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RWVoices

Thursday
Jul192018

Speak out NOW against Trump’s harmful Title X rule

Trump’s rule would undermine the Title X family planning program

 

The July 31 deadline for submitting your comments on Trump’s Title X rule is fast approaching! Raising Women’s Voices has created a Take Action page on the Community Catalyst website where you can find talking points about this harmful proposed rule and a direct link to the Department of Health and Human Services (HHS) website where you can submit comments opposing this rule. 

Take action today! CLICK HERE to submit your comments to HHS. (Don’t worry that the HHS page says the comments are about “Compliance with Statutory Program Integrity Requirements.” That’s just the bureaucratic way of describing the proposed Title X rule.

Tell HHS this rule would compromise the quality and scope of family planning services patients can receive from Title X clinics, allow biased counseling and deny patients th
e full information they need to make informed decisions about their reproductive health. It would also push out of the Title X network those clinics, such as Planned Parenthoods, that provide abortions on site using separate funds. Tell HHS to withdraw the proposed rule because of the serious harm it would do to patients, especially those who are low income, women of color and LGBTQ people. (See more below on the likely impact on health disparities). 

If you represent an organization, Raising Women’s Voices has drafted template comments that you can tailor to reflect the experiences of the people you serve and submit to HHS. Both the volume of comments submitted as well as the depth of the comments are critical, as they can set the stage for litigation or changes in regulations. HHS will also have to respond to all submitted comments, so quantity and diversity in comments will help delay finalization and implementation of the rule. We encourage you to share unique stories as to how the Title X proposed rule would impact your community. 

What else can you do? If you’re in D.C., join Raising Women’s Voices, Planned Parenthood, and other partner organizations on July 24 for a march from 11:00 am – 12:30 pm from Capitol Hill to the Department of Health and Human Services to show our opposition to the Title X rule. If you aren’t in the nation’s capital, you can join an online Day of Action! Like our Facebook page and follow us on Twitter to join us that day. 

Are you a doctor, nurse, physician assistant, medical or nursing student? If so, you can sign a pledge that you will always put your patients’ needs first, protect the patient-provider relationship, and oppose government restrictions that prohibit clinicians from providing care that aligns with well-established standards of care and ethics. Take the pledge at SaveTitleX.org. Having thousands of providers engage in this grassroots action will send a strong and powerful message to the administration. 

Title X rule would exacerbate health disparities

Each week, our Raising Women’s Voices newsletter has been highlighting ways the proposed Title X rule would threaten low-income patients’ access to comprehensive reproductive health information and services, such as by  allowing biased counseling, enforcing physical separation of abortion services, prohibiting referrals for abortion and jeopardizing minors’ patient confidentiality

This week, we want to emphasize how this rule would worsen existing health disparities and make it even more difficult for women of color, low-income women and LGBTQ people to find and receive comprehensive, affordable reproductive health care. All of the harmful impacts we discussed in previous newsletters will fall most heavily on historically marginalized and underserved people who are most in need of comprehensive, affordable reproductive and sexual health care services. 

Because of systemic inequities in access to comprehensive health care, Title X serves a racially and ethnically diverse group of patients, many of whom do not have health insurance. Women of color comprise a large proportion of the Title X population. Of the four million family planning patients served in 2016, 21 percent identified as Black or African American and 32 percent identified as Hispanic or Latino. Women of color experience worse health outcomes and encounter significant barriers to accessing reproductive health care. Human papillomavirus (HPV), one cause of cervical cancer, is more prevalent and deadly among Black women and Latinas. In fact, women of color experience higher rates of cervical cancer than do white women, and Black women are more likely to die of breast and cervical cancer, compared to women in any other racial or ethnic group. 


The burdensome and unnecessary requirements of the proposed rule for physical and financial separation between the Title  X-funded services of the clinic and any abortion services it may also provide would likely result in clinics dropping abortion care or being denied Title X funding they need to stay open. Many people, particularly women of color, would lose access to vital health services, such as cancer screenings, family planning services, and wellness exams. For 4 in 10 women, family planning clinics are their only source of care. 

