicero) argued: “Someone who is desirous of an abortion could simply say that they’ve been raped or there’s incest.”

NARAL’s team organized the laws into five major trends:

• Abortion-coverage bans (eight states enacted bans in 2011; one ban was vetoed)
• Abortion bans after 20 weeks (32 bills were introduced in 15 states; legislation was enacted in five states and vetoed in one state)
• Mandatory-ultrasound legislation (28 ultrasound‐related bills were introduced in 14 states compared with nine bills in 2010; legislation was enacted in three states and vetoed in one state)
• “Personhood” measures (one personhood measure is on the 2011 ballot in Mississippi; one has been proposed for the 2012 ballot in Florida; 32 personhood-related bills were introduced in 18 states)
• Race-and-sex-based abortion legislation (10 bills were introduced in six states, and one was enacted in Arizona; the bills were accompanied by anti-abortion rights billboard campaigns targeting the African-American community and recently the Latina community)

But the two states that win the prize for the most extreme anti-abortion rights legislation according to NARAL are Ohio and South Dakota. This week, the Ohio House of Representatives approved a law, bringing the state closer to becoming the first to outlaw abortion after a heartbeat is detectable, which could be as early as six weeks.

And on Friday, South Dakota’s new law establishing the longest mandatory wait time in the country is set to go into effect. Not only does the law require women to wait at least 72 hours before they can obtain an abortion; before they can have one, they must participate in one free counseling session at a so-called “crisis pregnancy center” and meet with the abortion-providing physician, who will have to assert in writing whether or not the woman is being coerced into having an abortion.

The law has been challenged on the grounds of unconstitutionality; on Monday, a court in Sioux Falls will rule whether or not to suspend the law while its being challenged, according to the Associated Press.

AP reports that thus far, only three pregnancy centers have registered to participate in the mandatory counseling sessions: Care Net Pregnancy Resource Center in Rapid City, Bella Pregnancy Resource Center in Spearfish and Alpha Center in Sioux Falls.

“[This law] makes the state a full partner with [crisis pregnancy centers], whose soul purpose is to coerce women,” said Cristi Schwarcz , a senior policy representative at NARAL.

Schwarcz said it is somewhat paradoxical for a CPC, which she referred to as “anti-abortion storefronts,” to be a gateway for a woman to obtain an abortion. “Imagine a law that blocks a man from obtaining condoms until [he receives] religious counseling,” she said.

Fourteen states’ sessions remain open: Four close this week, two close later this summer and eight are year-round.

Watch NARAL’s video reflection of the reproductive-health-related legislation this year, which it has dubbed “The War on Women in the States”:

 
]]> http://washingtonindependent.com/110306/as-legislative-sessions-close-anti-abortion-rights-laws-go-into-effect-starting-with-south-dakota/feed 0 http://washingtonindependent.com/108228/nrsc-chair-cornyn-still-not-sure-about-kyls-not-intended-to-be-factual-planned-parenthood-stats http://washingtonindependent.com/108228/nrsc-chair-cornyn-still-not-sure-about-kyls-not-intended-to-be-factual-planned-parenthood-stats#comments Mon, 18 Apr 2011 22:10:56 +0000 admin http://washingtonindependent.com/?p=108228 Last week, Twitter was host to a Stephen Colbert-encouraged pillorying of Sen. Jon Kyl (R-Ariz.) following a spokesman’s claim that when Kyl said on the Senate floor that “well over 90 percent of what Planned Parenthood does” is abortion-related, it was “not intended to be a factual statement” More...

“[This report] is long overdue,” said Valerie Jarrett, senior adviser and chairwoman of the White House Council on Women and Girls. “We understand that the success of women and girls is vital to winning the future.”

The report, titled Women in America: Indicators of Social and Economic Well-Being (PDF), is a collaborative effort of several federal departments prepared for the White House Council on Women and Girls. None of the data revealed in the report is new — and the most recently reported statistics are from 2009 or 2006 — but it is the first time such a report has been drafted since President John F. Kennedy commissioned one in 1963.

