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Ellen Willis on Abortion, 1968

23 May

“A young girl, a friend of some friends, comes to town to get an abortion and stays with me. Doctor is a well-known, respected abortionist. Charges her $700, which she has to borrow. I’m disturbed to learn she was given no antibiotics. Next day she starts hurting. Neither of us wants to face trouble, so we wait. But the pain gets worse. I waste an hour calling private doctors, leery of a police hassle at Bellevue. Her fever shoots up and I call an ambulance, panicked that I may have waited too long. The doctor, if you can call him that, lets her have it. While he’s examining her and giving her shots and sticking tubes in her and she’s yelling, in terrible pain and scared to death, he starts in, “YOU WENT TO A QUACK, RIGHT?” keeping at it until she says yes, and then, “That was a stupid thing to do, wasn’t it? How much did it cost you?” and on and on. She asks him if she’s going to die. The prick won’t say no. When he’s through I ask how she is. He gives me his nastiest you-East-Village-sluts-are-all-alike look and says, “She’s very sick,” loud enough for her to hear, and strides out of the ward. The nurse reassures me. She’s full of penicillin and it’s going to be all right.

She spends a week in the hospital. When she’s ready to go home one of the doctors gives her a prescription for birth control pills, but the clinic pharmacist won’t give her all the pills at once. She has to come back every month. Regulations. I argue: there’s no point to this, it’s harassment. “Don’t be smart, lady,” he says.”

From Up from Radicalism

An Open Letter of NARAL Pro-Choice America and NARAL Pro-Choice MD: Do Better

20 May

Our movement is small. You can count USA’s national organizations whose mission is to advance reproductive rights and access on one hand. NARAL is among them; NARAL is a leader in our movement.

As a leader in our movement, I am disappointed that you’ve turned your back on one of our own in the fight for access to abortion in the US.

I am referring to the news that NARAL MD has decided to endorse County Council President Craig Rice over his opponent, the fierce, well known, and unabashedly pro-choice activist, Neda Bolourian.

Neda is a vocal feminist and abortion advocate. She is a clinic defender, a natural leader, and a passionate activist and fundraiser for keeping, protecting, and expanding the full range of reproductive health options. She co-organized the grassroots movement Summer of Trust, welcoming Dr. Carhart into Montgomery County in 2011, and has not for one moment shied away from her strong belief in access to legal, safe abortion whilst on the campaign trail.

Candidates like Neda Bolourian are the future of our movement. We need actively prochoice politicians to move our movement forward so we can stop playing defense.

If NARAL MD researched the candidates for Montgomery County Council, there would be no ignoring Neda’s commitment to vocal pro-choice activism, which is clearly identifiable hereherehere, and here (to site a few of many exhibitions). Especially disturbing is that NARAL MD has a facebook album of a weeklong pro-choice Summer of Trust event Neda co-organized in Montgomery County in 2011. The album has pictures of Neda’s sisters including Lily Bolourian, her campaign manager.

NARAL MD needs to do better. NARAL MD needs to do better, more diligent research before endorsing candidates, and/or needs to do better at actively supporting upcoming pro-choice politicians. When NARAL, a pro-choice movement leader, supports the established order over a pro-choice activist, they join the patriarchal forces of oppressing feminist, pro-choice voices, rather than fight them. Furthermore, NARAL’s endorsement of Neda’s opponent sends a deeply troubling message to future pro-choice women candidates: That pro-choice leaders are more willing to support the establishment than feminist activist.

As someone who cares deeply about the future of our movement, I request that NARAL MD switch their endorsement to support Neda Bolourian and reflect core values of NARAL, and the pro-choice movement. Please join me in asking NARAL to do the same here at change.orgNARAL MD, Endorse Neda Bolourian.

Feeling Comfortable In The Grey

7 May

We live in a world that likes things to be black or white. You’re either for something or against something. Conservative or Liberal. Pro-Choice or Anti-Choice. No matter the issue, conflicting ideas are reduced to defined opposing views, with a clear line that marks the boundary to the other side. This construction is mirrored in our politics and in the media, resulting in structured talking points and campaigns that tell a single story and fit one narrative. The problem is that this representation isn’t accurate. No matter the issue, there is a spectrum of opinions that expand beyond the clearly defined boxes of “for” and “against,” and this is especially true when it comes to choice.