The impact of the proposed rule would be particularly detrimental to LGBTQ people, who already struggle to obtain vital health services. Stigma and discrimination against LGBTQ people remain pervasive and interfere with their access to health care. Transgender people are more likely to live in poverty and less likely to have health insurance than the general population. Many in the LGBTQ community -- including cisgender women, transgender men, intersex and gender-nonconforming people -- need affordable access to birth control to prevent pregnancy, regulate menstruation and treat such medical conditions as fibroids and endometriosis. 

The proposed rule would prevent LGBTQ individuals from accessing specialty services from Title X providers that meet their health needs. For example, cutting people off from care at Planned Parenthood could restrict transgender individuals from receiving quality, compassionate, and affordable transgender-specific care. Planned Parenthood offers hormone replacement therapy at over 100 of its health centers across 17 states, making it one of the largest providers of transition-related care in the United States.

Trump’s “Summer of Sabotage” of our health care

Last summer, we were out in the streets, on Capitol Hill in Washington and burning up the internet as we fought to save the Affordable Care Act from Republican efforts to repeal it. Fortunately, we won, and the ACA remains the law of the land. But this summer, the Trump administration is doing everything it can to undermine and sabotage the ACA!

Call it the Summer of Sabotage! That’s the title  of a new report just issued by national Protect Our Care coalition. The subtitle is: “How the Trump Administration continues to take active measures to undermine our care.”  For example, the report flags that Trump has:

  • Gone to court and asked that protections for people with pre-existing conditions be overturned;
  • Pushed junk insurance plans that can discriminate against people with pre-existing conditions and refuse coverage of essential health benefits, such as maternity care;
  • Slashed funding for in-person assistance to help people sign up for health coverage;
  • Approved onerous restrictions on Medicaid; and
  • Nominated a justice for the Supreme Court who was hand-picked to tip the balance of the Court and potentially rubber stamp the president’s sabotage agenda.
Want to learn more? You can read the Summer of Sabotage report here
Thursday
Jul122018

The escalating attacks on our health care!

SCOTUS pick the latest salvo in Trump’s war on our health care!
 
He couldn’t get Congress to repeal the Affordable Care Act (ACA), “defund” Planned Parenthood or end abortion. But now Donald Trump is using federal regulatory power and a Supreme Court nominee to wage attacks on reproductive rights and undermine the greatest advances in health coverage in a generation.

The latest salvo came Monday night, when Trump nominated conservative D.C. Circuit Court Judge Brett Kavanaugh to fill the Supreme Court seat of retiring Justice Anthony Kennedy. The choice of Kavanaugh fulfills Trump’s promise to his conservative supporters to nominate judges who are likely to vote to overturn or undermine Roe v. Wade. In addition to the threat to abortion, Raising Women’s Voices is paying close attention to what Kavanaugh’s nomination could mean for contraceptive coverage and the future of the ACA.
 
We’ll have more to say in the weeks ahead, but here are quick summaries of two areas of concern:
 
Abortion: Kavanaugh dissented to the DC Circuit Court’s decision last fall in Garza v. Hargan, allowing an undocumented immigrant teenager in federal custody to immediately obtain an abortion. Kavanaugh wrote that the teen should have had an “expeditious” transfer to her immigration sponsor before the abortion occurred, claiming such a transfer would be “merely seeking to place the minor in a better place when deciding whether to have an abortion.” However, it would have delayed the abortion, and there are many reasons why a minor may not want an appointed guardian, a stranger, to be involved with such a decision.
 
Contraception: Kavanaugh has ruled that the contraceptive coverage mandate implementing the ACA’s women’s health amendment infringes on the rights of religious employers. In a 2015 case, Priests for Life vs. HHS, Kavanaugh wrote that the forms and fees required by the Obama administration to exempt a religious organization from providing contraception coverage “substantially burden the religious organization’s exercise of religion.”
 
Title X rule would jeopardize minors’ patient confidentiality
 
Our weekly newsletters have been explaining ways the Trump administration’s proposed Title X rule would threaten low-income patients’ access to comprehensive reproductive health information and services by prohibiting referrals for abortionallowing biased counselingenforcing physical separation of abortion services, and prohibiting activities that encourage, promote, or advocate for abortion.
 
This week, we are highlighting two of the less-noticed but extremely dangerous provisions of the proposed rule, both affecting the patient confidentiality of minors who are seeking reproductive health services at Title X clinics.

