Mitt Romney defended a rule requiring insurers and employers to provide contraception coverage as part of their health insurance plans at Wednesday night’s GOP presidential debate in Arizona, so long as “people don’t have to have coverage for contraceptives or other type of medical devices which are contrary to their religious teachings.” The former Massachusetts governor was describing his own 2006 health care reform law, which greatly expanded access to contraception — but his characterization could also apply to President Obama’s contraception regulation. Watch the exchange:

“[T]here’s a provision in Massachusetts general laws that says people don’t have to have coverage for contraceptives or other type of medical devices which are contrary to their religious teachings,” Romney said. “Churches also don’t have to provide that to entities which are either the church themselves or entities they control.”

Under Romneycare, the state’s Commonwealth Care — which offers subsidized, low or no-cost insurance program for low-income residents without access to employer-sponsored health insurance — provides primary and preventive care that includes “family planning services” and prescription contraceptives. Massachusetts employers that are not “a church or qualified church-controlled organization” must also cover hormone replacement therapy and all FDA-approved contraceptive methods.

Romney argued that a similar regulation included in the Affordable Care Act would force “the Catholic Church to provide for its employees and its various enterprises health care insurance that would include birth control, sterilization and the morning-after pill.” The provision seeks to guarantee all women access to contraception without additional cost sharing, but actually exempts churches and nonprofits primarily serving people of the same faith from that mandate and, under a recent modification, would also allow religiously affiliated colleges, universities, and hospitals that raise religious objections to stop providing birth control coverage.

“We have to have individuals that will stand up for religious conscience, and I did and I will again as president,” Romney pledged at the debate. However, since Obama’s new federal standard would expand conscience protections beyond the “church or qualified church-controlled organization[s]” to include religiously affiliated nonprofits, his regulation would likely go further in meeting that goal than existing Massachusetts law. For instance, if Boston College is required to provide birth control under the law’s overseen by Romney in Massachusetts, it could drop the coverage — and leave the matter to its insurer — under Obama’s new requirement.

In 2005, Romney also “signed a bill that could expand the number of people who get family-planning services, including the morning-after pill.” Romney even pressured the state Department of Health and Human Services to issue regulations that required Catholic hospitals to issue the morning after pill to rape victims, despite initially vetoing the bill and claiming that the pill constituted an “abortifacient.” “My personal view in my heart of hearts is that people who are subject to rape should have the option of having emergency contraceptives or emergency contraceptive information,” he told the Boston Herald at the time.

In a major victory for women’s health advocates, Gov. Bob McDonnell (R) has publicly backtracked from his support for a bill requiring women to undergo an invasive transvaginal ultrasound before having an abortion. In a statement released this afternoon, McDonnell offered an amendment that would not force women to receive the procedure. “Mandating an invasive procedure in order to give informed consent is not a proper role for the state,” McDonnell said:

I am requesting that the General Assembly amend this bill to explicitly state that no woman in Virginia will have to undergo a transvaginal ultrasound involuntarily. I am asking the General Assembly to state in this legislation that only a transabdominal, or external, ultrasound will be required to satisfy the requirements to determine gestational age. Should a doctor determine that another form of ultrasound may be necessary to provide the necessary images and information that will be an issue for the doctor and the patient. The government will have no role in that medical decision.

The state Senate has already passed the bill, and the House is expected to pass the ultrasound bill as soon as today. McDonnell has previously backed the bill, saying that “the concept that a woman should have all of the information possible before she makes a decision about terminating a pregnancy” and that he would sign the bill.

But the ultrasound bill is still unnecessary. Studies have shown that viewing an ultrasound does not change a woman’s mind before an abortion, and the Guttmacher Institute reports that requiring an abortion only adds to the cost of an abortion. “Since routine ultrasound is not considered medically necessary as a component of first-trimester abortion, the requirements appear to be a veiled attempt to personify the fetus and dissuade a woman from obtaining an abortion,” the group writes.

Seventy-five percent of low-wage workers lack access to employer-provided healthcare coverage says a new study from the Center for Economic and Policy Research (CEPR), while nearly 40 percent have no health insurance whatsoever, private or public — up from 16 percent in 1979. The Health-insurance Coverage for Low-wage Workers, 1979-2010 Beyond report, which was authored in conjunction with the Georgetown University Kalmanovitz Initiative for Labor and the Working Poor, notes that over the past 30 years, employer-provided insurance has declined for all workers, but low-wage workers have been hit hardest. In 2010, only 26 percent had health insurance through their employer, while in 1979 the number was at a solid 43 percent.

Coverage through public insurance programs has been the only area where low-wage workers have experienced any improvement, with 10 percent gaining coverage through Medicaid, which is double 1979′s rate of 5 percent.

For the purposes of the study, low-wage workers are identified as people in the bottom 20 percent of hourly pay.