 

Now, I think and know that many in the pro-choice community would agree that choice shouldn’t be presented in this black and white dichotomy. Instead we need to focus on the grey and better represent the nuance and complexity within reproductive choices to honor that everyone’s narrative is different. The problem though is figuring out how to hold onto the greyness, while working in a system that operates in the black and white.

 

I really began thinking about this tension when I was at the Civil Liberties and Public Policy Conference at Hampshire College. CLPP is a conference I’ve wanted to go for years, and I was lucky enough to get to spend that weekend in April thinking deeply and critically about the issues I care about most, while being surrounded by inspiring reproductive justice activists. The last session I went to was called What If We Let Roe Go?, which was facilitated by Aimée Thorne-Thomsen with the panelists Angela Ferrell-Zabala and Julia Reticker-Flynn. The presenters brought up that while Roe is fundamentally important, since it only addresses the legal right to choose, it misses the myriad of other interrelated and contextual factors that intersect and impact one’s ability to have a choice in the first place. The panelists urged us to think about who we leave behind by only focusing on Roe, and how doing this affects the movement. Together, the panelists and audience began a dialogue about how choice is complex, and how by just focusing on Roe we may be limiting our scope. This narrow messaging may fit within the political realm and the need for talking points, but it fails to address the nuances in our experiences.

 

For me, what this session brought up was how limited our approaches can be and made be question whether laws and regulations are the best way to move forward.  This was reinforced last week after reading Jessica Valenti’s thoughtful and powerful article in the Guardian. Sharing her story of the birth of her daughter at 28 weeks, Valenti shows us once again, that this is complicated, and that “choices are far too nuanced and personal for us to ever believe we could create a policy around them.” She reminds us that issues around pregnancy and choice aren’t consistent or clear cut, and more importantly they don’t have to be. Our pro-choice beliefs and reproductive decisions are never in conflict with one another, but result in varied narratives and experiences.

 

Now, I’m not sure what the best answer is or how exactly to move forward. Do we have to operate within the structures that exist in order to affect the change we want to see? Or do we change our tactics? No matter what the best path is, it’s a conversation that needs to keep happening and it has been great to hear thoughts and perspectives from others on what to do. But most importantly, what I appreciated was the reminder that we should dream bigger. It’s time to be bolder and think beyond the limitations in the system. As we go forward let’s find ways to feel comfortable in the grey, embrace our different pro-choice narratives, and support initiatives that focus more broadly on the intersections of experiences that influence choice. It’s a messy world out there, but that’s what makes it interesting.

 

16 and Pregnant, Season 5, Episode 1: The Recap

20 Apr

We’re recapping 16 and Pregnant, Season 5!  The first episode of the season starts with Maddy, who’s 16 and from Tinley Park, Illinois. You can watch the episode online here

 

MTV

Megan: Should we start by talking about why we wanted to write about this, besides that we secretly love watching reality television?

Chanel:  I always feel like a terrible reproductive justice activist when I watch this show. I think one of my reasons for wanting to recap is to place an RJ lens onto it, if that’s possible.

M: I totally agree. I think there is a lot of possibility, and when I watch it I always find myself rooting for the moms to be able to make their own decisions without the adults in their lives telling them that they’ve messed up. But when I was thinking about us wanting to watch this for those reasons, I was also thinking about why this show is still on and why so many other people watch it? What do we see in that narrative put out by MTV to scare and shame young people? Why are we fascinated by that as a theme and willing to watch it happen over and over again? Why do people want to see that and not the story we see through our frameworks?

C:  We need to see young women as being incapable of making good choices. Like,  no matter what, I’m not sure M could have made a choice that would have made the audience feel okay about her getting pregnant. Sex is wrong and terrible, and young women are stupid and irresponsible. I think that’s pretty ingrained into our narrative.

One thing MTV has done is bust up the idea that it’s young women of color who get pregnant as teens-the girls on this show are mostly white.

M: That’s true. But while they’re defying the stereotype that it’s only poor girls of color who are getting pregnant, it’s also blocking those girls from seeing their own experiences. So we’re also choosing the narrative of middle-class white girls over low-income girls of color.

C: AGAIN. And perpetually.

