Tuesday, March 23, 2021
By Fallon Parker (Mar. 23, 2021)
In President Biden’s first two months in office, his team has fulfilled a number of campaign promises meant to make broad strides for reproductive rights and undo many of President Trump’s harmful anti-choice policies. Reproductive justice advocates and a group of Democratic Senators, however, are pushing Biden to go beyond merely repealing Trump-era policies by framing reproductive justice as a broader, more holistic policy through the creation of a new office.
Senators Elizabeth Warren, Cory Booker, and Kirsten Gillibrand are leading the effort to create an Office of Sexual and Reproductive Health. On Tuesday, February 23, the group of Democratic senators sent a letter pushing President Biden to create the office in order to “more holistically address the ‘human right to maintain personal bodily autonomy.'” The office would be independent of other agencies like Health and Human Services, and would reside within the Domestic Policy Council. The separation is intentional, says the letter, because “securing true reproductive justice is beyond the scope of any one existing executive department,” and an independent department will allow the office to expand beyond traditional reproductive rights. The office intends to focus on a broad range of reproductive justice issues, including health care, economic inequality, discrimination based on race, gender identity, and sexual orientation, food security, housing stability, environmental justice, immigrants’ rights, and disability rights, issues that are central to reproductive justice, but beyond the scope of existing reproductive rights offices.
An Office of Sexual and Reproductive Health and Wellbeing would mark a significant step for President Biden in his pledge to support reproductive rights. Biden has already taken broad actions to undo some of the harmful policies instituted by former President Trump, but reproductive justice organizations would like to see more.
In his first few months in office Biden rolled back the “global gag rule,” which prevented organizations abroad receiving U.S. aid from performing or discussing abortions. The administration also began the process to roll back the Title X gag order precluding domestic organizations from referring clients for abortions under the Trump administration.
Significantly, the American Rescue Plan, which Biden signed into law, provides for a child tax credit for families, lower Affordable Care Act premiums, and extended postpartum Medicaid coverage for people giving birth from 60 days to 12 months. Advocates, senators, and the Biden administration see these policies as wins for reproductive justice.
Reproductive rights advocates, however, are pushing the Biden administration to go beyond merely repealing Trump-era anti-abortion policies. On Wednesday, March 18, Planned Parenthood and 55 other reproductive rights, health, and justice groups sent a letter to Biden urging him to increase patient access to medication abortion by removing the federal restriction that requires mifepristone, one of two medications used in medication abortions, to be picked up directly from a doctor, hospital, or health center, rather than from a pharmacy or by mail.
Additionally, international human rights and reproductive justice organizations have called on Biden to repeal the Helms Amendment, which restricts funds from the U.S. Foreign Assistance Act from being used for abortions.
Senators Warren, Booker, and Gillibrand expressed their appreciation for Biden’s initial early executive actions on reproductive rights, but echoed activists’ desire for Biden to continue to build on this work and “institutionalize a reproductive justice policy framework” through this new office. The office would (1) develop a federal strategy for promoting equitable sexual and reproductive health and wellbeing through a human rights, gender and racial equity lens, and (2) better coordinate the actions of the many departments and agencies whose actions in both domestic and foreign policy contexts impact sexual and reproductive health and wellbeing.
Tuesday, March 16, 2021
By Kelly Folkers (March 16, 2021)
Since President Obama signed the Affordable Care Act (ACA) into law almost ten years ago, increasing numbers of patients have been able to use their desired form of contraception, according to the results of a recent national survey of OBGYNs. One of the law's most popular provisions requires insurers and employer-sponsored plans to cover most FDA-approved contraceptive methods without charging a co-pay or co-insurance. But with the COVID-19 pandemic continuing into its second year and the future of the ACA pending in the Supreme Court, these important gains furthering reproductive autonomy hang in a precarious balance.
The Kaiser Family Foundation reports that 63 percent of providers have seen contraceptive use significantly or somewhat increase after the implementation of the ACA's birth-control coverage mandate in 2012. Importantly, 69 percent of OBGYNs surveyed reported that the number of their patients able to select their desired method of contraception significantly or somewhat increased subsequent to the provision's implementation.
