The Arizona Senate approved a measure that bans abortions in the state after 20 weeks, joining a handful of states that have passed the same measure. Republicans argue 20 weeks is the point in gestation at which a fetus can feel pain — a widely disputed claim — but Democrats argue that setting an “arbitrary” deadline could prevent doctors from diagnosing fetal abnormalities.

And it turns out that Arizona’s definition of 20 weeks into a pregnancy is even more restrictive than the 20 week abortion restrictions that six other states have approved. As Mother Jones’ Kate Sheppard points out, the legislation “states that the gestational age of the fetus should be ‘calculated from the first day of the last menstrual period of the pregnant woman,’” which means that the bill could ban abortions at 18 weeks:

Most women ovulate about 14 or 15 days after their period starts, and women can usually get pregnant from sexual intercourse that occured anywhere between five days before ovulation and a day after it. Arizona’s law would start the clock at a woman’s last period—which means, in practice, that the law prohibits abortion later than 18 weeks after a woman actually becomes pregnant. [...]

Although it includes exceptions if the pregnancy poses a threat to the life of the woman, there are no exceptions if, for instance, the fetus is found to have a life-threatening condition or other severe impairment. Banning abortions at the 18-week mark would also preclude women from obtaining information about the condition of the fetus, as many medical tests are either not performed or are not conclusive at that early date.

The bill doesn’t stop there. Under this law, if a doctor performs an abortion after that 18-weeks, he or she can be charged with a crime, have his or her license revoked or suspended, and can be held liable for civil penalties if the father of the fetus decides to pursue legal action. The bill also requires a mandatory ultrasound for anyone seeking an abortion at any stage of pregnancy (hello, transvaginal probes) and mandates that a doctor offer to show a pregnant woman the ultrasound, describe it to her verbally and provide her with a photo of “the unborn child.” It would also require a woman to wait 24 hours after the ultrasound before she can obtain an abortion.

Now, Arizona’s restrictive abortion ban heads back to the state House for final approval. Along with the six that already have the measure, eight other states also considered the same abortion restriction this year. The Georgia legislature approved its version yesterday.

Despite claims by Arizona Republicans that banning abortion after 20 weeks is good for the mothers’ health, these states are enacting policies that only serve to further limit women’s access to abortions. Tossing up roadblocks like requiring ultrasounds does not change women’s minds before they have an abortion, and banning abortions after a set point for arbitrary reason only prevents women from making decisions about their own health.

Our guest blogger is Jessica Arons, director of the women’s health and rights program.

On Wednesday, the Supreme Court heard arguments on why the Medicaid expansion under the Affordable Care Act (ACA) may or may not be unconstitutional. For anyone familiar with the Spending Clause, it is perplexing to think that somehow the federal government might not have the power to give the states more money for Medicaid and in turn require them to provide more low-income people with access to health care. As has been pointed out already, if the Medicaid expansion under the ACA is unconstitutional now, that means it was also unconstitutional the four other times Medicaid was expanded, three of which occurred under President Reagan, and it was unconstitutional when the program was first enacted in 1965. That seems highly unlikely.

Because these arguments have been made mostly in the realm of theory and hypotheticals, it might be useful to take a look at a very current example of how the Spending Clause works in practice. Those who have been following the war on women’s health will know that Texas recently passed a law that disqualifies Planned Parenthood from participating in the state’s Medicaid Women’s Health Program (WHP) because some of its clinics provide abortion care, even though the organization is barred from using federal or state money to pay for abortion care. Instead, the state’s action cut off funds that Planned Parenthood used to provide contraceptive services and counseling, cancer screenings, diagnosis and treatment for sexually transmitted infections, and other preventive care.

The federal government pays for 90 of the WHP’s $40 million budget. From where does this money come? The Medicaid program. And why does federal Medicaid pay 90 percent of the cost? Because in 1972, Congress deemed family planning to be so important that it wanted to ensure every state would include those services and supplies in its Medicaid program. By the same token, Congress was so eager to ensure that every state adopt the Medicaid expansion under the ACA, that it will pay for more than 90 percent of the cost for that expansion. Yet the conservative justices on the bench yesterday questioned that incentive as “coercive.”

Unfortunately, in a game of political chicken that puts the health of 130,000 Texan women on the line, Texas has violated a core tenet of the Medicaid program in excluding Planned Parenthood from the WHP. Federal law requires states to allow beneficiaries to seek care from “any willing provider” that is qualified to provide the needed services. Because of Texas’ discriminatory action, the Health and Human Services (HHS) Department has had no choice but to cut off federal Medicaid family planning funds for the state.

It is incredibly frustrating that the very women the federal Medicaid law is intended to protect are the ones who are hurt the most, but those sanctions are the only tool HHS has at its disposal to enforce the law. It is the bargain that is struck when Congress uses its Spending Clause power to act, and it is a poignant reminder that the legal theories that have been debated in the halls of justice this week could have an all too concrete effect on the lives of everyday women.

