Women’s Health Caught in Congress’s Holiday Rush


Reproductive health advocates want federal lawmakers to enact a series of bills in time for the holidays. At the top of their wish list is legislation to lower the cost of birth control drugs on college campuses and at health care clinics that serve low-income women. They also want more money to finance family planning programs and study postpartum depression.

And they want it now.

Next year, when the presidential campaign further polarizes Capitol Hill, the kind of bipartisan compromise needed to pass reproductive health bills will be next to impossible to reach, advocates fear.

"We absolutely need Congress to act," Cecile Richards, president of the Planned Parenthood Federation of America in New York, said about a bill to allow pharmaceutical companies to return to their practice of selling birth control drugs at steep discounts on college campuses and clinics. "Every day we don't solve this problem there are more and more people who don't have access to birth control."

Higher prices are an unintended consequence of a provision in the Deficit Reduction Act of 2005, an omnibus spending bill passed in 2006. New York Democratic Rep. Joseph Crowley introduced legislation that would restore eligibility for discounted contraceptives for college and low-cost health providers on Nov. 1. Democratic Sens. Barack Obama of Illinois and Claire McCaskill of Missouri followed suit with similar legislation on Nov. 13.

If Congress does not pass the bill, women will continue to pay up to 10 times as much for birth control at clinics serving college and low-income women, Richards said.

Prices began to increase in January, when the Deficit Reduction Act took effect. Some clinics were able to temporarily defray the higher costs by purchasing low-cost contraceptives in anticipation of the change, but those stocks are nearly depleted. Now prices are as high as $40 or $50 a month–up from $5 to $10–at hundreds of clinics.

The House and Senate bills have the backing of Democrats and some moderate Republicans. Party leaders have signaled support, Crowley said in a telephone conference earlier this month, but have not scheduled committee or floor action.

The bill could win speedier passage if it is attached to major legislation currently in Congress, such as one of the 13 annual must-pass budget appropriations bills.

"We have some time here before we leave Washington, and I'm very hopeful we can get this passed this year," Crowley said.

But passing the contraceptive bill through both chambers will be difficult at a time when lawmakers are under pressure to complete action on 12 of the 13 spending bills, reach agreement on funding for the war in Iraq, reauthorize a 2002 farm law and change federal tax policy.

Working Women into the Agenda

Also on advocates' holiday wish list is a bill to increase federal family planning funding by $28 million. The increase–the largest in 25 years–is included in a $151 billion bill funding the Labor and Health and Human Services departments that cleared Congress earlier this month. But Bush vetoed the bill on Nov. 13 because he considered it too expensive.

Advocates are also asking for legislation that would finance federal programs to raise awareness and study postpartum depression. The bill cleared the House in October and now awaits action in the Senate. It has support from such groups as the Planned Parenthood Federation of America; Washington-based NARAL Pro-Choice America, the leading abortion rights lobby in the country; and Postpartum Support International in Santa Barbara, Calif.

Moving pro-choice legislation has not been as easy as was predicted at the beginning of the year, when California Democrat Nancy Pelosi–a staunch advocate for women's reproductive rights–became the first female Speaker of the House.

Even though Congress is now controlled by Democrats–a party that officially backs the right to abortion–the majority of lawmakers in both chambers still oppose full reproductive rights, according to NARAL Pro-Choice America. That opposition includes moderate Democrats who support some restrictions.

Cutting Deals in Congress

The numbers have meant that pro-choice lobbyists have had to give up some ground.

In order to move the postpartum research bill through a narrowly divided House, for example, Democrats brokered a deal with anti-choice Republicans to include language that calls for studies on depression after abortion and miscarriage.

The language furthered anti-choice efforts to legitimize "post-abortion syndrome," a disorder coined by anti-choice activists that is not recognized by either the American Psychiatric Association or the American Psychological Association. The language has since been watered down to require research on all outcomes of pregnancy rather than just the post-abortion syndrome.

Congress was able to secure more money for family planning services in the Labor and Health and Human Services spending bill. But to do that, Democrats supported increased funding for abstinence-only sex education programs by $28 million even though they were found to be ineffective in an April study authorized by Congress.

Enhanced abstinence-only education is "the most significant setback" this year, said Donna Crane, director of government relations at NARAL Pro-Choice America. "It's very disappointing. It's going to take more than one year to turn that ship around."

Pushing for Victory

Still, pro-choice groups have had reason to celebrate.

Congress is forcing a showdown with Bush over the so-called global gag rule, which bars distribution of U.S. family planning funds to clinics in other countries that provide abortion or abortion counseling or lobby on abortion policies.

The Senate passed a foreign spending bill that would overturn the rule, while the House voted to weaken it by allowing the United States to provide condoms to groups that are otherwise ineligible for aid.

The foreign spending bill faces a likely veto from Bush, who threatened to block "any legislation that weakens federal policies and laws on abortion or that encourages the destruction of human life at any stage."

Without solid majorities in favor of full reproductive rights, pro-choice lawmakers have largely taken a defensive rather than offensive posture.

In October, the Senate rejected an amendment to the Labor-Health bill that would have barred federal funding to Planned Parenthood and other health care clinics that perform abortion services. The House beat back a similar amendment in July.

Lawmakers also rejected an amendment to the State Children's Health Insurance Program bill to codify a Bush administration policy that allows states to make embryos and fetuses eligible for government insurance programs, a move to elevate the status of the fetus and lay the legal foundation for granting rights of personhood. (The bill has since been vetoed.)

"We were very excited about the anti-choice attacks we were able to beat back with new leadership," Crane said. "We are also very aware that the numbers will continue to pose a real problem for us. We need to make some more gains in the 2008 elections before we can make some real progress."

This article was first published by Women's eNews.

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