Historically, access to contraception has led to a number of beneficial outcomes for women and people with uteruses. Since oral birth control pills became legal in 1965, more women have enrolled in college and earned higher wages. But like any type of health care, birth control is not a one-size-fits-all approach. Patients need a menu of birth control options available as some may cause unwanted side effects.
Despite the ACA's important gains, the survey also revealed that lower-income patients, particularly those on Medicaid, face significant difficulty in affording and accessing sexual and reproductive healthcare. Though 78 percent of the OBGYNs surveyed accepted Medicaid, many noted barriers to enabling contraceptive choice like the need to get prior authorization or being limited to prescribing an initial contraceptive supply for only 30 days. While the survey provides important context to suggest that the ACA has significantly improved access to contraception nationwide, the survey respondents included, primarily, providers who practice in states with Medicaid expansion, in urban settings, and in private clinics.
At the same time, the ongoing COVID-19 pandemic has created new barriers to accessing care. According to the Guttmacher Institute, one third of women reported delays or cancellations in contraceptive or other sexual and reproductive healthcare. While physician accessibility has increased with the use of telemedicine, at least five states require that providers prescribe birth control in person.
Without guaranteed, affordable access to one's desired birth control method, many patients may need emergency contraception or abortion. But several states have essentially used the pandemic as a pretext for almost completely curtailing abortion access. For example, early in the pandemic Texas banned all abortions that were not "necessary to preserve the life and health of the mother," essentially requiring any person seeking an abortion in Texas to travel out of state. In many red states, patients have had to rely on the support of community organizations to provide transport for an abortion, risking their life and health to exercise their constitutionally protected right to reproductive autonomy.
While the ACA laid the foundation for increased access to reproductive health care, the Kaiser Family Foundation survey signals that access to the full array of FDA-approved birth-control options remains inequitable. Further, the pandemic has revealed the need for states to ensure reproductive autonomy and justice by guaranteeing coverage for the full array of contraceptive options for all and removing unnecessary barriers to accessing reproductive health care.
Tuesday, March 9, 2021
By Shelby Logan (March 9, 2021)
On International Women's Day this Monday, gender justice activists worldwide were able to celebrate a long-awaited victory. In February, for the first time in history, the International Criminal Court (ICC) convicted an individual for forced pregnancy as a war crime. The Court, in a landmark verdict, found Dominic Ongwen of Uganda, a former commander in the militaristic anti-government group Lord’s Resistance Army, guilty of 61 charges, including the widest range of sexual crimes ever brought before the ICC.
Ongwen’s conviction on charges including sexual-based violence, forced pregnancy, and outrages upon personal dignity committed against women, is a necessary move forward for the ICC: After decades of advocacy, the international community is holding individuals accountable for sexual crimes against women during conflict.
Although sexual and gender-based crimes have always been part of conflict, international criminal proceedings during the 20th century omitted them from charges beginning with the Nuremberg Tribunal, which specifically excluded sexual crimes against women from its charter. It wasn't until 2002, the year the International Criminal Court was inaugurated, that sexual crimes against women as elements of genocide, crimes against humanity and war crimes were enumerated in international criminal proceedings. Yet, even if prosecutors initially charged a defendant with sexual crimes, the charges were usually dismissed later to prioritize charges for mass killings.
A major shift occurred in 2014, when the Office of the Prosecutor of the ICC released the “Policy Paper on Sexual and Gender-Based Crimes.” Prosecutors began to introduce more charges for gender-based crimes but still failed to convict. On behalf of victims, gender-justice advocates began writing shadow reports pushing the Office of the Prosecutor to commit to charges and follow through with prosecution. As Ongwen’s personal story is also tragic—he was one of many young children who have been forced to join the Lord’s Resistance Army—the ICC found him guilty only for crimes committed after it considered him a “fully responsible adult.“ His conviction marks a first crucial step in accountability for sexual and gender-based war crimes and a turning point.