M:  As Gretchen Sisson says more eloquently than I have stated here: “Teen Mom will depict an argument with a romantic partner in great detail, but consistently overlook the real sources of struggle that lots of young mothers face: constant stigma and ridicule, lack of social support, and the challenge of accessing public benefits.”

On that note, let’s get into it.

C: The Other Baby, Maddy’s half sister Alyssa, has ears that stick out and is therefore a full on distraction for me.

M: Oh poor thing! One night stand. That is rough. Wait…haven’t we already had a baby named Aubrey?

C: SO MANY Aubreys. I think this is 3?

M: I hope this guy shows up to the doctor’s appointment. It’s such a positive thing to have the boyfriend at the ultrasound appointment. Can you even imagine being 16 and then getting pregnant with someone you just met and then having to figure out what you’re going to do? Like, I couldn’t even deal with just figuring out how to dress appropriately and what to decorate my locker with, let alone plan my entire future family. I don’t think I could have handled it.

C: Cody-“I should have paid more attention in health class. I should have used a condom.” Now would not be a terrible time to mention that it’s also  important that the girl be able to say, “Hey, maybe put on a condom?”

M: Wow, Mom is laying on the shame here.

C:  Oh my gd, Maddy’s mother. SHE CAN STILL BE A LAWYER.

M: Here’s the thing, it’s not going to “be a long time” before she’s going to get to do what she wants to do. Because right now she wants to be a mom. Maddy is more “responsible”-sounding than Mom at this point. She’s able to hold both that she did something she would consider a mistake and also own up to that she can’t change the past and now sees a new vision for herself. That’s a pretty adult thing to realize. But Mom is stuck in this “either/or” thinking.

C: There was an episode a few seasons ago where the girl’s dad was also like, “Hi, just because you’re pregnant doesn’t mean you have to live with the dude.” Also, here we are again with the “He ruined your life.”

M: Yeah. I just want to yell at them, “YOUR LIFE IS NOT RUINED”. And then give them hugs. I know I’m going to just keep saying this over and over but how responsible are these kids being? They are not romantically involved but their relationship has evolved to be this mutually-beneficial partnership where they are trying to figure this out together.

C: The word “responsible” in these situations always scares me. There are a lot of ways to be responsible, right? Abortion and adoption  are also examples of being responsible.

M: So true. We throw around that word like there’s a morally right and wrong way of being and no gray area. When I was 16 I couldn’t even function in my own home let alone move to an unfamiliar environment with a baby. That is scary shit.

C: Other Baby is the real star here. Sorry, Maddy.

M: What is the plot I’m supposed to be paying attention to? Adorable Baby? Staring at camera?

C: “The only time we ever left his house was to buy a pregnancy test.” Real talk.

M: High school dates: Still as awkward even if you having a baby together.

C: HERE COMES (MORE OF) THE SEXISM. “What kid do you know who has his mom’s last name?” CODY. PLEASE GET IN THE TIME MACHINE AND COME BACK FROM THE SIXTIES.

M: After Maddy raises her baby and takes her first gender studies class she is going to be so impressed by the way she handled this situation and refused to submit to the patriarchy.

C: There’s always stuff on this show about girls going from size zero to size 14 or whatever while pregnant. No one is ever a size 14 originally.

M: Yeah, and the size difference is always talked about like it’s the worst possible thing.

C: Here I will apply my creepily encyclopedic knowledge of this show and point out that Jamie in season 3 asked her doctor  if her stretch marks would go away when asked what she was most worried about. It’s normal, I know, but the emphasis is still bothering me.

M: Is this the appropriate time to mention that my cats really are into this right now? Or they want dinner. It’s one of those.

C: Cats love MTV.

M: You’re really missing out on this nail polish commercial where models rub their hands all over men’s faces.

C: Is it disembodied hands? Or can you see the models’ faces?

M: Disembodied, obviously.

C: Of course. Faces are superfluous. Especially on women.

M: As soon as you see faces, you think “people” with “minds”.

C: Just cut to the chase! This is about nail polish! AND MEN..

M: Not just any men, “alluring men”, says Youtube. I don’t know about you, but I’m sold.

C: I will be buying a lot of this nail polish. You are working, capitalism.

M: You just get me, MTV.

C: Oh, here comes Cody’s patriarchy induced temper tantrum.(re: Maddy wanting Aubrey to have her last name.)

