Category: Health and Fitness

Journalists Put Polio, Price Transparency, and a Personal Covid Battle in Perspective

KHN senior correspondent Arthur Allen discussed New York’s polio case with WBEZ’s “Reset With Sasha-Ann Simons” on Aug. 2.


KHN senior correspondent Julie Appleby discussed health insurance price transparency rules that took effect July 1 on WJR’s “The Pre W. Smith Show” on July 28.


KHN senior editor Andy Miller discussed his experience with covid-19 on WGUA’s “The Health Report” on Aug. 1.


Journalists Put Polio, Price Transparency, and a Personal Covid Battle in Perspective

KHN senior correspondent Arthur Allen discussed New York’s polio case with WBEZ’s “Reset With Sasha-Ann Simons” on Aug. 2.


KHN senior correspondent Julie Appleby discussed health insurance price transparency rules that took effect July 1 on WJR’s “The Pre W. Smith Show” on July 28.


KHN senior editor Andy Miller discussed his experience with covid-19 on WGUA’s “The Health Report” on Aug. 1.


A GOP Talking Point Suggests Birth Control Is Not at Risk. Evidence Suggests Otherwise.

“In no way, shape, or form is access to contraception limited or at risk of being limited.”

Rep. Kat Cammack (R-Fla.), co-chair, Congressional Pro-Life Caucus on the floor of the U.S. House, July 21, 2022

Republicans who oppose abortion have new talking points — birth control will remain easily available in the wake of the Supreme Court’s decision overturning the federal right to abortion, and when Democrats say otherwise, they are just trying to scare voters.

Variations on this claim were made by a series of Republicans on the House floor July 21 during debate on a bill that would add a right to contraception to federal law. Democrats advanced the bill as a way to ensure the availability of birth control before some abortion opponents have a chance to see whether the Supreme Court will overturn that right, too.

“This bill is completely unnecessary,” said Rep. Kat Cammack (R-Fla.), a co-chair of the Congressional Pro-Life Caucus. “In no way, shape, or form is access to contraception limited or at risk of being limited. The liberal majority is clearly trying to stoke fears and mislead the American people, once again, because in their minds stoking fear is clearly the only way that they can win.”

We reached out to Cammack’s office to inquire about the basis for this statement but did not receive a response.

Similar claims were made in the Senate as it declined to take up the House bill on July 27. “This idea that we ought to spend scarce time here in the Congress, which we have in limited supply, reaffirming rights that already exist is a clear political narrative designed to divert the American people’s attention from things that really are at risk,” said Sen. John Cornyn (R-Texas).

However, a review of documents and current efforts in some states to change laws indicates there is significant evidence that birth control — or at least some forms of it — may be at risk legally. So we dug in.

At the Supreme Court

The cornerstone for this concern can be found in Justice Clarence Thomas’ concurring opinion in Dobbs v. Jackson Women’s Health Organization, the case that overturned Roe v. Wade’s guarantee of access to abortion. Thomas suggested that having found no constitutional right to abortion, the court should next “reconsider all of this court’s substantive due process precedents, including Griswold.” That is a reference to Griswold v. Connecticut, the 1965 case that established a right for married couples to use contraception (single people were granted that right in a separate case in 1972). In Griswold, the court found that the “due process” clause of the 14th Amendment protects the right to privacy.

True, Thomas represents only one vote on the court, and the number of his fellow justices who share his opinion that the birth control case should be reversed is unclear. But the Supreme Court has already allowed some employers to decline to offer their workers contraceptive coverage based on their opposition to abortion. At issue in the 2014 Hobby Lobby case was the religious belief of the owners of the craft store chain that some forms of contraception — including the “morning-after” pill and two types of intrauterine devices — could produce early abortions by preventing the implantation of a fertilized egg. The court decided the government could not force the contraceptive coverage requirement from the Affordable Care Act on employers with those beliefs.

Scientific evidence suggests that neither the morning-after pill (which is a higher dose of a hormone used in regular birth control pills) nor IUDs stop the implantation of a fertilized egg and therefore do not cause abortions. Still, the court ruled that the owners’ religious beliefs trumped the government’s interest in workers getting contraceptive coverage.

“That legal blurring of distinct scientific boundaries between abortion and birth control threatens contraceptive access in the United States,” wrote professors Rachel VanSickle-Ward and Kevin Wallsten in The Washington Post. They predicted that some states “will probably ban some forms of contraception outright, using the discredited idea that contraceptives act as abortifacients.”