The first provision would require family planning providers to try to involve a teenager’s family members in the decision-making about the minor’s reproductive health care. This requirement could escalate existing problems of parental abuse, violence and incest, or subject young people to shame, judgment or even abandonment by their families
 
Forcing Title X providers to pressure for family participation when minors are seeking reproductive health care will destroy the trust between providers and patients, particularly those who are victims of family abuse or violence. The unfortunate result could be that young people will avoid seeking reproductive health care all together due to mistrust and lack of confidentiality.
 
The proposed rule would also require that clinics conduct screenings for any teen who presents with an STD, pregnancy or suspected abuse, in order to determine whether there has been victimization of a minor. The provider may then breach patient confidentiality to report cases of suspected child abuse, child molestation, sexual assault, rape, incest, intimate partner violence or human trafficking. Such reporting could inadvertently jeopardize a minor’s safety, and may deter vulnerable young people from seeking care at Title X clinics. 
 
Trump’s proposed Title X rule would be much #MoreThanAGagRule, particularly for young people needing reproductive health care. CLICK HERE to submit your comments to HHS by July 31 opposing the harmful provisions of the Title X rule.Tell HHS how this rule would compromise the patient-provider relationship and discourage adolescents from seeking much needed care.
 
Trump slashes funding for ACA navigators, adds new rules
 
The Trump administration this week also announced further devastating cuts to funding for the navigator agencies that help consumers enroll in ACA health plans. Funding for this fall’s open enrollment period work will be slashed by 90 percent from the 2016 funding levels.
 
Moreover, navigators that are funded will have to begin telling consumers about their options to purchase short-term or association health plans -- “junk plans” that won’t cover many services, such as maternity care, because they are not governed by ACA rules. Navigators will also be required to inform potential enrollees of their option not to purchase plans that cover abortion services.
 
Navigators have been key to past efforts to enroll some groups of uninsured consumers, especially those who are low income, have limited English language ability, are unfamiliar with health insurance and/or are distrustful of the health system. The cuts to navigator funding will present new challenges this fall for Raising Women’s Voices and our allies as we work to reach low-income women, women of color, immigrants and LGBTQ people who could enroll in coverage.
 
Opposing Trump’s immigration policies
 
Last week, our Denver-based regional coordinator, Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), participated in the national #FamiliesBelongTogether day of action to call for an end to policies that separate and detain immigrant families. COLOR recruited activists to attend the Denver Families Belong Together Rally at Civic Center Park, where attendees heard from immigrant right’s activists Jeanette Vizguerra and Nadeen Ibrahim. Pictured from left to right are Mariana Galvez, Leslie Lopez, and COLOR’s Development Manager, Marie Medina.
 
COLOR has also been issuing calls to action, encouraging people to ask their members of Congress to support legislation to end family separation. Em Alves, COLOR’s Policy and Communications Manager, explains that: “We believe that Immigrant Justice IS Reproductive Justice and that supporting family values means supporting families and their right to raise children in a safe and healthy environment.  We will continue to raise awareness and organize our network around this critical issue.”
 
 
Southern RJ Roundtable: Work in the states goes on!
 
SisterSong: National Women of Color Reproductive Justice Collective hosted their Southern RJ Roundtable in Atlanta, GA, in June. Many of our regional coordinators were in attendance, including Feminist Women’s Health Center, The Afiya Center, Mississippi in Action, SisterReach, and Women With a Vision.
 
The Roundtable gathered RJ organizations and supporters at the Motherhouse for engaging discussions on implementing the RJ framework, cross-sector work, deepening regional collaborations, strategic planning, effective collaborations and future visions for the RJ movement. The cross-movement learning labs on environmental justice, economic justice, and faith provided insights on changing the narrative when it comes to cross-sector RJ work.
 
Speakers included Cherisse Scott, founder & CEO of RWV’s Tennessee regional coordinator,SisterReach, who discussed their Faith & Advocacy toolkits for clergy, lay leaders, advocates, and activists. RWV’s Regional Field Manager, Kalena Murphy, also attended. 