M: The way that the men/boys act and fight about the last name stuff just reminds me about how the patriarchy hurts everyone. It makes people feel like they have to hold to these systemic ideals, and when those ideals are not met it makes people feel bad, like something is being taken away from them and like they’re not in control.

C: Yes! And not being able to show that something (a lady, a child, etc) is YOURS is threatening. It undercuts your masculinity.

M: Now is the only part where I feel old and yell, “Are you seriously telling them you’re not moving in via text?” Is that what the kids are doing these days?

C: Ughh. This makes me want to get a lawn so I can tell kids to get off of it.

M: I support Maddy in her decision to do what’s best for her and move into the environment where she feels most comfortable and supported, but if I were Cody and his mom, I would have preferred receiving that information in person. But I am not 16 so what do I know!

C: What do we know about on line classes in high school and if they keep ple from dropping out?

M: It seems like a great model to me, but I’d be interested to hear more about it. There must be data on it somewhere.

C: I really like M’s dad pushing her to do what’s best for her. And I’m reminded of how much of a role class plays in all this. I mean, her dad has an extra room in a house.

M: Yeah, an extra room and enough income to be able to feed two additional people!

C: Do we think Maddy’s jeans came with those holes?

M: I like how we’re not judgemental about teen moms but we are judgmental about teen fashion. And methods of virtual communication. And baby names.

C: I mean, I’m not made of stone.  So, do we have closing thoughts?

M: I guess mine are that the show is trying to paint Maddy as an irresponsible teenager who got herself into a serious and terrible situation that she can’t get out of, but I think there’s another more powerful narrative that she faced getting pregnant as a challenge instead of an obstacle, was able to stay true to herself, and has a solid vision of what she wants her future to look like and what she can accomplish.

I think we should end by sending some love and well wishes to Maddy and baby.

C: Agreed. (Maddy, I’m sorry about what I said about your jeans.)

 

We’ll be back with another recap next Sunday! 16 and Pregnant airs Mondays at 10/9 c. 

 

Abortion Gang at CLPP 2014

14 Apr

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Bloggers from Abortion Gang recently spent 3 days at the radical glory that is the CLPP conference, and we tweeted up a storm! You can find the tweets by searching #CLPP2014 on Twitter.

Check out Abortion Gang bloggers @chaneldubofsky, @annapopinchalk, and at @PProvide, as well as @graceishuman,@OpinionessWorld, @AbortionChat,  @RBraceySherman@poonam_pai ,

@SisterSong_WOC@LeahDoolittle@KimberlyInezDC@aimeett and others.

 

Stay tuned to Abortion Gang for more blog posts on CLPP!

 

 

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The Round Up

28 Mar

Here’s what some of us at Abortion Gang have been paying attention to lately:

Anna:

Most of my reading has been for classes but this week we are talking about conscientious objection and with the Supreme Court cases coming up this has been one of my favorite break downs of what’s at stake in this decision: http://kff.org/womens-health-policy/issue-brief/all-eyes-on-the-supreme-court-more-than-birth-control-at-stake/

Kaiser does a great job of outlining how this case isn’t only about contraceptive coverage and religious freedom, but also whether corporations should be considered people and the implications this case could have on corporate law.

 

Megan:

I’m reading my friend Tiffany’s post on why she’s fasting to support immigration reform: http://365breakfasts.wordpress.com/2014/03/23/fasting-for-families/

Steph and Chanel’s piece  on abortion stigma and culture change at Cosmo: http://www.cosmopolitan.com/celebrity/news/these-women-want-to-change-the-way-you-think-about-abortion

Latest Hyde blog post from Andrew Jenkins at Choice USA: http://thehill.com/blogs/congress-blog/healthcare/200991-abortion-hyde-and-the-presidents-2015-budget

Taja Lindley on RH Reality Check about queer women & sexual health: http://rhrealitycheck.org/article/2014/03/18/exam-rooms-bedrooms-navigating-queer-sexual-health/

 

Sara:

I’ve been reading about abortion access in Latin America using resources at the Guttmacher Institute and an article from RH Reality Check called The Politics of Abortion in Latin America.

I’ve been watching the hysteria from the anti-abortion zealots over the coathanger necklaces from the DC Abortion Fund , and am giddy at the thought of how much DCAF has been able to capitalize on the negative publicity to help women in need. Looking forward to being able to spot fellow supporters on the street and be able to match up our necklaces like a secret handshake. This is my personal favorite blog post I’ve seen.

