Republican war against reproductive health gaining ground

The Population Institute's annual 50-state report card on reproductive health and rights is not encouraging report. Nineteen states received a failing grade and the U.S. grade fell from a “C” to a “D+”. Attacks on Planned Parenthood, both physical and political, are jeopardizing the ability of women to access contraception and other reproductive health care services. At the same time, political assaults on sex education programs are gaining momentum and threatening the progress that we have made in reducing teen pregnancies. It all adds up to a bad report card for 2015, and it could get worse in 2016 as Congress inches ever closer to cutting off funding for Planned Parenthood, slashing support for comprehensive sex education programs in the schools, and eliminating funding for Title X, the federal program of assistance to family planning clinics serving low-income households.

In 2015, the U.S. House of Representatives voted seven times to defund Planned Parenthood, an action that would deny millions of women access to a trusted health care provider. The U.S. House Appropriations Committee voted again in 2015 to eliminate all funding for Title X, an action that would deny millions of women access to contraception and other vital health care services, including cancer screenings.

Planned Parenthood health centers make up only 10 percent of publicly funded safety-net providers, but they serve 36 percent of the clients seeking contraceptive services. In 103 counties with a Planned Parenthood health center, the Planned Parenthood facility serves all the women who are using safety-net clinics to access contraceptive services.

The defunding of Planned Parenthood would be particularly devastating for poor women and women living in remote areas. State assaults on reproductive health and rights also contributed to the low grade received by the U.S. for 2015. Abortion restrictions in Texas and in other states have forced the closures of dozens of family planning clinics. Worse still, the physical assaults on family planning clinics, which range from vandalism and arson to the devastating shooting that occurred at the Planned Parenthood clinic in Colorado Springs, are creating a climate of fear that will deter many women from accessing abortion and other services.

The news is not all bad. Seventeen states received a B- or higher and four states (California, New Jersey, Oregon and Washington) received an “A”. But the trend is not encouraging, as more states are adopting arbitrary and harassing abortion restrictions that — in addition to limiting a women’s access to legal abortion services –are forcing the closure of family planning clinics providing contraceptive services. Also, 21 states have refused to expand Medicaid coverage under the Affordable Care Act, thereby denying many poor women coverage for contraceptive services.

Equally worrisome, though less noticed, are the escalating attacks on support for comprehensive sex education in the schools. Sex education programs have made a significant contribution to the historic decline in the nation’s teen pregnancy rate, but America’s teen pregnancy rate is still very high compared to other industrialized countries, and much of the progress that has been realized could easily be lost if federal and state support for comprehensive sex education programs is slashed. By any standard, this is insane. About half of all pregnancies in the U.S. are unintended, and limiting access to contraceptive services and sex education will only increase the number of unwanted pregnancies and, of course, the demand for abortions.

One striking exception to this trend

Hit & Run - Tennessee state Sen. Steven Dickerson (R-Nashville) introduced legislation to allow birth control pills and the contraceptive patch to be accessible to anyone 18 and older without a prescription.

"Requiring a physician’s prescription can be an obstacle to access and effective use, especially among low-income women," Dickerson said. "One of the barriers for women is the fact they need to go to a doctor’s office to get a prescription. Often, this burdens them with missing work or takes them away from their family."

Dickerson, who is also an anesthesiologist, is one of many in the medical profession who think women should be able to access certain forms of birth control without a doctor's permission slip.

Oddly enough, the biggest supporters of over-the-counter contraception on the political front have been conservatives. Last May, Republican Sens. Cory Gardner (Colorado) and Kelly Ayotte (NH) co-sponsored a bill to spur action on over-the-counter oral contraception—though it didn't go anywhere. The subject was also a big one during Gardner's 2014 Senate campaign, a response to allegations from Democratic opponent Sen. John Udall that Gardner was opposed to contraception and women more generally.

The 2014 Reason-Rupe poll found 70 percent of Americans favor legalizing over-the-counter birth control pills and patches. Support was high among both men and women, and also showed bipartisan appeal, with 65 percent of self-identified Republicans, 69 percent of Democrats, and 74 percent of political independents in favor.