State Action

Confusion about how some forms of contraception work has led to efforts in several states to ban certain types of birth control. The most frequently targeted form of birth control is the morning-after pill, which can prevent pregnancy if taken within a few days of unprotected sex but which cannot interrupt an established pregnancy. It is not the same as the abortion pill, a regimen of two other medications that do end a pregnancy up to 10 weeks of gestation.

And even if the birth control methods did prevent a fertilized egg from implanting in a woman’s uterus, that would not be an abortion, at least not according to the medical community. Although many religious groups and abortion opponents argue that human life begins when the egg is fertilized, there is a consensus among doctors, scientists, and legal experts that pregnancy begins at implantation. And, they point out, an abortion is the termination of a pregnancy. Roughly half of all fertilized eggs never implant.

Even before Roe was overturned, lawmakers in Idaho called for hearings to ban emergency contraception, and Missouri lawmakers tried to bar Medicaid from paying for the morning-after pill and IUDs.

Anti-abortion groups are pushing the idea. “Plan B is Capable of Causing an Early Abortion,” said a fact sheet from Students for Life of America, referring to the name of a brand of the morning-after pill. Model legislation from the National Right to Life Committee would ban abortion from the moment of fertilization, not implantation.

The bottom line, wrote professors VanSickle-Ward and Wallsten before the decision overturning Roe was even final, is that “the court doesn’t have to formally end legal protection for contraception use.”

“If it allows plaintiffs to call contraception abortion, and Dobbs ends legal protection for abortion, then contraception is at risk.”

Our Ruling

It is true that, so far, no state has banned forms of contraception. But the threat appears very real. And the absolute nature of Cammack’s statement — saying there’s “no way, shape, or form” that access to contraception is at risk — is not accurate. We rate the statement False.

SourceS

Congressional Record, July 21, 2022, Pages H6927-H6940

Supreme Court, Dobbs v. Jackson Women’s Health Organization, June 24, 2022

Supreme Court, Burwell v. Hobby Lobby Stores, June 30, 2014

Supreme Court, Griswold v. Connecticut, June 7, 1965

Stateline, “Some States Already Are Targeting Birth Control,” May 19, 2022

The 19th, “With Abortion Rights in Limbo, Conservative Lawmakers Are Eyeing Restrictions on IUDs and Plan B,” May 25, 2022

The Daily Beast, “Why Can’t the FDA Fix Outdated Birth Control Labels,” updated July 12, 2017

Journal of Contraception, “Mechanism of Action of Emergency Contraception,” July 12, 2010

KHN, “FAQ: High Court’s Hobby Lobby Ruling Cuts Into Contraceptive Mandate,” June 30, 2014

KHN, “Misinformation Clouds America’s Most Popular Emergency Contraception,” June 7, 2022

National Right to Life, “National Right to Life Committee Proposes Legislation to Protect the Unborn Post-Roe,” June 15, 2022

NPR, “Abortion Foes Push To Redefine Personhood,” June 1, 2011

Students for Life, Facts About Plan B, accessed Aug. 1, 2022

The Washington Post, “If the Supreme Court Undermines Roe v. Wade, Contraception Could Be Banned,” updated May 3, 2022

In California, Abortion Could Become a Constitutional Right. So Could Birth Control.

SACRAMENTO, Calif. — Californians will decide in November whether to lock the right to abortion into the state constitution.

If they vote “yes” on Proposition 1, they will also lock in a right that has gotten less attention: the right to birth control.

Should the measure succeed, California would become one of the first states — if not the first — to create explicit constitutional rights to both abortion and contraception.

The lawmakers and activists behind the constitutional amendment said they hope to score a one-two punch: protect abortion in California after the U.S. Supreme Court ended the federal constitutional right to abortion under Roe v. Wade, and get ahead of what they see as the next front in the reproductive rights fight: birth control.

“The United States Supreme Court said that the privacy and liberty protections in the United States Constitution did not extend to abortion,” said UCLA law professor Cary Franklin, an expert in constitutional law and reproductive rights who has testified before the California legislature in support of the amendment. “If they said ‘no’ on abortion, they’re probably going to say ‘no’ on birth control because that has a similar history.”

In June, the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization ended the federal right to abortion and left states to regulate the service. In his concurring opinion, Justice Clarence Thomas said the court should revisit other cases that have created protections for Americans based on an implicit right to privacy in the U.S. Constitution, such as the 1965 case Griswold v. Connecticut, which established a federal right to contraception for married people — which was later extended to unmarried people.

Some congressional Democrats are now trying to codify the right to contraception in federal law. In July, the U.S. House of Representatives passed the Right to Contraception Act, which would give patients the right to access and use contraception and providers the right to furnish it. But the bill has little chance of success in the U.S. Senate, where Republicans have already blocked it once.