I’ve been reading up on the Hobby Lobby birth control case, and am looking forward to standing outside of the Supreme Court in DC on Tuesday with other women’s healthcare supporters as oral arguments are heard.

In NC, we had a hell of a year in 2014 with a Motorcycle Vagina law that threatened to close every clinic but one, a wonderful clinic in the furthest corner of our state called Femcare (if you have a short memory or live under a rock, catch up on Motorcycle Vagina here and here.)  With the 2014 session starting in less than two months and NC feminists waiting at the doors to find out how our general assembly will continue their path of destruction, Femcare’s owner has decided to retire and put the clinic up for sale. Planned Parenthood has announced plans to open a health center providing abortions in the same town and we await further developments.  There is a lot of uncertainty and some genuine concern about making sure one of our most dedicated NC providers is treated well.

 

 

“She was on the side of the Lord”- Anti Choice Rhetoric, Religion, and Ownership

19 Feb

This is a guest post by Leigh Sanders. 

One thing volunteering as an escort at a reproductive health clinic has taught me is anti-choice protesters have an exorbitant amount of time to oversee the reproductive lives of their neighbors. Since they believe they are acting on religious orders to participate in this sort of secular voyeurism, they have been willing to physically and emotionally harm those that get in the way of their mission. Therefore, we are trained as clinic escorts to never engage with protesters. I am limited in my intervention to meeting patients at their vehicles and offering to shield them with my big rainbow umbrella from the unholy provocation that loudly follows us to the door. Throughout history women and girls have been subjected to this sort of harassment when they exercise self-determination.

I made the mistake of walking up to a car with two anti-choice  folks this morning and one of the women got out and righteously proclaimed she was “not one of us, because she was on the side of the Lord.” I had to wonder whether the Lord would actually claim her. I mean technically, she is saying the Lord is the kind of guy who would spend his down time shouting, criticizing and frightening the hell out of people. It would seem that the Lord would be busy on the other side of those women’s choices, the side that ensures children never go hungry, employment is plentiful, housing choices affordable and sexual violence eradicated.

So here is what working on the side of the Lord looks like to people who protest at abortion clinics. They stop cars from parking by acting official, as if they might be working for the clinic. When the unsuspecting person rolls down the window, propaganda, void of scientific fact, is shoved inside their car. For instance, the pamphlet uses the picture of a stillborn baby to depict an abortion despite the reality that nearly every single abortion in this country occurs on or before the 8th week. The clinic escort must intercede so the patient can arrive promptly for their scheduled appointment because the protester’s aim is to make them miss their allotted time.

Once the patients proceed to the front door, the protesters start yelling at them about the psychological “trauma” they will suffer afterwards, their impending status as a “baby-killer” and the many “resources” available to them that they are not utilizing. Today, one woman yelled back “Resources? What resources? You mean welfare?”  The male protesters explained they meant the resources that come from “loving Jesus.” There is a less aggressive group of protesters that arrange pictures of Jesus to face the clinic and while holding rosaries sing hymns about hell and damnation. They are the “good” ones because they do not seem motivated to physically harm anyone. Then there are the ones like the woman who specifically addressed her allegiance with the Lord; they greet the incoming cars as if in a funeral procession holding signs that presumptuously proclaim “Your Mother Kept You.”  The protesters surround the clinic until the last patient arrives and then their work is done. It is not known whether Jesus is proud of them for their stamina to harass or disappointed with them for their failure to shame. Either way they will return on Monday, ever seeking the Holy Grail of religious intolerance.

The police do not get called because the protesters are not breaking any laws. Of course, neither are the girls and women who are entering the clinic. Yet, their rights are at the mercy of fanatics who use deception, violence, judgment, intolerance and moral superiority to scar the lives of people they have never met. Because the one thing an anti-women’s health terrorist abhors more than abortion, it is a society that grants women sovereignty over their own bodies.