A lot of the information in the report is old news — for instance, women are still trailing men in economic earnings: At all education levels women earned 75 percent of what men make in 2009. But the report does add some interesting perspectives. For example, the jobs that women tend to go for and the majors they take in college, tend to be in humanities or social work, something Obama is hoping to change. Acting Deputy Secretary of Commerce Rebecca Blank said in a phone conference Tuesday that the president will be encouraging young women to pursue the fields of science, technology, engineering and math.

Women currently make up 51 percent of the population; there are about 4 million more females than males in this country. And 57 percent of Americans over 65 are women. But though women still exceed men in life expectancy, they are likely to face more health problems and physical ailments down the road, particularly in the regions of mobility, obesity and depression; though figures point to a higher prevalence of heart disease and diabetes in men (14 percent of men 18 and older, compared with 10 percent of women).

About a quarter of women have reported arthritis and hypertension, with those figures increasing as women become seniors. And though less-educated women have reported higher rates of hypertension than more-educated women, among men, hypertension is not associated with education levels.

The report finds that women exercise less than men. Only about 41 percent of 25-year-old women said they participated in the federally recommended amount of aerobic and muscle-strengthening exercises, compared with more than half of 25-year-old men. And of all women, only 15 percent reported exercising the recommended amount. In 2009, about 25 percent of women said they ate fruits and vegetables five or more times a day. Almost one out of seven adult women smoked cigarettes every day.

Amid all the statistical figures one statement really stands out in summarizing women’s health:

“Women are almost 40 percent more likely than men to report difficulty walking.”

And that’s difficulty walking a quarter of a mile, or three city blocks. Walking trouble can point to arthritis, heart disease, pulmonary conditions, neurological conditions, near-blindness and other sensory limitations, and can “affect an individual’s ability to fully take part in all aspects of life,” according to the report.

And then, of course, there are different levels of walking difficulty among women, depending upon education and race:

• Women who did not complete high school (23 percent) were twice as likely to report difficulty walking than women who have had at least some college (11 percent).
• Non-Hispanic black women (18 percent) were more likely to report difficulty walking than Non-Hispanic white women (12 percent) and Hispanic women (11 percent).

From 'Women in America,' source National Center for Health Statistics

And even if the information is already out there, here are some, perhaps, surprising findings:

• In any two-week period, 8 percent of women and girls report experiencing clinically significant depression, compared with 5 percent for men and boys.
• Women make up two-thirds of graduates in the fields of humanities, arts, education, health and welfare but one-quarter of the graduates in science and technology.
• During the most recent recession, the unemployment rate among women over 20 rose from 4.4 percent to 7.7 percent; for men the unemployment rose from 4.4 to 9.9 percent.
• About 7 percent of women are severely obese. But 14 percent of non-Hispanic black women are obese, compared with 7 percent of Hispanics and 6 percent of white women.
• In 2008, intimate partners were responsible for 26 percent of all violence against women, compared with 5 percent of all violence against men. Of all Americans killed by an intimate partner, 70 percent were female, a percentage unchanged since 1993.
• The rate of rape against females over 12 (as defined by the National Crime Victimization Survey, which notes that between 2004 and 2008, police were not notified of nearly half of all rapes) declined by 60 percent between 1993 and 2000 and has remained at this level throughout the past decade.
• While male students are more likely to be victimized with weapons, female students are twice as likely to be electronically bullied as males.
• The number of women committing crimes is growing: Women made up 18 percent of all arrestees for violent felony offenses in 2008, up from 11 percent in 1990. The amount of women arrested for burglary or larceny grew from 25 to 35 percent.
• About 206,000 adult women were incarcerated in state or federal prisons or local jails in 2008.
• The number of women under community supervision or parole increased by 121 percent between 1990 and 2008: 1.1 million adult women were under community supervision on probation or parole in 2008.
• Homicide victims among black women dropped from 2,300 in 1993 to 1,200 in 2008. But for white women the figure remained steady during this same period of time at 2,200.