Protecting access to contraception is popular with voters. A national poll from Morning Consult and Politico conducted in late July found that 75% of registered voters support a federal law that protects a right to birth control access.

California isn’t the only state where voters are considering reproductive rights in their constitutions.

On Tuesday, Kansas voters decisively rejected a constitutional amendment that would have allowed state lawmakers to ban or dramatically restrict abortion. It failed by nearly 18 percentage points.

Kentucky voters will face a similar decision in November with a proposed constitutional amendment that would declare that the state’s constitutional right to privacy does not cover abortion.

Vermont is going in the opposite direction. Voters there will weigh a ballot measure in November that would add a right to “personal reproductive autonomy” to the state constitution, though it does not explicitly mention abortion or contraception. In Michigan, a proposed constitutional amendment that would guarantee a right to both abortion and contraception is expected to qualify for the November ballot.

In California, Proposition 1 would prevent the state from denying or interfering with “an individual’s reproductive freedom in their most intimate decisions, which includes their fundamental right to choose to have an abortion and their fundamental right to choose or refuse contraceptives.”

The proposed constitutional amendment doesn’t go into detail about what enshrining the right to contraception in the state constitution would mean.

California already has some of the strongest contraceptive-access laws in the country — and lawmakers are considering more proposals this year. For instance, state-regulated health plans must cover all FDA-approved contraception; pharmacists must dispense emergency contraception to anyone with a prescription, regardless of age; and pharmacists can prescribe birth control pills on the spot. State courts have also interpreted California’s constitution to include a right to privacy that covers reproductive health decisions.

The amendment, if adopted, could provide a new legal pathway for people to sue when they’re denied contraceptives, said Michele Goodwin, chancellor’s professor of law at the University of California-Irvine.

If a pharmacist refused to fill a birth control prescription or a cashier declined to ring up condoms, she said, customers could make a case that their rights had been violated.

Making the rights to abortion and contraception explicit in the state constitution — instead of relying on a right to privacy — would also protect against shifting political winds, said state Senate leader Toni Atkins (D-San Diego), who was the director of a women’s health clinic in the 1980s. Although California’s lawmakers and executive officers are solid supporters of abortion rights, she said, the composition of the legislature and courts’ interpretation of laws could change.

“I want to know for sure that that right is protected,” Atkins said at a legislative hearing in June. “We are protecting ourselves from future courts and future politicians.”

The amendment would solidify California’s role as a reproductive rights sanctuary as much of the country chips away at birth control availability, Goodwin added.

Experts said two forms of birth control that are vulnerable to restrictions in other states are intrauterine devices, or IUDs, and emergency contraception like Plan B. These methods are often incorrectly conflated with abortion pills, which end a pregnancy instead of preventing it.

Nine states have laws that restrict emergency contraception — for example, by allowing pharmacies to refuse to dispense it or excluding it from state family planning programs — according to the Guttmacher Institute, a research organization that supports abortion rights. In Alabama and Louisiana this year, abortion opponents introduced legislation that would restrict or ban abortion, and would also apply to emergency contraception.

“We’re seeing an erosion of abortion access that is playing out in statehouses across the country that have and will continue to target contraceptive care as well,” said Audrey Sandusky, senior director of policy and communications for the National Family Planning and Reproductive Health Association.

Susan Arnall, vice president of California’s Right to Life League, said the proposed amendment is symbolic and merely echoes current laws. Arnall thinks the campaign is mostly about Democratic politicians trying to score political points.

“It just allows the pro-abort legislators to trumpet and give them talking points about how they’re doing something about the overturn of Roe v. Wade,” she said. “It is political virtue signaling. I don’t think it does much of anything else.”

Goodwin argues that the measure’s symbolism is significant and overdue. She pointed to the Civil War era, when enslaved people in Southern states could look to free states for spiritual hope and material help. “Symbolically, what that meant is a kind of beacon of hope, that those places did exist, where one’s humanity could be regarded,” Goodwin said.

But California’s reputation as a haven for contraceptive availability may not be fully warranted, said Dima Qato, an associate professor at the University of Southern California School of Pharmacy. In her 2020 study of contraceptive access in Los Angeles County, which has some of the highest rates of teen and unintended pregnancy in the country, Qato found that only 10% of pharmacies surveyed offered pharmacist-prescribed birth control. Pharmacies in low-income and minority communities were the least likely to offer the service, Qato said, worsening disparities instead of solving them.

Qato supports the constitutional amendment but said California should focus on improving and enforcing the laws it already has.

“We don’t need more laws when we don’t address the root cause of a lack of effectiveness of these laws in these communities,” Qato said. “Lack of enforcement and accountability disproportionately impacts communities of color.”

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.