 

New Year, New Legislation Supporting Abortion Rights

17 Jan

It’s easy to feel disheartened by the number of anti-choice laws, ballot initiatives, and court cases sweeping the country.  In 2013, 22 states enacted 70 abortion restrictions and everyday it feels like there is another major news story on how our reproductive rights are being restricted. With the start of a new year, there have been a flurry of articles arguing that 2014 could be a make or break it year for reproductive rights. In a lot of ways, 2014 already feels reminiscent to the restrictions we saw in 2013. This week the Judiciary Committee in the House of Representatives passed HR 7,  to prohibit taxpayer funded abortions, and the Supreme Court is hearing cases on the contraception mandate and the buffer zone surrounding abortion clinics. But in exciting news, we are also seeing new state legislation that would actually protect abortion rights! Here are some important bills for you to keep an eye on:

Washington’s Reproductive Parity Act

Currently abortion coverage varies greatly by insurance carriers and by state, and since the ACA requires that no federal funds can be used to cover abortion services, coverage is even harder to come by in the health exchanges. In a direct response to this ACA requirement, the Washington state legislature introduced a bill that would require all insurance policies that cover maternity care to also cover abortion services. This bill would not only increase access to covered abortion services but also make sure that abortion coverage would not be affected even by the ACA abortion provisions.

New York’s Women’s Equality Act

This 10 point plan was first introduced last year but failed to pass during the legislative session. Governor Cuomo recently re-announced his support for The Women’s Equality Act which addresses a number of important equality issues including equal pay, sexual harassment, and trafficking. In terms of abortion policy, this bill would codify Roe v. Wade into state law and ensure abortion access up to 24 weeks or when necessary to protect the life or health of a pregnant person (currently it only includes exceptions when a pregnant persons’ life is in danger).

New Hampshire’s Abortion Clinic Buffer Zone Bill

Similar to the Massachusetts’s law currently being debated in the Supreme Court, SB319 would establish a buffer zone around abortion clinics. By establishing a 25 foot buffer zone, this bill hopes to help protect patients from harassment and intimidation from protestors.

Vermont’s Bill to Decriminalize Abortion

Bill S315 was introduced last week to decriminalize abortion in the state. While abortion is legal in Vermont, there are old laws that criminalize performing and advertising abortion services. As a result, this would law would officially recognize a persons’ right to have an abortion in the state of Vermont.

The Women’s Health Protection Act 

While this isn’t an example of state legislation, it is an exciting development in Congress. In 2013, the Senate introduced the Women’s Health Protection Act that would prohibit states from passing TRAP (Targeted Regulation of Abortion Providers) laws. This law would make it illegal for states to pass laws impeding access to abortion services including building standards for abortion clinics, and mandatory ultrasound laws.

All of this legislation is still in the beginning of stages, but it is nonetheless an exciting step in the right direction. But why does this matter when Vermont, New Hampshire, Washington and New York already protect a person’s right to choose and there are so many other states that are restricting abortion services? Because it’s about the message it’s sending. Of course, ideally we want to be seeing this type of legislation introduced in states where people face significant barriers to accessing abortion services. But seeing efforts to protect abortion access is a huge deal and what I believe is an important part of changing the conversation about abortion policy. Since 2010, we have been bombarded with abortion restrictions and examples of our reproductive rights being threatened. While there have been victories in defeating ballot initiatives and court cases, and important community organizing and activism, at the legislative level we have mostly been on the defensive. It’s shocking to think that the last time Congress passed proactive abortion legislation was in 1994 with the Freedom of Access to Clinic Entrances Act! Seeing legislation introduced that protects the right to choose allows us to be on the offensive, gives us time to talk about why these issues matter and engage with communities and lawmakers. But most importantly, this type of legislation shows that no matter the number of anti-choice laws introduced, we are not done fighting.

So thank you Vermont, Washington, New Hampshire, New York and to all those supporting the Women’s Health Protection Act for bringing us some much needed positive news. Here’s to hoping 2014 is a year filled with a lot more of it.

Abortion and the ACA: What You Need To Know

11 Dec

I believe that health care is a human right, which is why I have been a long time supporter of health care reform. When the Affordable Care Act (ACA) passed, while I realized it wasn’t going to be the answer to all of our healthcare problems, I also knew that it was a step in the right direction.  And now it’s game time! The roll out of the ACA has started and I feel very strongly about being an out and proud fan of the ACA and doing everything I can to help it be as successful as possible. But the problem is, the ACA actually really sucks when it comes to abortion coverage and it’s been making me think, as an abortion supporter, how do I negotiate fully supporting a law that may actually make access to abortion harder?