Yet, as the gender-justice community celebrates the result in the Ongwen case, it is clear that more change is needed in world courts. Even in Ongwen’s case, only charges against women-identifying persons were included. Several charges of sexual violence committed against men were left off the docket. While sexual violence against transgender and male-identifying persons is often underreported, the Ongwen decision as well as events unfolding in China and Myanmar, may provide ground for more inclusivity in prosecuting sexual-based crimes.
Advocates have a crucial window of opportunity to advance jurisprudence on sexual and gender-based violence crimes. Combined with the latest Strategic Plan for the ICC Office of the Prosecutor, which seeks to address the underreporting of sexual and gender-based crimes, and the recent Ongwen ruling, the priority of gender justice at the ICC has been pushed to the forefront.
Tuesday, March 2, 2021
By Fallon Parker (March 2, 2021)
In the wake of Amy Coney Barrett’s fast-tracked ascendance to the U.S. Supreme Court last fall, headlines have spotlighted the flurry of anti-abortion legislation making its way through state legislatures in anticipation of a receptive Supreme Court. However, in the four months since Barrett's confirmation, several states have introduced measures that would shore up reproductive rights and protect them against federal assault.
This legislation is vital given the conservative majority on the Supreme Court and the 17 pending abortion cases that could be argued before the court in 2022.
New Mexico made headlines on February 19th when state legislators voted to repeal a 1969 law that banned most abortions in the state after a failed 2019 attempt to rescind it. Although the statute has been dormant since 1973 when Roe v. Wade was decided, it could go back into effect if Roe is overturned. The statute mandated hospital board approval for medical termination of a pregnancy and restricted abortion to situations of incest, rape reported to the police, grave medical risks to the pregnant person, or indications of grave medical defects in the fetus. Governor Michelle Lujan Grisham (D) signed the repeal bill on February 26th, making it law as of that date.
In Minnesota, two Democratic state legislators, Representative Kelly Morrison, and Senator Jennifer McEwen, introduced the Protect Reproductive Options (PRO) Act on January 21st. The bill would establish the fundamental right of Minnesotans to make individual decisions about reproductive health care, including abortion; recognize a fundamental right to privacy with respect to personal reproductive decisions; and prevent the state from interfering with reproductive decisions. According to Rep. Morrison's press release, this legislation is in response to the nationwide attack on abortion rights and the possibility of a Supreme Court challenge to Roe. However, Minnesota’s state legislature is under split control, with Democrats controlling the House of Representatives and Republicans controlling the Senate, which makes it unlikely the legislation will pass.
In Virginia, after years of organizing, in 2019 Democrats gained control of both state chambers for the first time since 1996. The Senate quickly passed the Reproductive Health Protection Act in April of 2020 repealing a number of medically dubious restrictions on abortion. More recently, the Senate and House each passed a parallel bill to repeal the ban on abortion coverage for people on the state’s healthcare exchange. This legislation is expected to be signed by Governor Ralph Northam (D) in April. Similar bills mandating healthcare abortion coverage have recently been introduced in Arizona, Hawaii, California, and New Jersey, although only Virginia’s has been brought to a vote.
Massachusetts--a historically liberal state--acted quickly to codify abortion rights following Barrett’s appointment. In late 2020, the state legislature expanded access to abortion beyond 24 weeks in cases of fatal fetal anomalies, and lowered the age of consent from 18 to 16. Governor Charlie Baker (R) vetoed the bill, but the Massachusetts legislature easily overrode the veto by a vote of 107-46 in the House and 32-8 in the Senate making it law as of December 29, 2020.
Overall, since Barrett's confirmation, at least 13 states have introduced measures to protect the right to an abortion. As advocates face what could be a long battle over reproductive rights in federal courts, the importance of state-level organizing and the resulting legislation could prove paramount in the fight for abortion access. If a challenge to abortion reaches the Supreme Court, the disparity in abortion access among states could return the country to pre-Roe v. Wade conditions. If that happens, a pregnant person's access to reproductive choices will depend entirely on the political makeup and policy priorities of their state legislature.