The report also estimates the future effects of the Affordable Care Act (ACA) on insurance rates for low-wage workers using outside projections and the experience of the Massachusetts state health system, which shares many similarities with the ACA. The report concludes that the full implementation of the ACA — particularly the expansion of the Medicaid program — will slice non-coverage rates for low-wage workers in half from nearly 40 percent to somewhere below 20 percent.

– Fatima Najiy

If President Obama’s newly-proposed budget were to be enacted, its long-run projections show U.S. debt stabilizing as a percentage of GDP until approximately 2030, after which it begins to rise again indefinitely. Last Thursday, House Budget Committee Chairman Paul Ryan (R-WI) decided to take Treasury Secretary Tim Geithner to task over those numbers:

RYAN: Leaders are supposed to fix problems… Our government is making promises to Americans that it has no way of accounting for them. And so you’re saying, “Yeah, we’re stabilizing it but we’re not fixing it in the long run.” That means we’re just gonna keep lying to people. We’re going to keep all the empty promises going.

The most important thing to remember about the debt increase from 2030 onward is that it’s driven almost entirely by health care costs:

Some of this is the retirement of the baby boomers, and the resulting increase in retirees as a share of the population. Though Social Security is also effected by this, and its per year expenditures stabilize after a few decades at 6 percent of GDP. Some of this is also technological advancement, which just naturally makes health care more expensive as it’s able to do more things. Every advanced country’s health care is rising as a percent of GDP, but none are as high or rising nearly as quickly as the U.S. The fundamental problem is the cost of health care in America is rising at a much faster rate than overall economic output. And that’s the costs for everyone: Individuals, private insurers, and government alike. As a result, the amount of money the government is scheduled to spend each year on health care, the lion’s share of which goes to Medicare, is predicted to grow indefinitely as a percentage of GDP. Simply put, the thing Medicare buys is becoming ever more expensive, so Medicare’s budget is becoming ever larger.

There are two ways to solve this. One, the government can simply buy less health care over time — and by extension leave every American who has relied on that support to find some other way to make up the difference. That’s what Ryan and the Republicans did in their 2011 budget which passed the House last April. Ryan’s budget would’ve transformed Medicare into an exchange providing private insurance plans, with premium support to help seniors buy those plans. Ryan and the Republicans would then have slashed that support so drastically that by 2030 the typical 65-year-old would be paying 68 percent of their health care costs, according to the CBO. Absent those changes to Medicare, that amount would not rise above 30 percent. Ryan’s budget also called for severe cuts to Medicaid and discretionary spending, two-thirds of which would’ve fallen on the shoulders of America’s poorest and most vulnerable citizens. Read more

A depiction of the procedure

But now McDonnell is backing away from his previous wholehearted support of the measure. Earlier, he told ABC News he supports “the concept that a woman should have all of the information possible before she makes a decision about terminating a pregnancy.” Now, his office has clarified that he will “review” the bill if it passes the General Assembly:

“Our position is: If the General Assembly passes this bill the governor will review it, in its final form, at that time,” McDonnell spokesman Tucker Martin said in a statement. He declined to explain the change in approach, but Virginia’s governors can sign, veto or amend legislation.

The House and Senate have approved their versions of the bill. On Tuesday, the House postponed a final vote on the legislation…for the second day in a row. [...]

The officials with knowledge of Tuesday night’s Republican meeting said GOP leaders hope to introduce amendments on Wednesday, but it is unclear whether the rank and file would support them.

Virginians opposed to the ultrasound bill held a silent protest on Tuesday. Wearing stickers that said, “Say No to State-Mandated Rape” and “Private Property: Keep Out,” several hundred demonstrators locked arms outside of the Capitol. And a new poll shows that a majority in the state oppose the requirement, which has been spoofed by NBC’s Saturday Night Live and mocked on The Daily Show. “This is like a TSA pat-down inside their vagina,” Jon Stewart explained, contrasting McDonnell’s support for this measure and his opposition to TSA pat-downs.

But while Virginia’s governor is backing away from the invasive bill, legislators in Alabama and Pennsylvania are considering the same ultrasound policy. Even though studies show that viewing an ultrasound does not change a woman’s mind about having an abortion, Pennsylvania Rep. Marcy Toepel (R) argued that “Getting an ultrasound is a good thing for pregnant women.”

Seven states already mandate that an abortion provider perform an ultrasound on women seeking abortions and provide women an opportunity to view the image. In Virginia’s proposed law, a woman would have to sign a statement and have the ultrasound image added to her medical records if she refuses to view it.