WASHINGTON, DC — According to one Republican attorney general in the lawsuit against the health care individual mandate, the problem with Obamacare is that it’s not a government takeover of health care.

ThinkProgress spoke with Louisiana Attorney General Buddy Caldwell outside the Supreme Court on Wednesday. Caldwell opposes Obamacare and the individual mandate, but for a different reason than most of his fellow litigants: it props up the private health insurance industry. “Insurance companies are the absolute worst people to handle this kind of business,” he declared. “I trust the government more than insurance companies.” Caldwell went on to endorse the idea of a single-payer health care system, saying it’d “be a whole lot better” than Obamacare:

KEYES: You don’t think the subsidies for low-income people are going to be helpful?

CALDWELL: No, no. The worst thing you can do is give it to an insurance company. I want to make my point. All insurance companies are controlled in their particular state. If you have a hurricane come up the east coast, the first one that’s going to leave you when they gotta pay too many claims is an insurance company. Insurance companies are the absolute worst people to handle this kind of business. I trust the government more than insurance companies. If the government wants to put forth a policy where they will pay for everything and you won’t have to go through an insurance policy, that’d be a whole lot better.

Our guest blogger is Lindsay Rosenthal, special assistant for domestic policy at the Center for American Progress.

Wednesday was “Back Up Your Birth Control Day of Action!,” a day started by the National Institute for Reproductive Health’s Back Up Your Birth Control Campaign to dispel misinformation about emergency contraception (EC), also known as the “morning after pill.” The campaign is encouraging people to post pictures with the theme EC=BC, or “emergency contraception equals birth control,” on the campaign’s tumblr page, as well as distributing fact sheets about EC and coupons for a 5 dollar discount on emergency contraceptives

The need for an educational campaign on EC stems in part from the confusion created by the anti-choice movement’s strategy of intentionally mischaracterizing EC, and increasingly all forms of hormonal birth control, as abortion. The morning after pill is often mistaken for the actual “abortion pill,” also known as RU486, which does terminate a pregnancy within the first trimester by inducing a biological process similar to a natural miscarriage.

To set the record straight: EC works just like any other form of hormonal pregnancy prevention— by stopping a woman from becoming pregnant before fertilization. New evidence shows that not only does EC not interrupt an established pregnancy, it also does not prevent implantation. This is an important distinction because while the medical community defines pregnancy as beginning with the implantation of a fertilized egg, many religious opponents of reproductive rights have tried to redefine pregnancy as beginning with the fertilization of an egg. Thus, according to their definition, any drug or device that interferes with the implantation of a fertilized egg would constitute an abortifacient. However, because EC does not prevent implantation, it does not cause abortion, even by their own definition.

Just this week, we have again seen the anti-choice movement try to conflate contraception and abortion. Throughout the Supreme Court hearings on the constitutionality of the Affordable Care Act (ACA), anti-choice activists have been standing on the steps of the courthouse with the word “Life” taped across their mouth, presumably to protest the fact that the ACA guarantees women no-cost coverage of all FDA-approved methods of contraception, reflecting their belief— however un-scientific — that EC and even contraception more generally count as abortion.

Until the ACA is fully implemented, the cost of birth control will remain a significant barrier to women who need access to contraception. As a result of the high price of birth control, most young women report using their method inconsistently because they can’t afford to use their contraceptive method on a regular basis. EC is a crucial fallback method for these women, in addition to those who experience a method failure, who are victims of sexual assault, or who have had unprotected sex for some other reason. But because of all the misinformation about EC, it is likely that many women do not know that it provides them with another option for preventing pregnancy and eliminating the need for abortion.

The Back Up Your Birth Control Campaign is giving women accurate information about their contraceptive options. It is helping to get the crucial message out to the American public that EC is a pregnancy prevention, not abortion, and that it’s an essential part of women’s medical care.

The Affordable Care Act expands health insurance to the millions of uninsured Americans by making it more affordable and regulating the abusive practices of health insurance companies. But conservatives have attacked it as government overreach, with Rep. Michele Bachmann (R-MN) as one of the loudest critics. After the last day of Supreme Court hearings about the health care reform law, Bachmann told Fox News’ Sean Hannity that people are uninsured not because they can’t afford insurance, but because they simply choose to be uninsured:

BACHMANN: One argument that the government was trying to make is that somehow health care is uniquely different. That government can regulate it because everyone participates. Health insurance is not uniquely different. It’s still an opportunity that some people choose to engage in, but 40 million people do not. And the premise was made that people don’t buy insurance because they can’t afford it. That’s not true. There are people who just decide they want to roll the dice and take their chances that they won’t need insurance.

Watch her comments:

Bachmann’s assumption that 40 million people “choose” to not have health insurance downplays the plight that people can face trying to find affordable health insurance in the face of rising costs. For the past decade, the number of people uninsured has risen each year, and working families make up 80 percent of those who have no health insurance. And young adults make up the largest share of those who are uninsured.

Instead of acknowledging this growing problem, Bachmann has attacked the Affordable Care Act, the very thing that could help slow these costs and expand access to health care.