Officials stressed the point of the report is to draw a complete story of the American Woman, piecing everything we know about her to improve her well-being.

So what will the Obama administration be doing with this data? Should Americans expect to see new legislation, or at the very least, more discussion of women’s issues after Women’s History Month has turned into National Poetry Month?

Asked directly, Jarrett said: “[This report] will be a tool to help inform our policies and programs. Given the financial challenges, it is important we help spend our money wisely. … This report gives data that will help support that.”

As evidence to the president’s commitment to improving the “quality of life for women and girls,” Jarrett pointed out that Obama created the White House Council on Women and Girls. And look, they got a report — which Jarrett said the administration plans to help them “do more with less.”

What that means exactly remains to be seen, but Preeta Bansal, general counsel and senior policy adviser at the Office of Management and Budget, was slightly less vague. She said Obama has made a vow to enact policies that are evidenced-based, and the same goes for this information on women. She said he will be looking at how well existing programs targeted at women — in the areas of health, education, unemployment, and violence — are working.

Sponsored by Sens. Ben Nelson (D-Neb.) and Orrin Hatch (R-Utah), the bill would have banned subsidized insurance plans offered on proposed insurance marketplaces from offering abortion coverage.

The health reform bill passed by the House last month includes such a restriction.

The first sign came when Rep. John Shimkus (R-Ill.) announced in his opening statement that the breast cancer screening guidelines “will not be taken outside of the context of the H.R. 3962,” the Democrats’ health reform bill.

It happened again when Rep. Michael Burgess (R-Texas), also during opening statements, made reference to “the 2,000-page gorilla in the room.” (He wasn’t talking about the mammography guidelines.)

Any doubts on whether the hearing was political were put to rest when Rep. Frank Pallone (D-N.J.), chairman of the Energy and Commerce health subcommittee, cut off Petitti’s opening statement at the seven-minute mark.

“Doctor,” Pallone said, “I didn’t want to stop you, because it’s so important. But you’re two minutes over.”

That was after Petitti and Calonge had endured more than 90 minutes of opening statements from lawmakers.

But the charade didn’t stop there.

Instead, many lawmakers used their question-and-answer time to try to get the task force leaders to weigh in, not on how they arrived at their recommendations, but how the reform legislation would absorb them — a topic of legal interpretation that they, as medical experts, knew nothing about.

“That is not my role here,” said Petitti, one of many times. “My role is to speak to the mammography guidelines.”

But that message didn’t sink in very quickly among the lawmakers. At one point, Rep. John Dingell (D-Mich.) asked if the recommendations were to be used as a coverage ceiling or a coverage floor.

“It’s outside of the scope of our recommendations how they’re used by other entities,” Calonge said.

In another exchange, after Calonge declined to answer a question based on his lack of familiarity with the bill, Rep. Henry Waxman (D-Calif.) decided to fill him in. “You’re not an expert on the bill,” he said, “but let me explain what the new bill will do.” Waxman then explained what the new bill will do.

Rep. Marsha Blackburn (R-Tenn.) also inquired about the influence of the task force recommendations under the Democrats’ bill. Petitti’s response is a good reminder to those on Capitol Hill that life goes on outside the Beltway.

“As unbelievable as it may seem to those who are so caught up in Washington,” Petitti said, “I was writing my bio-statistics lectures, and have been actually woefully and naively oblivious of what’s been going on in health care reform arena.

“From the point of view of specific statutory language,” she added, “I know nothing.”

That statement brought a smile to the face of Pallone, who conceded that lawmakers on Capitol Hill tend to think of themselves as so influential that the world follows their every move.

“We all think we’re so important and everyone’s paying so much attention to everything we do,” Pallone said. “It’s kind of refreshing to know that you were not.”

Senate Minority Leader Mitch McConnell (R-Ky.) objected, arguing that a number of Republicans were still awaiting the chance to weigh in before the votes.

So here’s the summary thus far: Two days. Zero votes. Dozens of amendments to go. And they want to be out of town by Christmas. Gonna be some late nights and long weekends ahead.