A Democratic lawmaker in Georgia is responding to a Republican-backed effort to prevent women from receiving abortions 20 weeks after fertilization with a tongue-in-cheek measure that seeks to limit men’s health care choices: legislation that “would limit vasectomies only to men who will die or suffer dangerous health problems without one.” “Thousands of children are deprived of birth in this state every year because of the lack of state regulation over vasectomies,” said Rep. Yasmin Neal (D) explained. “It is patently unfair that men can avoid unwanted fatherhood by presuming that their judgment over such matters is more valid than the judgment of the General Assembly, while women’s ability to decide is constantly up for debate throughout the United States.”

The anti-abortion bill (HB 954), offered by Rep. Doug McKil­lip (R), “would effectively outlaw abortion 20 weeks after an egg is fertilized, the point where the lawmaker said fetuses can feel pain,” but would allow for exceptions in cases where a pregnancy threatens the life or health of the women. The bill also does not include exemptions for rape or incest and stipulates that doctors “performing abortions without the justifications the bill requires would be subject to a prison sentence of one to 10 years.”

Fourteen states have imposed prohibitions on abortions after a certain number of weeks, generally 24, and 6 of these states ban abortion at 20 weeks on the grounds that the fetus can feel pain at that point in gestation — a claim disputed by doctors:

Doctors’ groups and other experts testified during a committee hearing that establishing a 20-week rule could force prospective parents to make a decision on ending pregnancies before having all the information available from genetic tests that can reveal whether a fetus has severe physical problems.

“People could be making decisions on information that is not definitive,” said Dan Wies­man, a certified genetic counselor at Emory Health­care.

The concept of “fetal pain” is widely panned by many in the medical field, with the Journal of the American Medical Association determining that “pain perception probably does not function before the third trimester.” So discredited is the concept of fetal pain that even a Kansas Republican slammed the “false research,” adding “I would be embarrassed to be a state that bases its laws on untruths.”

Under current Georgia law, women can have abortions until 26 weeks after fertilization. Beyond that point, the procedure can only be performed “if three physicians agree that the woman needs it for medical reasons that can include mental health issues.”

“The Republican attack on women’s reproductive rights is unconscionable. What is more deplorable is the hypocrisy of HB 954’s author,” House Democratic Leader Stacey Abrams (D) said. “If we follow his logic, we believe it is the obligation of this General Assembly to assert an equally invasive state interest in the reproductive habits of men and substitute the will of the government over the will of adult men.”

Mitt Romney dodged a question about his policy for enhancing access to mental health care services during a town hall in Shelby Township, Michigan Tuesday afternoon and instead poked fun at Canada’s universal health care system. During an exchange with an audience member who had traveled from Ontario, Canada to speak with the former Massachusetts governor, Romney jokingly asked the questioner if he had come to mooch off America’s health system and could not explain how he would improve treatments for mental health in the United States. Instead, Romney reflexively promised to reduce federal funding to mental health programs by sending them back to the states:

QUESTIONER: You can’t have my health card!

ROMNEY: I don’t want it! Did you come down here to get medical treatment?

QUESTIONER: No, no! Absolutely not. I came down here because when your father was the governor of this state he was a leader in child care and mental health care and it’s now become horrible….this whole country has a deplorable record when it comes to dealing with mental health issues. I would like to know, what’s your position on fixing this? [...]

ROMNEY: We spend money very ineffectively…and I will look at the area of mental health spending and how it’s spent state by state and federally and how we can do a better job. But let me take an example I’m more familiar with, which is something that’s also important, which is workforce training…. For me, issues of the nature you’ve described, mental health issues, education issues, care for the poor, workforce training, these should be brought home closer to the people.

Watch it:

In reality, many states — including Michigan — have been cutting back on mental health services in an effort to reduce health care spending and balance their budgets. Romney’s pledge to repeal the Affordable Care Act would likely grow the number of people without insurance and disproportionately impact individuals with mental health conditions and his proposal to block grant federal aid could also significantly limit the government’s investment.

One-fifth to one-third of the uninsured suffer from mental and substance use disorders and experts estimate that four million Americans “have severe psychiatric disorders with a subset of 400,000 homeless and untreated not complying with their needed medications and another sub-sub set of 40,000 considered the most dangerous, not being treated or taking meds and demonstrating very violent behavior.” Under Obama’s health care reform law, some individuals with mental health problems are receiving insurance through the temporary high-risk insurance pools, and by 2014, they’ll be able to enroll in insurance through the exchanges, where private companies will have to offer mental health and substance use disorder services as part of the essential package of benefits. The law also expands parity — a requirement that benefits for mental illnesses to be on par with benefits for medical illnesses — “to a much wider pool, making it possible for millions more people to get the same coverage for substance abuse and illnesses like bipolar disorder, major depression and schizophrenia as they would for, say, diabetes or cancer.” Romney would repeal that provision.

But the question left Romney speechless and looking foolish as he attacked a nation with far better health care access than the United States and offered no solution to dealing with America’s mental health challenge.