Before we dive into that, let’s take a look at abortion coverage in the ACA.

1) Abortion cannot be listed as an essential health benefit. The ACA outlines 10 essential benefit categories that must be covered in health insurance plans, and the specific requirements are determined by each state. The ACA prohibits states from including abortion as an essential health benefit.

2) The Hyde Amendment is still in place. The Hyde Amendment, which prohibits the use of federal funding to cover abortions except in the case of rape, incest or endangerment of the life of the pregnant person, still applies. A big part of the ACA is the optional state expansion of Medicaid to persons up to 133% of the federal poverty guideline. While the Medicaid expansion is great for increasing coverage to low income people, with the Hyde Amendment in place Medicaid will continue not to  cover elective abortions unless someone lives in one of the 17 states that only uses state money to pay for abortions.

3) No federal funds, including federal subsidies used to buy health insurance, can be used to pay for elective abortions. If a health insurance plan in the healthcare exchanges offers abortion services for cases other than incest, rape or endangerment of the pregnant person, plans have to follow segregation requirements to make sure that no federal money is used to pay for abortion services. This means that individuals have to make two separate premium payments: one for the payment of abortion coverage which they have to use their own money for, and another payment for the remainder of the coverage which can use federal subsidies.

4) All state health insurance exchanges must offer one plan that does not cover abortion. But there is nothing that requires that there is at least one plan that DOES cover abortion.

Put all together, we end up with a system that fails to recognize abortion as an essential health right, expands the Hyde Amendment restrictions to more people, and creates a really complicated system for abortion coverage. Now it’s important to remember that the rules regarding the separate premium payments only applies to insurance bought in the state healthcare exchanges. So for people with private employer based insurance that covers abortion these rules won’t affect them. But considering that the health care exchanges are set up for people who should benefit from federal subsidies and don’t have any other access to health insurance, it continues to make access to abortion harder for people who may need it most. Also, the separate health insurance premium for abortion coverage, could act like an abortion rider that people can choose to purchase. So instead of someone just buying one insurance policy to cover everything, they’d have to choose to buy a separate policy for abortion coverage, and make two separate payments. But that takes away the whole point of having insurance because it’s supposed to protect us from the unexpected and as we all know, no one plans to have an abortion. What’s even worse is that insurance companies may become less willing to provide abortion coverage because of the hassle and red tape they have to go through to collect separate payments. And on top of that, there is also a lot of state variation. Already, 18 states have prohibited abortion coverage in any plans in the state exchanges and nine states have prohibited abortion coverage in the entire private health insurance market.

Basically that’s a lot of bad news. Sure, it’s great that the ACA will cover preventative services and now we can access birth control with no copay, but the problem is that people need access to the full spectrum of sexual and reproductive health care. People will always need abortions and we have a fundamental right to access them just like any other healthcare service. If the purpose of the ACA is to increase access to health insurance and consequently access to healthcare, it feels disingenuous to be perpetuating a system where not all healthcare services are treated equally. Not only does it affect access, but it continues the stigma and shame surrounding abortion.

So where do we go from here? The most important thing is to keep working hard to increase abortion access to those who need it. The ACA will make abortion funds, and sexual and reproductive health clinics as important as ever and they need our support and commitment. On top of that, we need advocates on the ground to help people navigate an ever changing system, and understand what their options are for abortion coverage. It won’t be easy, and at times it will feel really frustrating, which is why we also have to remember to put the situation in perspective. We have a broken health care system that needs to be fixed and the ACA finally offers an opportunity to start fixing the system slowly but surely. Obviously this doesn’t mean that the way the ACA treats abortion is justified, but it’s important to remember that this is just the first step in a long process. I am cautiously optimistic that the goal of the ACA to improve access to insurance and healthcare, will lead to deeper conversations and ideas about what that means and looks like on the ground. That’s why we have to remember that this fight is far from over. We have to keep talking about why abortion is an essential part of healthcare, so that we can grab any opportunity there is in the future to improve access and coverage of abortion services.

Same As It Ever Was: The incremental denial of abortion access in Texas

11 Nov

A guest post from Sarah Tuttle, Lilith Fund Board Member. 