There appears to be little reason for the Supreme Court to strike down the Affordable Care Act. As Ronald Reagan’s former Solicitor General, Charles Fried, said after the oral arguments, the legal rationale used by opponents of the law was “beneath contempt,” but should the Justices accept it, they would be breaking nearly two hundred years of precedent and writing new meaning into the Constitution.

That would be judicial activism, which, ironically, happens to be a favorite line of attack for Republicans against liberal justices. For example:

REP. STEVE KING (R-IA): If we’re going to respect judge-made law and stop praying in our public schools, that was the beginning of the judicial activism that’s begun to break down this civilization, and this culture.

SEN. JOHN CORNYN (R-TX): Unelected and serving with lifetime tenure, and substituting their view for the views of the people’s…the people and their elected representatives. That’s not the way our democracy is supposed to work.

SEN. CHUCK GRASSLEY (R-IA): Judges are not policymakers. That’s what we are in the Congress of the United States. Judges are called on to decide the facts and to apply the law.

Watch:

As E.J. Dionne wrote of the Court’s deliberations, “It fell to the court’s liberals — the so-called ‘judicial activists,’ remember? — to remind their conservative brethren that legislative power is supposed to rest in our government’s elected branches.”

- Zachary Bernstein

Timothy Cardinal Dolan of New York took his case against the Affordable Care Act’s new rule requiring insurers and employers to provide preventive care services — including contraception — at no additional cost to Fox News’ Bill O’Reilly. The Catholic Church is fighting the requirement against the tide of public opinion and despite being specifically exempt from providing birth control to its members.

Dolan pulled no punches, however, going so far as to imply that the requirement would undermine the “American enterprise” and spread “secularism” throughout the nation:

DOLAN: You’re a better historian than I am Bill, you know that every great movement in — in American history has been driven by people of religious conviction. And if we duct tape the churches — I’m just not talking about the Catholic Church — if we duct tape the role of religion and the churches and morally convince people in the marketplace that’s going to lead to a huge deficit a huge void. And there are many people who want to fill it up, namely a new religion called secularism, ok, which — which would be as doctrinaire and would consider itself as infallible as they caricature the other religions doing.

So to — to see — to see that morally-driven religiously-convinced people want to exercise their political responsibility, I think that is not only at the heart of biblical religion, it is at the heart of American enterprise.

Watch it:

But since most Americans — and Catholics — reject the Church’s teachings against contraception, Dolan is fighting an uphill battle that will persuade only the most ardent Catholic conservatives. It’s a reality he recognizes, telling O’Reilly, “It’s a tough battle because of that and our opponents are very shrewd because they’ve chosen an issue that they know we don’t — we’re not very popular on.” “[E]ven our — even — even very faithful Catholics, Bill, don’t like their bishops or priests telling them how to vote, a person or even on a particular issue.”

Stephen Colbert poked fun at some of the predictions of the Affordable Care Act’s demise before the Supreme Court. “Obamacare is dead!” he declared on Wednesday night’s episode of the Colbert Report. “It was killed by nine people in black robes. I told you there would be death panels.”

After the court adjourned Wednesday, legal and political analysts took to cable news networks to declare the proceedings a “train wreck,” which Colbert one-upped by calling the proceedings “a train wreck that slammed into the Hindenburg, landed on the deck of the Titanic, and then sailed it to see “John Carter.”

Colbert then poked fun at the misguided assumption that if the government can force you to buy health insurance, sooner or later they’ll force you to eat broccoli.

Watch the video:

The Colbert Report
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Across the country, conservatives have been pushing legislation designed to make obtaining an abortion as difficult as possible. In some cases, that means the best option for a woman seeking the procedure is to travel to a state with less restrictive regulations. If some lawmakers get their way, that could become more difficult.

Yesterday, the House of Representatives advanced the Child Interstate Abortion Notification Act (CIANA) out of the Judiciary Committee by a vote of 20-13. The legislation, which has 158 House co-sponsors, would impose jail sentences on doctors who perform abortions on out-of-state minors if a parent is not present. While the bill’s sponsor Rep. Ileana Ros-Lehtinen (R-FL) claimed the bill was designed to protect the right of parents “to be involved in their children’s lives,” its supporters do not appear to be concerned with protecting teenagers:

The committee rejected several proposed amendments that would have provided exceptions for victims of rape or incest, women facing threats to their health, and grandparents and older siblings trying to accompany their family members to abortion clinics. [...]

Opponents of the bill argue that it fails to consider the extenuating circumstances in which a teen would turn to another adult — such her grandmother or adult sister — for support, and could force young women to instead turn to unsafe alternatives to terminating her pregnancy.

This bill hampers a woman’s right to choose without offering any protections for extreme circumstances. A girl whose parents were “absent or abusive,” according to the Huffington Post, would still need to seek their help in obtaining an abortion, even if she had been raped or was facing a medical emergency.

The bill now heads to the full House for a vote. It remains unclear whether it will face a vote in the Senate, even though a companion bill has been introduced.

–Zachary Bernstein