Among the thorniest of the recommendations, the task force suggested that routine screenings begin at age 50 instead of 40, and occur biennially rather than every year. Democrats were quick to distance their health reform bills from the guidelines, yet both the House and Senate bills specify that certain task-force findings would automatically become a part of new minimum coverage requirements for all insurers. The biennial screening recommendation, for one, fell into this category.

That certainly wouldn’t prohibit insurers from offering broader coverage that includes routine annual screenings, and many states have their own requirements that guarantee such coverage. But it also wouldn’t require that they do so, again stirring concerns that private companies searching for ways to enhance profits (or states searching ways to balance budgets) could change policies to cover only diagnostic tests more frequently, as the task force recommends. [A quick note: Routine screenings, under current protocols, refer to the annual tests gotten by asymptomatic women aged 40 and up because another year has passed -- not to be confused with diagnostic mammograms, performed after a lump is detected or a screening turns up an abnormality.]

Mikulski yesterday offered her version of a legislative fix, introducing an amendment to the Senate health-reform bill that would prohibit insurance companies from using the task force recommendations to restrict mammogram coverage at any age or any frequency if a doctor recommends the test.

“We don’t mandate that you have a mammogram at age 40,” Mikulski said yesterday on the Senate floor. “What we say is discuss this with your doctor. But if your doctor says you need one, you are going to get one.”

Specifically, the provision would ensure that, under an essential benefits package to be offered by all insurers, women would be covered — at no extra cost — for “additional preventive care and screenings … supported by the Health Resources and Services Administration” — a branch of the HHS that aims to improve access to health-care services, particularly for the nation’s uninsured and under-insured populations. Aside from breast cancer, the provision is designed to encourage screenings for other prominent diseases, such as diabetes, cervical cancer and heart disease.

“Women often pay more and get less,” Mikulski said. “For many insurance companies, simply being a woman is a preexisting condition.”

Mikulski said the provision, as scored by the Congressional Budget Office, would cost the government $1 billion over the next decade.

Also of note, while Mikulski’s amendment retains the bill language automatically adopting A- and B-graded task-force recommendations as part of the minimum-coverage package, it also adds a clarifier that appears aimed at nullifying the recent, B-graded task-force recommendation for biennial routine screenings:

Nothing in this subsection shall be construed to prohibit a plan or issuer from providing coverage for services in addition to those recommended by United States Preventive Services Task Force or to deny coverage for services that are not recommended by such Task Force.

Mikulski spokeswoman Rachel MacKnight said Tuesday that she wasn’t sure if that language was added as a specific response to the new task-force recommendations. But it wasn’t a part of the original Mikulski amendment that passed the Senate health committee over the summer.

The U.S. Preventive Services Task Force caused a storm this month when it suggested that routine mammograms begin at age 50 — rather than 40 — and occur every two years, rather than annually. Some members of Congress pounced on the findings, arguing that, if adopted, they would undermine the ability of doctors to detect some cancers and save some lives.

“Breast cancer is a preventable and treatable disease if it is detected early but we don’t want to cause other health problems in the process,” Rep. Frank Pallone (D-N.J.), chairman of the subcommittee, said in a statement. “Providers and patients need to understand the risks of both screening and not screening so that they can make a balanced decision. … This hearing will increase everyone’s understanding of the issue.”

Testifying before the panel will be:

• Ned Calonge, chairman of the U.S. Preventive Services Task Force
• Diana B. Petitti, vice chair of the U.S. Preventive Services Task Force
• Otis Webb Brawley, chief medical officer of the American Cancer Society
• Jennifer Luray, president of the Susan G. Komen for the Cure Advocacy Alliance
• Fran Visco, president of the National Breast Cancer Coalition
• Donna Sweet, member of the American College of Physicians’ Clinical Assessment Efficacy Subcommittee

The hearing is scheduled for 10 a.m.

Sen. Tom Harkin (D-Iowa), chairman of the Senate health committee, is also promising to examine the new recommendations. With the Senate poised to spend most of December debating health reform legislation, however, Harkin might have to wait until 2010.