 

Friday
Jun292018

Justice Kennedy’s Retirement Threatens Our Health Care and Our Reproductive Rights

Justice Kennedy’s Retirement Threatens Our Health Care and Our Reproductive Rights
 


Justice Anthony Kennedy’s retirement hands President Trump an opportunity to push the Supreme Court further to the right and move our country backwards for generations to come. Trump has promised to only appoint biased judges who will overturn Roe v. Wade to the Supreme Court. He did exactly that by putting Neil Gorsuch on the bench. With an administration bent on sabotaging our health care, another Trump appointment would further jeopardize access to care. Reproductive rights, health care rights, immigrant rights, and LGBTQ rights are at risk.
 
Justice Kennedy, a Reagan appointee, mostly voted conservative, but he was a pivotal vote in cases critical to reproductive rights. In Whole Woman’s Health v. Hellerstedt, Justice Kennedy joined the 5-4 majority in striking down a Texas law that would have shut down most of the state’s abortion clinics. If Trump gets his way, there will no longer be enough justices on the Supreme Court to protect the constitutional right to safe and legal abortion.
 
According to the Guttmacher Institute, 17 states have laws that would restrict the right to legal abortion if the Supreme Court overturns Roe v. Wade. States hostile to abortion have intentionally enacted extreme restrictions, such as Iowa’s 6-week abortion ban and Missouri’s medication abortion ban, with the hopes that inevitable litigation would bring the case before a conservative Supreme Court. The next justice will likely rule on the constitutionality of abortion restrictions that push timely abortion care out of reach.
 
Under this extremely ideological and unpredictable administration, the highest court in the land is the last check on harmful policy. Given the administration’s relentless attempts to roll back health care consumer protections, Trump’s pick will likely be willing to also sabotage the Affordable Care Act.
 
Earlier this month, the Trump administration announced that it would not defend the ACA, and in fact, called to eliminate protections for people with pre-existing conditions. “The next Supreme Court justice may be faced with casting a deciding vote on the fate of our healthcare system, and we already know, unfortunately, the kind of vote that President Trump wants,” said Minority Leader Chuck Schumer (D-NY).
 
What can you do? Call your senators and urge them to reject any Supreme Court nominee who would not protect our health and our rights. They must reject any nominee who opposes Roe v. Wade and the right to safe and legal abortion. Tell them to only accept a justice that will hold this administration accountable in enforcing and defending the ACA, the law of the land. Because the stakes are so high, tell your senators to follow Majority Leader Mitch McConnell’s (R-KY) own rule, and not vote on any nominee until January. We need to let the people speak in November, before any hearings are held.

 

Wednesday
Jun272018

Celebrating Pride Month and intersectional LGBTQ health advocacy 

An advocate’s vision for LGBTQ-empowering models of health advocacy
 
This LGBTQ Pride Month, we sat down with Naushaba Patel from the Lesbian Health Initiative (LHI) – RWV’s Houston-based regional coordinator – to explore Naushaba’s vision for LGBTQ-empowering health programs and advocacy that come “from a place of love and a place of connection.”
“Pride has this dual purpose,” Naushaba explained. “Let’s celebrate what progress we have made, and at the same time, let’s be vocal about all the work that still needs to be done.” This perspective informs LHI’s work throughout the year. LHI connects LGBTQ people to needed health services, engages in local advocacy efforts and provides educational programs.
 
As a regional coordinator for RWV, LHI participated in successful work to promote Open Enrollment Period 5 last fall, especially among diverse LGBTQ people. Naushaba worked with RWV to create social media badges, flyers and messages that were LGBT affirming and inclusive, “not just white LGBT affirming, but messaging specifically about diversity within the queer community that featured larger bodied queer people and queer women of color.”(See example at left.) These messages addressed the specific concerns that were common in Naushaba’s queer community spaces, such as explaining that individuals can choose their own doctor rather than be forced to visit a doctor that is not affirming of their gender, sexuality or life experiences.
 
Naushaba explained that LHI’s work with RWV to promote open enrollment was informed by two critical lenses: an intersectional lens and a “joy and excitement lens.” Naushaba explains that to achieve the dual purpose of pride – both celebration and action – these two lenses are critical.
 
Approaching public health from an intersectional lens means recognizing and centering the experiences of people who sit at the intersection of multiple different marginalized identities. LGBTQ health work is more relevant when one “brings language justice, disability justice, intersex activism and undocumented folk into the work,” Naushaba said. To do this, Naushaba describes being intentional about which populations lack a seat at the table and how to focus on building trust with those who are not traditionally included.
 