The recent HB2 decision by the 5th Circuit Court of Appeals has meant a busy week in abortion access circles in Texas.  Many of us on the ground were unprepared for such swift action.  We were just adjusting to the 20 week ban which had come into effect, and were working to prepare for whatever came next.

Both the summer of action at the Capitol, and the swift motion of the court case, has awoken many people to the cause. We made jokes over the summer about taking a ship to international waters off the Gulf of Mexico where we’d have a doctor available to perform abortions. Joking was one of the only ways to shake the feeling that we were traveling back in time in an unexpectedly cruel way. It has been fantastic to see so many people rally, realizing a right we thought was secured by the Supreme Court was in such a vulnerable position.  For many people it was the first time they stopped to think about the effects that could ripple through the lives of Texans.

I serve on the Lilith Fund board and run our hotline committee. I’ve been with Lilith for a year and a half. And I’m here to remind you of something that I feel is lost, even when we talk with our allies.  Our clients are people. This isn’t just a cause. These are people’s lives, people’s families. Our clients are not just patients, stories, plantiffs, witnesses or data.

Passionate, well-meaning people from all over the country are calling and emailing Lilith to help, to donate,  and we are beyond grateful.  But when we get suggestions that we should start an “Abortion Underground Railroad,” we cringe.  This is not slavery.  This is not the time to appropriate the pain and suffering of generations of African Americans to try and comprehend our own.  Many of our clients our Latina and African American. We refuse to add insult to injury.

People are calling the Lilith Fund to offer rooms and rides to support abortion access.  We’re not the right people to talk to. There are practical support networks slowly growing around Texas to pool these resources.  These networks will be critical in the next few months, especially with the danger of the “Ambulatory Surgical Center” requirements looming in September. We could be down to a handful of clinics, and travel will become an even larger problem.

But the scope of the issue, of people being denied abortion because of lack of resources, this is not new. It is exacerbated by HB2, not created.  In just the last three years, we have been able to raise over $100,000 per year. Last year we provided over $80,000 in direct assistance to people who needed abortions. We do not come even close to meeting the state-wide need for financial assistance.

Even before HB2, Lilith was unable to meet the need of all our callers. We serve a portion of Texas (the rest is served by the Texas Equal Access fund).  Our hotline is open 3 half days a week. Each shift we get between 15-30 calls. We can usually fund less than half of them.  Our funds only cover a fraction of their abortion. For those who are earlier in pregnancy, perhaps we can cover a third of their procedure. For those further along we might only be able to cover a fifth, or a tenth. Our clients mostly get referred to us by clinics. We never even see those unable to reach a clinic.

The Lilith Fund has operated for over a decade. We work with our data to try and best meet our clients needs. We recently saw a dip in our redemption rate (how many clients actually redeemed their financial aid vouchers).  Data analysis revealed what you might have guessed: higher voucher amounts lead to higher redemption rates. Giving higher vouchers means helping fewer people. But obviously an unredeemed voucher implies no help at all.  We raised our voucher amounts.

Even this year, which has been an incredibly good fundraising year (for deeply frustrating reasons), we have nowhere near enough resources to meet the growing need for abortion funding. We talk to our clients to assess what their situation is, what other pressing needs they have. They may have a long way to travel.  They may have children that need looking after.  They may be struggling to get enough hours at work. There is not enough money to cover all their needs. When they call us they are already borrowing from friends, already pawning prized possessions. They are postponing their procedure a few more days till they get that next check, or taking from grocery money for a few weeks running.

When I give clients financial assistance vouchers, I am also giving practical support. My voucher frees up money for other things – maybe it is gas, or childcare. Maybe it is to pay rent.  When I give a client funding for an abortion, I am trusting her to decide what she needs. I am respecting her. As a person.

I understand the urge to give things, to share resources. But I think it is crucial to examine our motivations, especially when we reach out to those in need. One of the biggest indignities of poverty is the loss of choice. Not being able to choose the food you feed your family, not being able to choose the gifts you give your children at Christmas.  When I fund abortion, I hope that one of the things I’m giving is agency.  I respect you to look at your available resources and do what is best.

Our clients are people. They are not just stories, or placeholders, or ways for us to channel our activism. They are people who deserve respect, kindness, agency, and support while they live their lives. This isn’t just a cause, or something they can walk away from or take a break from. This is their life. In this moment, I hope we can provide the support they need.