Through work at LHI, Naushaba also advocates for the importance of a “joy lens.” Naushaba says, “Let’s talk about all that we have accomplished. Let’s build spaces for healing that aren’t just centered on stigma conversations. Let’s have joy and celebration.”
 
Together, the intersectional lens and the joy lens allow Naushaba to create spaces “where people can bring their entire selves to the table.” This approach provides an example for work in communities or at the state level, whether it’s in promoting health insurance literacy, conducting outreach and enrollment or carrying out grassroots organizing and policy advocacy. For LGBTQ Pride Month, RWV partners can join Naushaba in celebration and action by adopting messaging that addresses people with multiple marginalized identities and by recognizing the diverse lived experiences of people in their community. 
 
And yet another reason the Trump administration’s proposed Title X rule is #MoreThanAGagRule
 
In previous newsletters, we’ve highlighted three ways the proposed Title X rule would threaten low-income patients’ access to comprehensive reproductive health information and services by prohibiting referrals for abortionallowing biased counseling, andenforcing physical separation of abortion services.
 
This week our focus turns to an element of the rule that prohibits Title X funded-programs from engaging in activities that encourage, promote, or advocate for abortion. The rule prohibits any actions that “assist women to obtain abortions or to increase the availability or accessibility of abortion.” Prohibited activities would include lobbying, hosting speakers or educators who promote abortion and disseminating any materials that “promote a favorable attitude toward abortion.” A program can violate this restriction by doing something as small as having brochures with abortion information available in the waiting room.



This provision furthers the administration’s goal of creating a “bright line of separation” between Title X funds and abortion activities (even though, as we’ve mentioned before, family planning providers are already prohibited from using Title X federal funds to provide abortions). In doing so, the provision attempts to shift Title X funds away from organizations that support a woman’s right to access safe and legal abortion services. By limiting grantees educational and advocacy activities, this element of the rule further limits patient’s access to information about abortion and puts a “gag” on what organizations who serve Title X populations can publically support.
 
What can you do? CLICK HERE to take action and submit your comments to HHS on the proposed Title X rule. The deadline is July 31. Tell HHS how this rule would provide you with misleading reproductive information and limit your clinics ability to support your right to choose.
 
Families belong together
 
Like many of you, we are outraged by the Trump administration’s policy to separate immigrant children from their parents at the border. More than 2,000 children, including some under 5 years, don’t know if they will ever see their parents again. The executive order ending family separation will not erase the trauma or undo the harm inflicted on these families. This new policy of detaining entire families together will further threaten their health and well-being, both now and into the future.
 
The American Academy of Pediatrics warns that exposing children to trauma and prolonged stress interferes with a child’s healthy development and can lead to lifelong health problems. Public health experts note that family separation increases the risk of adverse childhood experiences, which leads to poor long-term health. Negative outcomes associated with adverse childhood experiences include alcoholism, depression, substance use, suicide, obesity, diabetes, and heart disease.
 
Separating breastfeeding infants from their moms can also have health consequences for both the child and mother. Breastfeeding lowers an infant’s risk of asthma, obesity, diabetes, ear and respiratory infections, and sudden infant death syndrome. Health benefits for mothers include a reduced risk of heart disease, diabetes, ovarian cancer, and breast cancer. In an interview with Vox, Alison Stuebe, a professor of obstetrics and gynecology at University of North Carolina explained, “A woman’s breasts are continuously making milk, and if that milk is not removed, her breasts become swollen and painful. She can develop mastitis, and mastitis can evolve into a breast abscess that may require surgical drainage.” 
 
Family detention is not the solution and can exacerbate health impacts, including anxiety, depression, and posttraumatic stress disorder, as noted by the American Academy of Pediatrics. Children do not belong in baby cages and internment-like camps and should not be detained indefinitely.
 
How can you raise your voice in opposition to these inhumane policies? Participate in the #FamiliesBelongTogether Day of Action by attending an event this Saturday, June 30th. RWV regional coordinators around the country will be participating in local events, including RWV’sDenver-based RC – Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR–  which will be joining several groups working on the ground to organize a march. You can go to familiesbelongtogether.org to find an event near you.
 
Supreme Court rules in favor of fake women’s health centers
 
By a single vote (5-4), the Supreme Court in NIFLA v. Becerra decided that fake women’s health centers can continue to use their dangerous and deceptive practices that block women from receiving time-sensitive information about their full range of reproductive care options.
 
The National Institute of Family and Life Advocates (NIFLA) and two if its member “pregnancy centers” had challenged California’s Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act – a law that requires fake women’s health centers to disclose that they are unlicensed providers and do not provide comprehensive health care, including abortion. The FACT Act also requires fake women’s health centers to post a sign that California has public programs that offer free or low-cost comprehensive family planning services, including abortion. The Supreme Court’s decision means that fake women’s health centers don’t have to disclose what they are – and that’s fake.
 
The more than 2,700 fake women’s health centers scattered across the country lure women in at a vulnerable time in their lives. Fake women’s health centers employ aggressive advertising tricks to make women believe they offer comprehensive health care, including abortion; lie about medical facts; and give inaccurate due dates to push women past the legal limit for abortion.
 
The Supreme Court’s ruling is a major setback for reproductive rights. Women deserve the truth.
 
What can you do? Hold Google accountable for their role in misinforming women. Fake women’s health centers intentionally design their websites to look like websites of real women’s health clinics. As a result, fake women’s health centers appear in Google paid ads, search, and map results for women searching for abortion. Google has said that it has removed the fake women’s health center ads, but the misleading ads are still showing up. Sign this petition to tell Google: “Keep your word. Take down ads that intentionally lie to women seeking information about abortion.” Or send a letter directly to Google’s CEO, Sundar Pichai (1600 Amphitheatre Parkway Mountain View, CA 94043) urging Google to take immediate action and stop their search engine from misleading women.

 

Friday
Jun222018

Here’s another reason why it’s #MoreThanAGagRule!

Clinics would have to relocate abortions, or lose funding
 
In a weekly series of articles, we’re explaining how the Trump administration’s proposed Title X rule is #MoreThanAGagRule. Previously, we’ve highlighted two ways the rule would threaten low-income patients’ access to comprehensive reproductive health information and services by prohibiting referrals for abortion and allowing biased counseling.
 
This week, we’re focusing on a third element of the rule, which requires a physical separation between Title X funded-programs and the provision of abortion services. This burdensome and unnecessary requirement threatens Title X sites that legally provide abortion, and would force them to either stop providing abortions on site, or lose Title X funding.
 

 
Title X rules already require clinics to maintain strict financial separation of Tile X federal funds from any funds used to provide abortions. As a result, many Title X sites provide abortions using non-federal funds and keep careful bookkeeping separation. This process is what allows Title X sites, such as Planned Parenthood and Federally Qualified Health Centers, to be key points of access for abortion services.
 
The new rule takes the separation requirement a big step further by requiring detailed physical separation. In addition to separate bookkeeping, Title X-funded entities would have to create separate physical spaces for providing abortions, such as separate waiting and exam rooms, entrances and exits. They would have to employ separate staff, use different phone numbers and email addresses, and set up separate patient health records, educational programs and signs.
 
This provision threatens clinics that offer abortion as part of comprehensive reproductive health care. Establishing the required level of separation between abortion services and Title X-funded family planning services may be more than many programs can afford. HHS estimates that it would cost Title X sites $20,000 to comply with the physical separation requirements. This analysis very likely grossly underestimates what would be needed to set up an entirely separate physical space with new staff, a different health record system and new educational programs. 
 
“HHS’s estimate that it would cost family planning providers about $20,000 to comply with this requirement is so far off-base it would be laughable if it weren’t so threatening,” said Cindy Pearson, RWV Co-founder and Director of the National Women’s Health Network. “I’ve been a clinic director and still serve on the board of a women’s clinic. $20,000 wouldn’t begin to cover the cost of creating separate entrances, exam rooms, counseling areas, waiting rooms and lavatories.  Plus there are administrative aspects of health care that would also have to be duplicated to create separate “entities”:  electronic health records, financial records, payroll services and more.” 
 
She explained that “providing comprehensive reproductive health services, including abortion care, in one setting makes sense from the perspective of the client and the provider. The cost of separating these services from each other is likely to be so expensive that many clinics would either have to give up providing abortion care, or start turning away people who need birth control because they no longer have a Title X grant.”
 
As a result, those Title X sites ( 1 in 10) that currently offer abortion using non-federal funds could be burdened with extra costs to relocate abortion services, or face a loss of funds if excluded from Title X eligibility. Either way, these clinics would face financial stress, and potential closure. 
 
Losing these providers would create a significant gap in services. The Guttmacher Institute estimates that the impact on Planned Parenthood alone would require other Title X sites to increase their client caseloads by 70 percent, on average. This gap could not realistically be filled by other Title X sites, which are already stretching their capacity to meet their communities’ needs. People seeking services would face heightened barriers to obtaining abortion, reproductive health services and preventive care. Women in rural and low-income areas, in particular, could find a hostile reproductive health care landscape in which affordable and high quality services are no longer available.
 
In facilities that do have the ability to create the mandated physical separation, patients would be required to go to a different location or use a different entrance for abortion care. Today, at sites around the country that receive Title X funds, abortion is provided as a regular part of care in the same exam rooms and by the same providers. This allows for a dignified experience of abortion. The new rule would serve to physically reinforce the idea that abortion is not a normal part of health care and increase stigma.

What can you do now? You can take action and submit your comments to HHS on the proposed Title X rule by following this link http://bit.ly/title-x-action. Deadline is July 31. Tell HHS how this rule would make it more difficult or impossible for you and others who may be affected to get timely reproductive and preventive health care.
 
Watch out for those “junk” health plans coming our way!
 
On Tuesday, the Department of Labor released the final rule to dramatically expand the sale of unregulated “junk” health insurance, in the form of association health plans. The final rule allows existing associations to create health plans to sell coverage, without any consumer protections, to small businesses and self-employed individuals. Self-employed people and small businesses can also create groups specifically to offer cheap association health insurance. The first wave of these junk plans is likely to be available starting September 1 of this year.
 
This is the latest in a series of attacks by the Trump administration to sabotage the Affordable Care Act. It will likely reduce  people’s coverage for essential health care, especially for women, older adults, and those with pre-existing conditions. Association health plans are not required to cover the 10 essential health benefits, such as maternity care, prescription drugs and treatment for mental health and substance use disorders. They can also charge higher premiums to women, older adults, residents of rural areas and anyone else the insurance industry thinks may have higher health care costs. 
 
Because they will cover less, these junk plans will be cheaper, so they will attract buyers among younger and healthier self-employed people and businesses that employ such people. As a result, the remaining people who are still buying more comprehensive coverage will be slightly older and sicker. This change would drive up premiums for those comprehensive plans, which would price out the next tier of healthy people. That, in turn, would leave ACA markets as a high-risk pool with only the very sickest people still trying to buy comprehensive coverage. The Congressional Budget Office estimates that premiums will increase 31-54% by 2019 because of Trump’s sabotage.
 
One of the chief concerns for those people who do buy the association health plans is that consumers may be vulnerable to fraud and abuse. These junk plans have a long history of attracting scam artists and becoming insolvent. They’ve left hundreds of thousands of beneficiaries stuck with millions of dollars in unpaid medical bills.
 
State Attorneys General in New York and Massachusetts are preparing a lawsuitchallenging the association health plan rule. "Yesterday's announcement by the Trump administration to dramatically expand the footprint of association health plans will invite fraud, mismanagement and deception and—as we've made clear—will do nothing to help ease the real health care challenges facing Americans," said New York AG Barbara Underwood. "We believe the rule, as proposed, is unlawful and would lead to fewer critical consumer health protections."
 
Most assessments of the rule conclude that states will have limited regulatory authority over the new association health plans. However, states can require association health plans to maintain specified levels of financial reserves to help ensure these plans can actually pay for the coverage their policies promise. States may need to first pass laws to legally authorize state insurance regulators to do this. (New York’s top insurance regulator told Crain’s Health Pulse that because of state laws pre-dating the ACA, New York can still regulate these plans.)
 
The administration is also set to release a final rule to expand the other kind of junk insurance – short-term health insurance plans. Again, these kinds of junk health plans won’t cover what women need!
 
What can you do now? Call your governor and state legislators and urge them to pass policies to regulate association health plans and to ensure consumer protections. Warn your friends and family members not to be fooled by cheap “junk” health plans!